Sample records for longer treatment periods

  1. Periodic catatonia with long-term treatment: a case report.

    PubMed

    Chen, Ruei-An; Huang, Tiao-Lai

    2017-09-29

    Periodic catatonia has long been a challenging diagnosis and there are no absolute guidelines for treatment when precipitating factors are also unclear. We report a schizophrenia patient with periodic catatonia with a 15-year treatment course. A possible correlation between decreased daylight exposure and periodic attacks has been observed. We describe a 49-year-old woman with periodic catatonia associated with schizophrenia with 15 years of follow-up. The patient was treated with the antipsychotics risperidone, haloperidol, loxapine and quetiapine, but catatonia still relapsed once per year during the first few years of her disease course. The treatment was consequently been switched to clozapine due to fluctuated psychotic illness, and a longer duration of remittance was achieved. Lorazepam-diazepam protocol was used for rapid relief of catatonic symptoms, and was able to significantly shorten the duration of the symptoms. In addition, we observed a possible correlation between catatonic episodes and decreased daylight exposure during the 15-year duration. Successful treatment of acute periodic catatonia was achieved with a lorazepam-diazepam protocol, and the patient remained in remission for a longer duration under clozapine treatment. Besides, the possibility of decreased daylight exposure acting as a precipitating factor was observed during our 15 years of follow-up.

  2. 77 FR 75466 - Self-Regulatory Organizations; ICE Clear Europe Limited; Notice of Designation of a Longer Period...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-20

    ...-Regulatory Organizations; ICE Clear Europe Limited; Notice of Designation of a Longer Period for Commission... October 15, 2012, ICE Clear Europe Limited (``ICE Clear Europe'') filed with the Securities and Exchange...-day time period. \\5\\ 15 U.S.C. 78s(b)(2). The proposed rule change would permit ICE Clear Europe to...

  3. Black bears with longer disuse (hibernation) periods have lower femoral osteon population density and greater mineralization and intracortical porosity.

    PubMed

    Wojda, Samantha J; Weyland, David R; Gray, Sarah K; McGee-Lawrence, Meghan E; Drummer, Thomas D; Donahue, Seth W

    2013-08-01

    Intracortical bone remodeling is persistent throughout life, leading to age related increases in osteon population density (OPD). Intracortical porosity also increases with age in many mammals including humans, contributing to bone fragility and fracture risk. Unbalanced bone resorption and formation during disuse (e.g., physical inactivity) also increases intracortical porosity. In contrast, hibernating bears are a naturally occurring model for the prevention of both age-related and disuse osteoporoses. Intracortical bone remodeling is decreased during hibernation, but resorption and formation remain balanced. Black bears spend 0.25-7 months in hibernation annually depending on climate and food availability. We found longer hibernating bears demonstrate lower OPD and higher cortical bone mineralization than bears with shorter hibernation durations, but we surprisingly found longer hibernating bears had higher intracortical porosity. However, bears from three different latitudes showed age-related decreases in intracortical porosity, indicating that regardless of hibernation duration, black bears do not show the disuse- or age-related increases in intracortical porosity which is typical of other animals. This ability to prevent increases in intracortical porosity likely contributes to their ability to maintain bone strength during prolonged periods of physical inactivity and throughout life. Improving our understanding of the unique bone metabolism in hibernating bears will potentially increase our ability to develop treatments for age- and disuse-related osteoporoses in humans. Copyright © 2013 Wiley Periodicals, Inc.

  4. Longer Interset Rest Periods Enhance Muscle Strength and Hypertrophy in Resistance-Trained Men.

    PubMed

    Schoenfeld, Brad J; Pope, Zachary K; Benik, Franklin M; Hester, Garrett M; Sellers, John; Nooner, Josh L; Schnaiter, Jessica A; Bond-Williams, Katherine E; Carter, Adrian S; Ross, Corbin L; Just, Brandon L; Henselmans, Menno; Krieger, James W

    2016-07-01

    Schoenfeld, BJ, Pope, ZK, Benik, FM, Hester, GM, Sellers, J, Nooner, JL, Schnaiter, JA, Bond-Williams, KE, Carter, AS, Ross, CL, Just, BL, Henselmans, M, and Krieger, JW. Longer interset rest periods enhance muscle strength and hypertrophy in resistance-trained men. J Strength Cond Res 30(7): 1805-1812, 2016-The purpose of this study was to investigate the effects of short rest intervals normally associated with hypertrophy-type training versus long rest intervals traditionally used in strength-type training on muscular adaptations in a cohort of young, experienced lifters. Twenty-one young resistance-trained men were randomly assigned to either a group that performed a resistance training (RT) program with 1-minute rest intervals (SHORT) or a group that employed 3-minute rest intervals (LONG). All other RT variables were held constant. The study period lasted 8 weeks with subjects performing 3 total body workouts a week comprised 3 sets of 8-12 repetition maximum (RM) of 7 different exercises per session. Testing was performed prestudy and poststudy for muscle strength (1RM bench press and back squat), muscle endurance (50% 1RM bench press to failure), and muscle thickness of the elbow flexors, triceps brachii, and quadriceps femoris by ultrasound imaging. Maximal strength was significantly greater for both 1RM squat and bench press for LONG compared to SHORT. Muscle thickness was significantly greater for LONG compared to SHORT in the anterior thigh, and a trend for greater increases was noted in the triceps brachii (p = 0.06) as well. Both groups saw significant increases in local upper body muscle endurance with no significant differences noted between groups. This study provides evidence that longer rest periods promote greater increases in muscle strength and hypertrophy in young resistance-trained men.

  5. 77 FR 61462 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Designation of Longer Period for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-09

    ...-Regulatory Organizations; NYSE Arca, Inc.; Notice of Designation of Longer Period for Commission Action on Proceedings To Determine Whether To Approve or Disapprove Proposed Rule Change Proposing a Pilot Program To... change to create and implement, on a pilot basis, a Lead Market Maker (``LMM'') Issuer Incentive Program...

  6. 77 FR 77151 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Designation of Longer Period for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-31

    ... Organizations; NYSE Arca, Inc.; Notice of Designation of Longer Period for Commission Action on Proceedings To Determine Whether To Approve or Disapprove a Proposed Rule Change To List and Trade Shares of the iShares...,\\2\\ a proposed rule change to list and trade shares of the iShares Copper Trust (``Trust'') pursuant...

  7. 77 FR 64180 - Self-Regulatory Organizations; BATS Y-Exchange, Inc.; Notice of Designation of a Longer Period...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-18

    ... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-68049; File No. SR-BYX-2012-019] Self-Regulatory Organizations; BATS Y-Exchange, Inc.; Notice of Designation of a Longer Period for Commission..., 2012, BATS Y-Exchange, Inc. (the ``Exchange'' or ``BYX'') filed with the Securities and Exchange...

  8. 77 FR 72429 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Designation of Longer Period for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-05

    ... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-68320; File No. SR-NYSEArca-2012-108] Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Designation of Longer Period for Commission Action on Proposed Rule Change, as Modified by Amendment No. 1 Thereto, Relating to the Listing and Trading of Shares of the NYSE Arca U.S. Equity Synthetic...

  9. 77 FR 72429 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Designation of Longer Period for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-05

    ... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-68319; File No. SR-NYSEArca-2012-109] Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Designation of Longer Period for Commission Action on Proposed Rule Change Relating to the Listing and Trading of Shares of the U.S. Equity High Volatility Put Write Index Fund Under NYSE Arca Equitie...

  10. 78 FR 36290 - Self-Regulatory Organizations; NYSE MKT LLC; Notice of Designation of a Longer Period for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-17

    ... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-69733; File No. SR-NYSEMKT-2013-25] Self-Regulatory Organizations; NYSE MKT LLC; Notice of Designation of a Longer Period for Commission Action on Proposed Rule Change Amending NYSE MKT Rule 104--Equities To Codify Certain Traditional Trading Floor Functions That May Be Performed by Designated...

  11. 77 FR 38116 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Designation of a Longer Period for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-26

    ...-Regulatory Organizations; NYSE Arca, Inc.; Notice of Designation of a Longer Period for Commission Action on Proposed Rule Change Proposing a Pilot Program To Create a Lead Market Maker Issuer Incentive Program for...'') \\1\\ and Rule 19b-4 thereunder,\\2\\ a proposed rule change to create and implement, on a pilot basis, a...

  12. 78 FR 50476 - Self-Regulatory Organizations; BATS Exchange, Inc.; Notice of Designation of a Longer Period for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-19

    ... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-70166; File No. SR-BATS-2013-035] Self-Regulatory Organizations; BATS Exchange, Inc.; Notice of Designation of a Longer Period for Commission Action on Proposed Rule Change, as Modified by Amendment No. 1 Thereto, To Amend the Competitive Liquidity Provider Program August 13, 2013. On June 17,...

  13. 77 FR 77152 - Self-Regulatory Organizations; NYSE MKT LLC; Notice of Designation of a Longer Period for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-31

    ... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-68521; File No. SR-NYSEMKT-2012-58] Self-Regulatory Organizations; NYSE MKT LLC; Notice of Designation of a Longer Period for Commission Action on Proposed Rule Change Deleting NYSE MKT Rules 95(c) and (d)--Equities and Related Supplementary Material December 21, 2012. On October 26, 2012, NYSE...

  14. 77 FR 50740 - Self-Regulatory Organizations; EDGA Exchange, Inc.; Notice of Designation of a Longer Period for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-22

    ... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-67677; File No. SR-EDGA-2012-28] Self-Regulatory Organizations; EDGA Exchange, Inc.; Notice of Designation of a Longer Period for Commission Action on Proposed Rule Change To Amend EDGA Rules To Add the Route Peg Order August 16, 2012. On June 26, 2012, EDGA Exchange, Inc. (``Exchange'') filed...

  15. 77 FR 50740 - Self-Regulatory Organizations; EDGX Exchange, Inc.; Notice of Designation of a Longer Period for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-22

    ... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-67676; File No. SR-EDGX-2012-25] Self-Regulatory Organizations; EDGX Exchange, Inc.; Notice of Designation of a Longer Period for Commission Action on Proposed Rule Change To Amend EDGX Rules To Add the Route Peg Order August 16, 2012. On June 26, 2012, EDGX Exchange, Inc. (``Exchange'') filed...

  16. 77 FR 66896 - Self-Regulatory Organizations; NYSE MKT LLC; Notice of Designation of a Longer Period for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-07

    ... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-68135; File No. SR-NYSEMKT-2012-41] Self-Regulatory Organizations; NYSE MKT LLC; Notice of Designation of a Longer Period for Commission Action on Proposed Rule Change To Amend Commentary .04 to NYSE Amex Options Rule 903 To Permit the Exchange To List Additional Strike Prices Until the Close of...

  17. 77 FR 66896 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Designation of a Longer Period for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-07

    ... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-68136; File No. SR-NYSEArca-2012-94] Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Designation of a Longer Period for Commission Action on Proposed Rule Change To Amend Commentary .06 to NYSE Arca Options Rule 6.4 To Permit the Exchange To List Additional Strike Prices Until the Clos...

  18. 78 FR 10652 - Self-Regulatory Organizations; ICE Clear Credit LLC; Notice of Designation of a Longer Period for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-14

    ... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-68881; File No. SR-ICC-2012-24] Self-Regulatory Organizations; ICE Clear Credit LLC; Notice of Designation of a Longer Period for Commission Action on Proposed.... On December 6, 2012, ICE Clear Credit LLC (``ICC'') filed with the Securities and Exchange Commission...

  19. 78 FR 10646 - Self-Regulatory Organizations; ICE Clear Credit LLC; Notice of Designation of a Longer Period for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-14

    ... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-68882; File No. SR-ICC-2012-23] Self-Regulatory Organizations; ICE Clear Credit LLC; Notice of Designation of a Longer Period for Commission Action on Proposed... December 6, 2012, ICE Clear Credit LLC (``ICC'') filed with the Securities and Exchange Commission...

  20. 77 FR 33013 - Self-Regulatory Organizations; ICE Clear Credit LLC; Notice of Designation of a Longer Period for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-04

    ... Organizations; ICE Clear Credit LLC; Notice of Designation of a Longer Period for Commission Action on Proposed Rule Change To Add Rules Related to the Clearing of Emerging Markets Sovereign Index Credit Default Swaps May 29, 2012. On April 3, 2012, ICE Clear Credit (``ICC'') filed with the Securities and Exchange...

  1. Analysis of longer period variation of the Kuroshio Current intrusion into the Luzon Strait using rectified wavelet power spectra

    NASA Astrophysics Data System (ADS)

    Yuan, Yaochu; Yang, Chenghao; Tseng, Yu-heng; Zhu, Xiao-Hua; Wang, Huiqun; Chen, Hong

    2017-08-01

    Longer period variation of the Kuroshio into the Luzon Strait (LS) was identified using acoustic Doppler current profiler (ADCP) observations as well as pressure and temperature time series data recorded by two TDs (manufactured by the RBR Ltd.) at mooring station N2 (20°40.441‧N, 120°38.324‧E). The ADCP was deployed at depths of 50-300 m between July 7, 2009 and April 10, 2011, and the TDs at around 340 and 365 m between July 9, 2009 and July 9, 2011. Observations provide strong evidence of longer period variation of the Kuroshio into the LS using the Vector rotary spectra (VRS) and Rectified wavelet power spectra analysis (RWPSA). RWPSA of the observations allowed the identification of two types of dominant periods. The first type, with the strongest power spectral density (PSD), had a dominant period of 112 d and was found throughout the upper 300 m. For example, the maximum PSD for western and northern velocity components time series were 3800 and 3550 at 50 m, respectively. The maximum power spectral density decrease with deeper depths, i.e., the depth dependence of maximum PSD. The 112 d period was also identified in the pressure and temperature time series data, at 340 m and 365 m. Combined RWPSA with VRS and mechanism analysis, it is clear that the occurrence of the most dominant period of 112 d in the upper 300 m is related to the clockwise meandering of the Kuroshio into the LS, which is caused by westward propagating stronger anticyclonic eddies from the interior ocean due to the interaction of Rossby eddies with the Kuroshio. The second type of dominant period, for example a 40 d period, is related to the anticlockwise meandering of the Kuroshio. The final dominant period of 14 d coincides with the fortnightly spring-neap tidal period.

  2. Invasive fungal infections during the neonatal period: diagnosis, treatment and prophylaxis.

    PubMed

    Tezer, Hasan; Canpolat, Fuat Emre; Dilmen, Uğur

    2012-02-01

    The incidence of preterm births seems to be increased in many countries around the world, in parallel to the advances in neonatal medicine. However, this has resulted in longer hospital stays and more exposure to invasive interventions, both of which can lead to an increase in late-onset nosocomial infections in the newborn period. In addition to bacteria, fungi are thought to be an important cause of hospital infections. The present article reviews the diagnosis, treatment and prophylaxis of invasive fungal infections (IFIs) during the neonatal period. IFIs are associated with high morbidity and mortality in preterm neonates. The main risk factors are multiple antibiotics, central venous catheters, parenteral nutrition, immunodepression, very low birth weight, and fungal colonization. Successful management of IFIs relies on early recognition and rapid initiation of effective treatment. Invasive-fungal-infection-related morbidity and mortality is a major concern for most neonatal intensive care units worldwide. Incidence rates are increasing for preterm neonates. Preterm infants display clinical characteristics that make them prone to fungal infections, and there is a high frequency of neurodevelopmental sequelae in those who survive after neonatal fungal infections. Specific prevention - rather than treatment - should be the optimal strategy. Both fluconazole and nystatin prophylaxis reduce the incidence of IFI and fungal colonization in very preterm infants.

  3. Successful treatment of pediatric nail psoriasis with periodic pustular eruption using topical indigo naturalis oil extract.

    PubMed

    Liang, Chung-Yu; Lin, Tung-Yi; Lin, Yin-Ku

    2013-01-01

    Psoriasis of the nail greatly affects quality of life because of the difficulty in achieving long-lasting remission. Pustular psoriasis of the nail apparatus is characterized by the formation of sterile pustules, starting on one or two fingers or less often on the toes, and spontaneous improvement has rarely been observed. This case presents a girl with refractory nail psoriasis accompanied by periodic pustular eruption that responded well to topical treatment with indigo naturalis oil extract drops, achieving a remission of longer than 1 year. © 2012 Wiley Periodicals, Inc.

  4. Optical Studies of 20 Longer-Period Cataclysmic Binaries

    NASA Astrophysics Data System (ADS)

    Thorstensen, John R.; Peters, Christopher S.; Skinner, Julie N.

    2010-11-01

    We obtained time-series radial-velocity spectroscopy of 20 cataclysmic variable stars, with the aim of determining orbital periods Porb. All of the stars reported here prove to have Porb > 3.5 h. For 16 of the stars, these are the first available period determinations, and for the remaining four (V709 Cas, AF Cam, V1062 Tau, and RX J2133 + 51), we use new observations to improve the accuracy of previously published periods. Most of the targets are dwarf novae, without notable idiosyncrasies. Of the remainder, three (V709 Cas, V1062 Tau, and RX J2133 + 51) are intermediate polars (DQ Her stars); one (IPHAS 0345) is a secondary-dominated system without known outbursts, similar to LY UMa; one (V1059 Sgr) is an old nova; and two others (V478 Her and V1082 Sgr) are long-period novalike variables. The stars with new periods are IPHAS 0345 (0.314 days) V344 Ori (0.234 days) VZ Sex (0.149 days) NSVS 1057 + 09 (0.376 days) V478 Her (0.629 days) V1059 Sgr (0.286 days) V1082 Sgr (0.868 days) FO Aql (0.217 days) V587 Lyr (0.275 days) V792 Cyg (0.297 days) V795 Cyg (0.181 days) V811 Cyg (0.157 days) V542 Cyg (0.182 days) PQ Aql (0.247 days) V516 Cyg (0.171 days) and VZ Aqr (0.161 days). Noteworthy results on individual stars are as follows. We see no indication of the underlying white dwarf star in V709 Cas, as has been previously claimed; based on the nondetection of the secondary star, we argue that the system is farther away that had been thought and the white dwarf contribution is probably negligible. V478 Her had been classified as an SU UMa-type dwarf nova, but this is incompatible with the long orbital period we find. We report the first secondary-star velocity curve for V1062 Tau. In V542 Cyg, we find a late-type contribution that remains stationary in radial velocity, yet the system is unresolved in a direct image, suggesting that it is a hierarchical triple system. Based on observations obtained at the MDM Observatory, operated by Dartmouth College, Columbia

  5. Canakinumab for treatment of cryopyrin-associated periodic syndrome.

    PubMed

    Feist, Eugen; Burmester, Gerd R

    2010-11-01

    Autoinflammatory syndromes such as cryopyrin-associated periodic syndromes (CAPS) place a heavy burden on affected individuals as well as on their families due to significant morbidity and increased mortality. The inflammatory response in CAPS is caused by an overwhelming activation of the pro-inflammatory cytokine IL-1, which was identified as a promising treatment target. This article focuses on the pathogenic background and different clinical manifestations in CAPS. Furthermore, the development program and characteristics of canakinumab, a recently approved fully human anti-IL-1β mAb for the treatment of CAPS, are described and compared to other available IL-1 blocking agents. Canakinumab targets selectively human IL-1ß with high affinity and prevents the cytokine from interaction to its receptor and, thus, effectively blocks the inflammatory response in CAPS. In all studies performed, canakinumab showed a rapid improvement of symptoms of CAPS and a complete clinical response was achieved in most patients. Inflammatory markers such as C-reactive protein and serum amyloid-A protein were reduced to normal levels within few days. In comparison to other IL-1 blockers, canakinumab provides a longer plasma half-life and less injection site reactions. Canakinumab offers the possibility of permanent disease control, almost symptom-free life, and hopefully less long-term morbidity and mortality in patients with CAPS.

  6. Determination of rifaximin treatment period according to lactulose breath test values in nonconstipated irritable bowel syndrome subjects.

    PubMed

    Bae, Suhyun; Lee, Kwang Jae; Kim, Young-Sang; Kim, Kyu-Nam

    2015-06-01

    Small intestinal bacterial overgrowth (SIBO) can partly explain irritable bowel syndrome (IBS), and rifaximin has been observed to improve abdominal symptoms in nonconstipated IBS patients. However, there are few reports on the association of the rifaximin treatment periods with the results of a lactulose breath test (LBT). Therefore, we performed a retrospective review of patient charts to investigate the relation between the rifaximin treatment periods with LBT results in nonconstipated IBS patients. We also evaluated the time to achieve a symptomatic improvement in the IBS patients as compared to the changes in the LBT. We reviewed the charts for patients who showed IBS symptoms with documented positive results for LBT during their initial visit and who had a follow-up LBT after treatment with rifaximin. The LBT values were compared to the subjects' symptom scores. A total of 102 subjects had a follow-up LBT to assess LBT normalization. The subjects were divided into groups according to treatment periods of 4 weeks (n = 36), 8 weeks (n = 43), and 12 weeks (n = 23). The groups with a longer treatment exhibited an increase in the hydrogen gas value at 90 min and its sum during 90 min at the initial LBT. There were significant differences in hydrogen gas value at 90 min and in its sum during 90 min at the initial LBT between the groups treated for 4 and 12 weeks. The most significant treatment response was observed during the first 4 weeks for all treatment groups. Symptomatic improvement occurred earlier than LBT normalization in the treatment period over 4 weeks. The results indicate that different rifaximin treatment periods are needed in accordance with LBT levels to effectively eradicate SIBO.

  7. Precisely measuring the density of small transiting exoplanets with particular emphasis on longer period planet using the HARPS-N spectrograph

    NASA Astrophysics Data System (ADS)

    Buchhave, Lars A.

    2015-08-01

    The majority of exoplanets discovered by the Kepler Mission have sizes that range between 1-4 Earth radii, populating a regime of planets with no Solar System analogues. This regime is critical for understanding the frequency of potentially habitable worlds and to help inform planet formation theories, because it contains the transition from lower-density planets with extended H/He envelopes to higher-density rocky planets with compact atmospheres. HARPS-N is an ultra-stable high-resolution spectrograph optimized for the measurement of precise radial velocities, yielding precise planetary masses and thus densities of small transiting exoplanets. In this talk, I will review the progress to populate the mass-radius parameter space with precisely measured densities of small planets. I will in particular focus on the latest HARPS-N results and their implication for our understanding of these super-Earth and small Neptune type planets.Additionally, I will discuss our progress to measure the masses of longer period sub-Neptune sized planets. In Buchhave el al. 2014, we found suggestive observational evidence that the transition from rocky to gaseous planets might depend on the orbital period, such that larger planets further away from their host star could be massive planets without a large gaseous envelope. To test this hypothesis, we have used HARPS-N to observe longer period planet candidates to determine whether they are in fact massive rocky planets or if they have extended H/He envelopes and thus lower bulk densities.HARPS-N at the Telescopio Nazionale Galileo, La Palma is an international collaboration and was funded by the Swiss Space Office, the Harvard Origin of Life Initiative, the Scottish Universities Physics Alliance, the University of Geneva, the Smithsonian Astrophysical Observatory, and the Italian National Astrophysical Institute, University of St. Andrews, Queens University Belfast, and University of Edinburgh.

  8. Targeted treatment trials for tuberous sclerosis and autism: no longer a dream.

    PubMed

    Sahin, Mustafa

    2012-10-01

    Genetic disorders that present with a high incidence of autism spectrum disorders (ASD) offer tremendous potential both for elucidating the underlying neurobiology of ASD and identifying therapeutic drugs and/or drug targets. As a result, clinical trials for genetic disorders associated with ASD are no longer a hope for the future but rather an exciting reality whose time has come. Tuberous sclerosis complex (TSC) is one such genetic disorder that presents with ASD, epilepsy, and intellectual disability. Cell culture and mouse model experiments have identified the mTOR pathway as a therapeutic target in this disease. This review summarizes the advantages of using TSC as model of ASD and the recent advances in the translational and clinical treatment trials in TSC. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Psychodynamic Treatment of the Criminal Offender: Making the Case for Longer-Term Treatment in a Longer-Term Setting.

    PubMed

    Mulay, Abby L; Kelly, Elspeth; Cain, Nicole M

    2017-01-01

    In recent years, prisons and jails have become de facto psychiatric hospitals, responsible for the care and treatment of individuals with serious mental illness. Historically, cognitive-behaviorally informed therapeutic approaches have been the treatment of choice among mental health practitioners in correctional settings. However, inmate-clients often present with complex diagnostic issues that are arguably better served by long-term treatment options, such as psychodynamic psychotherapy. We first review the nature of psychotherapy in the correctional setting, as well as treatment barriers and challenges faced by both mental health providers and inmate-clients. We then review treatment studies that examine the efficacy of various therapeutic techniques in correctional/forensic contexts. Finally, we argue that, due to the complex nature of psychopathology, average length of time incarcerated, and treatment issues that arise in this multifaceted and challenging setting, mental health treatment providers should consider providing psychodynamic treatment modalities when working with incarcerated individuals. We also argue that more research is needed to examine the efficacy of these treatment approaches with inmate-clients.

  10. 40 CFR 266.255 - When is your LLMW no longer eligible for the storage and treatment conditional exemption?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 26 2010-07-01 2010-07-01 false When is your LLMW no longer eligible for the storage and treatment conditional exemption? 266.255 Section 266.255 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR THE MANAGEMENT OF SPECIFIC HAZARDOUS WASTES AND SPECIFIC TYPES O...

  11. Longer aftershocks duration in extensional tectonic settings.

    PubMed

    Valerio, E; Tizzani, P; Carminati, E; Doglioni, C

    2017-11-27

    Aftershocks number decay through time, depending on several parameters peculiar to each seismogenic regions, including mainshock magnitude, crustal rheology, and stress changes along the fault. However, the exact role of these parameters in controlling the duration of the aftershock sequence is still unknown. Here, using two methodologies, we show that the tectonic setting primarily controls the duration of aftershocks. On average and for a given mainshock magnitude (1) aftershock sequences are longer and (2) the number of earthquakes is greater in extensional tectonic settings than in contractional ones. We interpret this difference as related to the different type of energy dissipated during earthquakes. In detail, (1) a joint effect of gravitational forces and pure elastic stress release governs extensional earthquakes, whereas (2) pure elastic stress release controls contractional earthquakes. Accordingly, normal faults operate in favour of gravity, preserving inertia for a longer period and seismicity lasts until gravitational equilibrium is reached. Vice versa, thrusts act against gravity, exhaust their inertia faster and the elastic energy dissipation is buffered by the gravitational force. Hence, for seismic sequences of comparable magnitude and rheological parameters, aftershocks last longer in extensional settings because gravity favours the collapse of the hangingwall volumes.

  12. Monogenic Periodic Fever Syndromes: Treatment Options for the Pediatric Patient.

    PubMed

    Ozen, Seza; Demir, Selcan

    2017-08-01

    Autoinflammatory diseases are disorders of the innate immune system characterized by uncontrolled inflammation. The most commonly encountered autoinflammatory diseases are the hereditary periodic fever syndromes, which present with fever and other features of the skin, serosal membranes, and musculoskeletal system. The main inherited (monogenic) periodic fever syndromes are familial Mediterranean fever (FMF), cryopyrin-associated periodic syndrome (CAPS), tumor necrosis factor receptor-associated periodic syndrome (TRAPS), and hyperimmunoglobulin D syndrome (HIDS)/mevalonate kinase deficiency (MKD). Recent advances in our understanding of the molecular and pathophysiological basis of autoinflammatory diseases have provided new treatment strategies. Patients with periodic fever syndromes have clearly benefited from anti-interleukin (IL)-1 treatment. Colchicine is still the mainstay of FMF therapy, but IL-1 blockade is also effective if colchicine fails. Early diagnosis and effective treatment can prevent irreversible organ damage. The scope of pathogenic mutations and more targeted therapy for better management of these rare diseases remains to be defined.

  13. Longer treatment with alternative non-drug reinforcement fails to reduce resurgence of cocaine or alcohol seeking in rats.

    PubMed

    Nall, Rusty W; Craig, Andrew R; Browning, Kaitlyn O; Shahan, Timothy A

    2018-04-02

    Provision of alternative non-drug reinforcement is among the most effective methods for treating substance use disorders. However, when alternative reinforcers become unavailable during treatment interruptions or upon cessation of treatment, relapse often occurs. Relapse following the loss of alternative reinforcement is known as resurgence. One factor that could reduce resurgence is longer duration of treatment with alternative reinforcement, but the available data are mixed. Further, the effects of length of treatment have previously only been examined with food seeking. The present experiments directly examined if duration of treatment impacted the magnitude of resurgence of cocaine or alcohol seeking in rats. First, rats were trained to self-administer cocaine (Experiment 1) or alcohol (Experiment 2) by performing a target behavior. Second, target behavior was extinguished and performing an alternative behavior produced an alternative non-drug (i.e., food) reinforcer. Finally, resurgence was assessed following removal of alternative reinforcement after either 5 or 20 sessions of treatment. Treatment duration did not differentially affect resurgence of cocaine seeking in Experiment 1 or Alcohol seeking in Experiment 2. These results suggest that extended treatment with alternative non-drug reinforcement may not decrease propensity to relapse. Further, these results may have implications for treatment of substance use disorders and for theories of resurgence. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Atomic weights: no longer constants of nature

    USGS Publications Warehouse

    Coplen, Tyler B.; Holden, Norman E.

    2011-01-01

    Many of us were taught that the standard atomic weights we found in the back of our chemistry textbooks or on the Periodic Table of the Chemical Elements hanging on the wall of our chemistry classroom are constants of nature. This was common knowledge for more than a century and a half, but not anymore. The following text explains how advances in chemical instrumentation and isotopic analysis have changed the way we view atomic weights and why they are no longer constants of nature

  15. Overview of systematic reviews assessing the evidence for shorter versus longer duration antibiotic treatment for bacterial infections in secondary care.

    PubMed

    Onakpoya, Igho J; Walker, A Sarah; Tan, Pui S; Spencer, Elizabeth A; Gbinigie, Oghenekome A; Cook, Johanna; Llewelyn, Martin J; Butler, Christopher C

    2018-01-01

    Our objective was to assess the clinical effectiveness of shorter versus longer duration antibiotics for treatment of bacterial infections in adults and children in secondary care settings, using the evidence from published systematic reviews. We conducted electronic searches in MEDLINE, Embase, Cochrane, and Cinahl. Our primary outcome was clinical resolution. The quality of included reviews was assessed using the AMSTAR criteria, and the quality of the evidence was rated using the GRADE criteria. We included 6 systematic reviews (n = 3,162). Four reviews were rated high quality, and two of moderate quality. In adults, there was no difference between shorter versus longer duration in clinical resolution rates for peritonitis (RR 1.03, 95% CI 0.98 to 1.09, I2 = 0%), ventilator-associated pneumonia (RR 0.93; 95% CI 0.81 to 1.08, I2 = 24%), or acute pyelonephritis and septic UTI (clinical failure: RR 1.00, 95% CI 0.46 to 2.18). The quality of the evidence was very low to moderate. In children, there was no difference in clinical resolution rates for pneumonia (RR 0.98, 95% CI 0.91 to 1.04, I2 = 48%), pyelonephritis (RR 0.95, 95% CI 0.88 to 1.04) and confirmed bacterial meningitis (RR 1.02, 95% CI 0.93 to 1.11, I2 = 0%). The quality of the evidence was low to moderate. In conclusion, there is currently a limited body of evidence to clearly assess the clinical benefits of shorter versus longer duration antibiotics in secondary care. High quality trials assessing strategies to shorten antibiotic treatment duration for bacterial infections in secondary care settings should now be a priority.

  16. Overview of systematic reviews assessing the evidence for shorter versus longer duration antibiotic treatment for bacterial infections in secondary care

    PubMed Central

    Walker, A. Sarah; Tan, Pui S.; Spencer, Elizabeth A.; Gbinigie, Oghenekome A.; Cook, Johanna; Llewelyn, Martin J.; Butler, Christopher C.

    2018-01-01

    Our objective was to assess the clinical effectiveness of shorter versus longer duration antibiotics for treatment of bacterial infections in adults and children in secondary care settings, using the evidence from published systematic reviews. We conducted electronic searches in MEDLINE, Embase, Cochrane, and Cinahl. Our primary outcome was clinical resolution. The quality of included reviews was assessed using the AMSTAR criteria, and the quality of the evidence was rated using the GRADE criteria. We included 6 systematic reviews (n = 3,162). Four reviews were rated high quality, and two of moderate quality. In adults, there was no difference between shorter versus longer duration in clinical resolution rates for peritonitis (RR 1.03, 95% CI 0.98 to 1.09, I2 = 0%), ventilator-associated pneumonia (RR 0.93; 95% CI 0.81 to 1.08, I2 = 24%), or acute pyelonephritis and septic UTI (clinical failure: RR 1.00, 95% CI 0.46 to 2.18). The quality of the evidence was very low to moderate. In children, there was no difference in clinical resolution rates for pneumonia (RR 0.98, 95% CI 0.91 to 1.04, I2 = 48%), pyelonephritis (RR 0.95, 95% CI 0.88 to 1.04) and confirmed bacterial meningitis (RR 1.02, 95% CI 0.93 to 1.11, I2 = 0%). The quality of the evidence was low to moderate. In conclusion, there is currently a limited body of evidence to clearly assess the clinical benefits of shorter versus longer duration antibiotics in secondary care. High quality trials assessing strategies to shorten antibiotic treatment duration for bacterial infections in secondary care settings should now be a priority. PMID:29590188

  17. Treatment of cytomegalovirus infection and disease pre- and post-quantitative nucleic acid test standardization: does use of a more sensitive assay lead to longer treatment duration?

    PubMed

    Dioverti, M Veronica; Lahr, Brian; Razonable, Raymund R

    2016-02-01

    Quantitative cytomegalovirus (CMV) nucleic acid testing (NAT) has been standardized using the World Health Organization (WHO) international calibration standard. A new FDA-approved WHO-calibrated assay (CA) was found to be more sensitive than a laboratory-developed test (LDT). We hypothesized that monitoring therapeutic response using a more sensitive assay may lead to longer antiviral therapy in solid organ and hematopoietic stem cell transplant patients with CMV infection. We reviewed transplant patients with CMV disease retrospectively, and divided them into two groups: those diagnosed and managed based on LDT and those managed using WHO-CA. Compared to patients monitored by LDT, the time to reach an undetectable viral load was significantly longer in the group monitored by the WHO-CA. However, a trend toward shorter duration of antiviral treatment was observed (median, 34 vs. 41 d; p = 0.058), with earlier discontinuation of induction antiviral therapy upon reaching undetectable viral load using WHO-CA (11 vs. 18 d; p = 002). We concluded that despite using a more sensitive CMV NAT, the total duration of antiviral treatment was not significantly prolonged in transplant patients with CMV infection and disease. Relapse rates did not differ between the two groups. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. The longer road to medical school graduation.

    PubMed

    Kassebaum, D G; Szenas, P L

    1994-10-01

    The authors followed the academic progress and graduation rates of students matriculating in U.S. medical schools each year between 1976 and 1988. The four-year graduation rates of medical students in MD programs declined from 91.4% for students who matriculated in 1976 to 81.2% for 1988 matriculants. During the same period, the percentage graduating in five years increased from 5.5% to 10.6%, while those still enrolled or on leaves of absence after five years rose from 1.9% to 4.1%. The lengthening of undergraduate medical education is associated with students' spending extra time on special studies or research, but to a greater extent graduation has been delayed for remediation of academic difficulty or slowing of the pace of education to overcome handicaps in academic preparation and learning skills. Underrepresented minority students, particularly black Americans, have lower four-year graduation rates than majority students, and the rate has fallen steadily across successive classes matriculating between 1976 and 1988. The longer periods of undergraduate medical education since 1984, however, have been accompanied by a reversal of the growing attrition rate for black-American students, probably the result of more appropriate pacing of education over the first year or two and the wider availability of student academic support. The longer road to graduation also accumulates greater educational costs, contributing to the escalation in student indebtedness that has been out of proportion to increases in tuition and fees.(ABSTRACT TRUNCATED AT 250 WORDS)

  19. A Reanalysis for the Seasonal and Longer-Period Cycles and the Trends in Middle Atmosphere Temperature from the HALOE

    NASA Technical Reports Server (NTRS)

    Remsberg, Ellis E.

    2007-01-01

    Previously published analyses for the seasonal and longer-period cycles in middle atmosphere temperature versus pressure (or T(p)) from the Halogen Occultation Experiment (HALOE) are extended to just over 14 years and updated to properly account for the effects of autocorrelation in its time series of zonally-averaged data. The updated seasonal terms and annual averages are provided, and they can be used to generate temperature distributions that are representative of the period 1991-2005. QBO-like terms have also been resolved and are provided, and they exhibit good consistency across the range of latitudes and pressure-altitudes. Further, exploratory analyses of the residuals from each of the 221 time series have yielded significant 11-yr solar cycle (or SC-like) and linear trend terms at a number of latitudes and levels. The amplitudes of the SC-like terms for the upper mesosphere agree reasonably with calculations of the direct solar radiative effects for T(p). Those SC amplitudes increase by about a factor of 2 from the lower to the upper mesosphere and are also larger at the middle than at the low latitudes. The diagnosed cooling trends for the subtropical latitudes are in the range, -0.5 to -1.0 K/decade, which is in good agreement with the findings from models of the radiative effects on pressure surfaces due to known increases in atmospheric CO2. The diagnosed trends are somewhat larger than predicted with models for the upper mesosphere of the northern hemisphere middle latitudes.

  20. Effects of periods of nonuse and fluctuating ammonia concentration on biofilter performance.

    PubMed

    Chen, Ying-Xu; Yin, Jun; Wang, Kai-Xiong; Fang, Shi

    2004-01-01

    A systematic study on the transient behavior of odor treatment using biofilters is described. The biofilters were exposed to variations in contaminant loading and periods of nonuse. Two bench-scale biofilters with different filter media were used. Mixtures of compost/perlite (5:1) and dry sludge/granular active carbon (5:1) were used as filter media. Ammonia (NH3), one of the main malodorous gases, was used as the target compound. The response of each biofilter to variations in contaminant mass loading, periodic nonuse, water content, and inlet concentration pulse was studied. The nonuse period comprised of two stages: the "idle phase" when no air was passing through the biofilters, and the "no-contaminant-loading phase" when only humidified air was passing through the biofilters. Concentration spike was applied to study the effects of shock loading on the biofilter performance. Biofilters responded effectively to NH3 concentration variations and shock loading by rapidly recovering to the original removal rates within 6-12h. The results indicated re-acclimation times ranged from several hours to longer than a day. Longer idle phase produced longer re-acclimation periods than periods of no contaminant loading. When the media was dried during the biofiltration process, elimination capacity dropped accordingly for both biofilters. After 24 h of drying, the biofilter experiment could be restarted and run for a few days for recovering.

  1. When to stop? Decision-making when children’s cancer treatment is no longer curative: a mixed-method systematic review

    PubMed Central

    2014-01-01

    Background Children with cancer, parents, and clinicians, face difficult decisions when cure is no longer possible. Little is known about decision-making processes, how agreement is reached, or perspectives of different actors. Professionals voice concerns about managing parental expectations and beliefs, which can be contrary to their own and may change over time. We conducted the first systematic review to determine what constitutes best medico-legal practice for children under 19 years as context to exploring the perspectives of actors who make judgements and decisions when cancer treatment is no longer curative. Methods Theory-informed mixed-method thematic systematic review with theory development. Results Eight legal/ethical guidelines and 18 studies were included. Whilst there were no unresolved dilemmas, actors had different perspectives and motives. In line with guidelines, the best interests of the individual child informed decisions, although how different actors conceptualized ‘best interests’ when treatment was no longer curative varied. Respect for autonomy was understood as following child/parent preferences, which varied from case to case. Doctors generally shared information so that parents alone could make an informed decision. When parents received reliable information, and personalized interest in their child, they were more likely to achieve shared trust and clearer transition to palliation. Although under-represented in research studies, young people’s perspectives showed some differences to those of parents and professionals. For example, young people preferred to be informed even when prognosis was poor, and they had an altruistic desire to help others by participating in research. Conclusion There needs to be fresh impetus to more effectively and universally implement the ethics of professionalism into daily clinical practice in order to reinforce humanitarian attitudes. Ethical guidelines and regulations attempt to bring

  2. Higher Risk Periods for Suicide Among VA Patients Receiving Depression Treatment

    PubMed Central

    Valenstein, Marcia; Kim, Hyungjin Myra; Ganoczy, Dara; McCarthy, John F.; Zivin, Kara; Austin, Karen L.; Hoggatt, Katherine; Eisenberg, Daniel; Piette, John D.; Blow, Frederic C.; Olfson, Mark

    2010-01-01

    Background Health systems with limited resources may have the greatest impact on suicide if their prevention efforts target the highest-risk treatment groups during the highest-risk periods. To date, few health systems have carefully segmented their depression treatment populations by level of risk and prioritized prevention efforts on this basis. Methods We conducted a retrospective cohort study of 887,859 VA patients receiving depression treatment between 4/1/1999 and 9/30/2004. We calculated suicide rates for five sequential 12-week periods following treatment events that health systems could readily identify: psychiatric hospitalizations, new antidepressant starts (>6 months without fills), “other” antidepressant starts, and dose changes. Using piecewise exponential models, we examined whether rates differed across time-periods. We also examined whether suicide rates differed by age-group in these periods. Results Over all time periods, the suicide rate was 114/100,000 person-years (95% CI; 108,120). In the first 12-week periods, suicide rates were: 568/100,000 p-y (95% CI; 493,651) following psychiatric hospitalizations; 210/100,000 p-y (95% CI; 187, 236) following new antidepressant starts; 193/100,000 p-y (95% CI; 167, 222) following other starts; and 154/100,000 p-y (95% CI; 133, 177) following dose changes. Suicide rates remained above the base rate for 48 weeks following hospital discharge and 12 weeks following antidepressant events. Adults aged 61–80 years were at highest risk in the first 12-weeks periods Conclusions To have the greatest impact on suicide, health systems should prioritize prevention efforts following psychiatric hospitalizations. If resources allow, closer monitoring may also be warranted in the first 12 weeks following antidepressant starts, across all age-groups. PMID:18945495

  3. Optimizing the treatment of mood disorders in the perinatal period

    PubMed Central

    Meltzer-Brody, Samantha; Jones, Ian

    2015-01-01

    The perinatal period is a time of high risk for women with unipolar and bipolar mood disorders. We discuss treatment considerations for perinatal mood disorders, including unipolar and bipolar depression as well as postpartum psychosis. We further explore the unique issues faced by women and their families across the full trajectory of the perinatal period from preconception planning through pregnancy and following childbirth. Treatment of perinatal mood disorders requires a collaborative care approach between obstetrics practitioners and mental health providers, to ensure that a thoughtful risk : benefit analysis is conducted. It is vital to consider the risks of the underlying illness versus risks of medication exposure during pregnancy or lactation. When considering medication treatment, attention must be paid to prior medication trials that were most efficacious and best tolerated. Lastly, it is important to assess the impact of individual psychosocial stressors and lifestyle factors on treatment response. PMID:26246794

  4. Oral ketamine for the treatment of pain and treatment-resistant depression†.

    PubMed

    Schoevers, Robert A; Chaves, Tharcila V; Balukova, Sonya M; Rot, Marije Aan Het; Kortekaas, Rudie

    2016-02-01

    Recent studies with intravenous (i.v.) application of ketamine show remarkable but short-term success in patients with MDD. Studies in patients with chronic pain have used different ketamine applications for longer time periods. This experience may be relevant for psychiatric indications. To review the literature about the dosing regimen, duration, effects and side-effects of oral, intravenous, intranasal and subcutaneous routes of administration of ketamine for treatment-resistant depression and pain. Searches in PubMed with the terms 'oral ketamine', 'depression', 'chronic pain', 'neuropathic pain', 'intravenous ketamine', 'intranasal ketamine' and 'subcutaneous ketamine' yielded 88 articles. We reviewed all papers for information about dosing regimen, number of individuals who received ketamine, number of ketamine days per study, results and side-effects, as well as study quality. Overall, the methodological strength of studies investigating the antidepressant effects of ketamine was considered low, regardless of the route of administration. The doses for depression were in the lower range compared with studies that investigated analgesic use. Studies on pain suggested that oral ketamine may be acceptable for treatment-resistant depression in terms of tolerability and side-effects. Oral ketamine, given for longer time periods in the described doses, appears to be well tolerated, but few studies have systematically examined the longer-term negative consequences. The short- and longer-term depression outcomes as well as side-effects need to be studied with rigorous randomised controlled trials. © The Royal College of Psychiatrists 2016.

  5. Modeling and Control of a Delayed Hepatitis B Virus Model with Incubation Period and Combination Treatment.

    PubMed

    Sun, Deshun; Liu, Fei

    2018-06-01

    In this paper, a hepatitis B virus (HBV) model with an incubation period and delayed state and control variables is firstly proposed. Furthermore, the combination treatment is adopted to have a longer-lasting effect than mono-therapy. The equilibrium points and basic reproduction number are calculated, and then the local stability is analyzed on this model. We then present optimal control strategies based on the Pontryagin's minimum principle with an objective function not only to reduce the levels of exposed cells, infected cells and free viruses nearly to zero at the end of therapy, but also to minimize the drug side-effect and the cost of treatment. What's more, we develop a numerical simulation algorithm for solving our HBV model based on the combination of forward and backward difference approximations. The state dynamics of uninfected cells, exposed cells, infected cells, free viruses, CTL and ALT are simulated with or without optimal control, which show that HBV is reduced nearly to zero based on the time-varying optimal control strategies whereas the disease would break out without control. At last, by the simulations, we prove that strategy A is the best among the three kinds of strategies we adopt and further comparisons have been done between model (1) and model (2).

  6. The longer term experiences of parent training: a qualitative analysis.

    PubMed

    Furlong, M; McGilloway, S

    2015-09-01

    Child conduct problems are a major public health priority. Group-based parenting programmes are popular in addressing such problems, but evidence for their longer-term effectiveness is limited. Moreover, process evaluations are rare and little is understood about the key facilitative and inhibitive factors associated with maintaining outcomes in the longer term. This study involved the use of qualitative methods as part of a larger process evaluation to explore the longer-term experiences of parents who participated in a randomized controlled trial (RCT) of the Incredible Years Parenting Programme (IYPP) in disadvantaged settings in Ireland. A series of one-to-one in-depth interviews was conducted with parents at 12- (n = 20) and 18-month follow-up (n = 8) and analysed using constructivist grounded theory. Most parents reported positive child behaviour despite several challenges, but a substantial subset reported periods of relapse in positive outcomes. A relapse in child behaviour was linked to relinquishing skills in stressful times, the negative influence of an unsupportive environment, and the perceived ineffectiveness of parenting skills. Resilience in implementing skills despite adversity, and the utilization of available social supports, were associated with the maintenance of positive outcomes. Strengthening resilience and social support capacities may be important factors in maintaining positive longer-term outcomes. Those who design, research and deliver parenting programmes might consider the possibility of including a relapse-prevention module and/or the provision of post-intervention supports for more vulnerable families. © 2014 John Wiley & Sons Ltd.

  7. Diagnosis, treatment, and nursing care of patients with chronic leukemia.

    PubMed

    Breed, Cheryl D

    2003-05-01

    To provide an update on the impact of new information about the molecular biology of chronic leukemia and new treatment modalities available to patients. Published articles, books, and research studies. There has been significant progress in the diagnosis and management of chronic myeloid and chronic lymphocytic leukemia. New therapies provide more options for patients and longer treatment periods. With increasing treatment options and longer survival, patients with chronic myelogenous or chronic lymphocytic leukemia need increased education, support, and assistance with symptom management. Nurses caring for these patients must remain knowledgeable about new treatments and their management.

  8. Adjuvant cytostatic therapy of breast cancer as an important factor in the postponing of a relapse and longer survival period.

    PubMed

    Stula, N

    1992-01-01

    This prospective clinical study shows the results of the adjuvant cytostatic therapy (ACT) in breast cancer applied to patients in the premenopausal age. Cyclophosphamide, methotrexate, 5-fluorouracil (CMF) group (70 patients): after operative and radiotherapeutic treatment the ACT is applied over the period of six months (six cycles). Control group (71 patients): only operative and radiotherapeutic treatment. Protocol of the ACT: cyclophosphamide, methotrexate, 5-fluorouracil (CMF) over 5 days with a 4-week break. Total 6 cycles. Control period: 10 years. Stratification of patients was made on the basis of the following risk factors: size of the tumour, number of positive lymph nodes of ipsilateral axilla, grade of the differentiation of the tumour, hormonal dependence of the tumour. Statistical method of analysis: actuary calculation, the Hi square test. The results show that the application of the ACT is statistically significant (P < 0.05) in regard to the disease-free interval. However, concerning the survival, the usefulness of its application is present but not statistically significant on the significance level of 5%. The usefulness of the ACT application as regards high risk factors (T3, T4 > or = 4 lymph nodes, grade of differentiation II, III, ER-PR-) is statistically significant (P < 0.05) both in regard to the DFI and survival. Regarding low risk factors the ACT application adversely influenced the results in the control group. This is probably the result of the ACT toxicity. The patients have a favourable prognosis in this subgroup in regard to the staging and biological nature of the tumour. The ACT in the premenopausal age of patients with high risk factors gives a significantly better results concerning the procrastination of relapse and the length of the survival period.

  9. A Retrospective Audit of Dental Treatment Provided to Special Needs Patients under General Anesthesia During a Ten-Year Period.

    PubMed

    Mallineni, Sreekanth Kumar; Yiu, Cynthia Kar Y

    The purpose of this study was to perform a comprehensive audit of dental treatment provided to special needs patients (SNP) under general anesthesia (GA) over a ten-year period. Special needs patients who received dental treatment under GA as an in-patient at Queen Mary Hospital, Hong Kong SAR during the time period January 2002 and December 2011 were included in the study. The study population was divided into three groups, based on age (<6years, 6-12 years, >12 years). One-way ANOVA was used to evaluate the effect of "age group" on duration of treatment, post-recovery time, treatment procedures and utilization of different restorative materials. Kappa statistics were used for intra-examiner reliability. A total of 275 patients (174 males and 101 females) were included in the study. The mean age of the patients at the time they received GA was 12.37±10.18 years. Dental procedures performed were mostly restorative in nature (47%). The >12 years group had significantly shorter treatment duration (p<0.05). No significant difference in post-operative recovery time was observed among the three age groups (p>0.05). The <6 years group received significantly less preventive, but more restorative procedures (p<0.05). Significantly fewer extractions were performed in the 6-12 years group (p<0.05). The use of composite restorations was significantly higher in the <6 years group; while amalgam restorations were more frequently used in the >12 years group (P<0.05). Stainless steel crowns were more frequently employed in SNP under 12 years of age (p<0.05). Intra-examiner reliability was good (k=0.94). Most of the dental procedures performed under GA on SNP were restorative procedures. For children less than 6 years of age, had longer treatment time under GA. Composite restorations and stainless steel crowns were more frequently used in the primary dentition and amalgam restorations were more frequently employed in the permanent dentition.

  10. Association between unmet needs and quality of life in hospitalised cancer patients no longer receiving anti-cancer treatment.

    PubMed

    Bužgová, R; Hajnová, E; Sikorová, L; Jarošová, D

    2014-09-01

    Assessing the quality of life and unmet needs of cancer patients is an integral part of palliative care. This cross-sectional study sought to determine whether there is an association between quality of life and unmet needs, anxiety and depression in cancer patients who are no longer receiving anti-cancer treatment. The sample consisted of 93 patients from the oncology department at the University Hospital in Ostrava for whom further cancer treatment had been terminated as ineffective in halting the progression of their cancer. The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the Patient Needs Assessment in Palliative Care (PNAP) questionnaire, and the Hospital Anxiety and Depression Scale (HADS) were used to collect data. The overall quality of life score was quite low at 46. Most unmet needs were defined in terms of physical, psychological or spiritual needs. Correlations were found between impaired quality of life and lower Karnofsky scores (r = 0.50); increased physical (r = 0.52), psychological (r = 0.44) and spiritual (r = 0.36) needs; and higher levels of anxiety (r = -0.30) and depression (r = -0.68). Effective management of patients' physical (pain, fatigue and depression), psychological and spiritual needs may improve their quality of life. © 2014 John Wiley & Sons Ltd.

  11. Unstable Angina Treatment in Various Periods of Geomagnetic Activity

    NASA Astrophysics Data System (ADS)

    Parshina, S. S.; Tokayeva, L. K.; Afanasiyeva, T. N.; Samsonov, S. N.; Petrova, V. D.; Dolgova, E. M.; Manykina, V. I.; Vodolagina, E. S.

    In 145 patients with unstable angina (UA) there was analized an efficiency of a drug therapy at different types of heliogeophysical activity (HA) during the 23th solar cycle. 83 patients were examined at the period of a lower HA (Kp-index 16,19±0,18), and 62 patients - at the period of a higher HA (Kp-index 17,25±0,21, p<0,05). Baseline severity of patients' condition with UA at the moment of hospitalization at the studied periods did not differ, but the effectiveness of the therapy depended on the period of HA. At the period of a higher HA antianginal effect was stronger than at the lower period of HA (2,27±0,16 points and 1,75±0,12 points, p<0,05), and the need in nitroglycerin on the background of a drug therapy disappeared for 5-7 days quicker than at the period of a lower HA. Maximal hypotensive effect at a higher HA was achieved quicker - on the 3rd day of the treatment, and at a lower HA - only up to hospital discharge (p<0,05). Blood viscosity did not normalize in both of the studied periods, but in small vessels there was noted a decrease of a BV (p<0,05). So, at a higher HA the effectiveness of a drug therapy in patients with UA is higher than at the period of a lower HA.

  12. A longer stay for the kissing disease: epidemiology of bacterial tonsillitis and infectious mononucleosis over a 20-year period.

    PubMed

    Lennon, P; Saunders, J; Fenton, J E

    2013-02-01

    Anecdotally, infectious mononucleosis is considered a more severe infection than bacterial tonsillitis, requiring a longer hospital stay. However, there is little in the literature comparing the epidemiology of the two conditions. This study aimed to compare the epidemiology of bacterial tonsillitis and infectious mononucleosis, in particular any differences in the length of in-patient stay. The hospital in-patient enquiry system was used to analyse patients admitted with bacterial tonsillitis and infectious mononucleosis between 1990 and 2009 inclusive. There was a total of 3435 cases over the 20 years: 3064 with bacterial tonsillitis and 371 with infectious mononucleosis. The mean length of stay was 3.22 days for bacterial tonsillitis and 4.37 days for infectious mononucleosis. The median length of stay for each condition was compared using the Mann-Whitney U non-parametric test, and a significant difference detected (p < 0.001). Patients with infectious mononucleosis have a significantly longer stay in hospital than those with bacterial tonsillitis.

  13. Economic impact of longer battery life of cardiac resynchronization therapy defibrillators in Sweden.

    PubMed

    Gadler, Fredrik; Ding, Yao; Verin, Nathalie; Bergius, Martin; Miller, Jeffrey D; Lenhart, Gregory M; Russell, Mason W

    2016-01-01

    The objective of this study was to quantify the impact that longer battery life of cardiac resynchronization therapy defibrillator (CRT-D) devices has on reducing the number of device replacements and associated costs of these replacements from a Swedish health care system perspective. An economic model based on real-world published data was developed to estimate cost savings and avoided device replacements for CRT-Ds with longer battery life compared with devices with industry-standard battery life expectancy. Base-case comparisons were performed among CRT-Ds of three manufacturers - Boston Scientific Corporation, St. Jude Medical, and Medtronic - over a 6-year time horizon, as per the available clinical data. As a sensitivity analysis, we evaluated CRT-Ds as well as single-chamber implantable cardioverter defibrillator (ICD-VR) and dual-chamber implantable cardioverter defibrillator (ICD-DR) devices over a longer 10-year period. All costs were in 2015 Swedish Krona (SEK) discounted at 3% per annum. Base-case analysis results show that up to 603 replacements and up to SEK 60.4 million cumulative-associated costs could be avoided over 6 years by using devices with extended battery life. The pattern of savings over time suggests that savings are modest initially but increase rapidly beginning in the third year of follow-up with each year's cumulative savings two to three times the previous year. Evaluating CRT-D, ICD-VR, and ICD-DR devices together over a longer 10-year period, the sensitivity analysis showed 2,820 fewer replacement procedures and associated cost savings of SEK 249.3 million for all defibrillators with extended battery life. Extended battery life is likely to reduce device replacements and associated complications and costs, which may result in important cost savings and a more efficient use of health care resources as well as a better quality of life for heart failure patients in Sweden.

  14. Effect of Treatment Modality on Long-Term Outcomes in Attention-Deficit/Hyperactivity Disorder: A Systematic Review

    PubMed Central

    Arnold, L. Eugene; Hodgkins, Paul; Caci, Hervé; Kahle, Jennifer; Young, Susan

    2015-01-01

    Background Evaluation of treatments for attention-deficit/hyperactivity disorder (ADHD) previously focused on symptom control, but attention has shifted to functional outcomes. The effect of different ADHD treatment periods and modalities (pharmacological, non-pharmacological, and combination) on long-term outcomes needs to be more comprehensively understood. Methods A systematic search of 12 literature databases using Cochrane’s guidelines yielded 403 English-language peer-reviewed, primary studies reporting long-term outcomes (≥2 years). We evaluated relative effects of treatment modalities and durations and effect sizes of outcomes reported as statistically significantly improved with treatment. Results The highest proportion of improved outcomes was reported with combination treatment (83% of outcomes). Among significantly improved outcomes, the largest effect sizes were found for combination treatment. The greatest improvements were associated with academic, self-esteem, or social function outcomes. A majority of outcomes improved regardless of age of treatment initiation (60%–75%) or treatment duration (62%–72%). Studies with short treatment duration had shorter follow-up times (mean 3.2 years total study length) than those with longer treatment durations (mean 7.1 years total study length). Studies with follow-up times <3 years reported benefit with treatment for 93% of outcomes, whereas those with follow-up times ≥3 years reported treatment benefit for 57% of outcomes. Post-hoc analysis indicated that this result was related to the measurement of outcomes at longer periods (3.2 versus 0.4 years) after treatment cessation in studies with longer total study length. Conclusions While the majority of long-term outcomes of ADHD improve with all treatment modalities, the combination of pharmacological and non-pharmacological treatment was most consistently associated with improved long-term outcomes and large effect sizes. Older treatment initiation age

  15. Sex and ancestry determine the free-running circadian period.

    PubMed

    Eastman, Charmane I; Tomaka, Victoria A; Crowley, Stephanie J

    2017-10-01

    The endogenous, free-running circadian period (τ) determines the phase relationship that an organism assumes when entrained to the 24-h day. We found a shorter circadian period in African Americans compared to non-Hispanic European Americans (24.07 versus 24.33 h). We speculate that a short circadian period, closer to 24 h, was advantageous to humans living around the equator, but when humans migrated North out of Africa, where the photoperiod changes with seasons, natural selection favoured people with longer circadian periods. Recently, in evolutionary terms, immigrants came from Europe and Africa to America ('the New World'). The Europeans were descendents of people who had lived in Europe for thousands of years with changing photoperiods (and presumably longer periods), whereas Africans had ancestors who had always lived around the equator (with shorter periods). It may have been advantageous to have a longer circadian period while living in Europe early in the evolution of humans. In our modern world, however, it is better to have a shorter period, because it helps make our circadian rhythms earlier, which is adaptive in our early-bird-dominated society. European American women had a shorter circadian period than men (24.24 versus 24.41), but there was no sex difference in African Americans (24.07 for both men and women). We speculate that selection pressures in Europe made men develop a slightly longer period than women to help them track dawn which could be useful for hunters, but less important for women as gatherers. © 2017 The Authors. Journal of Sleep Research published by John Wiley & Sons Ltd on behalf of European Sleep Research Society.

  16. 77 FR 2103 - Self-Regulatory Organizations; Fixed Income Clearing Corporation; Notice of Designation of Longer...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-13

    ...-Regulatory Organizations; Fixed Income Clearing Corporation; Notice of Designation of Longer Period for Commission Action on Proposed Rule Change To Allow the Mortgage-Backed Securities Division To Provide...''), and on November 21, 2011, amended a proposed rule change to allow the Mortgage-Backed Securities...

  17. 78 FR 66980 - Self-Regulatory Organizations; BOX Options Exchange LLC; Notice of Designation of Longer Period...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-07

    ... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-70797; File No. SR-BOX-2013-43] Self-Regulatory... Proposed Rule Change To Permit Complex Orders To Participate in Price Improvement Periods November 1, 2013... to permit Complex Orders to participate in Price Improvement Periods (the ``COPIP'') and to make...

  18. Relapse rate of uveitis post-methotrexate treatment in juvenile idiopathic arthritis.

    PubMed

    Kalinina Ayuso, Viera; van de Winkel, Evelyne Leonce; Rothova, Aniki; de Boer, Joke Helena

    2011-02-01

    To evaluate the efficacy of methotrexate (MTX) and the effect of its withdrawal on relapse rate of uveitis associated with juvenile idiopathic arthritis (JIA). Retrospective case series. Data of 22 pediatric JIA patients who were being treated with MTX for active uveitis were studied retrospectively. Relapse rate after the withdrawal of MTX was established. Anterior chamber (AC) inflammation, topical steroid use during the first year of MTX treatment, and associations of relapses after the withdrawal were evaluated statistically. Duration of MTX treatment and its withdrawal was determined individually in collaboration with a rheumatologist with an intention to continue the treatment for at least 1 year and to withdraw in case of inactivity of uveitis and arthritis. Inactivity of uveitis was defined as the presence of ≤0.5+ cells in the AC. Eighteen patients (18/22; 82%) showed improvement of their uveitis with a significant decrease in activity of AC inflammation after a minimal period of 3 months of MTX treatment. A topical steroid-sparing effect was observed when MTX was administered for a period of 3 to 9 months. MTX was discontinued because of inactive uveitis in 13 patients. In 9 patients (8/13; 69%) a relapse of uveitis was observed after a mean time of 7.5 months (± SD 7.3). Six patients (6/13; 46%) had a relapse within the first year after the withdrawal. Relapse-free survival after withdrawal of MTX was significantly longer in patients who had been treated with MTX for more than 3 years (P = .009), children who were older than 8 years at the moment of withdrawal (P = .003), and patients who had an inactivity of uveitis of longer than 2 years before withdrawal of MTX (P = .033). Longer inactivity under MTX therapy was independently protective for relapses after the withdrawal (hazard ratio = 0.07; 95% confidence interval 0.01-0.86; P = .038), which means that 1-year increase of duration of inactive uveitis before the withdrawal of MTX results in a

  19. Reconstruction of local perturbations in periodic surfaces

    NASA Astrophysics Data System (ADS)

    Lechleiter, Armin; Zhang, Ruming

    2018-03-01

    This paper concerns the inverse scattering problem to reconstruct a local perturbation in a periodic structure. Unlike the periodic problems, the periodicity for the scattered field no longer holds, thus classical methods, which reduce quasi-periodic fields in one periodic cell, are no longer available. Based on the Floquet-Bloch transform, a numerical method has been developed to solve the direct problem, that leads to a possibility to design an algorithm for the inverse problem. The numerical method introduced in this paper contains two steps. The first step is initialization, that is to locate the support of the perturbation by a simple method. This step reduces the inverse problem in an infinite domain into one periodic cell. The second step is to apply the Newton-CG method to solve the associated optimization problem. The perturbation is then approximated by a finite spline basis. Numerical examples are given at the end of this paper, showing the efficiency of the numerical method.

  20. Periodicity in cell dynamics in some mathematical models for the treatment of leukemia

    NASA Astrophysics Data System (ADS)

    Halanay, A.

    2012-11-01

    A model for the evolution of short-term hematopoietic stem cells and of leukocytes in leucemia under periodic treatment is introduced. It consists of a system of periodic delay differential equations and takes into consideration the asymmetric division. A guiding function is used, together with a theorem of Krasnoselskii, to prove the existence of a strictly positive periodic solution and its stability is investigated.

  1. Critical period of weed control in aerobic rice.

    PubMed

    Anwar, M P; Juraimi, A S; Samedani, B; Puteh, A; Man, A

    2012-01-01

    Critical period of weed control is the foundation of integrated weed management and, hence, can be considered the first step to design weed control strategy. To determine critical period of weed control of aerobic rice, field trials were conducted during 2010/2011 at Universiti Putra Malaysia. A quantitative series of treatments comprising two components, (a) increasing duration of weed interference and (b) increasing length of weed-free period, were imposed. Critical period was determined through Logistic and Gompertz equations. Critical period varied between seasons; in main season, it started earlier and lasted longer, as compared to off-season. The onset of the critical period was found relatively stable between seasons, while the end was more variable. Critical period was determined as 7-49 days after seeding in off-season and 7-53 days in main season to achieve 95% of weed-free yield, and 23-40 days in off-season and 21-43 days in main season to achieve 90% of weed-free yield. Since 5% yield loss level is not practical from economic view point, a 10% yield loss may be considered excellent from economic view point. Therefore, aerobic rice should be kept weed-free during 21-43 days for better yield and higher economic return.

  2. Critical Period of Weed Control in Aerobic Rice

    PubMed Central

    Anwar, M. P.; Juraimi, A. S.; Samedani, B.; Puteh, A.; Man, A.

    2012-01-01

    Critical period of weed control is the foundation of integrated weed management and, hence, can be considered the first step to design weed control strategy. To determine critical period of weed control of aerobic rice, field trials were conducted during 2010/2011 at Universiti Putra Malaysia. A quantitative series of treatments comprising two components, (a) increasing duration of weed interference and (b) increasing length of weed-free period, were imposed. Critical period was determined through Logistic and Gompertz equations. Critical period varied between seasons; in main season, it started earlier and lasted longer, as compared to off-season. The onset of the critical period was found relatively stable between seasons, while the end was more variable. Critical period was determined as 7–49 days after seeding in off-season and 7–53 days in main season to achieve 95% of weed-free yield, and 23–40 days in off-season and 21–43 days in main season to achieve 90% of weed-free yield. Since 5% yield loss level is not practical from economic view point, a 10% yield loss may be considered excellent from economic view point. Therefore, aerobic rice should be kept weed-free during 21–43 days for better yield and higher economic return. PMID:22778701

  3. Effect of longer health service provider delays on stage at diagnosis and mortality in symptomatic breast cancer.

    PubMed

    Murchie, P; Raja, E A; Lee, A J; Brewster, D H; Campbell, N C; Gray, N M; Ritchie, L D; Robertson, R; Samuel, L

    2015-06-01

    This study explored whether longer provider delays (between first presentation and treatment) were associated with later stage and poorer survival in women with symptomatic breast cancer. Data from 850 women with symptomatic breast cancer were linked with the Scottish Cancer Registry; Death Registry; and hospital discharge dataset. Logistic regression and Cox survival analyses with restricted cubic splines explored relationships between provider delays, stage and survival, with sequential adjustment for patient and tumour factors. Although confidence intervals were wide in both adjusted analyses, those with the shortest provider delays had more advanced breast cancer at diagnosis. Beyond approximately 20 weeks, the trend suggests longer delays are associated with more advanced stage, but is not statistically significant. Those with symptomatic breast cancer and the shortest presentation to treatment time (within 4 weeks) had the poorest survival. Longer time to treatment was not significantly associated with worsening mortality. Poor prognosis patients with breast cancer are being triaged for rapid treatment with limited effect on outcome. Prolonged time to treatment does not appear to be strongly associated with poorer outcomes for patients with breast cancer, but the power of this study to assess the effect of very long delays (>25 weeks) was limited. Efforts to reduce waiting times are important from a quality of life perspective, but tumour biology may often be a more important determinant of stage at diagnosis and survival outcome. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. 78 FR 6154 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Designation of Longer...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-29

    ...-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Designation of Longer Period for Commission Action on Proceedings To Determine Whether To Approve or Disapprove Proposed Rule Change To Amend Rule...,\\2\\ a proposed rule change to amend Exchange Rule 4626--Limitation of Liability (``accommodation...

  5. 77 FR 70857 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Designation of Longer...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-27

    ... 2, 2012, The NASDAQ Stock Market LLC (``NASDAQ'' or ``Exchange'') filed with the Securities and... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-68279; File No. SR-NASDAQ-2012-117] Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Designation of Longer Period for Commission...

  6. 77 FR 71860 - Self-Regulatory Organizations; National Stock Exchange, Inc.; Notice of Designation of Longer...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-04

    ... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-68312; File No. SR-NSX-2012-015] Self-Regulatory Organizations; National Stock Exchange, Inc.; Notice of Designation of Longer Period for Commission Action on a Proposed Rule Change Relating to Adoption of Listing Standards for Compensation Committees and Advisors as Required by Rule 10C-1...

  7. 77 FR 71852 - Self-Regulatory Organizations; Chicago Stock Exchange, Inc.; Notice of Designation of Longer...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-04

    ... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-68311; File No. SR-CHX-2012-013] Self-Regulatory Organizations; Chicago Stock Exchange, Inc.; Notice of Designation of Longer Period for Commission Action on a Proposed Rule Change Relating to Adoption of Listing Standards for Compensation Committees and Advisors as Required by Rule 10C-1...

  8. Treatment of Latent Tuberculosis Infection in HIV: Shorter or Longer?

    PubMed Central

    Sterling, Timothy R.

    2012-01-01

    Nine months of daily isoniazid is efficacious in treating latent M. tuberculosis infection, but completion rates are low, limiting treatment effectiveness. In 2011, three important studies were published involving novel regimens for the treatment of latent M. tuberculosis infection. At least 36 months of isoniazid was more effective than 6 months of isoniazid in one study, but not in another—both of which were conducted among tuberculin skin test positive HIV-infected adults living in high tuberculosis incidence settings. Three months of once-weekly isoniazid plus rifapentine or twice-weekly isoniazid plus rifampin (both given under direct observation) resulted in tuberculosis rates similar to those seen with 6 months of isoniazid among HIV-infected persons in high tuberculosis incidence settings. Three months of once-weekly, directly-observed isoniazid plus rifapentine was at least as effective as 9 months of daily isoniazid among predominantly HIV-uninfected persons living in low and medium tuberculosis incidence countries. The 3-month once-weekly isoniazid plus rifapentine regimen demonstrates promise for treatment of latent M. tuberculosis infection in HIV-infected persons. PMID:22581360

  9. 77 FR 68873 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Designation of Longer...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-16

    ...-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Designation of Longer Period for Commission Action on Proceedings to Determine Whether to Approve or Disapprove Proposed Rule Change To Establish... proposed rule change to establish various ``Benchmark Orders'' under NASDAQ Rule 4751(f). The proposed rule...

  10. Rumination predicts longer sleep onset latency after an acute psychosocial stressor.

    PubMed

    Zoccola, Peggy M; Dickerson, Sally S; Lam, Suman

    2009-09-01

    Rumination has been linked to self-reported sleep quality. However, whether rumination is related to an objective sleep parameter has not been tested. This study examined whether rumination predicts sleep onset latency (SOL) on the night after an acute psychosocial stressor. We hypothesized that those who ruminate (assessed with both trait and stressor-specific measures) would have longer SOL (assessed with objective and subjective methods). Seventy participants delivered a 5-minute speech in front of an evaluative panel during an afternoon laboratory session. Trait rumination was assessed before the stressor. Stressor-specific rumination was captured with the frequency of task-related thoughts participants experienced during a 10-minute rest period after the stressor. Participants wore actigraphs on their wrists on the night after the laboratory session to measure objective sleep onset latency (SOL-O). Subjective sleep onset latency was estimated by participants on the subsequent morning. Consistent with hypotheses, trait and stressor-specific rumination predicted longer SOL-O and subjective sleep onset latency, respectively. In addition, trait and stressor-specific rumination interacted to predict longer SOL-O. SOL-O was longest among those who engaged in more stressor-specific rumination and had greater trait rumination scores. Neither rumination measure was related to sleep duration or wakefulness after sleep onset. The findings from this study are consistent with previous research linking rumination to subjective sleep quality. The results also suggest that post-stressor ruminative thought may predict delayed sleep onset for those with a propensity for rumination.

  11. 76 FR 44388 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Designation of Longer...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-25

    ...-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Designation of Longer Period for Commission Action on Proceedings To Determine Whether To Approve or Disapprove Proposed Rule Change To Link Market... Rule 19b-4 thereunder,\\2\\ a proposed rule change to discount certain market data fees and increase...

  12. Minimum Wage Effects in the Longer Run

    ERIC Educational Resources Information Center

    Neumark, David; Nizalova, Olena

    2007-01-01

    Exposure to minimum wages at young ages could lead to adverse longer-run effects via decreased labor market experience and tenure, and diminished education and training, while beneficial longer-run effects could arise if minimum wages increase skill acquisition. Evidence suggests that as individuals reach their late 20s, they earn less the longer…

  13. Sport-Related Concussion: Optimizing Treatment Through Evidence-Informed Practice.

    PubMed

    Schneider, Kathryn J

    2016-08-01

    Concussion is one of the most common injuries in sport and recreation today. Reports of concussion have increased in recent years, likely due to increased societal awareness and the risk of longer-term sequelae. Presently, treatment includes a period of prescribed rest in the acute period following injury, followed by a protocol of graded exertion. Despite an initial period of rest and attempts at a gradual return to play, up to 30% of individuals may have ongoing symptoms past the acute period. The goal of this viewpoint is to introduce the reader to the most common symptoms of concussion and the need for a new, more active paradigm during treatment. J Orthop Sports Phys Ther 2016;46(8):613-616. doi:10.2519/jospt.2016.0607.

  14. 25 CFR 134.3 - Period for payments extended.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false Period for payments extended. 134.3 Section 134.3 Indians... CHARGES ON INDIAN IRRIGATION PROJECTS § 134.3 Period for payments extended. Furthermore, in recent... to extend the payment of such charges over a longer period of years. ...

  15. 25 CFR 134.3 - Period for payments extended.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Period for payments extended. 134.3 Section 134.3 Indians... CHARGES ON INDIAN IRRIGATION PROJECTS § 134.3 Period for payments extended. Furthermore, in recent... to extend the payment of such charges over a longer period of years. ...

  16. 25 CFR 134.3 - Period for payments extended.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 1 2014-04-01 2014-04-01 false Period for payments extended. 134.3 Section 134.3 Indians... CHARGES ON INDIAN IRRIGATION PROJECTS § 134.3 Period for payments extended. Furthermore, in recent... to extend the payment of such charges over a longer period of years. ...

  17. 25 CFR 134.3 - Period for payments extended.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 1 2012-04-01 2011-04-01 true Period for payments extended. 134.3 Section 134.3 Indians... CHARGES ON INDIAN IRRIGATION PROJECTS § 134.3 Period for payments extended. Furthermore, in recent... to extend the payment of such charges over a longer period of years. ...

  18. 25 CFR 134.3 - Period for payments extended.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 1 2013-04-01 2013-04-01 false Period for payments extended. 134.3 Section 134.3 Indians... CHARGES ON INDIAN IRRIGATION PROJECTS § 134.3 Period for payments extended. Furthermore, in recent... to extend the payment of such charges over a longer period of years. ...

  19. Light period regulation of carbohydrate partitioning

    NASA Technical Reports Server (NTRS)

    Janes, Harry W.

    1994-01-01

    We have shown that the photosynthetic period is important in regulating carbon partitioning. Even when the same amount of carbon is fixed over a 24h period considerably more is translocated out of the leaf under the longer photosynthetic period. This is extremely important when parts of the plant other than the leaves are to be sold. It is also important to notice the amount of carbon respired in the short photosynthetic period. The light period effect on carbohydrate fixation, dark respiration, and translocation is shown in this report.

  20. Long-Period Variability in o Ceti

    NASA Astrophysics Data System (ADS)

    Templeton, Matthew R.; Karovska, Margarita

    2009-02-01

    We carried out a new and sensitive search for long-period variability in the prototype of the Mira class of long-period pulsating variables, o Ceti (Mira A), the closest and brightest Mira variable. We conducted this search using an unbroken light curve from 1902 to the present, assembled from the visual data archives of five major variable star observing organizations from around the world. We applied several time-series analysis techniques to search for two specific kinds of variability: long secondary periods (LSPs) longer than the dominant pulsation period of ~333 days, and long-term period variation in the dominant pulsation period itself. The data quality is sufficient to detect coherent periodic variations with photometric amplitudes of 0.05 mag or less. We do not find evidence for coherent LSPs in o Ceti to a limit of 0.1 mag, where the amplitude limit is set by intrinsic, stochastic, low-frequency variability of approximately 0.1 mag. We marginally detect a slight modulation of the pulsation period similar in timescale to that observed in the Miras with meandering periods, but with a much lower period amplitude of ±2 days. However, we do find clear evidence of a low-frequency power-law component in the Fourier spectrum of o Ceti's long-term light curve. The amplitude of this stochastic variability is approximately 0.1 mag at a period of 1000 days, and it exhibits a turnover for periods longer than this. This spectrum is similar to the red noise spectra observed in red supergiants.

  1. Review of the Diagnosis and Treatment of Periodic Paralysis

    PubMed Central

    Fontaine, Bertrand; Hanna, Michael G.; Johnson, Nicholas E.; Kissel, John T.; Sansone, Valeria A.; Shieh, Perry B.; Tawil, Rabi N.; Trivedi, Jaya; Cannon, Stephen C.; Griggs, Robert C.

    2017-01-01

    ABSTRACT Periodic paralyses (PPs) are rare neuromuscular disorders caused by mutations in skeletal muscle sodium, calcium, and potassium channel genes. PPs include hypokalemic paralysis, hyperkalemic paralysis, and Andersen‐Tawil syndrome. Common features of PP include autosomal dominant inheritance, onset typically in the first or second decades, episodic attacks of flaccid weakness, which are often triggered by diet or rest after exercise. Diagnosis is based on the characteristic clinic presentation then confirmed by genetic testing. In the absence of an identified genetic mutation, documented low or high potassium levels during attacks or a decrement on long exercise testing support diagnosis. The treatment approach should include both management of acute attacks and prevention of attacks. Treatments include behavioral interventions directed at avoidance of triggers, modification of potassium levels, diuretics, and carbonic anhydrase inhibitors. Muscle Nerve 57: 522–530, 2018 PMID:29125635

  2. 77 FR 58604 - Self-Regulatory Organizations; BOX Options Exchange LLC; Notice of Designation of a Longer Period...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-21

    ... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-67871; File No. SR-BOX-2012-003] Self... Action on Proposed Rule Change To Amend the Price Improvement Period September 17, 2012. On July 25, 2012... 19b-4 thereunder,\\3\\ a proposed rule change to amend Rule 7150 (the Price Improvement Period (``PIP...

  3. 78 FR 9762 - Self-Regulatory Organizations; The Depository Trust Company; Notice of Designation of a Longer...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-11

    ... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-68834; File No. SR-DTC-2012-10] Self-Regulatory Organizations; The Depository Trust Company; Notice of Designation of a Longer Period for Commission Action on Proposed Rule Change To Reduce Liquidity Risk Relating to Its Processing of Maturity and Income Presentments and Issuances of Money Marke...

  4. 78 FR 12116 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Designation of a Longer...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-21

    ... from NASDAQ Rule 2460 (Payment for Market Making). Accordingly, the Commission, pursuant to Section 19...-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Designation of a Longer Period for... Market Quality Program February 14, 2013. On December 7, 2012, The NASDAQ Stock Market LLC (``Exchange...

  5. 77 FR 31050 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Designation of a Longer...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-24

    ... from NASDAQ Rule 2460 (Payment for Market Making). Accordingly, the Commission, pursuant to Section 19...-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Designation of a Longer Period for Commission Action on Proposed Rule Change, as Modified by Amendment No. 1 Thereto, To Establish the Market...

  6. Sleep-stage sequencing of sleep-onset REM periods in MSLT predicts treatment response in patients with narcolepsy.

    PubMed

    Drakatos, Panagis; Patel, Kishankumar; Thakrar, Chiraag; Williams, Adrian J; Kent, Brian D; Leschziner, Guy D

    2016-04-01

    Current treatment recommendations for narcolepsy suggest that modafinil should be used as a first-line treatment ahead of conventional stimulants or sodium oxybate. In this study, performed in a tertiary sleep disorders centre, treatment responses were examined following these recommendations, and the ability of sleep-stage sequencing of sleep-onset rapid eye movement periods in the multiple sleep latency test to predict treatment response. Over a 3.5-year period, 255 patients were retrospectively identified in the authors' database as patients diagnosed with narcolepsy, type 1 (with cataplexy) or type 2 (without) using clinical and polysomnographic criteria. Eligible patients were examined in detail, sleep study data were abstracted and sleep-stage sequencing of sleep-onset rapid eye movement periods were analysed. Response to treatment was graded utilizing an internally developed scale. Seventy-five patients were included (39% males). Forty (53%) were diagnosed with type 1 narcolepsy with a mean follow-up of 2.37 ± 1.35 years. Ninety-seven percent of the patients were initially started on modafinil, and overall 59% reported complete response on the last follow-up. Twenty-nine patients (39%) had the sequence of sleep stage 1 or wake to rapid eye movement in all of their sleep-onset rapid eye movement periods, with most of these diagnosed as narcolepsy type 1 (72%). The presence of this specific sleep-stage sequence in all sleep-onset rapid eye movement periods was associated with worse treatment response (P = 0.0023). Sleep-stage sequence analysis of sleep-onset rapid eye movement periods in the multiple sleep latency test may aid the prediction of treatment response in narcoleptics and provide a useful prognostic tool in clinical practice, above and beyond their classification as narcolepsy type 1 or 2. © 2015 European Sleep Research Society.

  7. 77 FR 39314 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Designation of a Longer...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-02

    ...-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Designation of a Longer Period for Commission Action on Proposed Rule Change To Establish ``Benchmark Orders'' Under NASDAQ Rule 4751(f) June 26, 2012. On May 1, 2012, The NASDAQ Stock Market LLC (``NASDAQ'' or ``Exchange'') filed with the...

  8. War No Longer Exists

    DTIC Science & Technology

    2012-03-22

    new paradigm. States are no longer the primary actors in conflicts. Non-state actors, including warlords, tribes, guerillas/insurgent groups ...narco-terrorists and religious extremist groups are responsible for the preeminence of intrastate conflicts today. With very few exceptions, countries...work of definitive research” and more of a “…thematic discussion rather than a definitive history …”4 As such, the book lacks any references to

  9. 78 FR 18377 - Self-Regulatory Organizations; National Stock Exchange, Inc.; Notice of Designation of a Longer...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-26

    ... Organizations; National Stock Exchange, Inc.; Notice of Designation of a Longer Period for Commission Action on Proposed Rule Change To Adopt a New Order Type Called the ``Auto-Ex Only'' Order March 19, 2013. On January... (``Act'') \\1\\ and Rule 19b-4 thereunder,\\2\\ a proposed rule change to adopt a new order type called the...

  10. A light-responsive and periodic NADH oxidase activity of the cell surface of Tetrahymena and of human buffy coat cells

    NASA Technical Reports Server (NTRS)

    Peter, A. D.; Morre, D. J.; Morre, D. M.

    2000-01-01

    Oxidation of external NADH (NADH is an impermeant substrate) by cells of Tetrahymena pyriformis oscillated with a period of 24-26 min. The period length in darkness (25.6 min) appeared to be slightly longer than the period in light (approximately 24 min). When Tetrahymena were placed in darkness for 30-50 min and then returned to light, a new maximum in the rate of NADH oxidation was observed 36-38 min (13 + 24) min after the beginning of the light treatment. The cell-surface NADH oxidase of human buffy coats (a mixture of white cells and platelets) also was periodic and light responsive.

  11. Initial abstinence status and contingency management treatment outcomes: does race matter?

    PubMed

    Montgomery, LaTrice; Carroll, Kathleen M; Petry, Nancy M

    2015-06-01

    Limited research has evaluated African American substance users' response to evidence-based treatments. This study examined the efficacy of contingency management (CM) in African American and White cocaine users. A secondary analysis evaluated effects of race, treatment condition, and baseline cocaine urine sample results on treatment outcomes of African American (n = 444) and White (n = 403) cocaine abusers participating in one of six randomized clinical trials comparing CM to standard care. African American and White patients who initiated treatment with a cocaine-negative urine sample remained in treatment for similar durations and submitted a comparable proportion of negative samples during treatment regardless of treatment type; CM was efficacious in both races in terms of engendering longer durations of abstinence in patients who began treatment abstinent. Whites who began treatment with a cocaine positive sample remained in treatment longer and submitted a higher proportion of negative samples when assigned to CM than standard care. African Americans who initiated treatment with a cocaine positive sample, however, did not remain in treatment longer with CM compared with standard care, and gains in terms of drug use outcomes were muted in nature relative to Whites. This interaction effect persisted through the 9-month follow-up period. CM is not equally effective in reducing drug use among all subgroups, specifically African American patients who are using cocaine upon treatment entry. Future research on improving treatment outcomes in this population is needed. (c) 2015 APA, all rights reserved).

  12. Rilonacept in the management of cryopyrin-associated periodic syndromes (CAPS)

    PubMed Central

    Gillespie, Justin; Mathews, Rebeccah; McDermott, Michael F

    2010-01-01

    Cryopyrin-associated periodic syndromes (CAPS) are a subgroup of the hereditary periodic fever syndromes, which are rare autoinflammatory and inherited disorders, characterized by recurrent inflammation and varying degrees of severity. CAPS are thought to be driven by excessive production of interleukin-1β (IL-1β), through over-activation of the inflammasome by gain of function mutations in the gene encoding cryopyrin (NLRP3). This conclusion is supported by the remarkable efficacy of IL-1β blockade in these conditions. Rilonacept (ArcalystTM; Regeneron) is the first us Food and Drug Administration-approved treatment for familial cold autoinflammatory syndrome and Muckle–Wells syndrome and the first in a new line of drugs designed for longer-acting IL-1 blockade. Rilonacept has been associated with a decrease in disease activity, high-sensitivity C-reactive protein (hsCRP) and serum amyloid A (SAA) in the treatment of CAPS. The clinical safety and efficacy of rilonacept in CAPS and non-CAPS populations will be summarized in this review. Rilonacept is also beneficial for patients who tolerate injections poorly, due to an extended half-life over the unapproved CAPS treatment, anakinra, requiring weekly rather than daily self-administration. Other autoinflammatory disorders may also benefit from rilonacept treatment, with clinical trials in progress for systemic onset juvenile idiopathic arthritis, gout and familial mediterranean fever. PMID:22096352

  13. Rilonacept in the management of cryopyrin-associated periodic syndromes (CAPS).

    PubMed

    Gillespie, Justin; Mathews, Rebeccah; McDermott, Michael F

    2010-01-01

    Cryopyrin-associated periodic syndromes (CAPS) are a subgroup of the hereditary periodic fever syndromes, which are rare autoinflammatory and inherited disorders, characterized by recurrent inflammation and varying degrees of severity. CAPS are thought to be driven by excessive production of interleukin-1β (IL-1β), through over-activation of the inflammasome by gain of function mutations in the gene encoding cryopyrin (NLRP3). This conclusion is supported by the remarkable efficacy of IL-1β blockade in these conditions. Rilonacept (Arcalyst(TM); Regeneron) is the first us Food and Drug Administration-approved treatment for familial cold autoinflammatory syndrome and Muckle-Wells syndrome and the first in a new line of drugs designed for longer-acting IL-1 blockade. Rilonacept has been associated with a decrease in disease activity, high-sensitivity C-reactive protein (hsCRP) and serum amyloid A (SAA) in the treatment of CAPS. The clinical safety and efficacy of rilonacept in CAPS and non-CAPS populations will be summarized in this review. Rilonacept is also beneficial for patients who tolerate injections poorly, due to an extended half-life over the unapproved CAPS treatment, anakinra, requiring weekly rather than daily self-administration. Other autoinflammatory disorders may also benefit from rilonacept treatment, with clinical trials in progress for systemic onset juvenile idiopathic arthritis, gout and familial mediterranean fever.

  14. Comparison of Periodized and Non-Periodized Resistance Training on Maximal Strength: A Meta-Analysis.

    PubMed

    Williams, Tyler D; Tolusso, Danilo V; Fedewa, Michael V; Esco, Michael R

    2017-10-01

    Periodization is a logical method of organizing training into sequential phases and cyclical time periods in order to increase the potential for achieving specific performance goals while minimizing the potential for overtraining. Periodized resistance training plans are proposed to be superior to non-periodized training plans for enhancing maximal strength. The primary aim of this study was to examine the previous literature comparing periodized resistance training plans to non-periodized resistance training plans and determine a quantitative estimate of effect on maximal strength. All studies included in the meta-analysis met the following inclusion criteria: (1) peer-reviewed publication; (2) published in English; (3) comparison of a periodized resistance training group to a non-periodized resistance training group; (4) maximal strength measured by 1-repetition maximum (1RM) squat, bench press, or leg press. Data were extracted and independently coded by two authors. Random-effects models were used to aggregate a mean effect size (ES), 95% confidence intervals (CIs) and potential moderators. The cumulative results of 81 effects gathered from 18 studies published between 1988 and 2015 indicated that the magnitude of improvement in 1RM following periodized resistance training was greater than non-periodized resistance training (ES = 0.43, 95% CI 0.27-0.58; P < 0.001). Periodization model (β = 0.51; P = 0.0010), training status (β = -0.59; P = 0.0305), study length (β = 0.03; P = 0.0067), and training frequency (β = 0.46; P = 0.0123) were associated with a change in 1RM. These results indicate that undulating programs were more favorable for strength gains. Improvements in 1RM were greater among untrained participants. Additionally, higher training frequency and longer study length were associated with larger improvements in 1RM. These results suggest that periodized resistance training plans have a moderate effect on 1RM compared to non-periodized

  15. Treatment of a long-acting anticoagulant rodenticide poisoning cohort with vitamin K1 during the maintenance period

    PubMed Central

    Long, Jianhai; Peng, Xiaobo; Luo, Yuan; Sun, Yawei; Lin, Guodong; Wang, Yongan; Qiu, Zewu

    2016-01-01

    Abstract Currently, there are few guidelines for the use of vitamin K1 in the maintenance treatment of long-acting anticoagulant rodenticide (LAAR) poisonings. We explored factors in the treatment of LAAR poisoning during the maintenance period in order to suggest feasible treatment models. Data from 24 cases of anticoagulant rodenticide poisoning in our hospital were collected from January 2013 to May 2016. The patients’ sex, age, coagulation function, total time from poisoning to treatment with vitamin K1 (prehospital time), vitamin K1 sustained treatment time (VKSTT), anticoagulant rodenticide category, and specific poison dosage were collected. Multivariate analysis was used to evaluate the correlation between vitamin K1 dosage and other factors during the maintenance period. Only VKSTT (partial regression coefficient −1.133, 0.59, P = 0.035) had an obvious influence on the therapeutic dose of vitamin K1 required during the maintenance period. After an initial pulse therapy, the bleeding and coagulation functions were stabilized, and the patients were subsequently treated with vitamin K1 during the maintenance period. Over time, the maintenance dose of vitamin K1 (10–120 mg/d, intravenous drip) was gradually decreased and was not related to toxicant concentration. PMID:28002326

  16. Comparison of the efficacy of 12 months and longer courses of interferon therapy for the treatment of chronic delta hepatitis: a retrospective cohort study.

    PubMed

    Soyer, Ozlem Mutluay; Baran, Bulent; Ormeci, Aslı Ciftcibasi; Gokturk, Suut; Aydın, Esra; Onel, Derya; Gulluoglu, Mine; Karaca, Cetin; Akyuz, Filiz; Demir, Kadir; Besisik, Fatih; Kaymakoglu, Sabahattin

    2016-05-01

    Interferon (IFN) therapy is associated with low rates of treatment success and high rates of recurrence in hepatitis D virus (HDV) infection. Several strategies to increase efficacy, including extending the treatment duration, have been tested. This study aimed to compare treatment outcomes between patients receiving 12 months vs. longer courses of interferon therapy for chronic delta hepatitis (CDH). Data from CDH patients receiving standard or pegylated IFN therapy were retrospectively evaluated. Patients were divided into two groups: group I received ≤12 months of therapy and group II received >12 months (maximum: 24 months) of therapy. Viral response at the end of treatment (EOT-VR), post-treatment week 24 viral response (PTW24- VR) and viral response after long-term follow-up (LTFU-VR) were compared. Parameters affecting virologic response were investigated. Sixty-five patients, 14 in group I and 51 in group II, were included. The EOT-VRs were 21% and 45% (p > 0.05), and the PTW24-VRs were 7% and 41% (p = 0.02), respectively. Recurrence rates were 66% and 17% in Groups I and II, respectively. The LTFU-VRs were 7% and 37%, respectively (p = 0.04). The HDV RNA at week 24 of treatment was the only parameter significantly affecting the PTW24-VR (odds ratio: 71.2; 95% CI: 3.7-1353, p = 0.005). PTW24-VR was achieved in 68% and 5% of patients with negative and positive HDV RNA, respectively, at week 24 of treatment (p < 0.01). IFN treatment for up to 24 months may increase the virologic response rate for CDH. HDV RNA negativity at week 24 of treatment was a significant predictor of virologic response.

  17. Long-period fiber phase grating devices

    NASA Astrophysics Data System (ADS)

    Stegall, David Brian

    In recent years, the explosive growth of the internet has virtually surpassed the limits of the global communications infrastructure. As a result, the fiber- optic communications industry is spearheading research and development to transmit information at ever increasing rates and over longer distances. The industry faces several obstacles to improving the performance of these systems. One problem is dispersion, which manifests at faster transmission rates when pulse spreading and distortion scramble the signal. Furthermore, high transmission powers needed for longer distances introduce deleterious optical nonlinearity phenomenon. Several waveguide and bulk devices have been implemented to address these issues, but each have shortcomings. Many of these problems and challenges have also impacted other fiber-optic industries, such as sensor systems. Long- period optical fiber gratings pose simple solutions to these problems and offer novel applications previously impractical through any other means. In this dissertation, research is presented in which modeling and fabrication of long-period gratings is improved over existing techniques by incorporating the effects of waveguide dispersion. An arbitrary dispersion also can be introduced into a long-period grating intentionally and a theoretical examination is made relating the chirp of a long-period grating and the resulting dispersion. In addition, several device applications such as a biological sensor and the concept of an actively controlled transmission spectrum of a long-period grating are explored. Finally, multiple in-series Bragg and long- period gratings are investigated for novel device configurations.

  18. Novel thermal annealing methodology for permanent tuning polymer optical fiber Bragg gratings to longer wavelengths.

    PubMed

    Pospori, A; Marques, C A F; Sagias, G; Lamela-Rivera, H; Webb, D J

    2018-01-22

    The Bragg wavelength of a polymer optical fiber Bragg grating can be permanently shifted by utilizing the thermal annealing method. In all the reported fiber annealing cases, the authors were able to tune the Bragg wavelength only to shorter wavelengths, since the polymer fiber shrinks in length during the annealing process. This article demonstrates a novel thermal annealing methodology for permanently tuning polymer optical fiber Bragg gratings to any desirable spectral position, including longer wavelengths. Stretching the polymer optical fiber during the annealing process, the period of Bragg grating, which is directly related with the Bragg wavelength, can become permanently longer. The methodology presented in this article can be used to multiplex polymer optical fiber Bragg gratings at any desirable spectral position utilizing only one phase-mask for their photo-inscription, reducing thus their fabrication cost in an industrial setting.

  19. PERIOD].

    PubMed

    Budi, S; Žic, R; Martić, K; Rudman, F; Vlajčić, Z; Milanović, R; Roje, Z; Munjiza, A; Rajković, I; Gorjanc, B; Held, R; Maletić, A; Tucaković, H; Stanec, Z

    2016-01-01

    Results of this clinical study on surgical treatment of pressure ulcers at Department of Plastic, Reconstructive and Aesthetic Surgery, Dubrava University Hospital showed that there was no difference between the 2011-2016 and 2003-2008 periods, indicating continuation of good surgical treatment planning and appropriate postoperative care. Despite the smaller number of hospitalized patients in the 2011-2016 period (31 patients and 42 reconstructive procedures), the number of reconstructive procedure was similar to the recent 2003-2008 period (47 patients and 57 reconstructive procedures). The best results of reconstruction of sacral region pressure ulcer were achieved with fasciocutaneous and musculocutaneous flaps. Whenever possible, depending on the extent of the defect, musculocutaneous flaps should be preferred for reconstruction. It is especially suitable for pressure ulcer recurrence. For ischial region reconstruction, good results can be obtained by mobilizing the semimembranosus and/or semitendinosus in defect gap. For trochanteric region, the tensor fascia lata flap is a good choice. For maximal functional and reconstructive results, a multidisciplinary approach in pressure ulcer treatment has the leading role in the modern concept of wound healing. Surgical treatment should always include radical debridement, ostectomy and well planned defect reconstruction. Conservative treatment should be support to surgical treatment with a focus on patient health care and high hygiene measures. In recent years (2011-2016), the usage of better conservative treatment led to reduction of patient hospital stay and surgical treatment of pressure ulcer. Further ‘wound care’ nurses training in Croatia can lead the trend towards advanced practice nursing in pressure ulcer prevention and conservative treatment.

  20. Periodic behavior in lava dome eruptions

    NASA Astrophysics Data System (ADS)

    Barmin, A.; Melnik, O.; Sparks, R. S. J.

    2002-05-01

    Lava dome eruptions commonly display fairly regular alternations between periods of high activity and periods of low or no activity. The time scale for these alternations is typically months to several years. Here we develop a generic model of magma discharge through a conduit from an open-system magma chamber with continuous replenishment. The model takes account of the principal controls on flow, namely the replenishment rate, magma chamber size, elastic deformation of the chamber walls, conduit resistance, and variations of magma viscosity, which are controlled by degassing during ascent and kinetics of crystallization. The analysis indicates a rich diversity of behavior with periodic patterns similar to those observed. Magma chamber size can be estimated from the period with longer periods implying larger chambers. Many features observed in volcanic eruptions such as alternations between periodic behaviors and continuous discharge, sharp changes in discharge rate, and transitions from effusive to catastrophic explosive eruption can be understood in terms of the non-linear dynamics of conduit flows from open-system magma chambers. The dynamics of lava dome growth at Mount St. Helens (1980-1987) and Santiaguito (1922-2000) was analyzed with the help of the model. The best-fit models give magma chamber volumes of ∼0.6 km3 for Mount St. Helens and ∼65 km3 for Santiaguito. The larger magma chamber volume is the major factor in explaining why Santiaguito is a long-lived eruption with a longer periodicity of pulsations in comparison with Mount St. Helens.

  1. 77 FR 77160 - Self-Regulatory Organizations; New York Stock Exchange LLC; Notice of Designation of a Longer...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-31

    ... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-68522; File No. SR-NYSE-2012-57] Self-Regulatory Organizations; New York Stock Exchange LLC; Notice of Designation of a Longer Period for Commission Action on Proposed Rule Change Deleting NYSE Rules 95(c) and (d) and Related Supplementary Material December 21, 2012. On October 26, 2012, New Yor...

  2. Student Instruction Should Be Distributed over Long Time Periods

    ERIC Educational Resources Information Center

    Rohrer, Doug

    2015-01-01

    In many academic courses, students encounter a particular fact or concept many times over a period of a few weeks and then do not see it again during the remainder of the course. Are these brief instructional periods sufficient, or should the same amount of instruction be distributed over longer periods of time? This question was the focus of…

  3. Collective antibiotic treatment of trachoma

    PubMed Central

    Reinhards, J.; Weber, A.; Maxwell-Lyons, F.

    1959-01-01

    By the early 1950's, it was clear from numerous independent reports that certain of the broad-spectrum antibiotics were effective against the agent of trachoma. It seemed, however, that treatment had to be continued over long periods to effect a cure of the average case. With the assistance of WHO, comparative trials on a scale hitherto unprecedented in the disease—involving more than 9000 schoolchildren with active trachoma—have been conducted in Morocco since 1953 in order to assess the value of local treatment of trachoma with chlortetracycline and to develop simple and economic methods of treatment, for which there was a pressing need. Local application of 1% chlortetracycline ointment two or three times daily for 60 days gave almost 80% cures under reasonably favourable conditions and nearly 100% cures after re-treatment of cases not cured by the first course. Equally good results followed intermittent short-term treatment over longer periods. Relapse and reinfection rates were low. Collective mass treatment with antibiotics is clearly a valuable method of trachoma control. The use of intermittent treatment allows for a great economy both in antibiotics and in staff and other campaign expenses and makes possible the wide expansion of mass treatment programmes. PMID:14437176

  4. Canakinumab for the treatment of cryopyrin-associated periodic syndromes.

    PubMed

    Walsh, Garry M

    2009-10-01

    Familial cold-induced autoinflammatory syndrome, Muckle-Wells syndrome and neonatal-onset multisystem inflammatory disease make up cryopyrin-associated periodic syndromes (CAPS). These are autoinflammatory inherited disorders caused by autosomal dominant gain-of-function mutations in the NLRP3 gene, located on chromosome 1q44. Cryopyrin/NALP3/NLRP3 is an essential component of intracellular inflammasomes that activate caspase-1, which in turn converts interleukin-1beta (IL-1beta) to its active form. IL-1beta is a potent cytokine that activates diverse elements of the immune and inflammatory systems leading to the pathogenic changes characteristic of CAPS. There is therefore much interest in the development of IL-1beta blocking agents as novel biologic treatments for these conditions. Canakinumab (ACZ-885; Ilaris, Novartis Pharma) is a fully humanized monoclonal antibody (mAb) specific for IL-1beta and is indicated for a wide range of inflammatory disorders including CAPS. This review will assess the utility of canakinumab as a treatment for CAPS. Copyright 2009 Prous Science, S.A.U. or its licensors. All rights reserved.

  5. Even! But No Longer Odd

    ERIC Educational Resources Information Center

    Ramaswami, Rama

    2009-01-01

    With hundreds of K-12 schools routinely offering online courses, the idea of a full-time virtual school is no longer as outlandish as it once may have seemed. Thanks to giant improvements in technology and the quality of their academic instruction, most virtual schools now hold a trump card they had not possessed: credibility. "There were…

  6. Long-term periodic anthelmintic treatments are associated with increased allergen skin reactivity

    PubMed Central

    Endara, P; Vaca, M; Chico, M E; Erazo, S; Oviedo, G; Quinzo, I; Rodriguez, A; Lovato, R; Moncayo, A-L; Barreto, M L; Rodrigues, L C; Cooper, P J

    2010-01-01

    Background The low prevalence of allergic disease in the rural tropics has been attributed to the protective effects of chronic helminth infections. There is concern that treatment-based control programmes for these parasites may lead to an increase in the prevalence of allergic diseases. Objective We measured the impact of 15–17 years of anthelmintic treatment with ivermectin on the prevalence of allergen skin test reactivity and allergic symptoms in school-age children. Methods The prevalence of allergen skin test reactivity, exercise-induced bronchospasm and allergic symptoms was compared between school-age children living in communities that had received community-based treatments with ivermectin (for onchocerciasis control) for a period of 15–17 years with those living in geographically adjacent communities that had received no ivermectin. Results The prevalence of allergen skin test reactivity was double in children living in treated communities compared with those in untreated communities (16.7% vs. 8.7%, adjusted OR 2.10, 95% CI 1.50–2.94, P<0.0001), and the effect was mediated partly by a reduced prevalence of Trichuris trichiura among treated children. Ivermectin treatments were associated with an increased prevalence of recent eczema symptoms (adjusted OR 2.24, 95% CI 1.05–4.78, P=0.04) but not symptoms of asthma or rhino-conjunctivitis. The effect on eczema symptoms was not associated with reductions in geohelminth infections. Conclusion Long-term periodic treatments with ivermectin were associated with an increased prevalence of allergen skin test reactivity. There was some evidence that treatment was associated with an increased prevalence of recent eczema symptoms but not those of asthma or rhino-conjunctivitis. Cite this as: P. Endara, M. Vaca, M. E. Chico, S. Erazo, G. Oviedo, I. Quinzo, A. Rodriguez R. Lovato, A.-L. Moncayo, M. L. Barreto, L. C. Rodrigues and P. J. Cooper, Clinical & Experimental Allergy, 2010 (40) 1669–1677. PMID

  7. Longer thaw seasons increase nitrogen availability for leaching during fall in tundra soils

    DOE PAGES

    Treat, Claire C.; Wollheim, Wilfred M.; Varner, Ruth K.; ...

    2016-06-15

    Climate change has resulted in warmer soil temperatures, earlier spring thaw and later fall freeze-up, resulting in warmer soil temperatures and thawing of permafrost in tundra regions. While these changes in temperature metrics tend to lengthen the growing season for plants, light levels, especially in the fall, will continue to limit plant growth and nutrient uptake. We conducted a laboratory experiment using intact soil cores with and without vegetation from a tundra peatland to measure the effects of late freeze and early spring thaw on carbon dioxide (CO 2) exchange, methane (CH 4) emissions, dissolved organic carbon (DOC) and nitrogenmore » (N) leaching from soils. We compared soil C exchange and N production with a 30 day longer seasonal thaw during a simulated annual cycle from spring thaw through freeze-up and thaw. Across all cores, fall N leaching accounted for similar to 33% of total annual N loss despite significant increases in microbial biomass during this period. Nitrate(NO 3 -) leaching was highest during the fall (5.33 ± 1.45 mgNm -2 d -1) following plant senescence and lowest during the summer (0.43 ± 0.22 mg Nm -2 d -1). In the late freeze and early thaw treatment, we found 25% higher total annual ecosystem respiration but no significant change in CH 4 emissions or DOC loss due to high variability among samples. The late freeze period magnified N leaching and likely was derived from root turnover and microbial mineralization of soil organic matter coupled with little demand from plants or microbes. Furthermore, large N leaching during the fall will affect N cycling in low-lying areas and streams and may alter terrestrial and aquatic ecosystem nitrogen budgets in the arctic.« less

  8. Polymyxin B-immobilized fiber column hemoperfusion removes endotoxin throughout a 24-hour treatment period.

    PubMed

    Mitaka, Chieko; Fujiwara, Naoto; Yamamoto, Mamoru; Toyofuku, Takahiro; Haraguchi, Go; Tomita, Makoto

    2014-10-01

    The purpose of this study was to evaluate the extent of endotoxin adsorption by polymyxin B-immobilized fiber column hemoperfusion (PMX) performed for a 24-hour treatment period in patients with septic shock. Nineteen patients with septic shock were retrospectively studied. The plasma endotoxin concentrations of blood drawn from the radial artery and from the outlet circuit of the PMX column were measured by kinetic turbidimetric limulus assay using an MT-358 Toxinometer (Wako Pure Chemical Industries, Ltd, Osaka, Japan) after 24 hours of PMX treatment. The endotoxin removal rate was defined by the following equation: ([radial artery endotoxin concentration - outlet circuit of PMX column endotoxin concentration]/radial artery endotoxin concentration) × 100%. The patients had a median Acute Physiology and Chronic Health Evaluation II score of 29 at intensive care unit admission and a 28-day mortality of 47%. Before the start of the PMX treatment, the median radial arterial plasma endotoxin concentration was 16.48 pg/mL. After 24 hours of PMX treatment, the median radial plasma endotoxin concentration had decreased to 1.857 pg/mL, and the concentration at the outlet circuit of the PMX column was further decreased to 0.779 pg/mL. The median endotoxin removal rate was 74.4%. These findings suggest that 24-hour PMX treatment was effective in removing endotoxin continuously throughout the entire treatment period. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. The STOP-AB trial protocol: efficacy and safety of discontinuing patient antibiotic treatment when physicians no longer consider it necessary.

    PubMed

    Llor, Carl; Moragas, Ana; Bayona, Carolina; Cots, Josep M; Molero, José M; Ribas, Joana; Fóthy, Julio Francisco; Gutiérrez, Isabel; Sánchez, Coro; Ortega, Jesús; Arranz, Javier; Botanes, Jenifer; Robles, Purificación

    2017-06-06

    Since 2011, the Spanish Society of Family Medicine has recommended general practitioners (GPs) to ask their patients to stop taking antibiotics when they suspect a viral infection. However, this practice is seldom used because uncertainty about diagnosis, and fear of consequences of discontinuing antibiotic therapy, as well as perceived pressure to continue prescribing antibiotics and potential conflict with patients are more of a concern for GPs than antibiotic resistance. The main objective of this study is to determine whether discontinuation of antibiotic therapy when a GP no longer considers it necessary has any impact on the number of days with severe symptoms. This is a multicentre, open-label, randomised controlled clinical trial. The study was conducted in 10 primary care centres in Spain. We included patients from 18 to 75 years of age with uncomplicated acute respiratory tract infections-acute rhinosinusitis, acute sore throat, influenza or acute bronchitis-who had previously taken any dose of antibiotic for <3 days, which physicians no longer considered necessary. The patients were randomly assigned to the usual strategy of continuing antibiotic treatment or to discontinuing antibiotic therapy. A sample size of 240 patients per group was calculated on the basis of a reduction of 1 day in the duration of severe symptoms being a clinically relevant outcome. The primary outcome was the duration of severe symptoms, that is, symptoms scored 5 or 6 by means of validated symptom diaries. Secondary outcomes included antibiotics taken, adverse events, patient satisfaction and complications within the first 3 months. The study was approved by the Ethical Board of Fundació Jordi Gol i Gurina (reference number: 16/093). The findings of this trial will bedisseminated through research conferences and peer-reviewed journals. NCT02900820; pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights

  10. Efficacy of Erbium:YAG laser treatment compared to topical estriol treatment for symptoms of genitourinary syndrome of menopause.

    PubMed

    Gaspar, Adrian; Brandi, Hugo; Gomez, Valentin; Luque, Daniel

    2017-02-01

    The objective of this prospective comparative cohort study was to establish the effectiveness and safety of Erbium:YAG (Er:YAG) laser treatment for genitourinary syndrome of menopause and to compare it with an established topical estriol treatment. Fifty patients with genitourinary syndrome of menopause were divided into two groups. The estriol group received a treatment of 0.5 mg estriol ovules for 8 weeks and the laser group was first treated for 2 weeks with 0.5 mg estriol ovules 3 times per week to hydrate the mucosa and then received three sessions with 2,940 nm Er:YAG laser in non-ablative mode. Biopsies were taken before and at 1, 3, 6, and 12 months post-treatment. Maturation index, maturation value and pH where recorded up to 12-months post-treatment, while the VAS analysis of symptoms was recorded up to 18 months post-treatment. Statistically significant (P < 0.05), reduction of all assessed symptoms was observed in the laser group at all follow-ups up to 18 months post-treatment. Significant improvement in maturation value and a decrease of pH in the laser group was detected up to 12 months after treatment. The improvement in all endpoints was more pronounced and longer lasting in the laser group. Histological examination showed changes in the tropism of the vaginal mucosa and also angiogenesis, congestion, and restructuring of the lamina propria in the laser group. Side effects were minimal and of transient nature in both groups, affecting 4% of patients in the laser group and 12% of patients in the estriol group. Our results show that Er:YAG laser treatment successfully relieves symptoms of genitourinary syndrome of menopause and that the results are more pronounced and longer lasting compared to topical estriol treatment. Lasers Surg. Med. 49:160-168, 2017. © 2016 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc. © 2016 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.

  11. Effect of Temperature on Feeding Period of Larval Blacklegged Ticks (Acari: Ixodidae) on Eastern Fence Lizards.

    PubMed

    Rulison, Eric L; Lebrun, Roger A; Ginsberg, Howard S

    2014-11-01

    Ambient temperature can influence tick development time, and can potentially affect tick interactions with pathogens and with vertebrate hosts. We studied the effect of ambient temperature on duration of attachment of larval blacklegged ticks, Ixodes scapularis Say, to eastern fence lizards, Sceloporus undulatus (Bosc & Daudin). Feeding periods of larvae that attached to lizards under preferred temperature conditions for the lizards (WARM treatment: temperatures averaged 36.6°C at the top of the cage and 25.8°C at the bottom, allowing behavioral thermoregulation) were shorter than for larvae on lizards held under cool conditions (COOL treatment temperatures averaged 28.4°C at top of cage and 24.9°C at the bottom). The lizards were infested with larvae four times at roughly monthly intervals. Larval numbers successfully engorging and dropping declined and feeding period was longer after the first infestation. © 2014 Entomological Society of America.

  12. Effect of temperature on feeding period of larval blacklegged ticks (Acari: Ixodidae) on eastern fence lizards

    USGS Publications Warehouse

    Rulison, Eric L.; LeBrun, Roger A.; Ginsberg, Howard S.

    2014-01-01

    Ambient temperature can influence tick development time, and can potentially affect tick interactions with pathogens and with vertebrate hosts. We studied the effect of ambient temperature on duration of attachment of larval blacklegged ticks, Ixodes scapularis Say, to eastern fence lizards, Sceloporus undulatus (Bose & Daudin). Feeding periods of larvae that attached to lizards under preferred temperature conditions for the lizards (WARM treatment: temperatures averaged 36.6°C at the top of the cage and 25.8°C at the bottom, allowing behavioral thermoregulation) were shorter than for larvae on lizards held under cool conditions (COOL treatment temperatures averaged 28.4°C at top of cage and 24.9°C at the bottom). The lizards were infested with larvae four times at roughly monthly intervals. Larval numbers successfully engorging and dropping declined and feeding period was longer after the first infestation.

  13. [Use of semisynthetic penicillin in the treatment of infectious mastitis in cows during the dry period].

    PubMed

    Vasil', M; Federic, F

    1990-03-01

    During two years in a herd of dairy cows with an average number of 94 cows the effects on infection level were investigated of single nonselective antibiotics treatment of cow's udder in the dry period. The treatment influenced favourably the results of complex periodic three-months examinations: --level of infection with infectious mastitis was reduced from 38.3% to 9.8%; --occurrence of clinical forms of mastitis dropped from 17.4% to 5.9%;--occurrence of NK-test positive reactions decreased from 55.8% to 21.8%. An investigation into therapeutic efficiency of three intramammary preparations revealed the highest total therapeutic effect of Stapenor retard (Bayer, FRG)--93.2%; Syntarpene 500 (Polfa, Poland) had the total therapeutic efficiency of 92.6% and the efficiency of Oxaclene foam (Spofa, CSSR) made 86.5%. The results demonstrate good efficiency of the method because the levels of mastitis infection in the herd were positively influenced, and excellent therapeutic efficiency of semisynthetic penicillins containing intramammary preparations used for mastitis treatment of dairy cows in the dry period.

  14. [Treatment with the use of microcurrent lymphatic drainage physiotherapy during the postoperative period following rhinoplastic surgery].

    PubMed

    Aleksanyan, T A; Kazantsev, E V

    The objective of the present study was to evaluate the effectiveness of the combined treatment of the patients who had undergone either primary or secondary rhinoplastic surgery with the use of photo- and magnetic therapy in comparison with the effectiveness of phototherapy in the combination with microcurrent therapy. The patients were divided into four groups depending on the type of the surgical intervention and the mode of the combined physiotherapeutic treatment. All the patients were given combined physiotherapeutic treatment in addition to the standard pharmacotherapy starting from the second day of the postoperative period. The patients of groups 1 and 3 received phototherapy in the combination with magnetic therapy while those in groups 2 and 4 were treated by phototherapy in the combination with microcurrent lymphatic drainage physiotherapy. It was shown that the different combinations of physiotherapeutic modalities during the postoperative period following primary «closed» rhinoplasty were not different significantly in terms of effectiveness. After secondary «closed» rhinoplasty, the combination of phototherapy with the application of microcurrents looks more preferable. It is concluded that microcurrent lymphdraining physiotherapy should be regarded as the priority component of the combined physiotherapeutic treatment during the postoperative period following secondary «closed» rhinoplasty.

  15. Therapeutic Manuka Honey: No Longer So Alternative

    PubMed Central

    Carter, Dee A.; Blair, Shona E.; Cokcetin, Nural N.; Bouzo, Daniel; Brooks, Peter; Schothauer, Ralf; Harry, Elizabeth J.

    2016-01-01

    Medicinal honey research is undergoing a substantial renaissance. From a folklore remedy largely dismissed by mainstream medicine as “alternative”, we now see increased interest by scientists, clinical practitioners and the general public in the therapeutic uses of honey. There are a number of drivers of this interest: first, the rise in antibiotic resistance by many bacterial pathogens has prompted interest in developing and using novel antibacterials; second, an increasing number of reliable studies and case reports have demonstrated that certain honeys are very effective wound treatments; third, therapeutic honey commands a premium price, and the honey industry is actively promoting studies that will allow it to capitalize on this; and finally, the very complex and rather unpredictable nature of honey provides an attractive challenge for laboratory scientists. In this paper we review manuka honey research, from observational studies on its antimicrobial effects through to current experimental and mechanistic work that aims to take honey into mainstream medicine. We outline current gaps and remaining controversies in our knowledge of how honey acts, and suggest new studies that could make honey a no longer “alternative” alternative. PMID:27148246

  16. [Correlation between social support and quality of life in patients with breast cancer at different periods of treatment].

    PubMed

    Yang, L; Song, W P; Chen, Z L; Wang, Y; Chen, Y Y; Hua, Y H; Chen, M; Zou, W B

    2017-03-23

    Objective: To analyze the differences between the social support for breast cancer patients and healthy female, and to explore the correlation between social support and quality of life (QOL) in the patients. Methods: From January 2013 to December 2014, 101 patients with operable breast cancer treated at Xinyu City People's Hospital were recruited as the experimental group. They completed questionnaires in the preoperative, postoperative chemoradiotherapy and rehabilitation periods, respectively.101 healthy female volunteers recruited from the community were included as control group, whose age and level of education were matched with those of the experimental group.The general questionnaire including basic information, disease conditions and other projects, perceived social support scale (PSSS), quality of life of breast cancer patients (FACT-B) were applied to evaluate the general situation, social support and QOL of the subjects. The differences in PSSS scores between the experimental and control groups were compared. The correlation between PSSS score and FACT-B score in the experimental group was analyzed. SPSS 18.0 software was used for statistical analysis. Results: The general situations of the experimental and control groups were comparable (all P >0.05). The rates of the total social support score ≥50 in the experimental and control groups were not significantly different (93.6% vs. 94.7%, P =0.067). Compared with that of the control group (23.2±4.8), the scores of family support in the experimental group in preoperative, postoperative chemoradiotherapy and rehabilitation periods were statistically higher (25.6±3.2, 24.2±4.2 and 24.0±3.4, respectively, P =0.034). The social support scores of patients with different demographic characteristics were different. Among the demographic characteristics, years of education and place of residence had the largest impact. The scores of social support in patients with longer education years and living in the

  17. Longer period of oral administration of aspartame on cytokine response in Wistar albino rats.

    PubMed

    Choudhary, Arbind Kumar; Sheela Devi, Rathinasamy

    2015-03-01

    Aspartame is a non-nutritive sweetener particularly used in 'diet' and 'low calorie' products and also in a variety of foods, drugs and hygiene products. Aspartame is metabolized by gut esterases and peptidases to three common chemicals: the amino acids, aspartic acid and phenylalanine, and small amounts of methanol. The aim of the present study was to assess potential changes in molecular mediators of aspartame as a chemical stressor in rats. The effects of long-term administration of aspartame (40 mg/kg body weight/day) were tested in Wistar Albino rats. The treatment effects were assessed in different conditions, including control groups. After 90 days of treatment, circulating concentrations of different parameters were assessed: corticosterone, lipid peroxidation, antioxidant activity, nitric oxide, reduced glutathione and cytokines (interleukin 2, interleukin 4, tumor necrosis factor-α and interferon-γ). The results show that there was a significant increase in plasma corticosterone, serum lipid peroxidation and nitric oxide level along with a decrease in enzymatic and non-enzymatic antioxidant as well as significant decrease in interleukin 2, tumor necrosis factor-α and interferon-γ. There was also a significant increase in interleukin 4 irrespective of whether the animals were immunized or not. The findings clearly point out that aspartame acts as a chemical stressor because of increased corticosterone level and increased lipid peroxidation and nitric oxide level induce generation of free radicals in serum which may be the reason for variation of cytokine level and finally results in alteration of immune function. Aspartame metabolite methanol or formaldehyde may be the causative factors behind the changes observed. Copyright © 2014 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  18. ROTATION PERIODS OF WIDE BINARIES IN THE KEPLER FIELD

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

    Janes, K. A.

    In a search of proper motion catalogs for common proper motion stars in the field of the Kepler spacecraft I identified 93 likely binary systems. A comparison of their rotation periods is a test of the gyrochronology concept. To find their periods I calculated the autocorrelation function (ACF) of the Kepler mission photometry for each star. In most systems for which good periods can be found, the cooler star has a longer period than the hotter component, in general agreement with models. However, there is a wide range in the gradients of lines connecting binary pairs in a period–color diagram.more » Furthermore, near the solar color, only a few stars have longer periods than the Sun, suggesting that they, and their cooler companions, are not much older than the Sun. In addition, there is an apparent gap at intermediate periods in the period distribution of the late K and early M stars. Either star formation in this direction has been variable, or stars evolve in period at a non-uniform rate, or some stars evolve more rapidly than others at the same mass. Finally, using the ACF as a measure of the activity level, I found that while the F, G, and early K stars become less active as their periods increase, there is no correlation between period and activity for the mid K to early M stars.« less

  19. Health-related quality of life and cognitive functioning at on- and off-treatment periods in children aged between 6-13 years old with brain tumors: a prospective longitudinal study.

    PubMed

    An, Kyung Jin; Joung, Yoo Sook; Sung, Ki Woong; Kim, Ji-Hae

    2013-03-01

    Our study aimed to examine the relationship between intelligence and health-related quality of life (HRQOL) in children (6-13 years old) diagnosed as having a brain tumor. We administered a Korean version of the Wechsler Intelligence Scale for Children-III, the Pediatric Quality of Life Inventory, version 4.0 (PedsQL), the Korean version of the Parenting Stress Index-Short Form, and the Korean Version of the Parenting Sense of Competence (K-PSOC) scale before or after initial radiotherapy (T1) and after treatment termination (T2). In total, 13 patients completed both the T1 and T2 interviews. Scores significantly declined between T1 and T2 on the full-scale intelligence quotients (FIQ), verbal intelligence quotients (VIQ), performance intelligence quotients (PIQ), similarity and coding tests, as well as the K-PSOC, which measures parental anxiety. FIQ scores at T1 were correlated with the self-reported PedsQL total scores (r=0.739) and the parent proxy-report PedsQL scores for school functioning (r=0.706) at T2. Also, the FIQ scores at T2 were correlated with the self-reported PedsQL total scores (r=0.748) and scores for physical health (r=0.728) at T2. The cognitive ability and intelligence level of the patients significantly declined between on and off treatment periods, and higher intelligence functioning at both on and off treatment was correlated with long-term higher HRQOL. Further investigations that monitor intelligence, HRQOL and parenting stress over a longer period, using a greater number of participants, are needed.

  20. Use of antidepressants in the treatment of major depressive disorder in primary care during a period of economic crisis

    PubMed Central

    Sicras-Mainar, Antoni; Navarro-Artieda, Ruth

    2016-01-01

    Objective To describe antidepressant (AD) use in the treatment of major depressive disorder during a period of economic crisis. Patients and methods This was a retrospective, observational study using population-based databases. Two periods were considered: 1) 2008–2009, precrisis, and 2) 2012–2013, economic crisis. Certain inclusion/exclusion criteria were taken into account for the study (initiation of AD treatment). Patients were followed up for 12 months. The main measures were use (defined daily doses), epidemiologic measures, strategies used and treatment persistence, referrals, and use of resources. Statistical significance was set at P<0.05. Results In the precrisis period, 3,662 patients were enrolled, and 5,722 were enrolled in the period of economic crisis. Average age was 58.8 years and 65.4% were women. Comparing the two periods, major depressive disorder prevalence was 5.4% vs 8.1%, P<0.001. During the period of economic crisis, AD use rose by 35.2% and drug expenditures decreased by 38.7%. Defined daily dose per patient per day was 10.0 mg vs 13.5 mg, respectively, P<0.001. At 12-month follow-up, the majority of patients (60.8%) discontinued the treatment or continued on the same medication as before, and in 23.3% a change of AD was made. Conclusion Primary health care professionals are highly involved in the management of the illness; in addition, during the period of economic crisis, patients with major depressive disorder showed higher rates of prevalence of the illness, with increased use of AD drugs. PMID:26766910

  1. Daily Light Exposure Patterns Reveal Phase and Period of the Human Circadian Clock.

    PubMed

    Woelders, Tom; Beersma, Domien G M; Gordijn, Marijke C M; Hut, Roelof A; Wams, Emma J

    2017-06-01

    Light is the most potent time cue that synchronizes (entrains) the circadian pacemaker to the 24-h solar cycle. This entrainment process is an interplay between an individual's daily light perception and intrinsic pacemaker period under free-running conditions. Establishing individual estimates of circadian phase and period can be time-consuming. We show that circadian phase can be accurately predicted (SD = 1.1 h for dim light melatonin onset, DLMO) using 9 days of ambulatory light and activity data as an input to Kronauer's limit-cycle model for the human circadian system. This approach also yields an estimated circadian period of 24.2 h (SD = 0.2 h), with longer periods resulting in later DLMOs. A larger amount of daylight exposure resulted in an earlier DLMO. Individuals with a long circadian period also showed shorter intervals between DLMO and sleep timing. When a field-based estimation of tau can be validated under laboratory studies in a wide variety of individuals, the proposed methods may prove to be essential tools for individualized chronotherapy and light treatment for shift work and jetlag applications. These methods may improve our understanding of fundamental properties of human circadian rhythms under daily living conditions.

  2. Propranolol in Treatment of Huge and Complicated Infantile Hemangiomas in Egyptian Children

    PubMed Central

    Hassan, Basheir A.; Shreef, Khalid S.

    2014-01-01

    Background. Infantile hemangiomas (IHs) are the most common benign tumours of infancy. Propranolol has recently been reported to be a highly effective treatment for IHs. This study aimed to evaluate the efficacy and side effects of propranolol for treatment of complicated cases of IHs. Patients and Methods. This prospective clinical study included 30 children with huge or complicated IHs; their ages ranged from 2 months to 1 year. They were treated by oral propranolol. Treatment outcomes were clinically evaluated. Results. Superficial cutaneous hemangiomas began to respond to propranolol therapy within one to two weeks after the onset of treatment. The mean treatment period that was needed for the occurrence of complete resolution was 9.4 months. Treatment with propranolol was well tolerated and had few side effects. No rebound growth of the tumors was noted when propranolol dosing stopped except in one case. Conclusion. Propranolol is a promising treatment for IHs without obvious side effects. However, further studies with longer follow-up periods are needed. PMID:24899888

  3. Propranolol in treatment of huge and complicated infantile hemangiomas in egyptian children.

    PubMed

    Hassan, Basheir A; Shreef, Khalid S

    2014-01-01

    Background. Infantile hemangiomas (IHs) are the most common benign tumours of infancy. Propranolol has recently been reported to be a highly effective treatment for IHs. This study aimed to evaluate the efficacy and side effects of propranolol for treatment of complicated cases of IHs. Patients and Methods. This prospective clinical study included 30 children with huge or complicated IHs; their ages ranged from 2 months to 1 year. They were treated by oral propranolol. Treatment outcomes were clinically evaluated. Results. Superficial cutaneous hemangiomas began to respond to propranolol therapy within one to two weeks after the onset of treatment. The mean treatment period that was needed for the occurrence of complete resolution was 9.4 months. Treatment with propranolol was well tolerated and had few side effects. No rebound growth of the tumors was noted when propranolol dosing stopped except in one case. Conclusion. Propranolol is a promising treatment for IHs without obvious side effects. However, further studies with longer follow-up periods are needed.

  4. Development, prevention, and treatment of feeding tube dependency.

    PubMed

    Krom, Hilde; de Winter, J Peter; Kindermann, Angelika

    2017-06-01

    Enteral nutrition is effective in ensuring nutritional requirements and growth. However, when tube feeding lasts for a longer period, it can lead to tube dependency in the absence of medical reasons for continuation of tube feeding. Tube-dependent children are unable or refuse to start oral activities and they lack oral skills. Tube dependency has health-, psychosocial-, and economy-related consequences. Therefore, the transition to oral feeding is of great importance. However, this transition can be very difficult and needs a multidisciplinary approach. Most studies for treatment of tube dependency are based on behavioral interventions, such as family therapy, individual behavior therapy, neuro-linguistic programming, and parental anxiety reduction. Furthermore, oral motor therapy and nutritional adjustments can be helpful in tube weaning. The use of medication has been described in the literature. Although mostly chosen as the last resort, hunger-inducing methods, such as the Graz-model and the Dutch clinical hunger provocation program, are also successful in weaning children off tube feeding. The transition from tube to oral feeding is important in tube-dependent children but can be difficult. We present an overview for the prevention and treatment of tube dependency. What is known: • Longer periods of tube feeding can lead to tube dependency. • Tube weaning can be very difficult. What is new: • Weaning as soon as possible and therefore referral to a multidisciplinary team are recommended. • An overview of treatment options for tube dependency is presented in this article.

  5. The operative treatment of pressure sores in the pelvic region: A 10-year period overview

    PubMed Central

    Jósvay, János; Klauber, András; Both, Béla; Kelemen, Péter B.; Varga, Zsombor Z.; Pesthy, Pál Cs.

    2015-01-01

    Context Pelvic region pressure sores often develop following spinal cord injury. Surgery is often necessary for long standing, large-sized pressure sores not responding to conservative treatment. Authors analyze their results of a 10-year period, and identify factors contributing to the reduction of the recurrence rate. Methods A total of 119 pressure sores were operated on 98 patients in two institutions during a 10-year period (1 January 2003 to 31 December 2012). The encountered perioperative complications are summarized, and the recurrence rate is analyzed with a patient follow-up questionnaire. Results We experienced 15 perioperative complications (12.6%). All complications were fully resolved by conservative treatment. Fifty-eight returned patient replies were processed. The average follow-up time after surgery was 5.2 years. The recurrence rate was 5.47%. Conclusion The strict adherence to surgical indications, full patient compliance, specialized pre- and post-operative patient care, our routinely used preferred surgical method, all contribute to a low post-operative complication rate, long-term flap survival, and an extended recurrence free period. PMID:25299238

  6. The operative treatment of pressure sores in the pelvic region: A 10-year period overview.

    PubMed

    Jósvay, János; Klauber, András; Both, Béla; Kelemen, Péter B; Varga, Zsombor Z; Pesthy, Pál Cs

    2015-07-01

    Pelvic region pressure sores often develop following spinal cord injury. Surgery is often necessary for long standing, large-sized pressure sores not responding to conservative treatment. Authors analyze their results of a 10-year period, and identify factors contributing to the reduction of the recurrence rate. A total of 119 pressure sores were operated on 98 patients in two institutions during a 10-year period (1 January 2003 to 31 December 2012). The encountered perioperative complications are summarized, and the recurrence rate is analyzed with a patient follow-up questionnaire. We experienced 15 perioperative complications (12.6%). All complications were fully resolved by conservative treatment. Fifty-eight returned patient replies were processed. The average follow-up time after surgery was 5.2 years. The recurrence rate was 5.47%. The strict adherence to surgical indications, full patient compliance, specialized pre- and post-operative patient care, our routinely used preferred surgical method, all contribute to a low post-operative complication rate, long-term flap survival, and an extended recurrence free period.

  7. Improved sonothrombolysis from a modified diagnostic transducer delivering impulses containing a longer pulse duration.

    PubMed

    Wu, Juefei; Xie, Feng; Kumar, Tanmay; Liu, Jinjin; Lof, John; Shi, William; Everbach, E Carr; Porter, Thomas R

    2014-07-01

    Although guided high-mechanical-index (MI) impulses from a diagnostic ultrasound transducer have been used in preclinical studies to dissolve coronary arterial and microvascular thrombi in the presence of intravenously infused microbubbles, it is possible that pulse durations (PDs) longer than that used for diagnostic imaging may further improve the effectiveness of this approach. By use of an established in vitro model flow system, a total of 90 occlusive porcine arterial thrombi (thrombus age: 3-4 h) within a vascular mimicking system were randomized to 10-min treatments with two different PDs (5 and 20 μs) using a Philips S5-1 transducer (1.6-MHz center frequency) at a range of MIs (from 0.2 to 1.4). All impulses were delivered in an intermittent fashion to permit microbubble replenishment within the thrombosed vessel. Diluted lipid-encapsulated microbubbles (0.5% Definity) were infused during the entire treatment period. A tissue-mimicking phantom 5 cm thick was placed between the transducer and thrombosed vessel to mimic transthoracic attenuation. Two 20-MHz passive cavitation detection systems were placed confocal to the insonified vessel to assess for inertial cavitational activity. Percentage thrombus dissolution was calculated by weighing the thrombi before and after each treatment. Percentage thrombus dissolution was significantly higher with a 20-μs PD already at the 0.2 and 0.4 MI therapeutic impulses (54 ± 12% vs. 33 ± 17% and 54 ± 22% vs. 34 ± 17%, p < 0.05 compared with the 5-μs PD group, respectively), and where passive cavitation detection systems detected only low intensities of inertial cavitation. At higher MI settings and 20-μs PDs, percentage thrombus dissolution decreased most likely from high-intensity cavitation shielding of the thrombus. Slightly prolonging the PD on a diagnostic transducer improves the degree of sonothrombolysis that can be achieved without fibrinolytic agents at a lower mechanical index. Copyright © 2014 World

  8. Longer is Larger--Or is It?

    ERIC Educational Resources Information Center

    Roche, Anne

    2005-01-01

    The author cites research from students' misconceptions of decimal notation that indicates that many students treat decimals as another whole number to the right of the decimal point. This "whole number thinking" leads some students to believe, in the context of comparing decimals, that "longer is larger" (for example, 0.45 is larger than 0.8…

  9. Inpatient Cognitive Behavior Therapy for Adolescents with Anorexia Nervosa: Immediate and Longer-Term Effects

    PubMed Central

    Dalle Grave, Riccardo; Calugi, Simona; El Ghoch, Marwan; Conti, Maddalena; Fairburn, Christopher G.

    2014-01-01

    Introduction: Inpatient treatment for anorexia nervosa is often successful in restoring body weight, but a high percentage of patients relapse following discharge. The aim of the present study was to establish the immediate and longer-term effects of a novel inpatient program for adolescents that was designed to produce enduring change. Method: Twenty-seven consecutive patients with severe anorexia nervosa were admitted to a 20-week inpatient treatment program based on the enhanced cognitive behavior therapy (CBT-E). The patients were assessed before and after hospitalization, and 6 and 12 months later. Results: Twenty-six patients (96%) completed the program. In these patients, there was a substantial improvement in weight, eating disorder features, and general psychopathology that was well maintained at 12-month follow-up. Conclusion: These findings suggest that inpatient CBT-E is a promising approach to the treatment of adolescents with severe anorexia nervosa. PMID:24575055

  10. Three-year follow-up of treatment-naïve and previously treated patients with CLL and SLL receiving single-agent ibrutinib.

    PubMed

    Byrd, John C; Furman, Richard R; Coutre, Steven E; Burger, Jan A; Blum, Kristie A; Coleman, Morton; Wierda, William G; Jones, Jeffrey A; Zhao, Weiqiang; Heerema, Nyla A; Johnson, Amy J; Shaw, Yun; Bilotti, Elizabeth; Zhou, Cathy; James, Danelle F; O'Brien, Susan

    2015-04-16

    Ibrutinib is an orally administered inhibitor of Bruton tyrosine kinase that antagonizes B-cell receptor, chemokine, and integrin-mediated signaling. In early-phase studies, ibrutinib demonstrated high response rates and prolonged progression-free survival (PFS) in chronic lymphocytic leukemia (CLL). The durable responses observed with ibrutinib relate in part to a modest toxicity profile that allows the majority of patients to receive continuous therapy for an extended period. We report on median 3-year follow-up of 132 patients with symptomatic treatment-naïve and relapsed/refractory CLL or small lymphocytic lymphoma. Longer treatment with ibrutinib was associated with improvement in response quality over time and durable remissions. Toxicity with longer follow-up diminished with respect to occurrence of grade 3 or greater cytopenias, fatigue, and infections. Progression remains uncommon, occurring primarily in some patients with relapsed del(17)(p13.1) and/or del(11)(q22.3) disease. Treatment-related lymphocytosis remains largely asymptomatic even when persisting >1 year and does not appear to alter longer-term PFS and overall survival compared with patients with partial response or better. Collectively, these data provide evidence that ibrutinib controls CLL disease manifestations and is well tolerated for an extended period; this information can help direct potential treatment options for different subgroups to diminish the long-term risk of relapse. © 2015 by The American Society of Hematology.

  11. Three-year follow-up of treatment-naïve and previously treated patients with CLL and SLL receiving single-agent ibrutinib

    PubMed Central

    Furman, Richard R.; Coutre, Steven E.; Burger, Jan A.; Blum, Kristie A.; Coleman, Morton; Wierda, William G.; Jones, Jeffrey A.; Zhao, Weiqiang; Heerema, Nyla A.; Johnson, Amy J.; Shaw, Yun; Bilotti, Elizabeth; Zhou, Cathy; James, Danelle F.; O'Brien, Susan

    2015-01-01

    Ibrutinib is an orally administered inhibitor of Bruton tyrosine kinase that antagonizes B-cell receptor, chemokine, and integrin-mediated signaling. In early-phase studies, ibrutinib demonstrated high response rates and prolonged progression-free survival (PFS) in chronic lymphocytic leukemia (CLL). The durable responses observed with ibrutinib relate in part to a modest toxicity profile that allows the majority of patients to receive continuous therapy for an extended period. We report on median 3-year follow-up of 132 patients with symptomatic treatment-naïve and relapsed/refractory CLL or small lymphocytic lymphoma. Longer treatment with ibrutinib was associated with improvement in response quality over time and durable remissions. Toxicity with longer follow-up diminished with respect to occurrence of grade 3 or greater cytopenias, fatigue, and infections. Progression remains uncommon, occurring primarily in some patients with relapsed del(17)(p13.1) and/or del(11)(q22.3) disease. Treatment-related lymphocytosis remains largely asymptomatic even when persisting >1 year and does not appear to alter longer-term PFS and overall survival compared with patients with partial response or better. Collectively, these data provide evidence that ibrutinib controls CLL disease manifestations and is well tolerated for an extended period; this information can help direct potential treatment options for different subgroups to diminish the long-term risk of relapse. PMID:25700432

  12. Individual and system influences on waiting time for substance abuse treatment.

    PubMed

    Carr, Carey J A; Xu, Jiangmin; Redko, Cristina; Lane, D Timothy; Rapp, Richard C; Goris, John; Carlson, Robert G

    2008-03-01

    Waiting time is a contemporary reality of many drug abuse treatment programs, resulting in substantial problems for substance users and society. Individual and system factors that influence waiting time are diverse and may vary at different points in the treatment continuum. This study assessed waiting time preceding clinical assessment at a centralized intake unit and during the period after the assessment but before treatment entry. The present study included 577 substance abusers who were enrolled in a large clinical trial of two brief treatment interventions in a midsize metropolitan area in Ohio. Bivariate analyses identified individual and system factors that influenced preassessment and postassessment waiting time, as well as total wait to treatment services. Multivariate analyses demonstrated that longer wait time for an assessment is influenced by being court referred, less belief in having a substance abuse problem, and less desire for change. A shorter wait to actually enter treatment is predicted by having a case manager, being more ready for treatment, and having less severe employment and alcohol problems. The different influences present during the two waiting periods suggest that assessment and treatment programs need to implement system changes and entry enhancement interventions that are specific to the needs of substance abusers at each waiting period.

  13. Predicting Time Spent in Treatment in a Sample of Danish Survivors of Child Sexual Abuse.

    PubMed

    Fletcher, Shelley; Elklit, Ask; Shevlin, Mark; Armour, Cherie

    2017-07-01

    The aim of this study was to identify significant predictors of length of time spent in treatment. In a convenience sample of 439 Danish survivors of child sexual abuse, predictors of time spent in treatment were examined. Assessments were conducted on a 6-month basis over a period of 18 months. A multinomial logistic regression analysis revealed that the experience of neglect in childhood and having experienced rape at any life stage were associated with less time in treatment. Higher educational attainment and being male were associated with staying in treatment for longer periods of time. These factors may be important for identifying those at risk of terminating treatment prematurely. It is hoped that a better understanding of the factors that predict time spent in treatment will help to improve treatment outcomes for individuals who are at risk of dropping out of treatment at an early stage.

  14. Guidelines for the management and treatment of periodic fever syndromes: periodic fever, aphthous stomatitis, pharyngitis and adenitis syndrome.

    PubMed

    Terreri, Maria Teresa R A; Bernardo, Wanderley Marques; Len, Claudio Arnaldo; da Silva, Clovis Artur Almeida; de Magalhães, Cristina Medeiros Ribeiro; Sacchetti, Silvana B; Ferriani, Virgínia Paes Leme; Piotto, Daniela Gerent Petry; Cavalcanti, André de Souza; de Moraes, Ana Júlia Pantoja; Sztajnbok, Flavio Roberto; de Oliveira, Sheila Knupp Feitosa; Campos, Lucia Maria Arruda; Bandeira, Marcia; Santos, Flávia Patricia Sena Teixeira; Magalhães, Claudia Saad

    2016-01-01

    To establish guidelines based on scientific evidence for the management of periodic fever, aphthous stomatitis, pharyngitis and adenitis (PFAPA) syndrome. The Guideline was prepared from 5 clinical questions that were structured through PICO (Patient, Intervention or indicator, Comparison and Outcome), to search in key primary scientific information databases. After defining the potential studies to support the recommendations, these were graduated considering their strength of evidence and grade of recommendation. 806 articles were retrieved and evaluated by title and abstract; from these, 32 articles were selected to support the recommendations. 1. PFAPA is a diagnosis of exclusion established on clinical grounds, and one must suspect of this problem in children with recurrent and periodic febrile episodes of unknown origin, or with recurrent tonsillitis interspersed with asymptomatic periods, especially in children in good general condition and with preservation of weight and height development. 2. Laboratory findings are nonspecific. Additional tests do not reveal pathognomonic changes. 3. The evidence supporting an indication for surgical treatment (tonsillectomy with or without adenoidectomy), is based on two non-blinded randomized clinical trials with small numbers of patients. 4. The use of prednisone at the onset of fever in patients with PFAPA proved to be an effective strategy. There is still need for more qualified evidence to support its use in patients with PFAPA. 5. Despite promising results obtained in studies with IL-1β inhibitors, such studies are limited to a few case reports. Copyright © 2015 Elsevier Editora Ltda. All rights reserved.

  15. Predictors of anger treatment outcomes.

    PubMed

    Mackintosh, Margaret-Anne; Morland, Leslie A; Kloezeman, Karen; Greene, Carolyn J; Rosen, Craig S; Elhai, Jon D; Frueh, B Christopher

    2014-10-01

    This study investigated predictors of therapeutic outcomes for veterans who received treatment for dysregulated anger. Data are from a randomized controlled trial investigating the effectiveness of video teleconferencing compared to in-person delivery of anger management therapy (AMT) among 125 military veterans. Multilevel modeling was used to assess 2 types of predictors (demographic characteristics and mental health factors) of changes in anger symptoms after treatment. Results showed that while veterans benefited similarly from treatment across modalities, veterans who received two or more additional mental health services and who had longer commutes to care showed the greatest improvement on a composite measure of self-reported anger symptoms. Results highlight that veterans with a range of psychosocial and mental health characteristics benefited from AMT, while those receiving the most additional concurrent mental health services had better outcomes. © 2014 Wiley Periodicals, Inc.

  16. [The international communication and cooperation of prevention and treatment of epidemics in the Republican period of China].

    PubMed

    Zhang, Tai-shan

    2008-07-01

    During the Republican period of China, either the Northern Warlords Government or the National Government at Nanking, to different extent, all conducted international communication and cooperation in the prevention and treatment of epidemics. Firstly, they communicated and cooperated with International League in epidemic information, establishment of new health organization, health investigation and prevention and treatment of epidemics. Secondly, with WHO in epidemic information, live prevention and treatment of epidemics and personnel training. In addition, with international medical academic society by the initiative means of selecting and sending returned students abroad, dispatching overseas staff to study and attend international academic meeting. These communications and cooperations not only created good circumstances of international society for the prevention and treatment of epidemics in the Republican period of China, but also open a special window for the mutual understanding between China and the world, at the same time, promoted and reinforced independent research and development forces of prevention and treatment technology of infectious disease of our nation. Unfortunately, the inherent defects of the society of Republic of China greatly detracted from the effects of these endeavor.

  17. Critical periods and amblyopia.

    PubMed

    Daw, N W

    1998-04-01

    During the past 20 years, basic science has shown that there are different critical periods for different visual functions during the development of the visual system. Visual functions processed at higher anatomical levels within the system have a later critical period than functions processed at lower levels. This general principle suggests that treatments for amblyopia should be followed in a logical sequence, with treatment for each visual function to be started before its critical period is over. However, critical periods for some visual functions, such as stereopsis, are not yet fully determined, and the optimal treatment is, therefore, unknown. This article summarizes the current extent of our knowledge and points to the gaps that need to be filled.

  18. Longitudinal alterations in health-related quality of life and its impact on the clinical course of patients with advanced hepatocellular carcinoma receiving sorafenib treatment.

    PubMed

    Shomura, Masako; Kagawa, Tatehiro; Okabe, Haruka; Shiraishi, Koichi; Hirose, Shunji; Arase, Yoshitaka; Tsuruya, Kota; Takahira, Sachiko; Mine, Tetsuya

    2016-11-11

    This study aimed to identify the health-related quality of life (HRQOL) domains associated with prognosis by assessing longitudinal alterations in HRQOL in patients with advanced hepatocellular carcinoma receiving sorafenib. We prospectively assessed HRQOL by administering the SF-36 questionnaire 3-monthly to consecutive patients with advanced hepatocellular carcinoma receiving sorafenib. We evaluated the impact of HRQOL on their overall survival and duration of treatment with sorafenib using Cox's proportional hazards model. There were 54 participants: 42 (78 %) were male, the median age was 71 years, 24 (44 %) had hepatitis C virus infection, 33 (61 %) had Child-Pugh scores of 5, and 30 (56 %) had TNM stage IV hepatocellular carcinoma. The median overall survival and treatment duration were 9 and 5 months, respectively, and 40 patients (74 %) died. Thirteen patients receiving sorafenib over a 1-year period maintained all domain scores >40, without a significant decline during the treatment period. In contrast, physical functioning, physical role, and vitality scores declined continuously and significantly in the year before death (in the 40 patients who died). Previous curative treatment and physical functioning scores ≥40 at baseline were significantly associated with longer overall survival by multivariate analysis. Social functioning scores ≥40, absence of vascular invasion, and lower DCP value were significant predictors of longer treatment duration. HRQOL was not significantly impaired in those patients who were able to complete a 1-year course of sorafenib treatment. Baseline physical functioning scores ≥40 and social functioning scores ≥40 were significantly associated with longer overall survival and longer treatment duration, respectively. Thus, HRQOL could be a valuable marker to predict the clinical course of patients with advanced hepatocellular carcinoma receiving sorafenib.

  19. Cryopyrin-associated periodic syndrome in Australian children and adults: Epidemiological, clinical and treatment characteristics.

    PubMed

    Mehr, Sam; Allen, Roger; Boros, Christina; Adib, Navid; Kakakios, Alyson; Turner, Paul J; Rogers, Maureen; Zurynski, Yvonne; Singh-Grewal, Davinder

    2016-09-01

    Cryopyrin-associated periodic syndromes (CAPS) encapsulate three auto-inflammatory conditions, ranging in severity from mild (familial cold auto-inflammatory syndrome: FCAS), moderate (Muckle-Wells syndrome: MWS) and severe (neonatal onset multi-inflammatory disorder: NOMID). We aimed to describe the epidemiology, clinical features and outcomes of Australian children and adults with CAPS. Patients were identified and clinical data collected through a questionnaire sent during 2012-2013 to clinicians reporting to the Australian Paediatric Surveillance Unit and subscribing to the Australasian Societies for Allergy/Immunology, Rheumatology and Dermatology. Eighteen cases of CAPS were identified (8 NOMID; 8 MWS, 2 FCAS); 12 in children <18 years of age. The estimated population prevalence of CAPS was 1 per million persons. Diagnostic delay was frequent, particularly in those with milder phenotypes (median diagnostic delay in MWS/FCAS 20.6 years compared with NOMID 2.1 years; P = 0.04). Common presenting features included urticaria (100%), periodic fever (78%), arthralgia (72%) and sensorineural hearing loss (61%). Almost all (90%) MWS patients had a family member similarly affected compared with none in the NOMID group (P = 0.004). A significant proportion of patients on anti-interleukin (IL)-1 therapy (n = 13) no longer had systemic inflammation. Only 50% with sensorineural hearing loss had hearing restored on anti-IL-1 therapy. Although CAPS are rare, patients often endured prolonged periods of systemic inflammation. This is despite almost all MWS patients having family members with similar symptoms and children with NOMID presenting with chronic infantile urticaria associated with multi-system inflammation. Hearing loss in NOMID/MWS was frequent, and reversible in only 50% of cases. © 2016 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  20. Happy orang-utans live longer lives.

    PubMed

    Weiss, Alexander; Adams, Mark J; King, James E

    2011-12-23

    Nonhuman primate ageing resembles its human counterpart. Moreover, ratings of subjective well-being traits in chimpanzees, orang-utans and rhesus macaques are similar to those of humans: they are intercorrelated, heritable, and phenotypically and genetically related to personality. We examined whether, as in humans, orang-utan subjective well-being was related to longer life. The sample included 184 zoo-housed orang-utans followed up for approximately 7 years. Age, sex, species and number of transfers were available for all subjects and 172 subjects were rated on at least one item of a subjective well-being scale. Of the 31 orang-utans that died, 25 died a mean of 3.4 years after being rated. Even in a model that included, and therefore, statistically adjusted for, sex, age, species and transfers, orang-utans rated as being "happier" lived longer. The risk differential between orang-utans that were one standard deviation above and one standard deviation below baseline in subjective well-being was comparable with approximately 11 years in age. This finding suggests that impressions of the subjective well-being of captive great apes are valid indicators of their welfare and longevity.

  1. Facilitating longer working lives: international evidence on why and how.

    PubMed

    Wise, David A

    2010-01-01

    The article advances the view that social and economic choices in societies can reasonably adjust as the age structure of the population changes; in particular, some of the bounty of longer lives can reasonably be allocated to prolonging the labor force participation of older workers. Data on reductions in mortality and, in some countries, declines in disability are presented in ways that help to clarify that prolonged working lives may be a natural concomitant of living longer. The article reviews the problems inherent in the combination of living longer and reducing labor force participation at older ages. It discusses two ways to facilitate longer working lives: (1) eliminating penalties on work at older ages--inherent in the provisions of the social security programs in many countries--that induce older persons to leave the labor force at younger ages; and (2) correcting a false rationale--the "boxed economy" view of the labor market--that is often used to support retention of the provisions that induce older persons to leave the labor force.

  2. Log-periodic crashes revisited

    NASA Astrophysics Data System (ADS)

    Matsushita, Raul; da Silva, Sergio; Figueiredo, Annibal; Gleria, Iram

    2006-05-01

    We revisit the finding that crashes can be deterministic and governed by log-periodic formulas [D. Sornette, A. Johansen, Significance of log-periodic precursors to financial crashes, Quant. Finance 1 (2001) 452-471; D. Sornette, W.X. Zhou, The US 2000-2002 market descent: how much longer and deeper?, Quant. Finance 2 (2002) 468-481]. One- and two-harmonic equations are usually employed to fit daily data during bubble episodes. But a three-harmonics has been shown to fit anti-bubbles [A. Johansen, D. Sornette, Financial “anti-bubbles”: log-periodicity in gold and Nikkei collapses, Int. J. Mod. Phys. C 10 (1999) 563-575]. Here we show that the three-harmonic formula can work for bubble episodes as well as anti-bubbles. This is illustrated with daily data from the Brazilian real-US dollar exchange rate. And we also show that the three-harmonics can fit an intraday data set from that foreign exchange rate.

  3. Predictive value of early changes in triglycerides and weight for longer-term changes in metabolic measures during olanzapine, ziprasidone or aripiprazole treatment for schizophrenia and schizoaffective disorder post hoc analyses of 3 randomized, controlled clinical trials.

    PubMed

    Hoffmann, Vicki P; Case, Michael; Stauffer, Virginia L; Jacobson, Jennie G; Conley, Robert R

    2010-12-01

    The objective of this study was to determine if early changes in triglycerides and weight may be useful in predicting longer-term changes in weight and other metabolic parameters. Data were from three 24- to 28-week randomized, controlled studies comparing olanzapine to ziprasidone or aripiprazole for treatment of schizophrenia. Analyses were restricted to completers with fasting laboratory data at all protocol specified time points. Analyses were primarily descriptive and included mean changes and categorical outcomes. In all treatment groups, participants who did not experience a 20 mg/dL or greater increase in triglycerides at early time points were unlikely to experience a change of 50 mg/dL or more in triglycerides after 6 months. Negative predictive values were 83% to 95%. However, early change in triglycerides was not useful for predicting later change in glucose, cholesterol, or weight. Similarly, early weight change gave robust negative predictive values for longer-term weight change (≥10 kg), but not for change in glucose or cholesterol. Lack of early elevation in triglyceride concentrations was predictive of later lack of substantial increase in triglycerides in olanzapine-, ziprasidone-, and aripiprazole-treated participants. Lack of early elevation in weight was predictive of later lack of substantial increase in weight in all 3 treatment groups. Early monitoring of triglyceride concentrations and weight may help clinicians assess risk that individuals will experience significant increase in triglycerides or weight gain, allowing assessments of potential risks and benefits earlier in treatment. Clinical monitoring is advised throughout treatment for all patients.

  4. Daily Light Exposure Patterns Reveal Phase and Period of the Human Circadian Clock

    PubMed Central

    Woelders, Tom; Beersma, Domien G. M.; Gordijn, Marijke C. M.; Hut, Roelof A.; Wams, Emma J.

    2017-01-01

    Light is the most potent time cue that synchronizes (entrains) the circadian pacemaker to the 24-h solar cycle. This entrainment process is an interplay between an individual’s daily light perception and intrinsic pacemaker period under free-running conditions. Establishing individual estimates of circadian phase and period can be time-consuming. We show that circadian phase can be accurately predicted (SD = 1.1 h for dim light melatonin onset, DLMO) using 9 days of ambulatory light and activity data as an input to Kronauer’s limit-cycle model for the human circadian system. This approach also yields an estimated circadian period of 24.2 h (SD = 0.2 h), with longer periods resulting in later DLMOs. A larger amount of daylight exposure resulted in an earlier DLMO. Individuals with a long circadian period also showed shorter intervals between DLMO and sleep timing. When a field-based estimation of tau can be validated under laboratory studies in a wide variety of individuals, the proposed methods may prove to be essential tools for individualized chronotherapy and light treatment for shift work and jetlag applications. These methods may improve our understanding of fundamental properties of human circadian rhythms under daily living conditions. PMID:28452285

  5. Patients’ priorities for treatment decision making during periods of incapacity: quantitative survey

    PubMed Central

    RID, ANNETTE; WESLEY, ROBERT; PAVLICK, MARK; MAYNARD, SHARON; ROTH, KATALIN; WENDLER, DAVID

    2017-01-01

    Objective Clinical practice aims to respect patient autonomy by basing treatment decisions for incapacitated patients on their own preferences. Yet many patients do not complete an advance directive, and those who do frequently just designate a family member to make decisions for them. This finding raises the concern that clinical practice may be based on a mistaken understanding of patient priorities. The present study aimed to collect systematic data on how patients prioritize the goals of treatment decision making. Method We employed a self-administered, quantitative survey of patients in a tertiary care center. Results Some 80% or more of the 1169 respondents (response rate = 59.8%) ranked six of eight listed goals for treatment decision making as important. When asked which goal was most important, 38.8% identified obtaining desired or avoiding unwanted treatments, 20.0% identified minimizing stress or financial burden on their family, and 14.6% identified having their family help to make treatment decisions. No single goal was designated as most important by 25.0% of participants. Significance of Results Patients endorsed three primary goals with respect to decision making during periods of incapacity: being treated consistent with their own preferences; minimizing the burden on their family; and involving their family in the decision-making process. However, no single goal was prioritized by a clear majority of patients. These findings suggest that advance care planning should not be limited to documenting patients’ treatment preferences. Clinicians should also discuss and document patients’ priorities for how decisions are to be made. Moreover, future research should evaluate ways to modify current practice to promote all three of patients primary goals for treatment decision making. PMID:25273677

  6. Patients' priorities for treatment decision making during periods of incapacity: quantitative survey.

    PubMed

    Rid, Annette; Wesley, Robert; Pavlick, Mark; Maynard, Sharon; Roth, Katalin; Wendler, David

    2015-10-01

    Clinical practice aims to respect patient autonomy by basing treatment decisions for incapacitated patients on their own preferences. Yet many patients do not complete an advance directive, and those who do frequently just designate a family member to make decisions for them. This finding raises the concern that clinical practice may be based on a mistaken understanding of patient priorities. The present study aimed to collect systematic data on how patients prioritize the goals of treatment decision making. We employed a self-administered, quantitative survey of patients in a tertiary care center. Some 80% or more of the 1169 respondents (response rate = 59.8%) ranked six of eight listed goals for treatment decision making as important. When asked which goal was most important, 38.8% identified obtaining desired or avoiding unwanted treatments, 20.0% identified minimizing stress or financial burden on their family, and 14.6% identified having their family help to make treatment decisions. No single goal was designated as most important by 25.0% of participants. Patients endorsed three primary goals with respect to decision making during periods of incapacity: being treated consistent with their own preferences; minimizing the burden on their family; and involving their family in the decision-making process. However, no single goal was prioritized by a clear majority of patients. These findings suggest that advance care planning should not be limited to documenting patients' treatment preferences. Clinicians should also discuss and document patients' priorities for how decisions are to be made. Moreover, future research should evaluate ways to modify current practice to promote all three of patients primary goals for treatment decision making.

  7. The effect of stimulant and sedative use on treatment outcome of patients admitted to methadone maintenance treatment.

    PubMed

    DeMaria, P A; Sterling, R; Weinstein, S P

    2000-01-01

    While methadone maintenance treatment (MMT) has been demonstrated to be an effective treatment for opiate dependence, its impact on the treatment outcome of other illicit drug abuse is not as clear. Using the initial urine drug screen (UDS) and follow-up UDS at 1, 6, 12, and 24 months, 167 patients consecutively admitted to MMT were evaluated for opiate, sedative (predominantly benzodiazepine), and stimulant (predominantly cocaine) use. Retention for the opiate only group was 97.32 days longer on average than for patients using opiates along with stimulants, sedatives, or both stimulants and sedatives. Patients abusing opiates only had the greatest decrease in drug use; however, MMT was also associated with decreases in cocaine and sedative use over the 24 month follow-up period. There was no evidence that patients "switched" their drugs of abuse with time in treatment. The negative impact of non-opiate drug use on outcome in MMT and its implications for treatment planning are discussed.

  8. Mutations in the Circadian Gene period Alter Behavioral and Biochemical Responses to Ethanol in Drosophila

    PubMed Central

    Liao, Jennifer; Seggio, Joseph A.; Ahmad, S. Tariq

    2016-01-01

    Clock genes, such as period, which maintain an organism’s circadian rhythm, can have profound effects on metabolic activity, including ethanol metabolism. In turn, ethanol exposure has been shown in Drosophila and mammals to cause disruptions of the circadian rhythm. Previous studies from our labs have shown that larval ethanol exposure disrupted the free-running period and period expression of Drosophila. In addition, a recent study has shown that arrhythmic flies show no tolerance to ethanol exposure. As such, Drosophila period mutants, which have either a shorter than wild-type free-running period (perS) or a longer one (perL), may also exhibit altered responses to ethanol due to their intrinsic circadian differences. In this study, we tested the initial sensitivity and tolerance of ethanol exposure on Canton-S, perS, and perL, and then measured their Alcohol Dehydrogenase (ADH) and body ethanol levels. We showed that perL flies had slower sedation rate, longer recovery from ethanol sedation, and generated higher tolerance for sedation upon repeated ethanol exposure compared to Canton-S wild-type flies. Furthermore, perL flies had lower ADH activity and had a slower ethanol clearance compared to wild-type flies. The findings of this study suggest that period mutations influence ethanol induced behavior and ethanol metabolism in Drosophila and that flies with longer circadian periods are more sensitive to ethanol exposure. PMID:26802726

  9. Stroke Severity Affects Timing: Time From Stroke Code Activation to Initial Imaging is Longer in Patients With Milder Strokes.

    PubMed

    Kwei, Kimberly T; Liang, John; Wilson, Natalie; Tuhrim, Stanley; Dhamoon, Mandip

    2018-05-01

    Optimizing the time it takes to get a potential stroke patient to imaging is essential in a rapid stroke response. At our hospital, door-to-imaging time is comprised of 2 time periods: the time before a stroke is recognized, followed by the period after the stroke code is called during which the stroke team assesses and brings the patient to the computed tomography scanner. To control for delays due to triage, we isolated the time period after a potential stroke has been recognized, as few studies have examined the biases of stroke code responders. This "code-to-imaging time" (CIT) encompassed the time from stroke code activation to initial imaging, and we hypothesized that perception of stroke severity would affect how quickly stroke code responders act. In consecutively admitted ischemic stroke patients at The Mount Sinai Hospital emergency department, we tested associations between National Institutes of Health Stroke Scale scores (NIHSS), continuously and at different cutoffs, and CIT using spline regression, t tests for univariate analysis, and multivariable linear regression adjusting for age, sex, and race/ethnicity. In our study population, mean CIT was 26 minutes, and mean presentation NIHSS was 8. In univariate and multivariate analyses comparing CIT between mild and severe strokes, stroke scale scores <4 were associated with longer response times. Milder strokes are associated with a longer CIT with a threshold effect at a NIHSS of 4.

  10. Association between Severity of MERS-CoV Infection and Incubation Period.

    PubMed

    Virlogeux, Victor; Park, Minah; Wu, Joseph T; Cowling, Benjamin J

    2016-03-01

    We analyzed data for 170 patients in South Korea who had laboratory-confirmed infection with Middle East respiratory syndrome coronavirus. A longer incubation period was associated with a reduction in the risk for death (adjusted odds ratio/1-day increase in incubation period 0.83, 95% credibility interval 0.68-1.03).

  11. Marketing EPSDT to Clients: A Self-Instructional Module for Early Periodic Screening Diagnosis Treatment.

    ERIC Educational Resources Information Center

    Simon, John L.; McArdle, Patricia

    Early and Periodic Screening, Diagnosis and Treatment (EPSDT) is a program of preventive health services available to individuals under 21 years of age who are eligible for Medicaid benefits. As of July 1, 1973, all states operating a Medicaid program were required to provide EPSDT services to all those eligible. The purpose of this module is to…

  12. Treatment outcome of new smear positive pulmonary tuberculosis patients in Penang, Malaysia

    PubMed Central

    2014-01-01

    Background According to the World Health Organization’s recent report, in Malaysia, tuberculosis (TB) treatment success rate for new smear positive pulmonary tuberculosis (PTB) patients is still below the global success target of 85%. In this study, we evaluated TB treatment outcome among new smear positive PTB patients, and identified the predictors of unsuccessful treatment outcome and longer duration of treatment (i.e., > 6 months). Methods The population in this study consisted of all new smear positive PTB patients who were diagnosed at the chest clinic of Penang General Hospital between March 2010 and February 2011. During the study period, a standardized data collection form was used to obtain socio-demographic, clinical and treatment related data of the patients from their medical charts and TB notification forms (Tuberculosis Information System; TBIS). These data sources were reviewed at the time of the diagnosis of the patients and then at the subsequent follow-up visits until their final treatment outcomes were available. The treatment outcomes of the patients were reported in line with six outcome categories recommended by World Health Organization. Multiple logistic regression analysis was used to find the independent risk factors for unsuccessful treatment outcome and longer treatment duration. Data were analyzed using the PASW (Predictive Analysis SoftWare, version 19.0. Armonk, NY: IBM Corp). Results Among the 336 PTB patients (236 male and 100 female) notified during the study period, the treatment success rate was 67.26% (n = 226). Out of 110 patients in unsuccessful outcome category, 30 defaulted from the treatment, 59 died and 21 were transferred to other health care facilities. The mean duration of TB treatment was 8.19 (SD 1.65) months. In multiple logistic regression analysis, risk factors for unsuccessful treatment outcome were foreign nationality, male gender and being illiterate. Similarly, risk factors for mortality due to TB

  13. Whole-plant capacitance, embolism resistance and slow transpiration rates all contribute to longer desiccation times in woody angiosperms from arid and wet habitats

    USDA-ARS?s Scientific Manuscript database

    Low water potentials in xylem can result in damaging levels of cavitation, yet little is understood about which hydraulic traits have most influence in delaying the onset of hydraulic dysfunction during periods of drought. We examined three traits contributing to longer desiccation times in excised ...

  14. The effectiveness of alternative planned durations of residential drug abuse treatment.

    PubMed Central

    McCusker, J; Vickers-Lahti, M; Stoddard, A; Hindin, R; Bigelow, C; Zorn, M; Garfield, F; Frost, R; Love, C; Lewis, B

    1995-01-01

    Randomized controlled trials were conducted at two residential drug abuse treatment facilities to compare programs that differed in planned duration. One trial compared a 6-month and a 12-month therapeutic community program (n = 184), and the second compared a 3-month and a 6-month relapse prevention program (n = 444). Retention rates over comparable time periods differed minimally by planned treatment duration, and the longer programs had lower completion rates. There was no effect in either trial of planned treatment duration on changes in psychosocial variables between admission and exit or on rates or patterns of drug use at follow-up between 2 and 6 months after exit. PMID:7573630

  15. Specimen origin, type and testing laboratory are linked to longer turnaround times for HIV viral load testing in Malawi

    PubMed Central

    Chipungu, Geoffrey; Kim, Andrea A.; Sarr, Abdoulaye; Ali, Hammad; Mwenda, Reuben; Nkengasong, John N.; Singer, Daniel

    2017-01-01

    Background Efforts to reach UNAIDS’ treatment and viral suppression targets have increased demand for viral load (VL) testing and strained existing laboratory networks, affecting turnaround time. Longer VL turnaround times delay both initiation of formal adherence counseling and switches to second-line therapy for persons failing treatment and contribute to poorer health outcomes. Methods We utilized descriptive statistics and logistic regression to analyze VL testing data collected in Malawi between January 2013 and March 2016. The primary outcomes assessed were greater-than-median pretest phase turnaround time (days elapsed from specimen collection to receipt at the laboratory) and greater-than-median test phase turnaround time (days from receipt to testing). Results The median number of days between specimen collection and testing increased 3-fold between 2013 (8 days, interquartile range (IQR) = 6–16) and 2015 (24, IQR = 13–39) (p<0.001). Multivariable analysis indicated that the odds of longer pretest phase turnaround time were significantly higher for specimen collection districts without laboratories capable of conducting viral load tests (adjusted odds ratio (aOR) = 5.16; 95% confidence interval (CI) = 5.04–5.27) as well as for Malawi’s Northern and Southern regions. Longer test phase turnaround time was significantly associated with use of dried blood spots instead of plasma (aOR = 2.30; 95% CI = 2.23–2.37) and for certain testing months and testing laboratories. Conclusion Increased turnaround time for VL testing appeared to be driven in part by categorical factors specific to the phase of turnaround time assessed. Given the implications of longer turnaround time and the global effort to scale up VL testing, addressing these factors via increasing efficiencies, improving quality management systems and generally strengthening the VL spectrum should be considered essential components of controlling the HIV epidemic. PMID:28235013

  16. Large-brained frogs mature later and live longer.

    PubMed

    Yu, Xin; Zhong, Mao Jun; Li, Da Yong; Jin, Long; Liao, Wen Bo; Kotrschal, Alexander

    2018-05-01

    Brain sizes vary substantially across vertebrate taxa, yet, the evolution of brain size appears tightly linked to the evolution of life histories. For example, larger brained species generally live longer than smaller brained species. A larger brain requires more time to grow and develop at a cost of exceeded gestation period and delayed weaning age. The cost of slower development may be compensated by better homeostasis control and increased cognitive abilities, both of which should increase survival probabilities and hence life span. To date, this relationship between life span and brain size seems well established in homoeothermic animals, especially in mammals. Whether this pattern occurs also in other clades of vertebrates remains enigmatic. Here, we undertake the first comparative test of the relationship between life span and brain size in an ectothermic vertebrate group, the anuran amphibians. After controlling for the effects of shared ancestry and body size, we find a positive correlation between brain size, age at sexual maturation, and life span across 40 species of frogs. Moreover, we also find that the ventral brain regions, including the olfactory bulbs, are larger in long-lived species. Our results indicate that the relationship between life history and brain evolution follows a general pattern across vertebrate clades. © 2018 The Author(s). Evolution © 2018 The Society for the Study of Evolution.

  17. PERIODS OF VERTEBRAL COLUMN SENSITIVITY TO BORIC ACID TREATMENT IN CD-1 MICE IN UTERO

    EPA Science Inventory

    Periods of vertebral column sensitivity to boric acid treatment in CD-1 mice in utero.

    Cherrington JW, Chernoff N.

    Department of Toxicology, North Carolina State University, Raleigh, NC 27695, USA. jana_cherrington@hotmail.com

    Boric acid (BA) has many uses as...

  18. [Prevention and treatment of perioperative period complication of total ankle replacement].

    PubMed

    Liao, Xiang; Gao, Zhizeng; Huang, Shanhu; Yang, Shuhua

    2008-01-01

    To explore the cause of the perioprative period complication of scandinavian total ankle replacement (STAR) and to summarize the experience in the treatment and prevention. From March 1999 to November 2006, 35 patients were given total ankle replacement (TAR) with STAR system. There were 19 males and 16 females with an average age of 50.5 years (27 to 68 years), including 12 cases of posttraumatic arthritis, 8 cases of osteoarthritis and 15 cases of rheumatoid arthritis. All patients had pain of ankle joint, swelling and limitation of joint motion. The disease course was 9-64 months. The curative effect was estimated by Kofoed total ankle scoring system. The mean preoperative ankle score was 29 (6-48); the mean pain score was 18.3 (0-35); the mean function score was 11.7 (6-18); and the mean activity score was 9.2 (3-12). The type of all complications were record, and its cause, prevetion and treatment were analyszed. Thirty-three patients achieved healing by first intention, 2 achieved delayed union because of infection. Twenty-eight patients were followed up 3-80 months (mean 43.5 months). Medial malleolus fracture occurred in 2 cases, unstable ankle joint introversion in 2 cases, limitation of ankle dorsiextension in 1 case and 1 case had hypoesthesia at intermediate dorsal skin of foot and 3rd-5th metatarsal skin without obvious dysfunction; all were treated with symptomatic medication. The postoperative mean ankle score was 85.5 (58-95); the mean pain score was 48.3 (35-50); the mean function score was 20.7 (18-30); the mean activity score was 17.2 (16-20). There were statistically significant differences when compared with preoperative score (P<0.01). The clinical results were excellent in 16 patients, good in 9 patients and fair in 3 patients. The X-ray films showed no loosening and subsidence of prosthesis. Although STAR can retain the functions of the operated joint, it has its special complications. It is important to obey operation principle with

  19. Incubation period and immune function: A comparative field study among coexisting birds

    USGS Publications Warehouse

    Palacios, M.G.; Martin, T.E.

    2006-01-01

    Developmental periods are integral components of life history strategies that can have important fitness consequences and vary enormously among organisms. However, the selection pressures and mechanisms causing variation in length of developmental periods are poorly understood. Particularly puzzling are prolonged developmental periods, because their selective advantage is unclear. Here we tested the hypotheses that immune function is stronger in species that are attacked at a higher rate by parasites and that prolonged embryonic development allows the development of this stronger immune system. Through a comparative field study among 12 coexisting passerine bird species, we show that species with higher blood parasite prevalence mounted stronger cellular immune responses than species with lower prevalence. These results provide support for the hypothesis that species facing greater selection pressure from parasites invest more in immune function. However, species with longer incubation periods mounted weaker cellular immune responses than species with shorter periods. Therefore, cellular immune responses do not support the hypothesis that longer development time enhances immunocompentence. Future studies should assess other components of the immune system and test alternative causes of variation in incubation periods among bird species. ?? Springer-Verlag 2005.

  20. Adapting to warmer climate through prolonged maize grain filling period in the US Midwest

    NASA Astrophysics Data System (ADS)

    Zhu, P.; Zhuang, Q.; Jin, Z.

    2017-12-01

    Climate warming is expected to negatively impact the US food productivity. How to adapt to the future warmer environment and meet the rising food requirement becomes unprecedented urgent. Continuous satellite observational data provides an opportunity to examine the historic responses of crop plants to climate variation. Here 16 years crop growing phases information across US Midwest is generated based on satellite observations. We found a prolonged grain-filling period during 2000-2015, which could partly explain the increasing trend in Midwest maize yield. This longer grain-filling period might be resulted from the adoption of longer maturity group varieties or more resistant varieties to temperature variation. Other management practice changes like advance in planting date could be also an effective way of adapting future warmer climate through lowering the possibility of exposure to heat and drought stresses. If the progress in breeding technology enables the maize grain-filling period to prolong with the current rate, the maize grain filling length could be longer and maize yield in Midwest could adapt to future climate despite of the warming.

  1. Prospective Memory Deficits in Ecstasy Users: Effects of Longer Ongoing Task Delay Interval

    PubMed Central

    WEINBORN, MICHAEL; WOODS, STEVEN PAUL; NULSEN, CLAIRE; PARK, KATHERINE

    2011-01-01

    Ecstasy use has been associated with neurotoxicity and neurocognitive impairment in a variety of domains, including prospective memory (ProM), which involves the delayed execution of a previously encoded intention in response to a specific cue. The present study adopted the multiprocess theory of ProM to evaluate the hypothesis that ecstasy users would evidence differentially impaired ProM on longer versus shorter ongoing task delays. Ecstasy (n = 31) users, high-risk alcohol users (n = 21) and healthy nonusers (n = 31) completed the short (2-min) and long (15-min) delay ProM scales of the Memory for Intentions Screening Test. Results showed a significant group by ProM delay interaction, such that ecstasy users performed comparably to the comparison groups on short-delay trials, but were impaired on long-delay ProM, particularly for time-based cues. Among the ecstasy users, long-delay ProM was positively associated with risky decision-making, but not with retrospective memory or other aspects of executive functions. These findings suggest that ecstasy users may be particularly susceptible to deficits in strategic target monitoring and maintenance of cue-intention pairings over longer ProM delays. Findings are discussed in the context of their potential everyday functioning (e.g., academic, vocational) and treatment implications for ecstasy users. PMID:22047194

  2. Baby boomers in the United States: Factors associated with working longer and delaying retirement.

    PubMed

    Dong, Xiuwen Sue; Wang, Xuanwen; Ringen, Knut; Sokas, Rosemary

    2017-04-01

    This study estimated the self-reported probability of working full-time past age 62 (P62) or age 65 (P65) among four cohorts of Americans born between 1931 and 1959. Data from the Health and Retirement Study (HRS) were analyzed. Respondents in four age cohorts were selected for comparison. Multivariable linear regression models were used to assess cohort differences in P62 and P65 while adjusting for covariates. P62 and P65 increased among boomers despite worsened self-rated health compared to the two preceding cohorts, with 37% and 80% increases among mid-boomers in construction trades. Cohort differences in P62 and P65 remained after controlling for covariates. Changes in pensions, income inequity, and education were significantly associated with work expectations, but SSA policy was not. Baby boomers expect to work longer than their predecessors. Efforts to improve work quality and availability for older workers are urgently needed, particularly in physically demanding occupations. Am. J. Ind. Med. 60:315-328, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  3. Evaluation of pre-hospital transport time of stroke patients to thrombolytic treatment.

    PubMed

    Simonsen, Sofie Amalie; Andresen, Morten; Michelsen, Lene; Viereck, Søren; Lippert, Freddy K; Iversen, Helle Klingenberg

    2014-11-13

    Effective treatment of stroke is time dependent. Pre-hospital management is an important link in reducing the time from occurrence of stroke symptoms to effective treatment. The aim of this study was to evaluate time used by emergency medical services (EMS) for stroke patients during a five-year period in order to identify potential delays and evaluate the reorganization of EMS in Copenhagen in 2009. We performed a retrospective analysis of ambulance records from stroke patients suitable for thrombolysis from 1 January 2006 to 7 July 2011. We noted response time from dispatch of the ambulance to arrival at the scene, on-scene time and transport time to the hospital-in total, alarm-to-door time. In addition, we noted baseline characteristics. We reviewed 481 records (58% male, median age 66 years). The median (IQR) alarm-to-door time in minutes was 41 (33-52), of which 18 (12-24) minutes were spent on scene. Response time was reduced from the period before to the period after reorganization (7 vs. 5 minutes, p <0.001). In a linear multiple regression model, higher patient age and longer distance to the hospital correlated with significantly longer transportation time (p <0.001). This study shows an unchanged alarm-to-door time of 41 minutes over a five-year period. Response time, but not total alarm-to-door time, was reduced during the five years. On-scene time constituted nearly half of the total alarm-to-door time and is thus a point of focus for improvement.

  4. Tuberculosis (TB): Treatment

    MedlinePlus

    ... Education & Training Home Conditions Tuberculosis (TB) Tuberculosis: Treatment Tuberculosis: Treatment Make an Appointment Refer a Patient Ask ... or bones is treated longer. NEXT: Preventive Treatment Tuberculosis: Diagnosis Tuberculosis: History Clinical Trials For more than ...

  5. Long-term treatment with carprofen of 805 dogs with osteoarthritis.

    PubMed

    Mansa, S; Palmér, E; Grøndahl, C; Lønaas, L; Nyman, G

    2007-03-31

    The pain-relieving effect of carprofen and tolerance to the drug were investigated in 805 dogs that were lame as a result of osteoarthritis. The dogs were of different breeds, ages and bodyweights and of both sexes, and were selected from 51 veterinary clinics. Each dog was treated orally by its owner with 4 mg/kg carprofen for 84 consecutive days. Twenty-four dogs were removed from the study because of side effects, and 55 left the study for reasons unrelated to the treatment. The condition of the dogs and the benefit of the treatment were evaluated by the veterinary surgeons and the owners after 14 days, and at the end of the period of treatment, when 194 of the dogs (26.7 per cent) were no longer lame, and 357 (49.2 per cent) had improved. The period for which the dogs had been lame before entering the study significantly (P<0.01) affected the results and the rate of improvement. Too much exercise during the 84 days of treatment caused some dogs to relapse.

  6. Hypericin-mediated photocytotoxic effect on HT-29 adenocarcinoma cells is reduced by light fractionation with longer dark pause between two unequal light doses.

    PubMed

    Sacková, Veronika; Kuliková, Lucia; Mikes, Jaromír; Kleban, Ján; Fedorocko, Peter

    2005-01-01

    The present study demonstrates the in vitro effect of hypericin-mediated PDT with fractionated light delivery. Cells were photosensitized with unequal light fractions separated by dark intervals (1 or 6 h). We compared the changes in viability, cell number, survival, apoptosis and cell cycle on HT-29 cells irradiated with a single light dose (12 J/cm(2)) to the fractionated light delivery (1 + 11 J/cm(2)) 24 and 48 h after photodynamic treatment. We found that a fractionated light regime with a longer dark period resulted in a decrease of hypericin cytotoxicity. Both cell number and survival were higher after light sensitization with a 6-h dark interval. DNA fragmentation occurred after a single light-dose application, but in contrast no apoptotic DNA formation was detected with a 6-h dark pause. After fractionation the percentage of cells in the G1 phase of the cell cycle was increased, while the proportion of cells in the G2 phase decreased as compared to a single light-dose application, i.e. both percentage of cells in the G1 and G2 phase of the cell cycle were near control levels. We presume that the longer dark interval after the irradiation of cells by first light dose makes them resistant to the effect of the second illumination. These findings confirm that the light application scheme together with other photodynamic protocol components is crucial for the photocytotoxicity of hypericin.

  7. Probable longer incubation period for human infection with avian influenza A(H7N9) virus in Jiangsu Province, China, 2013.

    PubMed

    Huang, Y; Xu, K; Ren, D F; Ai, J; Ji, H; Ge, A H; Bao, C J; Shi, G Q; Shen, T; Tang, F Y; Zhu, Y F; Zhou, M H; Wang, H

    2014-12-01

    Human infection with the emerging avian influenza A(H7N9) virus in China in 2013 has raised global concerns. We conducted a retrospective descriptive study of 27 confirmed human influenza A(H7N9) cases in Jiangsu Province, to elaborate poultry-related exposures and to provide a more precise estimate of the incubation periods of the illness. The median incubation period was 6 days (range 2-10 days) in cases with single known exposure and was 7·5 days (range 6·5-12·5 days) in cases with exposures on multiple days, difference between the two groups was not significant (Z = -1·895, P = 0·058). The overall median incubation period for all patients was estimated to be 7·5 days (range 2-12·5 days). Our findings further highlight the necessity for public health authorities to extend the period of medical surveillance from 7 days to 10 days.

  8. Self-reported adherence to medical treatment, breastfeeding behaviour, and disease activity during the postpartum period in women with Crohn's disease.

    PubMed

    Julsgaard, Mette; Nørgaard, Mette; Hvas, Christian Lodberg; Grosen, Anne; Hasseriis, Sara; Christensen, Lisbet Ambrosius

    2014-08-01

    Adherence to medical treatment among women with Crohn's disease (CD) in the postpartum period has never been examined. The impact of breast-feeding on disease activity remains controversial. We aimed to assess rates of non-adherence to medical treatment among women with CD in the postpartum period. Further, to assess breast-feeding rates and the impact of breast-feeding on the risk of relapse. Within a population of 1.6 million, we identified 154 women with CD who had given birth within a 6-year period. We combined questionnaire data, data from medical records and public register data. We used logistic regression to estimate prevalence odds ratios (POR) for non-adherence, relapse and breast-feeding according to different predictors. Among 105 (80%) respondents, 59 (56%) reported taking medication. Of these, 66.1% reported to be adherent to medical treatment. Fear of medication transmission to the breast milk was stated as the reason for non-adherence in 60%. Those who received counselling regarding medical treatment were less likely to be non-adherent (POR 0.55, 95% confidence interval [CI] 0.1-2.5). In total, 87.6% were breast-feeding. Breast-feeding rates did not vary by medical treatment. Predictors for relapse in CD were smoking (POR 1.85, 95% CI 0.62-5.54) and non-adherence among medical treated (POR 1.25, 95% CI 0.26-6.00). Breast-feeding seemed protective against relapse (POR 0.33, 95% CI 0.10-1.26). Adherence to medical treatment in the postpartum period was high, and counselling seemed to increase adherence. Relapse may be explained by non-adherence or smoking while breast-feeding seemed protective.

  9. Choice of recall period for patient-reported outcome (PRO) measures: criteria for consideration.

    PubMed

    Norquist, Josephine M; Girman, Cynthia; Fehnel, Sheri; DeMuro-Mercon, Carla; Santanello, Nancy

    2012-08-01

    Understand the choice of recall period for PRO measures based on intended use, characteristics of the disease, treatment, and attributes of studies. Current practice and considerations were reviewed within several disease areas (overactive bladder, menopausal hot flashes, niacin-induced flushing, osteoarthritis pain, irritable bowel symptoms, benign prostatic hyperplasia, and alopecia). Rationales were identified for using different recall periods, including event-driven (immediate), daily, up to weekly, and longer than weekly. This work demonstrates that (1) recall depends on what the PRO measure captures, its intended use, and attributes of the disease and study; (2) within the same disease area, recall can vary depending on the concept or phenomenon of interest; (3) recall must consider patient burden and their ability to easily and accurately recall the information requested; and (4) recall must be consistent with the duration of the trial and the scheduled clinic visits. Shorter recall periods may underestimate symptom burden when symptoms have diurnal or day-to-day fluctuation and may place undue burden on patients. On the other hand, recall intervals that are too long may either over- or underestimate the health state. Therefore, appropriate criteria should be considered given attributes of the disease when selecting an adequate recall period.

  10. The Longer School Day and Five Term Year in CTCs: Some Initial Observations.

    ERIC Educational Resources Information Center

    Hagedorn, Julia

    To satisfy the requirements of the British national curriculum and to provide greater emphasis on the teaching of mathematics, science, and technology, city technical colleges (CTCs) have adopted a longer working week and, in several cases, a longer school year. This document examines outcomes of the longer school day and the five-term year, 4…

  11. Implications of longer term rest from grazing in the sagebrush steppe

    Treesearch

    K.W. Davies; M. Vavra; B. Schultz; N. Rimbey

    2014-01-01

    Longer term grazing rest has occurred or been proposed in large portions of the sagebrush steppe based on the assumption that it will improve ecosystem properties. However, information regarding the influence of longer term rest from grazing is limited and has not been summarized. We synthesized the scientific literature on long-term rest in the sagebrush steppe to...

  12. Treatment Satisfaction Among Patients Taking Antidepressant Medication.

    PubMed

    López-Torres Hidalgo, Jesús; López Gallardo, Yolanda; Párraga Martínez, Ignacio; Del Campo Del Campo, José María; Villena Ferrer, Alejandro; Morena Rayo, Susana

    2016-08-01

    This study sought to assess treatment satisfaction among patients on antidepressants, ascertaining whether there might be an association with depressive symptomatology and other variables. Cross-sectional study conducted on 564 adult patients taking antidepressant medication. Satisfaction with antidepressant treatment was assessed using the Assessment of Satisfaction with Antidepressant Treatment Questionnaire (ESTA/Evaluación de la Satisfacción con el Tratamiento Antidepresivo). A moderate negative correlation was observed between satisfaction and intensity of depressive symptoms, as assessed with the Montgomery-Asberg scale. A weak negative correlation was observed between greater satisfaction and less favourable views about taking medication. Satisfaction scale scores were higher among those who took antidepressant medication for 1 year or more versus shorter periods. Most patients reported being satisfied with the antidepressant treatment but the level of satisfaction was higher among those who presented with less marked depressive symptoms, received longer-term treatment and viewed drug treatments favourably. Treatment satisfaction is one of the patient-reported outcome measures that can serve to complement clinical evaluation of depressive disorders.

  13. Laser Treatment of Peri-Implantitis: A Literature Review

    PubMed Central

    Ashnagar, Sajjad; Nowzari, Hessam; Nokhbatolfoghahaei, Hanieh; Yaghoub Zadeh, Behnoush; Chiniforush, Nasim; Choukhachi Zadeh, Nastaran

    2014-01-01

    Peri-implantitis is a state defined as an inflammatory reaction around osseointegrated implants, leading to progressive loss of supporting bone. Various treatment methods are suggested in the treatment of peri-implantitis and clinicians have to choose a method over a large number of treatment protocols. Lasers have shown promising therapeutic effect in treatment of peri-implantitis. However, some controversies have been found in clinical outcomes after using lasers. Therefore, we aimed to review the current literature over the past ten years for the use of lasers in treatment of peri-implantitis, via the Pubmed electronic database of the US National Library of Medicine. Fifteen human studies were reviewed. Er:YAG (Erbium-Doped Yttrium Aluminum Garnet), CO2(Carbon Dioxide Laser) and Diode lasers were used. Despite inconsistencies and disharmonies among studies in terms of study design, positive treatment outcomes were obvious among the majority of them. However, short period of follow-ups and poor control of plaque index, as a critical confounding factor, were the major problems which these studies suffered from. It seems that one session laser therapy is not adequate for achieving optimal clinical outcome. Further studies with longer periods of follow-ups, intense control of plaque index, and various sessions of laser treatments are needed to clearly illustrate the clinical privilege of laser therapy. PMID:25653815

  14. Cats and owners interact more with each other after a longer duration of separation

    PubMed Central

    Eriksson, Matilda; Keeling, Linda J.

    2017-01-01

    Little is known about the cat’s (Felis silvestris catus) need for human contact, although it is generally believed that cats are more independent pets than e.g. dogs. In this study, we investigated the effect of time left alone at home on cat behaviour (e.g. social and distress-related) before, during and after separation from their owner. Fourteen privately owned cats (single-housed) were each subjected to two treatments: the cat was left alone in their home environment for 30 min (T0.5) and for 4 h (T4). There were no differences between treatments in the behaviour of the cat (or owner) before owner departure, nor during the first 5 min of separation. During separation, cats were lying down resting proportionally less (T = 22.5, P = 0.02) in T0.5 (0.27±0.1 (mean±SE)) compared to in T4 (0.58±0.08), probably due to a similar duration of higher activity early in the separation phase in both treatments. Comparisons of the time interval (min 20–25) in both treatments indicated no differences across treatments, which supports such an explanation. Towards the end of the separation phase (the last two 5-min intervals of separation in both treatments), no differences were observed in the cats’ behaviour, indicating that cats were unaffected by separation length. At reunion however, cats purred more (T = 10.5, P = 0.03) and stretched their body more (T = 17, P = 0.04) after a longer duration of separation (T4:0.05±0.02; 0.03±0.01; T0.5: 0.01±0.007; 0.008±0.003). Also, owners initiated more verbal contact (T = 33.5, P = 0.04) after 4 h (0.18±0.05) compared to after 30 min (0.12±0.03). There was no evidence of any correlations between the level of purring or body stretching by the cat and verbal contact by the owner implying that the behavioural expressions seen in the cats are independent of the owner’s behaviour. Hence, it seemed as cats coped well with being left alone, but they were affected by the time they were left alone, since they expressed

  15. Time to relapse following treatment for methamphetamine use: a long-term perspective on patterns and predictors.

    PubMed

    Brecht, Mary-Lynn; Herbeck, Diane

    2014-06-01

    This paper describes methamphetamine (MA) use patterns, specifically the duration of continuing abstinence ("time to relapse") for periods averaging 5 years post-discharge from treatment for MA use, and the relationship with selected user and treatment characteristics. A sample of 350 treatment admissions from a large county substance use disorder (SUD) treatment system was randomly selected (within gender, race/ethnicity, treatment modality strata). Retrospective self-report data are from natural history interviews (NHI) conducted approximately 3 years after treatment and a follow-up of 2-3 years later. Relapse is defined as any use of MA with time as the number of months of continuous MA abstinence after treatment discharge until relapse. This outcome was constructed from a monthly MA use timeline using NHI data. A Cox model was used to examine time to relapse and predictors. Sixty-one percent of the sample relapsed to MA use within 1 year after treatment discharge and 14% during years 2-5. Significant protective factors predicting longer time to relapse included having experienced serious MA-related psychiatric/behavioral problems (hazard ratio [HR]=0.75, p=0.027), longer duration of the index treatment episode (HR=0.93, p=0.001), and participating in self-help or other treatment during the post-treatment abstinence period (HR=0.29, p<0.001); risk factors for shorter time to relapse included having a parent with alcohol and/or drug use problems (HR=1.35, p=0.020) and involvement in MA sales (HR=1.48, p=0.002). Results contribute a long-term perspective on patterns of MA use following treatment and support a need for early post-treatment and long-term continuing care and relapse-prevention services. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. Duration of orthognathic-surgical treatment.

    PubMed

    Paunonen, Jaakko; Helminen, Mika; Peltomäki, Timo

    2017-07-01

    The objective of this study was to determine the duration of orthognathic-surgical treatment conducted with conventional pre- and post-surgical orthodontic treatment phases. The study material was comprised of the files of 185 consecutive patients treated in Oral and Maxillofacial Unit, Tampere University Hospital, Finland, in 2007-2014. The files were reviewed and the following data was obtained: gender and age of patients, ICD-10 diagnosis, type of malocclusion, duration of pre- and post-surgical orthodontic treatment and type of operation. Total treatment duration (median) from placement of separating rings for banding until fixed orthodontic appliances were removed and retention period started was 31.1 months, of which pre-surgical orthodontics took 24.4 months and postsurgical 6.4 months. Treatment duration (median) was in BSSO was 32.1, LeFort 1 30.1 and bimaxillary osteotomy 29.7 months. Orthodontic extractions were performed in 35 patients (19%). If the orthodontic treatment included tooth extraction, the duration of pre-surgical treatment was on average 10 months longer, which is a statistically highly significant difference (p < .001, linear regression). Tooth extractions (excluding 3rd molars) included in pre-surgical orthodontic treatment prolong treatment time by an average of 8-9 months.

  17. Long-period quasi-periodic oscillations of a small-scale magnetic structure on the Sun

    NASA Astrophysics Data System (ADS)

    Kolotkov, D. Y.; Smirnova, V. V.; Strekalova, P. V.; Riehokainen, A.; Nakariakov, V. M.

    2017-02-01

    Aims: Long-period quasi-periodic variations of the average magnetic field in a small-scale magnetic structure on the Sun are analysed. The structure is situated at the photospheric level and is involved in a facula formation in the chromosphere. Methods: The observational signal obtained from the SDO/HMI line-of-sight magnetograms of the target structure has a non-stationary behaviour, and is therefore processed with the Hilbert-Huang Transform spectral technique. Results: The empirical decomposition of the original signal and subsequent testing of the statistical significance of its intrinsic modes reveal the presence of the white and pink noisy components for the periods shorter and longer than 10 min, respectively, and a significant oscillatory mode. The oscillation is found to have a non-stationary period growing from approximately 80 to 230 min and an increasing relative amplitude, while the mean magnetic field in the oscillating structure is seen to decrease. The observed behaviour could be interpreted either by the dynamical interaction of the structure with the boundaries of supergranula cells in the region of interest or in terms of the vortex shedding appearing during the magnetic flux emergence.

  18. Chronic rapamycin treatment causes diabetes in male mice

    PubMed Central

    Schindler, Christine E.; Partap, Uttara; Patchen, Bonnie K.

    2014-01-01

    Current evidence indicates that the mammalian target of rapamycin inhibitor rapamycin both increases longevity and, seemingly contradictorily, impairs glucose homeostasis. Most studies exploring the dimensions of this paradox have been based on rapamycin treatment in mice for up to 20 wk. We sought to better understand the metabolic effects of oral rapamycin over a substantially longer period of time in HET3 mice. We observed that treatment with rapamycin for 52 wk induced diabetes in male mice, characterized by hyperglycemia, significant urine glucose levels, and severe glucose and pyruvate intolerance. Glucose intolerance occurred in male mice by 4 wk on rapamycin and could be only partially reversed with cessation of rapamycin treatment. Female mice developed moderate glucose intolerance over 1 yr of rapamycin treatment, but not diabetes. The role of sex hormones in the differential development of diabetic symptoms in male and female mice was further explored. HET3 mice treated with rapamycin for 52 wk were gonadectomized and monitored over 10 wk. Castrated male mice remained glucose intolerant, while ovariectomized females developed significant glucose intolerance over the same time period. Subsequent replacement of 17β-estradiol (E2) in ovariectomized females promoted a recovery of glucose tolerance over a 4-wk period, suggesting the protective role of E2 against rapamycin-induced diabetes. These results indicate that 1) oral rapamycin treatment causes diabetes in male mice, 2) the diabetes is partially reversible with cessation of treatment, and 3) E2 plays a protective role against the development of rapamycin-induced diabetes. PMID:24965794

  19. Evaluating the longer-term cognitive effects of adjunctive perampanel compared to lacosamide in a naturalistic outpatient setting.

    PubMed

    Meschede, Carolin; Witt, Juri-Alexander; Rademacher, Michael; von Wrede, Randi D; Elger, Christian E; Helmstaedter, Christoph

    2018-04-22

    This retrospective longitudinal study aims to compare the longer-term cognitive and behavioral side effects of adjunctive antiepileptic treatment with perampanel (PER) and lacosamide (LCM), two third generation antiepileptic drugs with suggested favorable cognitive profiles. The two drugs were monitored according to a previously established routine diagnostic protocol (Helmstaedter et al. E&B 2013;26:182-7) which facilitates the retrospective comparison of antiepileptic drug tolerability in a naturalistic outpatient setting. Records from 94 patients were evaluated who underwent neuropsychological assessment before and under adjunctive treatment with either PER (n = 57) or LCM (n = 37). Cognition was assessed using the EpiTrack screening for executive functions and a VLMT short form for verbal memory. Subjective assessments included a German QOLIE-10 adaptation (quality of life) and an extended Adverse Events Profile (AEP). The median follow-up interval was 36 weeks. Multivariate repeated measures statistics revealed a non-significant trend towards an interaction effect "time - treatment arm" on both executive function and memory. When analyzed separately executive functions and memory scores significantly improved under LCM (t = -2.76 p < 0.01 and t = -2.44 p < 0.05 respectively). Subjectively, PER was associated with improvements in 2/18 physiological domains and in the LCM group 1/9 cognitive domains deteriorated. Seizure freedom was achieved for five patients treated with LCM (14%) and 15 treated with PER (26%, χ 2  = 2.2, n.s.). In a naturalistic outpatient setting, chronic adjunctive treatment with PER and LCM did not negatively affect cognition and LCM may even improve cognition. Neither drug increased self-reported irritability or aggression. This suggests favorable longer-term tolerability. Copyright © 2018 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  20. Evaluation of different recall periods for the US National Cancer Institute's PRO-CTCAE.

    PubMed

    Mendoza, Tito R; Dueck, Amylou C; Bennett, Antonia V; Mitchell, Sandra A; Reeve, Bryce B; Atkinson, Thomas M; Li, Yuelin; Castro, Kathleen M; Denicoff, Andrea; Rogak, Lauren J; Piekarz, Richard L; Cleeland, Charles S; Sloan, Jeff A; Schrag, Deborah; Basch, Ethan

    2017-06-01

    The US National Cancer Institute recently developed the PRO-CTCAE (Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events). PRO-CTCAE is a library of questions for clinical trial participants to self-report symptomatic adverse events (e.g. nausea). The objective of this study is to inform evidence-based selection of a recall period when PRO-CTCAE is included in a trial. We evaluated differences between 1-, 2-, 3-, and 4-week recall periods, using daily reporting as the reference. English-speaking patients with cancer receiving chemotherapy and/or radiotherapy were enrolled at four US cancer centers and affiliated community clinics. Participants completed 27 PRO-CTCAE items electronically daily for 28 days, and then weekly over 4 weeks, using 1-, 2-, 3-, and 4-week recall periods. For each recall period, mean differences, effect sizes, and intraclass correlation coefficients were calculated to evaluate agreement between the maximum of daily ratings and the corresponding ratings obtained using longer recall periods (e.g. maximum of daily scores over 7 days vs 1-week recall). Analyses were repeated using the average of daily scores within each recall period rather than the maximum of daily scores. A total of 127 subjects completed questionnaires (57% male; median age: 57). The median of the 27 mean differences in scores on the PRO-CTCAE 5-point response scale comparing the maximum daily versus the longer recall period (and corresponding effect size) was -0.20 (-0.20) for 1-week recall, -0.36 (-0.31) for 2-week recall, -0.45 (-0.39) for 3-week recall, and -0.47 (-0.40) for 4-week recall. The median intraclass correlation across 27 items between the maximum of daily ratings and the corresponding longer recall ratings for 1-week recall was 0.70 (range: 0.54-0.82), for 2-week recall was 0.74 (range: 0.58-0.83), for 3-week recall was 0.72 (range: 0.61-0.84), and for 4-week recall was 0.72 (range: 0.64-0.86). Similar results were

  1. 40 CFR 60.2120 - What happens during periods of startup, shutdown, and malfunction?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 6 2010-07-01 2010-07-01 false What happens during periods of startup... 1, 2001 Emission Limitations and Operating Limits § 60.2120 What happens during periods of startup... during CISWI unit startups, shutdowns, or malfunctions. (b) Each malfunction must last no longer than 3...

  2. 40 CFR 60.2685 - What happens during periods of startup, shutdown, and malfunction?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 7 2012-07-01 2012-07-01 false What happens during periods of startup...-Emission Limitations and Operating Limits § 60.2685 What happens during periods of startup, shutdown, and... startups, shutdowns, or malfunctions. (b) Each malfunction must last no longer than 3 hours. Effective Date...

  3. 40 CFR 60.2120 - What happens during periods of startup, shutdown, and malfunction?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 6 2011-07-01 2011-07-01 false What happens during periods of startup... 1, 2001 Emission Limitations and Operating Limits § 60.2120 What happens during periods of startup... during CISWI unit startups, shutdowns, or malfunctions. (b) Each malfunction must last no longer than 3...

  4. 40 CFR 60.2120 - What happens during periods of startup, shutdown, and malfunction?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 7 2012-07-01 2012-07-01 false What happens during periods of startup... 1, 2001 Emission Limitations and Operating Limits § 60.2120 What happens during periods of startup... during CISWI unit startups, shutdowns, or malfunctions. (b) Each malfunction must last no longer than 3...

  5. Longer Nature-Based Rehabilitation May Contribute to a Faster Return to Work in Patients with Reactions to Severe Stress and/or Depression

    PubMed Central

    Grahn, Patrik; Pálsdóttir, Anna María; Ottosson, Johan; Jonsdottir, Ingibjörg H.

    2017-01-01

    The global burden of depression and stress-related mental disorders is substantial, and constitutes a major need for effective rehabilitation. Can nature-based rehabilitation help people return to work? Objective: To study if the length of a nature-based rehabilitation program affects the outcome with regard to return to work one year after the onset of the program, in a group of patients with long-term reactions to severe stress and/or depression. Methods: A prospective, quasi-experimental study comparing results from 8-, 12-, and 24-week periods of rehabilitation. The rehabilitation of 106 participants was carried out by a multimodal rehabilitation team in a specially designed rehabilitation garden. Return to work data were collected before the intervention and one year after the start of rehabilitation. In addition, data were collected regarding self-assessed occupational competence, personal control, and sense of coherence. As many as 68% of the participants returned to work or participated in job training or work-oriented measures, full- or part-time, after one year. Participants with a longer period of rehabilitation reported better results on occupational competence, and were more likely to participate in paid work, full-time or part-time, one year after rehabilitation. Study outcomes indicate that a longer rehabilitation period in a rehabilitation garden increases the possibility of a return to paid work. PMID:29076997

  6. Longer Nature-Based Rehabilitation May Contribute to a Faster Return to Work in Patients with Reactions to Severe Stress and/or Depression.

    PubMed

    Grahn, Patrik; Pálsdóttir, Anna María; Ottosson, Johan; Jonsdottir, Ingibjörg H

    2017-10-27

    The global burden of depression and stress-related mental disorders is substantial, and constitutes a major need for effective rehabilitation. Can nature-based rehabilitation help people return to work? To study if the length of a nature-based rehabilitation program affects the outcome with regard to return to work one year after the onset of the program, in a group of patients with long-term reactions to severe stress and/or depression. A prospective, quasi-experimental study comparing results from 8-, 12-, and 24-week periods of rehabilitation. The rehabilitation of 106 participants was carried out by a multimodal rehabilitation team in a specially designed rehabilitation garden. Return to work data were collected before the intervention and one year after the start of rehabilitation. In addition, data were collected regarding self-assessed occupational competence, personal control, and sense of coherence. As many as 68% of the participants returned to work or participated in job training or work-oriented measures, full- or part-time, after one year. Participants with a longer period of rehabilitation reported better results on occupational competence, and were more likely to participate in paid work, full-time or part-time, one year after rehabilitation. Study outcomes indicate that a longer rehabilitation period in a rehabilitation garden increases the possibility of a return to paid work.

  7. Lack of lasting effectiveness of PEG 3350 laxative treatment of constipation.

    PubMed

    Tran, Lily C; Di Palma, Jack A

    2005-08-01

    PEG 3350 (MiraLax, Braintree Laboratories Inc., Braintree, MA) 17 g daily has been shown to be safe and effective in a 14-day trial for constipation. This present investigation was designed to extend the treatment and safety experience with PEG 3350 and to evaluate any lasting effectiveness during a 30-day post-treatment observation period. Study subjects met Rome II criteria for constipation and reported <3 bowel movements a week. They were treated with PEG 3350 17 g daily for 14 days. Treatment efficacy was defined by resolution of constipation symptoms as determined by the Rome II and stool frequency definitions during the treatment period. Fifty healthy constipated subjects formed the study group. There were 42 females and 8 males. Mean age was 52 +/- 15.5 years (+/-SD). Symptom duration was 22.6 +/- 16.7 months (+/-SD). At baseline, all had <3 bowel movements a week and met Rome II criteria. Two were lost to follow-up. Two took enemas or laxatives and 2 discontinued active treatment because of "gas" and were considered treatment failures. At the end of 14 days, 40 of 48 (83.3%) had >3 stools in the last week and no longer met Rome criteria. Thirty-two of 45 (71.1%) reported satisfaction with the first bowel movement after initiating treatment. Thirty days after active treatment, 29 of 47 (61.7%) responded that they needed laxative treatment. PEG 3350 relieved constipation in most treated study subjects. During a 30-day post-treatment observation period, 29 of 47 (61.7%) had additional constipation treatment interventions.

  8. Assessment of the treatment costs of extracorporeal shock wave therapy versus surgical treatment for shoulder diseases.

    PubMed

    Haake, M; Rautmann, M; Wirth, T

    2001-01-01

    To determine the actual costs of extracorporeal shock wave therapy (ESWT) in patients with tendinitis of the supraspinatus muscle. A comparison of the costs of surgical treatment versus the costs for ESWT was made. The total accrued costs were determined 12 weeks after intervention, using a sample group of 60 patients with calcifying or noncalcifying tendinitis of the supraspinatus muscle. The costs per case ranged from EUR 2,700 to EUR 4,300 per patient for ESWT and from EUR 13,400 to EUR 23,450 for surgical treatment, dependent on the method of calculation. Approximately 65% of the per-patient cost is attributable to productivity losses in the workplace. In comparable short-term results, costs for operative treatment are 5-7 times higher than for ESWT. The greater trauma caused by an operative procedure leads to patients being off work for a longer period and thus a correspondingly higher social economic burden.

  9. Qatar-2: A K Dwarf Orbited by a Transiting Hot Jupiter and a Longer-Period Massive Planet

    NASA Astrophysics Data System (ADS)

    Bryan, Marta; Alsubai, K. A.; Latham, D. W.; Quinn, S. N.; Collier Cameron, A.; Carter, J. A.; Buchave, L. A.

    2012-01-01

    We report the discovery and initial characterization of Qatar-2b, a hot Jupiter transiting a K dwarf in a circular orbit with a short period, Pb = 1.34 days. Differential photometry and model fitting of transit data from both KeplerCam and LCOGT yielded light curve parameters Rp/Rs, a/Rs, u1, u2, and i that were optimized using the Markov Chain Monte Carlo technique. Radial velocity measurements from the Tillinghast Reflector Echelle Spectrograph of Qatar-2 over a span of 153 days provided a mass estimate for Qatar-2b, with velocity residuals from the orbital solution that pointed to the presence of a third body in the system. The light curve parameter a/Rs and spectroscopic values for effective temperature and metallicity were used in conjunction with stellar models to estimate the mass and radius of Qatar-2, leading to a mass and radius for Qatar-2b of MP = 2.54 MJ and RP = 1.14 RJ, respectively. Next we used the Systemic Console to explore possible orbital solutions for the outer companion, Qatar-2c. Plausible solutions have periods slightly less than a year and a mass of several MJ. However, further observations are needed to determine a reliable orbit for Qatar-2c. Qatar-2 is only the fourth example in the short but growing list of systems with a transiting hot Jupiter and an outer companion. This system architecture is in sharp contrast to that found by Kepler for multi-transiting systems, which are dominated by objects smaller than Neptune, usually with tightly spaced orbits that must be nearly coplanar.

  10. Problem severity and motivation for treatment in incarcerated substance abusers.

    PubMed

    Hiller, Matthew L; Narevic, Egle; Webster, J Matthew; Rosen, Paul; Staton, Michele; Leukefeld, Carl; Garrity, Thomas F; Kayo, Rebecca

    2009-01-01

    Studies of community-based treatment programs for substance users document that motivation for treatment is a consistent predictor of clients remaining under treatment for a longer period of time. Recent research has replicated this in prison-based treatment programs, implying that motivation is clinically important regardless of setting. The current study examines predictors of treatment motivation using data collected from 661 male drug-involved inmates during in-depth interviews that include components of the Addiction Severity Index, TCU Motivation Scale, and the Heath Services Research Instrument. Findings showed treatment motivation can be measured effectively in prison-based settings. Motivation scores were not significantly different between individuals in a prison-based treatment program and those in the general prison population. Furthermore, higher motivation for treatment scores were associated with greater levels of problem severity, suggesting that individuals with more drug-use related life problems may recognize this need and desire help for beginning long-term recovery.

  11. Cognitive changes in people with temporal lobe epilepsy over a 13-year period.

    PubMed

    Mameniškienė, Rūta; Rimšienė, Justė; Puronaitė, Roma

    2016-10-01

    The aims of our study were to evaluate cognitive decline in people with temporal lobe epilepsy over a period of 13years and to determine what clinical and treatment characteristics may have been associated with these. Thirty-three individuals with temporal lobe epilepsy underwent the same neuropsychological assessment of verbal and nonverbal memory, attention, and executive functions using the same cognitive test battery as one used 13years ago. Long-term verbal and nonverbal memory was tested four weeks later. Results were compared with those carried out 13years earlier. There was no significant change in verbal and verbal-logical memory tests; however, nonverbal memory worsened significantly. Long-term verbal memory declined for 21.9% of participants, long-term verbal-logical memory for 34.4%, and long-term nonverbal memory for 56.3%. Worsening of working verbal and verbal-logical memory was associated with longer epilepsy duration and lower levels of patients' education; worsening of verbal delayed recall and long-term verbal-logical memory was associated with higher seizure frequency. Decline in long-term nonverbal memory had significant association with a longer duration of epilepsy. The worsening of reaction and attention inversely correlated with the symptoms of depression. Over a 13-year period, cognitive functions did not change significantly. Good seizure control and reduced symptoms of depression in this sample of people with temporal lobe epilepsy were associated with better cognitive functioning. The predictors of change of cognitive functions could be complex and require further study. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Diagnosis and treatment of iron deficiency anemia during pregnancy and the postpartum period: Iron deficiency anemia working group consensus report

    PubMed Central

    Api, Olus; Breyman, Christian; Çetiner, Mustafa; Demir, Cansun; Ecder, Tevfik

    2015-01-01

    According to the World Health Organization (WHO), anemia is the most common disease, affecting >1.5 billion people worldwide. Furthermore, iron deficiency anemia (IDA) accounts for 50% of cases of anemia. IDA is common during pregnancy and the postpartum period, and can lead to serious maternal and fetal complications. The aim of this report was to present the experiences of a multidisciplinary expert group, and to establish reference guidelines for the optimal diagnosis and treatment of IDA during pregnancy and the postpartum period. Studies and guidelines on the diagnosis and treatment of IDA published in Turkish and international journals were reviewed. Conclusive recommendations were made by an expert panel aiming for a scientific consensus. Measurement of serum ferritin has the highest sensitivity and specificity for diagnosis of IDA unless there is a concurrent inflammatory condition. The lower threshold value for hemoglobin (Hb) in pregnant women is <11 g/dL during the 1st and 3rd trimesters, and <10.5 g/dL during the 2nd trimester. In postpartum period a Hb concentration <10 g/dL indicates clinically significant anemia. Oral iron therapy is given as the first-line treatment for IDA. Although current data are limited, intravenous (IV) iron therapy is an alternative therapeutic option in patients who do not respond to oral iron therapy, have adverse reactions, do not comply with oral iron treatment, have a very low Hb concentration, and require rapid iron repletion. IV iron preparations can be safely used for the treatment of IDA during pregnancy and the postpartum period, and are more beneficial than oral iron preparations in specific indications. PMID:28913064

  13. SU-E-J-17: Intra-Fractional Prostate Movement Correction During Treatment Delivery Period for Prostate Cancer Using the Intra-Fractional Orthogonal KV-MV Image Pairs

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

    Zhang, J; Azawi, S; Cho-Lim, J

    Purpose: To evaluate the intra-fractional prostate movement range during the beam delivery and implement new IGRT method to correct the prostate movement during the hypofractionated prostate treatment delivery. Methods: To evaluate the prostate internal motion range during the beam delivery, 11 conventional treatments were utilized. Two-arc RapidArc plans were used for the treatment delivery. Orthogonal KV imaging is performed in the middle of the treatment to correct intra-fractional prostate movement. However, it takes gantry-mounted on-board imaging system relative long time to finish the orthogonal KV imaging because of gantry rotation. To avoid gantry movement and accelerate the IGRT processing time,more » orthogonal KV-MV image pair is tested using the OBI daily QA Cube phantom. Results: The average prostate movement between two orthogonal KV image pairs was 0.38cm (0.20cm ∼ 0.85cm). And the interval time between them was 6.71 min (4.64min ∼ 9.22 min). 2-arc beam delivery time is within 3 minutes for conventional RapidArc treatment delivery. Hypofractionated treatment or SBRT need 4 partial arc and possible non-coplanar technology, which need much longer beam delivery time. Therefore prostate movement might be larger. New orthogonal KV-MV image pair is a new method to correct the prostate movement in the middle of the beam delivery if real time tracking method is not available. Orthogonal KV-MV image pair doesn’t need gantry rotation. Images were acquired quickly which minimized possible new prostate movement. Therefore orthogonal KV-MV image pair is feasible for IGRT. Conclusion: Hypofractionated prostate treatment with less PTV margin always needs longer beam delivery time. Therefore prostate movement correction during the treatment delivery is critical. Orthogonal KV-MV imaging pair is efficient and accurate to correct the prostate movement during treatment beam delivery. Due to limited fraction number and high dose per fraction, the MV imaging

  14. Chronic treatment with CP 55,940 during the peri-adolescent period differentially affects the behavioural responses of male and female rats in adulthood.

    PubMed

    Biscaia, Miguel; Marín, Susana; Fernández, Beatriz; Marco, Eva M; Rubio, Marina; Guaza, Carmen; Ambrosio, Emilio; Viveros, Maria Paz

    2003-11-01

    Despite the increasing use of cannabis among adolescents, there is scarce information about the long-term effects of cannabinoid receptor agonists in appropriate animal models. We aimed to investigate the behavioural features of adult male and female Wistar rats that had been exposed to a chronic treatment with the cannabinoid receptor agonist CP 55,940 (CP) during the juvenile period. CP (0.4 mg/kg i.p.) or its corresponding vehicle was administered once daily, from day 35 to day 45. In adulthood, the animals were tested in the holeboard, the open field and the elevated plus-maze, under different stress (illumination) conditions. After a resting period, the serum corticosterone levels (radioimmunoassay) of the animals were measured. The effects of CP on food intake and somatic growth were monitored throughout the experimental period. The CP treatment induced significant sex-dependent effects on holeboard activity, as well as a decrease in the level of emotionality/anxiety in the open field and in the plus-maze. The animals receiving CP also showed diminished food intake and body weights during the treatment period, but both parameters recovered normal values during the period after treatment. No significant effect of the CP treatment on corticosterone levels was found. The results demonstrate that chronic administration of CP during the peri-adolescent period resulted in marked behavioural effects in adulthood. The nature of these effects depended on the sex of the animals and on the specific behavioural test. The possible neurobiological substrates underlying the effects of CP are discussed.

  15. Empirical observations on longer-term use of incentives for weight loss.

    PubMed

    John, Leslie K; Loewenstein, George; Volpp, Kevin G

    2012-11-01

    Behavioral economic-based interventions are emerging as powerful tools to help individuals accomplish their own goals, including weight loss. Deposit contract incentive systems give participants the opportunity to put their money down toward losing weight, which they forfeit if they fail to lose weight; lottery incentive systems enable participants to win money if they attain weight loss goals. In this paper, we pool data from two prior studies to examine a variety of issues that unpublished data from those studies allow us to address. First, examining data from the deposit contract treatments in greater depth, we investigate factors affecting deposit frequency and size, and discuss possible ways of increasing deposits. Next, we compare the effectiveness of both deposit contract and lottery interventions as a function of participant demographic characteristics. These observations may help to guide the design of future, longer-term, behavioral economic-based interventions. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Effect of the first night shift period on sleep in young nurse students.

    PubMed

    Fietze, Ingo; Knoop, Karsten; Glos, Martin; Holzhausen, Martin; Peter, Jan Giso; Penzel, Thomas

    2009-12-01

    In young hospital nurses being exposed to a night shift work schedule for the first time in their occupational life, sleep quality is investigated quantitatively. A main sleep period and supplementary sleep periods were defined and analyzed to investigate sleep behavior and quality. A total of 30 young nurses (26 women, 4 men), mean age 20.2 +/- 2.1 years participated. A 3 week nursing school period was followed by a 3 week work period with a 3-5 night shift sub-period and recovery days. Sleep-wake behavior was assessed with an actigraph, sleep diaries, Epworth sleepiness scale (ESS), and quality of life was assessed with a standard questionnaire (SF-36). Comparing the school period with the work shift period when excluding recovery days after night shift period significant increase of total sleep time within 24 h was found during the work days (ANOVA P < 0.05). During the night shift sub-period, there was just a small decline of the main sleep period at day (n.s.) which was not compensated by supplementary sleep episodes. The supplementary sleep during work day varied between 11 min (school period) and 18 min after recovery days from night shift (n.s.). Young healthy nurses tolerate the first night shift exposure very well, according to objective and subjective parameters related to quality of sleep. An increased sleep need during work days lead to longer total sleep time, but do not lead to longer supplementary sleep episodes. Young nurses tolerate the first rotating shift period and the first night shift period very well.

  17. 20 CFR 220.20 - Notice that an annuitant is no longer disabled.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Notice that an annuitant is no longer disabled. 220.20 Section 220.20 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE... Employee's Regular Railroad Occupation § 220.20 Notice that an annuitant is no longer disabled. The...

  18. 20 CFR 220.20 - Notice that an annuitant is no longer disabled.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false Notice that an annuitant is no longer disabled. 220.20 Section 220.20 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE... Employee's Regular Railroad Occupation § 220.20 Notice that an annuitant is no longer disabled. The...

  19. 20 CFR 220.20 - Notice that an annuitant is no longer disabled.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false Notice that an annuitant is no longer disabled. 220.20 Section 220.20 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE... Employee's Regular Railroad Occupation § 220.20 Notice that an annuitant is no longer disabled. The...

  20. 20 CFR 220.20 - Notice that an annuitant is no longer disabled.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 1 2014-04-01 2012-04-01 true Notice that an annuitant is no longer disabled. 220.20 Section 220.20 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD... Regular Railroad Occupation § 220.20 Notice that an annuitant is no longer disabled. The regulation...

  1. 20 CFR 220.20 - Notice that an annuitant is no longer disabled.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true Notice that an annuitant is no longer disabled. 220.20 Section 220.20 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD... Regular Railroad Occupation § 220.20 Notice that an annuitant is no longer disabled. The regulation...

  2. Multiple period-doubling bifurcation route to chaos in periodically pulsed Murali-Lakshmanan-Chua circuit-controlling and synchronization of chaos.

    PubMed

    Parthasarathy, S; Manikandakumar, K

    2007-12-01

    We consider a simple nonautonomous dissipative nonlinear electronic circuit consisting of Chua's diode as the only nonlinear element, which exhibit a typical period doubling bifurcation route to chaotic oscillations. In this paper, we show that the effect of additional periodic pulses in this Murali-Lakshmanan-Chua (MLC) circuit results in novel multiple-period-doubling bifurcation behavior, prior to the onset of chaos, by using both numerical and some experimental simulations. In the chaotic regime, this circuit exhibits a rich variety of dynamical behavior including enlarged periodic windows, attractor crises, distinctly modified bifurcation structures, and so on. For certain types of periodic pulses, this circuit also admits transcritical bifurcations preceding the onset of multiple-period-doubling bifurcations. We have characterized our numerical simulation results by using Lyapunov exponents, correlation dimension, and power spectrum, which are found to be in good agreement with the experimental observations. Further controlling and synchronization of chaos in this periodically pulsed MLC circuit have been achieved by using suitable methods. We have also shown that the chaotic attractor becomes more complicated and their corresponding return maps are no longer simple for large n-periodic pulses. The above study also indicates that one can generate any desired n-period-doubling bifurcation behavior by applying n-periodic pulses to a chaotic system.

  3. Comparison of mortality in hyperthyroidism during periods of treatment with thionamides and after radioiodine.

    PubMed

    Boelaert, Kristien; Maisonneuve, Patrick; Torlinska, Barbara; Franklyn, Jayne A

    2013-05-01

    Hyperthyroidism is common, but opinions regarding optimal therapy with antithyroid drugs or radioiodine (131-I) differ. There are no randomized trials comparing these options in terms of mortality. The aim of the study was to determine whether mortality associated with hyperthyroidism varies with treatment administered or other factors. We conducted a prospective observational population-based study of 1036 subjects aged ≥ 40 years presenting to a single specialist clinic from 1989-2003 with a first episode of hyperthyroidism who were followed until June 2012. Antithyroid drugs or radioiodine (131-I) were administered. We compared causes of death with age-, sex-, and period-specific mortality in England and Wales and used within-cohort analysis of influence of treatment modality, outcome, disease etiology, severity and control, and comorbidities. In 12 868 person-years of follow-up, 334 died vs 290.6 expected (standardized mortality ratio [SMR], 1.15 [95% confidence interval (CI),1.03-1.28]; P = .01). Increased all-cause mortality largely reflected increased circulatory deaths (SMR, 1.20 [95% CI, 1.01-1.43]; P = .04). All-cause mortality was increased for the person-years accumulated during thionamide treatment (SMR, 1.30 [95% CI, 1.05-1.61]; P = .02) and after 131-I not associated with hypothyroidism (SMR, 1.24 [95% CI, 1.04-1.46]; P = .01) but not during T₄ replacement for 131-I-induced hypothyroidism (SMR, 0.98 [95% CI, 0.82-1.18]; P = .85). Within-cohort analysis comparing mortality during thionamide treatment showed a similar hazard ratio (HR) for all-cause mortality when 131-I did not result in hypothyroidism (HR, 0.95 [95% CI, 0.70-1.29]), but reduced mortality with 131-I-induced hypothyroidism (HR, 0.70 [95% CI, 0.51-0.96]). Reduced mortality associated with hypothyroidism was seen only in those without significant comorbidities and not in those with other serious diseases. Atrial fibrillation at presentation (P = .02) and an increment of 10 pmol/L in

  4. Monte Carlo Simulations Suggest Current Chlortetracycline Drug-Residue Based Withdrawal Periods Would Not Control Antimicrobial Resistance Dissemination from Feedlot to Slaughterhouse.

    PubMed

    Cazer, Casey L; Ducrot, Lucas; Volkova, Victoriya V; Gröhn, Yrjö T

    2017-01-01

    Antimicrobial use in beef cattle can increase antimicrobial resistance prevalence in their enteric bacteria, including potential pathogens such as Escherichia coli . These bacteria can contaminate animal products at slaughterhouses and cause food-borne illness, which can be difficult to treat if it is due to antimicrobial resistant bacteria. One potential intervention to reduce the dissemination of resistant bacteria from feedlot to consumer is to impose a withdrawal period after antimicrobial use, similar to the current withdrawal period designed to prevent drug residues in edible animal meat. We investigated tetracycline resistance in generic E. coli in the bovine large intestine during and after antimicrobial treatment by building a mathematical model of oral chlortetracycline pharmacokinetics-pharmacodynamics and E. coli population dynamics. We tracked three E. coli subpopulations (susceptible, intermediate, and resistant) during and after treatment with each of three United States chlortetracycline indications (liver abscess reduction, disease control, disease treatment). We compared the proportion of resistant E. coli before antimicrobial use to that at several time points after treatment and found a greater proportion of resistant enteric E. coli after the current withdrawal periods than prior to treatment. In order for the proportion of resistant E. coli in the median beef steer to return to the pre-treatment level, withdrawal periods of 15 days after liver abscess reduction dosing (70 mg daily), 31 days after disease control dosing (350 mg daily), and 36 days after disease treatment dosing (22 mg/kg bodyweight for 5 days) are required in this model. These antimicrobial resistance withdrawal periods would be substantially longer than the current U.S. withdrawals of 0-2 days or Canadian withdrawals of 5-10 days. One published field study found similar time periods necessary to reduce the proportion of resistant E. coli following chlortetracycline disease

  5. Monte Carlo Simulations Suggest Current Chlortetracycline Drug-Residue Based Withdrawal Periods Would Not Control Antimicrobial Resistance Dissemination from Feedlot to Slaughterhouse

    PubMed Central

    Cazer, Casey L.; Ducrot, Lucas; Volkova, Victoriya V.; Gröhn, Yrjö T.

    2017-01-01

    Antimicrobial use in beef cattle can increase antimicrobial resistance prevalence in their enteric bacteria, including potential pathogens such as Escherichia coli. These bacteria can contaminate animal products at slaughterhouses and cause food-borne illness, which can be difficult to treat if it is due to antimicrobial resistant bacteria. One potential intervention to reduce the dissemination of resistant bacteria from feedlot to consumer is to impose a withdrawal period after antimicrobial use, similar to the current withdrawal period designed to prevent drug residues in edible animal meat. We investigated tetracycline resistance in generic E. coli in the bovine large intestine during and after antimicrobial treatment by building a mathematical model of oral chlortetracycline pharmacokinetics-pharmacodynamics and E. coli population dynamics. We tracked three E. coli subpopulations (susceptible, intermediate, and resistant) during and after treatment with each of three United States chlortetracycline indications (liver abscess reduction, disease control, disease treatment). We compared the proportion of resistant E. coli before antimicrobial use to that at several time points after treatment and found a greater proportion of resistant enteric E. coli after the current withdrawal periods than prior to treatment. In order for the proportion of resistant E. coli in the median beef steer to return to the pre-treatment level, withdrawal periods of 15 days after liver abscess reduction dosing (70 mg daily), 31 days after disease control dosing (350 mg daily), and 36 days after disease treatment dosing (22 mg/kg bodyweight for 5 days) are required in this model. These antimicrobial resistance withdrawal periods would be substantially longer than the current U.S. withdrawals of 0–2 days or Canadian withdrawals of 5–10 days. One published field study found similar time periods necessary to reduce the proportion of resistant E. coli following chlortetracycline disease

  6. Spatial and temporal variations in landscape evolution: historic and longer-term sediment flux through global catchments

    USGS Publications Warehouse

    Covault, Jacob A.; Craddock, William H.; Romans, Brian W.; Fildani, Andrea; Gosai, Mayur

    2013-01-01

    Sediment generation and transport through terrestrial catchments influence soil distribution, geochemical cycling of particulate and dissolved loads, and the character of the stratigraphic record of Earth history. To assess the spatiotemporal variation in landscape evolution, we compare global compilations of stream gauge–derived () and cosmogenic radionuclide (CRN)–derived (predominantly 10Be; ) denudation of catchments (mm/yr) and sediment load of rivers (Mt/yr). Stream gauges measure suspended sediment loads of rivers during several to tens of years, whereas CRNs provide catchment-integrated denudation rates at 102–105-yr time scales. Stream gauge–derived and CRN-derived sediment loads in close proximity to one another (<500 km) exhibit broad similarity ( stream gauge samples; CRN samples). Nearly two-thirds of CRN-derived sediment loads exceed historic loads measured at the same locations (). Excessive longer-term sediment loads likely are a result of longer-term recurrence of large-magnitude sediment-transport events. Nearly 80% of sediment loads measured at approximately the same locations exhibit stream gauge loads that are within an order of magnitude of CRN loads, likely as a result of the buffering capacity of large flood plains. Catchments in which space for deposition exceeds sediment supply have greater buffering capacity. Superior locations in which to evaluate anthropogenic influences on landscape evolution might be buffered catchments, in which temporary storage of sediment in flood plains can provide stream gauge–based sediment loads and denudation rates that are applicable over longer periods than the durations of gauge measurements. The buffering capacity of catchments also has implications for interpreting the stratigraphic record; delayed sediment transfer might complicate the stratigraphic record of external forcings and catchment modification.

  7. Immediate and Longer-Term Stressors and the Mental Health of Hurricane Ike Survivors

    PubMed Central

    Lowe, Sarah R.; Tracy, Melissa; Cerdá, Magdalena; Norris, Fran H.; Galea, Sandro

    2014-01-01

    Previous research has documented that individuals exposed to more stressors during disasters and their immediate aftermath (immediate stressors) are at risk of experiencing longer-term postdisaster stressors. Longer-term stressors, in turn, have been found to play a key role in shaping postdisaster psychological functioning. Few studies have simultaneously explored the links from immediate to longer-term stressors, and from longer-term stressors to psychological functioning, however. Additionally, studies have inadequately explored whether postdisaster psychological symptoms influence longer-term stressors. In the current study, we aimed to fill these gaps. Participants (N = 448) were from population-based study of Hurricane Ike survivors and completed assessments 2–5 months (Wave 1), 5–9 months (Wave 2) and 14–18 months (Wave 3) postdisaster. Through path analysis, we found that immediate stressors, assessed at Wave 1, were positively associated with Wave 2 and Wave 3 stressors, which in turn were positively associated with Wave 2 and Wave 3 posttraumatic stress and depressive symptoms. Wave 2 posttraumatic stress symptoms were positively associated with Wave 3 stressors, and Wave 1 depressive symptoms were positively associated with Wave 2 stressors. The findings suggest that policies and interventions can reduce the impact of disasters on mental health by preventing and alleviating both immediate and longer-term postdisaster stressors. PMID:24343752

  8. Magnetospheric Truncation, Tidal Inspiral, and the Creation of Short-period and Ultra-short-period Planets

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

    Lee, Eve J.; Chiang, Eugene, E-mail: evelee@berkeley.edu

    Sub-Neptunes around FGKM dwarfs are evenly distributed in log orbital period down to ∼10 days, but dwindle in number at shorter periods. Both the break at ∼10 days and the slope of the occurrence rate down to ∼1 day can be attributed to the truncation of protoplanetary disks by their host star magnetospheres at corotation. We demonstrate this by deriving planet occurrence rate profiles from empirical distributions of pre-main-sequence stellar rotation periods. Observed profiles are better reproduced when planets are distributed randomly in disks—as might be expected if planets formed in situ—rather than piled up near disk edges, as wouldmore » be the case if they migrated in by disk torques. Planets can be brought from disk edges to ultra-short (<1 day) periods by asynchronous equilibrium tides raised on their stars. Tidal migration can account for how ultra-short-period planets are more widely spaced than their longer-period counterparts. Our picture provides a starting point for understanding why the sub-Neptune population drops at ∼10 days regardless of whether the host star is of type FGK or early M. We predict planet occurrence rates around A stars to also break at short periods, but at ∼1 day instead of ∼10 days because A stars rotate faster than stars with lower masses (this prediction presumes that the planetesimal building blocks of planets can drift inside the dust sublimation radius).« less

  9. Effects of different doses of nandrolone decanoate on estrous cycle and ovarian tissue of rats after treatment and recovery periods.

    PubMed

    Simão, Vinícius Augusto; Berloffa Belardin, Larissa; Araújo Leite, Gabriel Adan; de Almeida Chuffa, Luiz Gustavo; Camargo, Isabel Cristina Cherici

    2015-10-01

    This study tested the hypothesis that different doses of nandrolone decanoate (ND) will cause changes in the estrous cycle and ovarian tissue of adult rats; and investigated the duration of the recovery period that is sufficient to restore the damage in the animals treated with different doses. Wistar rats were treated with ND at doses of 1.87, 3.75, 7.5 and 15 mg/kg body weight, or received mineral oil (control group) for 15 days, subcutaneously. All animals were divided into three groups according to the treatment periods: (i) ND treatment for 15 days; (ii) ND treatment followed by a 30-day recovery; and (iii) ND treatment followed by a 60-day recovery. Estrous cycle was monitored daily, and at the end of each period, the animals were euthanized for histopathological analysis. During ND treatment and after 30-day recovery, all animals exhibited persistent diestrus. After a 60-day recovery, persistent diestrus was only maintained in the group that had received the highest dose. Ovarian weight was decreased significantly after the 30-day recovery, regardless of ND doses, compared with the control group. There was a reduction (P < 0.05) in the number of corpora lutea and antral and growing follicles, in contrast to an increase (P < 0.05) in atretic follicles in a dose- and time-dependent manner. Remarkable histopathological changes occurred in the ovaries of all ND-treated groups. In conclusion, the different doses of ND caused changes in the estrous cycle and ovarian tissue of rats, and recovery periods (30 and 60 days) were insufficient to completely restore the damage in the animals treated with the highest dose. © 2015 The Authors. International Journal of Experimental Pathology © 2015 International Journal of Experimental Pathology.

  10. The optimal period of Ca-EDTA treatment for parthenogenetic activation of porcine oocytes during maturation culture

    PubMed Central

    MORITA, Yasuhiro; TANIGUCHI, Masayasu; TANIHARA, Fuminori; ITO, Aya; NAMULA, Zhao; DO, Lanh Thi Kim; TAKAGI, Mitsuhiro; TAKEMOTO, Tatsuya; OTOI, Takeshige

    2016-01-01

    The changes triggered by sperm-induced activation of oocytes, which are required for normal oocyte development, can be mediated by other agents, thereby inducing the parthenogenesis. In this study, we exposed porcine oocytes to 1 mM Ca-EDTA, a metal-ion chelator, at various intervals during 48 hr of in vitro maturation to determine the optimum period of Ca-EDTA treatment for parthenogenetic activation. When the oocytes were cultured with or without Ca-EDTA from 36 hr (post-12), 24 hr (post-24), 12 hr (post-36) and 0 hr (post-48) after the start of maturation culture, the blastocyst formation rates were significantly higher (P<0.05) in the post-24, post-36 and post-48 groups (3.3%, 4.0% and 2.6%, respectively) than those in the control group without treatment (0%). Furthermore, when the oocytes were cultured with Ca-EDTA for 0 hr (control), 12 hr (pre-12), 24 hr (pre-24), 36 hr (pre-36) and 48 hr (pre-48) from the start of maturation culture, the oocytes formed blastocysts only in the pre-36 and pre-48 groups (0.4% or 0.8%, respectively). Pronuclei (<66.7%) were observed only when the periods of Ca-EDTA treatment were more than 12 hr during maturation culture. In the control group, no pronuclei were detected. Our findings demonstrate that porcine immature oocytes can be parthenogenetically activated by Ca-EDTA treatment for at least 24 hr to 36 hr during maturation culture, leading to pronucleus formation followed by the formation of blastocysts. PMID:26947170

  11. The optimal period of Ca-EDTA treatment for parthenogenetic activation of porcine oocytes during maturation culture.

    PubMed

    Morita, Yasuhiro; Taniguchi, Masayasu; Tanihara, Fuminori; Ito, Aya; Namula, Zhao; DO, Lanh Thi Kim; Takagi, Mitsuhiro; Takemoto, Tatsuya; Otoi, Takeshige

    2016-07-01

    The changes triggered by sperm-induced activation of oocytes, which are required for normal oocyte development, can be mediated by other agents, thereby inducing the parthenogenesis. In this study, we exposed porcine oocytes to 1 mM Ca-EDTA, a metal-ion chelator, at various intervals during 48 hr of in vitro maturation to determine the optimum period of Ca-EDTA treatment for parthenogenetic activation. When the oocytes were cultured with or without Ca-EDTA from 36 hr (post-12), 24 hr (post-24), 12 hr (post-36) and 0 hr (post-48) after the start of maturation culture, the blastocyst formation rates were significantly higher (P<0.05) in the post-24, post-36 and post-48 groups (3.3%, 4.0% and 2.6%, respectively) than those in the control group without treatment (0%). Furthermore, when the oocytes were cultured with Ca-EDTA for 0 hr (control), 12 hr (pre-12), 24 hr (pre-24), 36 hr (pre-36) and 48 hr (pre-48) from the start of maturation culture, the oocytes formed blastocysts only in the pre-36 and pre-48 groups (0.4% or 0.8%, respectively). Pronuclei (<66.7%) were observed only when the periods of Ca-EDTA treatment were more than 12 hr during maturation culture. In the control group, no pronuclei were detected. Our findings demonstrate that porcine immature oocytes can be parthenogenetically activated by Ca-EDTA treatment for at least 24 hr to 36 hr during maturation culture, leading to pronucleus formation followed by the formation of blastocysts.

  12. Efficacy of Erbium:YAG laser treatment compared to topical estriol treatment for symptoms of genitourinary syndrome of menopause

    PubMed Central

    Brandi, Hugo; Gomez, Valentin; Luque, Daniel

    2016-01-01

    Objectives The objective of this prospective comparative cohort study was to establish the effectiveness and safety of Erbium:YAG (Er:YAG) laser treatment for genitourinary syndrome of menopause and to compare it with an established topical estriol treatment. Methods Fifty patients with genitourinary syndrome of menopause were divided into two groups. The estriol group received a treatment of 0.5 mg estriol ovules for 8 weeks and the laser group was first treated for 2 weeks with 0.5 mg estriol ovules 3 times per week to hydrate the mucosa and then received three sessions with 2,940 nm Er:YAG laser in non‐ablative mode. Biopsies were taken before and at 1, 3, 6, and 12 months post‐treatment. Maturation index, maturation value and pH where recorded up to 12‐months post‐treatment, while the VAS analysis of symptoms was recorded up to 18 months post‐treatment. Results Statistically significant (P < 0.05), reduction of all assessed symptoms was observed in the laser group at all follow‐ups up to 18 months post‐treatment. Significant improvement in maturation value and a decrease of pH in the laser group was detected up to 12 months after treatment. The improvement in all endpoints was more pronounced and longer lasting in the laser group. Histological examination showed changes in the tropism of the vaginal mucosa and also angiogenesis, congestion, and restructuring of the lamina propria in the laser group. Side effects were minimal and of transient nature in both groups, affecting 4% of patients in the laser group and 12% of patients in the estriol group. Conclusions Our results show that Er:YAG laser treatment successfully relieves symptoms of genitourinary syndrome of menopause and that the results are more pronounced and longer lasting compared to topical estriol treatment. Lasers Surg. Med. 49:160–168, 2017. © 2016 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc. PMID:27546524

  13. Worsened MRI findings during the early period of treatment with penicillin in a patient with general paresis.

    PubMed

    Zhang, She-Qing; Wan, Bo; Ma, Xiao-Long; Zheng, Hui-Min

    2008-10-01

    A 52-year-old man was diagnosed with general paresis, whose HIV antibodies were negative. After initiation of treatment with penicillin on the first day, no obvious clinical Jarisch-Herxheimer reaction was found. However, 6 days after treatment, the patient was found more irritable and was unable to fall asleep at night. On the seventh day, worsened magnetic resonance imaging (MRI) abnormalities in the bilateral medial and anterior temporal lobes were unexpectedly discovered. These worsened MRI abnormalities improved quickly after the addition of dexamethasone treatment. We consider that these transient and slight mental symptoms may be associated with the transiently worsening phenomenon in cerebral MRI findings during the early period of treatment with penicillin. This indicates that some nonspecific inflammatory process has happened in the early stage of treatment, which necessitates the use of corticosteroids after the occurrence of systemic or mental symptoms.

  14. 27 CFR 11.34 - Products which may no longer be lawfully sold.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Products which may no longer be lawfully sold. 11.34 Section 11.34 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO... affiliate of the trade buyer has no control, a particular size or brand is no longer permitted to be sold...

  15. Sleep in lonely heroin-dependent patients receiving methadone maintenance treatment: longer sleep latency, shorter sleep duration, lower sleep efficiency, and poorer sleep quality.

    PubMed

    Li, Hong-Jie; Zhong, Bao-Liang; Xu, Yan-Min; Zhu, Jun-Hong; Lu, Jin

    2017-10-24

    Given the socially isolated status of Chinese heroin-dependent patients (HDPs) and the significant association between loneliness and sleep problem in the general population, the impact of loneliness on sleep of HDPs is potentially substantial. The study aimed to test whether loneliness is associated with poor sleep in terms of quantity and quality in a consecutive sample of Chinese HDPs receiving methadone maintenance treatment (MMT). The study participants were 603 HDPs of three MMT clinics in Wuhan, China. Data on socio-demographic and clinical characteristics were collected by a standardized self-administered questionnaire. Sleep outcomes included sleep latency, sleep duration, sleep efficiency, and sleep quality. We measured depressive symptoms, loneliness, and sleep quality by using Zung's Self-rating Depression Scale, the single-item self-report of loneliness, and the Pittsburgh Sleep Quality Index, respectively. Multiple linear regression was used to examine whether loneliness is independently associated with sleep measures. After controlling for the confounding effects of potential socio-demographic and clinical variables, loneliness was significantly associated with longer sleep latency, shorter sleep duration, lower sleep efficiency, and poorer sleep quality. Loneliness may exacerbate sleep disturbance in Chinese HDPs of MMT clinics. Psychosocial interventions aimed at reducing loneliness in MMT clinics would improve the sleep of HDPs.

  16. A Window into Longer Lasting Batteries

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

    None

    2016-11-29

    There’s a new tool in the push to engineer rechargeable batteries that last longer and charge more quickly. An X-ray microscopy technique recently developed at Berkeley Lab has given scientists the ability to image nanoscale changes inside lithium-ion battery particles as they charge and discharge. The real-time images provide a new way to learn how batteries work, and how to improve them. The method was developed at Berkeley Lab’s Advanced Light Source, a DOE Office of Science User Facility, by a team of researchers from the Department of Energy’s SLAC National Accelerator Laboratory, Berkeley Lab, Stanford University, and other institutions.

  17. Reinforcement-Based Treatment Improves the Maternal Treatment and Neonatal Outcomes of Pregnant Patients Enrolled in Comprehensive Care Treatment

    PubMed Central

    Jones, Hendrée E.; O’Grady, Kevin E.; Tuten, Michelle

    2011-01-01

    This randomized clinical trial examined the efficacy of comprehensive Usual Care (UC) alone (n=42) or enhanced by Reinforcement-Based Treatment (RBT) (n=47) to produce improved treatment outcomes, maternal delivery, and neonatal outcomes in pregnant women with opioid and/or cocaine substance use disorders. RBT participants spent, on average, 32.6 days longer in treatment (p<.001) and almost six times longer in recovery housing than did UC participants (p=.01). There were no significant differences between the RBT and UC conditions in proportion of participants testing positive for any illegal substance. Neonates in the RBT condition spent 1.3 fewer days hospitalized after birth than UC condition neonates (p=.03), although the two conditions did not differ significantly in neonatal gestational age at delivery, birth weight, or number of days hospitalized. Integrating RBT into a rich array of comprehensive care treatment components may be a promising approach to increase maternal treatment retention and reduce neonatal length of hospital stay. PMID:21477047

  18. Advances in the diagnosis and treatment of tumor necrosis factor receptor-associated periodic syndrome.

    PubMed

    Aguado-Gil, L; Irarrazaval-Armendáriz, I; Pretel-Irazabal, M

    2013-09-01

    Tumor necrosis factor receptor-associated periodic syndrome (TRAPS) is a rare autosomal dominant disease included in the group of autoinflammatory syndromes. It is characterized by recurrent episodes of fever and inflammation in different regions of the body. The main clinical manifestations are myalgia, migratory erythematous rash, periorbital edema, and abdominal pain. The diagnosis is reached using gene analysis and prognosis depends on the appearance of amyloidosis secondary to the recurrent episodes of inflammation. Tumor necrosis factor inhibitors and corticosteroids are the most widely used treatments. In recent years, significant advances have been made in the diagnosis and treatment of TRAPS, thanks to a better understanding of its pathogenesis. Dermatologists must be aware that the skin manifestations of TRAPS are particularly important, as they are often diagnostic. Copyright © 2012 Elsevier España, S.L. and AEDV. All rights reserved.

  19. Treatment priorities in oncology: do we want to live longer or better?

    PubMed Central

    Marta, Guilherme Nader; Del Nero, Luís G; Marta, Gustavo Nader; Mangabeira, Andrea; Critchi, Gabriela; Kovács, Maria J; da Silva, João Luis Fernandes; Saad, Everardo D

    2014-01-01

    OBJECTIVES: Despite the progress achieved in the fight against cancer over the past several years, assessing the needs, goals and preferences of patients with cancer is of the utmost importance for the delivery of health care. We sought to assess priorities regarding quantity versus quality of life among Brazilian patients, comparing them with individuals without cancer. METHODS: Using a questionnaire presenting four hypothetical cancer cases, we interviewed cancer patients, oncology health-care professionals and laypersons, most of whom had administrative functions in our hospital. RESULTS: A total of 214 individuals participated: 101 patients, 44 health-care professionals and 69 laypersons. The mean ages in the three groups were 56, 34 and 31 years old, respectively (p<0.001). The patients had gastrointestinal (25%), breast (22%), hematologic (10%), lung (8%) or other tumors (36%) and the tumor-node- metastasis (TNM) stage was I, II, III or IV in 22%, 13%, 34% and 31% of cases, respectively. Treatment priorities differed significantly among the three groups (p = 0.005), with survival time being a higher priority for patients than for the other two groups and with opposite trends regarding quality of life. In multivariate analysis, the age and sex distributions were not associated with the choice to maximize quality of life. In this limited sample of cancer patients, there were no associations between treatment priorities and disease stages. CONCLUSIONS: Both survival time and quality of life appeared to be important to cancer patients, oncology health-care professionals and laypersons, but survival time seemed to have higher priority for people diagnosed with cancer than for healthy people. Additionally, survival seemed to be more important than quality of life for all three groups assessed. PMID:25141108

  20. Homogenous UV/periodate process in treatment of p-nitrophenol aqueous solutions under mild operating conditions.

    PubMed

    Saien, Javad; Fallah Vahed Bazkiaei, Marzieh

    2018-07-01

    Aqueous solutions of p-nitrophenol (PNP) were treated with UV-activated potassium periodate (UV/KPI) in an efficient photo-reactor. Either periodate or UV alone had little effect; however, their combination led to a significant degradation and mineralization. The response surface methodology was employed for design of experiments and optimization. The optimum conditions for treatment of 30 mg/L of the substrate were determined as [KPI] = 386.3 mg/L, pH = 6.2 and T = 34.6°C, under which 79.5% degradation was achieved after 60 min. Use of 25 and 40 kHz ultrasound waves caused the degradation to enhance to 88.3% and 92.3%, respectively. The intermediates were identified by gas chromatography-mass spectroscopy analysis, leading to propose the reaction pathway. The presence of water conventional bicarbonate, chloride, sulfate and nitrate anions caused unfavorable effects in efficiency. Meanwhile, the kinetic study showed that PNP degradation follows a pseudo-first-order reaction and the activation energy was determined. The irradiation energy consumption required for one order of magnitude degradation was estimated as 11.18 kWh/m 3 . Accordingly, comparison with the previously reported processes showed the superiority of PNP treatment with the employed process.

  1. Incubation period of ebola hemorrhagic virus subtype zaire.

    PubMed

    Eichner, Martin; Dowell, Scott F; Firese, Nina

    2011-06-01

    Ebola hemorrhagic fever has killed over 1300 people, mostly in equatorial Africa. There is still uncertainty about the natural reservoir of the virus and about some of the factors involved in disease transmission. Until now, a maximum incubation period of 21 days has been assumed. We analyzed data collected during the Ebola outbreak (subtype Zaire) in Kikwit, Democratic Republic of the Congo, in 1995 using maximum likelihood inference and assuming a log-normally distributed incubation period. The mean incubation period was estimated to be 12.7 days (standard deviation 4.31 days), indicating that about 4.1% of patients may have incubation periods longer than 21 days. If the risk of new cases is to be reduced to 1% then 25 days should be used when investigating the source of an outbreak, when determining the duration of surveillance for contacts, and when declaring the end of an outbreak.

  2. A Guide to Screening for the Early and Periodic Screening, Diagnosis and Treatment Program (EPSDT) Under Medicaid.

    ERIC Educational Resources Information Center

    Frankenburg, William K.; North, A. Frederick, Jr.

    The manual was designed to help public officials, physicians, nurses, and others to plan and implement an Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program under Medicaid. Procedures for carrying out components of an EPSDT program are recommended. Part 1 discusses organization and administration of screening, diagnosis, and…

  3. Optimal Alignment of Structures for Finite and Periodic Systems.

    PubMed

    Griffiths, Matthew; Niblett, Samuel P; Wales, David J

    2017-10-10

    Finding the optimal alignment between two structures is important for identifying the minimum root-mean-square distance (RMSD) between them and as a starting point for calculating pathways. Most current algorithms for aligning structures are stochastic, scale exponentially with the size of structure, and the performance can be unreliable. We present two complementary methods for aligning structures corresponding to isolated clusters of atoms and to condensed matter described by a periodic cubic supercell. The first method (Go-PERMDIST), a branch and bound algorithm, locates the global minimum RMSD deterministically in polynomial time. The run time increases for larger RMSDs. The second method (FASTOVERLAP) is a heuristic algorithm that aligns structures by finding the global maximum kernel correlation between them using fast Fourier transforms (FFTs) and fast SO(3) transforms (SOFTs). For periodic systems, FASTOVERLAP scales with the square of the number of identical atoms in the system, reliably finds the best alignment between structures that are not too distant, and shows significantly better performance than existing algorithms. The expected run time for Go-PERMDIST is longer than FASTOVERLAP for periodic systems. For finite clusters, the FASTOVERLAP algorithm is competitive with existing algorithms. The expected run time for Go-PERMDIST to find the global RMSD between two structures deterministically is generally longer than for existing stochastic algorithms. However, with an earlier exit condition, Go-PERMDIST exhibits similar or better performance.

  4. Cryopyrin-associated periodic syndrome: an update on diagnosis and treatment response.

    PubMed

    Yu, Justin R; Leslie, Kieron S

    2011-02-01

    Cryopyrin-associated periodic syndrome (CAPS) is a rare hereditary inflammatory disorder encompassing a continuum of three phenotypes: familial cold autoinflammatory syndrome, Muckle-Wells syndrome, and neonatal-onset multisystem inflammatory disease. Distinguishing features include cutaneous, neurological, ophthalmologic, and rheumatologic manifestations. CAPS results from a gain-of-function mutation of the NLRP3 gene coding for cryopyrin, which forms intracellular protein complexes known as inflammasomes. Defects of the inflammasomes lead to overproduction of interleukin-1, resulting in inflammatory symptoms seen in CAPS. Diagnosis is often delayed and requires a thorough review of clinical symptoms. Remarkable advances in our understanding of the genetics and the molecular pathway that is responsible for the clinical phenotype of CAPS has led to the development of effective treatments. It also has become clear that the NLRP3 inflammasome plays a critical role in innate immune defense and therefore has wider implications for other inflammatory disease states.

  5. Reference datasets for 2-treatment, 2-sequence, 2-period bioequivalence studies.

    PubMed

    Schütz, Helmut; Labes, Detlew; Fuglsang, Anders

    2014-11-01

    It is difficult to validate statistical software used to assess bioequivalence since very few datasets with known results are in the public domain, and the few that are published are of moderate size and balanced. The purpose of this paper is therefore to introduce reference datasets of varying complexity in terms of dataset size and characteristics (balance, range, outlier presence, residual error distribution) for 2-treatment, 2-period, 2-sequence bioequivalence studies and to report their point estimates and 90% confidence intervals which companies can use to validate their installations. The results for these datasets were calculated using the commercial packages EquivTest, Kinetica, SAS and WinNonlin, and the non-commercial package R. The results of three of these packages mostly agree, but imbalance between sequences seems to provoke questionable results with one package, which illustrates well the need for proper software validation.

  6. Longer duration of homelessness is associated with a lower likelihood of non-detectable plasma HIV-1 RNA viral load among people who use illicit drugs in a Canadian setting.

    PubMed

    Loh, Jane; Kennedy, Mary Clare; Wood, Evan; Kerr, Thomas; Marshall, Brandon; Parashar, Surita; Montaner, Julio; Milloy, M-J

    2016-11-01

    Homelessness is common among people who use drugs (PWUD) and, for those living with HIV/AIDS, an important contributor to sub-optimal HIV treatment outcomes. This study aims to investigate the relationship between the duration of homelessness and the likelihood of plasma HIV-1 RNA viral load (VL) non-detectability among a cohort of HIV-positive PWUD. We used data from the ACCESS study, a long-running prospective cohort study of HIV-positive PWUD linked to comprehensive HIV clinical records including systematic plasma HIV-1 RNA VL monitoring. We estimated the longitudinal relationship between the duration of homelessness and the likelihood of exhibiting a non-detectable VL (i.e., <500 copies/mL plasma) using generalized linear mixed-effects modelling. Between May 1996 and June 2014, 922 highly active antiretroviral therapy-exposed participants were recruited and contributed 8188 observations. Of these, 4800 (59%) were characterized by non-detectable VL. Participants reported they were homeless in 910 (11%) interviews (median: six months, interquartile range: 6-12 months). A longer duration of homelessness was associated with lower odds of VL non-detectability (adjusted odds ratio = 0.71 per six-month period of homelessness, 95% confidence interval: 0.60-0.83) after adjustment for age, ancestry, drug use patterns, engagement in addiction treatment, and other potential confounders. Longer durations of episodes of homelessness in this cohort of HIV-positive illicit drug users were associated with a lower likelihood of plasma VL non-detectability. Our findings suggest that interventions that seek to promptly house homeless individuals, such as Housing First approaches, might assist in maximizing the clinical and public health benefits of antiretroviral therapy among people living with HIV/AIDS.

  7. Notes on testing equality and interval estimation in Poisson frequency data under a three-treatment three-period crossover trial.

    PubMed

    Lui, Kung-Jong; Chang, Kuang-Chao

    2016-10-01

    When the frequency of event occurrences follows a Poisson distribution, we develop procedures for testing equality of treatments and interval estimators for the ratio of mean frequencies between treatments under a three-treatment three-period crossover design. Using Monte Carlo simulations, we evaluate the performance of these test procedures and interval estimators in various situations. We note that all test procedures developed here can perform well with respect to Type I error even when the number of patients per group is moderate. We further note that the two weighted-least-squares (WLS) test procedures derived here are generally preferable to the other two commonly used test procedures in the contingency table analysis. We also demonstrate that both interval estimators based on the WLS method and interval estimators based on Mantel-Haenszel (MH) approach can perform well, and are essentially of equal precision with respect to the average length. We use a double-blind randomized three-treatment three-period crossover trial comparing salbutamol and salmeterol with a placebo with respect to the number of exacerbations of asthma to illustrate the use of these test procedures and estimators. © The Author(s) 2014.

  8. LWIR pupil imaging and longer-term calibration stability

    NASA Astrophysics Data System (ADS)

    LeVan, Paul D.; Sakoglu, Ünal

    2016-09-01

    A previous paper described LWIR pupil imaging, and an improved understanding of the behavior of this type of sensor for which the high-sensitivity focal plane array (FPA) operated at higher flux levels includes a reversal in signal integration polarity. We have since considered a candidate methodology for efficient, long-term calibration stability that exploits the following two properties of pupil imaging: (1) a fixed pupil position on the FPA, and (2) signal levels from the scene imposed on significant but fixed LWIR background levels. These two properties serve to keep each pixel operating over a limited dynamic range that corresponds to its location in the pupil and to the signal levels generated at this location by the lower and upper calibration flux levels. Exploiting this property for which each pixel of the Pupil Imager operates over its limited dynamic range, the signal polarity reversal between low and high flux pixels, which occurs for a circular region of pixels near the upper edges of the pupil illumination profile, can be rectified to unipolar integration with a two-level non-uniformity correction (NUC). Images corrected real-time with standard non-uniformity correction (NUC) techniques, are still subject to longer-term drifts in pixel offsets between recalibrations. Long-term calibration stability might then be achieved using either a scene-based non-uniformity correction approach, or with periodic repointing for off-source background estimation and subtraction. Either approach requires dithering of the field of view, by sub-pixel amounts for the first method, or by large off-source motions outside the 0.38 milliradian FOV for the latter method. We report on the results of investigations along both these lines.

  9. 18 CFR 301.4 - Exchange Period Average System Cost determination.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... paragraph (a)(3)(iv) of this section indicates that no escalation to the Account will be made. (5... the Exchange Period by the same rate of growth as total Contract System Load. (7) If any of the escalators specified in paragraph (a) of this section are no longer available, Bonneville will designate a...

  10. 18 CFR 301.4 - Exchange Period Average System Cost determination.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... paragraph (a)(3)(iv) of this section indicates that no escalation to the Account will be made. (5... the Exchange Period by the same rate of growth as total Contract System Load. (7) If any of the escalators specified in paragraph (a) of this section are no longer available, Bonneville will designate a...

  11. 18 CFR 301.4 - Exchange Period Average System Cost determination.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... paragraph (a)(3)(iv) of this section indicates that no escalation to the Account will be made. (5... the Exchange Period by the same rate of growth as total Contract System Load. (7) If any of the escalators specified in paragraph (a) of this section are no longer available, Bonneville will designate a...

  12. 18 CFR 301.4 - Exchange Period Average System Cost determination.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... paragraph (a)(3)(iv) of this section indicates that no escalation to the Account will be made. (5... the Exchange Period by the same rate of growth as total Contract System Load. (7) If any of the escalators specified in paragraph (a) of this section are no longer available, Bonneville will designate a...

  13. 18 CFR 301.4 - Exchange Period Average System Cost determination.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... paragraph (a)(3)(iv) of this section indicates that no escalation to the Account will be made. (5... the Exchange Period by the same rate of growth as total Contract System Load. (7) If any of the escalators specified in paragraph (a) of this section are no longer available, Bonneville will designate a...

  14. National disparities in treatment package time for resected locally advanced head and neck cancer and impact on overall survival.

    PubMed

    Guttmann, David M; Kobie, Julie; Grover, Surbhi; Lin, Alexander; Lukens, John N; Mitra, Nandita; Rhodes, Karin V; Feng, Weiwei; Swisher-McClure, Samuel

    2018-06-01

    The purpose of this study was to determine national disparities in head and neck cancer treatment package time (the time interval from surgery through the completion of radiation) and the associated impact on survival. We conducted an observational cohort study using the National Cancer Database of 15 234 patients with resected head and neck cancer who underwent adjuvant radiotherapy from 2004-2012. Predictors of prolonged package time were identified by multivariable linear regression. Survival outcomes were assessed using a multivariable Cox model. Mean package time was 100 days (SD 23). Package time was 7.52 days (95% confidence interval [CI] 6.23-8.81; P < .001) longer with Medicaid versus commercial insurance. Low income and African American race also predicted for longer package times. All-cause mortality increased an average of 4% with each 1 week increase in treatment package time (hazard ratio [HR] 1.04; 95% CI 1.03-1.05; P < .001). Significant national socioeconomic disparities exist in treatment package time. Treatment delays in this setting may contribute to worse survival outcomes. © 2018 Wiley Periodicals, Inc.

  15. Dark Period Following UV-C Treatment Enhances Killing of Botrytis cinerea Conidia and Controls Gray Mold of Strawberries.

    PubMed

    Janisiewicz, Wojciech J; Takeda, Fumiomi; Glenn, D Michael; Camp, Mary J; Jurick, Wayne M

    2016-04-01

    Strawberries are available throughout the year either from production in the field or from high and low tunnel culture. Diversity of production conditions results in new challenges in controlling diseases before and after harvest. Fungicides have traditionally been used to control these diseases; however, their limitations necessitate a search for new approaches. We found that UV-C irradiation of Botrytis cinerea, a major pathogen of strawberry, can effectively kill this fungus if a dark period follows the treatment. The inclusion of a 4-h dark period resulted in almost complete kill of B. cinerea conidia on agar media at a dose of 12.36 J/m2. The UV-C dose did not cause a reduction in photosynthesis in strawberry leaves or discoloration of sepals, even after exposing plants repeatedly (twice a week) for 7 weeks. Although irradiation of dry conidia of B. cinerea with this dose resulted in some survival, the conidia were not infective and not able to cause decay even when inoculated onto a highly susceptible mature apple fruit. Irradiation of strawberry pollen at 12.36 J/m2 did not affect pollen germination, tube growth and length in vitro, or germination and tube growth in the style of hand-pollinated emasculated strawberry flowers. No negative effect of the UV-C treatment was observed on fruit yield and quality in high tunnel culture. In the fruit and flower petal inoculation tests, the UV-C treatment was highly effective in reducing fruit decay and petal infection. This UV-C treatment with an exposure time of 60 s may be useful in controlling gray mold in tunnel production of strawberries and may also have the potential for use in intensive field and indoor production of other fruits and vegetables providing that a 4-h dark period follows the irradiation.

  16. The Effect of Aromatherapy Treatment on Fatigue and Relaxation for Mothers during the Early Puerperal Period in Japan: A Pilot Study.

    PubMed

    Asazawa, Kyoko; Kato, Yoshihiro; Yamaguchi, Atsuko; Inoue, Asako

    2017-10-01

    Early in the postpartum period, mothers are often nervous and tired from the delivery, breast-feeding and caring for a new-born. The aim of this study was to evaluate the process and outcome of using aromatherapy treatments to increase relaxation and decrease fatigue for mothers during the first to the seventh day of the postpartum period. This non-randomized controlled study with a quasi-experimental one-group pretest-posttest design was used to evaluate scores in relaxation and fatigue before and after the intervention. Aromatherapy hand treatments were performed on a purposive sample of 34 postpartum mothers in Tokyo, Japan, from May to July 2016. The single treatment included a choice of one of five essential aroma oils through hand and forearm massage. Relaxation and fatigue were measured by self-administered valid and reliable questionnaires. Wilcoxon signed-rank test was conducted to analyze the data before and after the intervention. The software programs SPSS, v. 23.0 (SPSS, Tokyo), was used to analyze the data, with the significance level set at 5%. Valid responses were obtained from 29 participants. A comparison of the scores before and after aroma treatment intervention indicated that the participants' relaxation scores increased significantly (P<0.001) and fatigue scores were significantly reduced (P<0.001). The majority of participants (77.8%) were satisfied with the treatment. The aroma treatments significantly improved relaxation and reduced fatigue for mothers in the early puerperal period and were well received. Therefore, a larger study using a pretest-posttest random control trial is recommended.

  17. The Effect of Aromatherapy Treatment on Fatigue and Relaxation for Mothers during the Early Puerperal Period in Japan: A Pilot Study

    PubMed Central

    Asazawa, Kyoko; Kato, Yoshihiro; Yamaguchi, Atsuko; Inoue, Asako

    2017-01-01

    ABSTRACT Background: Early in the postpartum period, mothers are often nervous and tired from the delivery, breast-feeding and caring for a new-born. The aim of this study was to evaluate the process and outcome of using aromatherapy treatments to increase relaxation and decrease fatigue for mothers during the first to the seventh day of the postpartum period. Methods: This non-randomized controlled study with a quasi-experimental one-group pretest-posttest design was used to evaluate scores in relaxation and fatigue before and after the intervention. Aromatherapy hand treatments were performed on a purposive sample of 34 postpartum mothers in Tokyo, Japan, from May to July 2016. The single treatment included a choice of one of five essential aroma oils through hand and forearm massage. Relaxation and fatigue were measured by self-administered valid and reliable questionnaires. Wilcoxon signed-rank test was conducted to analyze the data before and after the intervention. The software programs SPSS, v. 23.0 (SPSS, Tokyo), was used to analyze the data, with the significance level set at 5%. Results: Valid responses were obtained from 29 participants. A comparison of the scores before and after aroma treatment intervention indicated that the participants’ relaxation scores increased significantly (P<0.001) and fatigue scores were significantly reduced (P<0.001). The majority of participants (77.8%) were satisfied with the treatment. Conclusion: The aroma treatments significantly improved relaxation and reduced fatigue for mothers in the early puerperal period and were well received. Therefore, a larger study using a pretest-posttest random control trial is recommended. PMID:29043282

  18. Effectiveness of adjunct psychotherapy for cancer treatment: a review.

    PubMed

    Chen, YokeYong; Ahmad, Mahadir

    2018-05-16

    Psychotherapies were offered to alleviate psychological and physical symptoms; however, most psychological interventions were only delivered after cancer treatment. Newly diagnosed cancer patients experienced psychological distress while waiting for treatments. This review paper focused on randomized control trial studies, aimed to investigate the effectiveness of psychological intervention among newly diagnosed cancer patients. Eight randomized control trial papers were found in recent 10 years period through electronic database. A moderate to large effect size was detected on the outcomes, ranging from 0.43 to 0.89. This indicated that psychological-based prehabilitation with standard care yielded better outcomes than standard care alone. Psychological-based prehabilitation provides evidence in its effectiveness to reduce psychological distress, functional impairment, recurrence of cancer, numbers of immune reactivity and sleeping quality; however, inconsistent with longer survival result among cancer patients. In conclusion, psychological-based prehabilitation before cancer treatment is necessary for better treatment outcome, and future research is needed to investigate more directly the outcome.

  19. Revisiting Academic Capitalism in Canada: No Longer the Exception

    ERIC Educational Resources Information Center

    Metcalfe, Amy Scott

    2010-01-01

    In "Academic Capitalism: Politics, Policies, and the Entrepreneurial University" (1997), Slaughter and Leslie found that Canada showed signs of resisting academic capitalism. Changes in postsecondary education funding policies and the emergence of new commercialization initiatives are evidence that Canada is certainly no longer, and…

  20. Studies of the Long Secondary Periods in Pulsating Red Giants. II. Lower-Luminosity Stars

    NASA Astrophysics Data System (ADS)

    Percy, J. R.; Leung, H. W.

    2017-06-01

    We have used AAVSO visual and photoelectric V data, and the AAVSO time-series package VSTAR and the Lomb-Scargle time-series algorithm to determine improved pulsation periods, "long secondary periods" (LSPs), and their amplitudes in 51 shorter-period pulsating red giants in the AAVSO photoelectric photometry program, and in the AAVSO long-period variable (LPV) binocular program. As is well known, radial pulsation becomes detectable in red giants at about spectral type M0, with periods of about 20 days. We find that the LSP phenomenon is also first detectable at about M0. Pulsation and LSP amplitudes increase from near zero to about 0.1 at pulsation periods of 100 days. At longer periods, the pulsation amplitudes continue to increase, but the LSP amplitudes are generally between 0.1 and 0.2 on average. The ratios of LSP to pulsation period cluster around 5 and 10, presumably depending on whether the pulsation period is the fundamental or first overtone. The pulsation and LSP phase curves are generally close to sinusoidal, except when the amplitude is small, in which case they may be distorted by observational scatter or, in the case of the LSP amplitude, by the pulsational variability. As with longer-period stars, the LSP amplitude i ncreases and decreases by a factor of two or more, for unknown reasons, on a time scale of about 20 LSPs. The LSP phenomenon is thus present and similar in radially pulsating red giants of all periods. Its cause remains unknown.

  1. Resource selection by juvenile Swainson's thrushes during the postfledging period

    Treesearch

    Jennifer D. ​White; Thomas Gardali; Frank R. Thompson; John Faaborg

    2005-01-01

    Resource-selection studies of passerine birds during the breeding season have mainly been limited to understanding those factors important to nesting. However, little is known about what resources are selected by juveniles that are no longer dependent on their parents. The postfledging period may be a critical part of the breeding season for independent juveniles...

  2. Effect of follow-up period on minimal-significant dose in the atomic-bomb survivor studies.

    PubMed

    Cologne, John; Preston, Dale L; Grant, Eric J; Cullings, Harry M; Ozasa, Kotaro

    2018-03-01

    It was recently suggested that earlier reports on solid-cancer mortality and incidence in the Life Span Study of atomic-bomb survivors contain still-useful information about low-dose risk that should not be ignored, because longer follow-up may lead to attenuated estimates of low-dose risk due to longer time since exposure. Here it is demonstrated, through the use of all follow-up data and risk models stratified on period of follow-up (as opposed to sub-setting the data by follow-up period), that the appearance of risk attenuation over time may be the result of less-precise risk estimation-in particular, imprecise estimation of effect-modification parameters-in the earlier periods. Longer follow-up, in addition to allowing more-precise estimation of risk due to larger numbers of radiation-related cases, provides more-precise adjustment for background mortality or incidence and more-accurate assessment of risk modification by age at exposure and attained age. It is concluded that the latest follow-up data are most appropriate for inferring low-dose risk. Furthermore, if researchers are interested in effects of time since exposure, the most-recent follow-up data should be considered rather than the results of earlier reports.

  3. Association between the Severity of Influenza A(H7N9) Virus Infections and Length of the Incubation Period

    PubMed Central

    Fang, Vicky J.; Feng, Luzhao; Tsang, Tim K.; Jiang, Hui; Wu, Peng; Zheng, Jiandong; Lau, Eric H. Y.; Qin, Ying; Peng, Zhibin; Peiris, J. S. Malik; Yu, Hongjie; Cowling, Benjamin J.

    2016-01-01

    Background In early 2013, a novel avian-origin influenza A(H7N9) virus emerged in China, and has caused sporadic human infections. The incubation period is the delay from infection until onset of symptoms, and varies from person to person. Few previous studies have examined whether the duration of the incubation period correlates with subsequent disease severity. Methods and Findings We analyzed data of period of exposure on 395 human cases of laboratory-confirmed influenza A(H7N9) virus infection in China in a Bayesian framework using a Weibull distribution. We found a longer incubation period for the 173 fatal cases with a mean of 3.7 days (95% credibility interval, CrI: 3.4–4.1), compared to a mean of 3.3 days (95% CrI: 2.9–3.6) for the 222 non-fatal cases, and the difference in means was marginally significant at 0.47 days (95% CrI: -0.04, 0.99). There was a statistically significant correlation between a longer incubation period and an increased risk of death after adjustment for age, sex, geographical location and underlying medical conditions (adjusted odds ratio 1.70 per day increase in incubation period; 95% credibility interval 1.47–1.97). Conclusions We found a significant association between a longer incubation period and a greater risk of death among human H7N9 cases. The underlying biological mechanisms leading to this association deserve further exploration. PMID:26885816

  4. Association between the Severity of Influenza A(H7N9) Virus Infections and Length of the Incubation Period.

    PubMed

    Virlogeux, Victor; Yang, Juan; Fang, Vicky J; Feng, Luzhao; Tsang, Tim K; Jiang, Hui; Wu, Peng; Zheng, Jiandong; Lau, Eric H Y; Qin, Ying; Peng, Zhibin; Peiris, J S Malik; Yu, Hongjie; Cowling, Benjamin J

    2016-01-01

    In early 2013, a novel avian-origin influenza A(H7N9) virus emerged in China, and has caused sporadic human infections. The incubation period is the delay from infection until onset of symptoms, and varies from person to person. Few previous studies have examined whether the duration of the incubation period correlates with subsequent disease severity. We analyzed data of period of exposure on 395 human cases of laboratory-confirmed influenza A(H7N9) virus infection in China in a Bayesian framework using a Weibull distribution. We found a longer incubation period for the 173 fatal cases with a mean of 3.7 days (95% credibility interval, CrI: 3.4-4.1), compared to a mean of 3.3 days (95% CrI: 2.9-3.6) for the 222 non-fatal cases, and the difference in means was marginally significant at 0.47 days (95% CrI: -0.04, 0.99). There was a statistically significant correlation between a longer incubation period and an increased risk of death after adjustment for age, sex, geographical location and underlying medical conditions (adjusted odds ratio 1.70 per day increase in incubation period; 95% credibility interval 1.47-1.97). We found a significant association between a longer incubation period and a greater risk of death among human H7N9 cases. The underlying biological mechanisms leading to this association deserve further exploration.

  5. A multicenter, open-label extension study of velaglucerase alfa in Japanese patients with Gaucher disease: Results after a cumulative treatment period of 24months.

    PubMed

    Ida, Hiroyuki; Tanaka, Akemi; Matsubayashi, Tomoko; Murayama, Kei; Hongo, Teruaki; Lee, Hak-Myung; Mellgard, Björn

    2016-07-01

    Enzyme replacement therapy (ERT) with exogenous glucocerebrosidase is indicated to treat symptomatic Gaucher disease (GD), a rare, inherited metabolic disorder. ERT with velaglucerase alfa, which is produced in a human cell line using gene activation technology, was studied in a 12-month phase III trial in Japanese patients with type 1 or 3 GD who were switched from imiglucerase ERT (n=6); the current, open-label, 12-month extension study was designed to assess longer-term safety and efficacy. Two adult and three pediatric patients (aged <18years) were enrolled into the extension study. Every-other-week intravenous infusions were administered for 63-78weeks at average doses between 51.5 and 60.7units/kg. Three non-serious adverse events were considered related to velaglucerase alfa treatment, but no patient discontinued from the study. Six serious but non-drug-related adverse events were reported. No patient tested positive for anti-velaglucerase alfa antibodies. Hemoglobin concentrations, platelet counts, and liver and spleen volumes (normalized to body weight) in these patients were generally stable over a cumulative 24-month period from the baseline of the parent trial. The data suggest that velaglucerase alfa was well tolerated and maintained clinical stability in Japanese GD patients over 2years after switching from imiglucerase. ClinicalTrials.gov identifier NCT01842841. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  6. Cluster Randomized Controlled Trial: Clinical and Cost-Effectiveness of a System of Longer-Term Stroke Care.

    PubMed

    Forster, Anne; Young, John; Chapman, Katie; Nixon, Jane; Patel, Anita; Holloway, Ivana; Mellish, Kirste; Anwar, Shamaila; Breen, Rachel; Knapp, Martin; Murray, Jenni; Farrin, Amanda

    2015-08-01

    We developed a new postdischarge system of care comprising a structured assessment covering longer-term problems experienced by patients with stroke and their carers, linked to evidence-based treatment algorithms and reference guides (the longer-term stroke care system of care) to address the poor longer-term recovery experienced by many patients with stroke. A pragmatic, multicentre, cluster randomized controlled trial of this system of care. Eligible patients referred to community-based Stroke Care Coordinators were randomized to receive the new system of care or usual practice. The primary outcome was improved patient psychological well-being (General Health Questionnaire-12) at 6 months; secondary outcomes included functional outcomes for patients, carer outcomes, and cost-effectiveness. Follow-up was through self-completed postal questionnaires at 6 and 12 months. Thirty-two stroke services were randomized (29 participated); 800 patients (399 control; 401 intervention) and 208 carers (100 control; 108 intervention) were recruited. In intention to treat analysis, the adjusted difference in patient General Health Questionnaire-12 mean scores at 6 months was -0.6 points (95% confidence interval, -1.8 to 0.7; P=0.394) indicating no evidence of statistically significant difference between the groups. Costs of Stroke Care Coordinator inputs, total health and social care costs, and quality-adjusted life year gains at 6 months, 12 months, and over the year were similar between the groups. This robust trial demonstrated no benefit in clinical or cost-effectiveness outcomes associated with the new system of care compared with usual Stroke Care Coordinator practice. URL: http://www.controlled-trials.com. Unique identifier: ISRCTN 67932305. © 2015 Bradford Teaching Hospitals NHS Foundation Trust.

  7. 77 FR 19076 - High Density Traffic Airports; Notice of Determination Regarding Low Demand Periods at Ronald...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-30

    ... 10 p.m. to 10:59 p.m. no longer is a low demand period at Ronald Reagan Washington National Airport... Airport, LaGuardia Airport, O'Hare International Airport, Ronald Reagan Washington National Airport (DCA...-1024] High Density Traffic Airports; Notice of Determination Regarding Low Demand Periods at Ronald...

  8. 76 FR 58393 - High Density Traffic Airports; Notice of Determination Regarding Low Demand Periods at Ronald...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-21

    ... 6 a.m. to 6:59 a.m. no longer is a low demand period at Ronald Reagan Washington National Airport... Airport, LaGuardia Airport, O'Hare International Airport, Ronald Reagan Washington National Airport (DCA...-1024] High Density Traffic Airports; Notice of Determination Regarding Low Demand Periods at Ronald...

  9. Three-Year Follow-Up of Insomnia and Hypnotics after Controlled Internet Treatment for Insomnia.

    PubMed

    Blom, Kerstin; Jernelöv, Susanna; Rück, Christian; Lindefors, Nils; Kaldo, Viktor

    2016-06-01

    To investigate the long-term effects of therapist-guided Internet-based insomnia treatment on insomnia severity and sleep medication use, compared with active control. This study was an 8 week randomized controlled trial with follow-up posttreatment and at 6, 12, and 36 months, set at the Internet Psychiatry Clinic, Stockholm, Sweden. Participants were 148 media-recruited nondepressed adults with insomnia. Interventions were Guided Internet-based cognitive behavioral therapy for insomnia (ICBT-i) or active control treatment (ICBT-ctrl). Primary outcome was insomnia severity, measured with the Insomnia Severity Index. Secondary outcomes were sleep medication use and use of other treatments. The large pretreatment to posttreatment improvements in insomnia severity of the ICBT-i group were maintained during follow-up. ICBT-ctrl exhibited significantly less improvement posttreatment (between-Cohen d = 0.85), but after 12 and 36 months, there was no longer a significant difference. The within-group effect sizes from pretreatment to the 36-months follow-up were 1.6 (ICBT-i) and 1.7 (ICBT-ctrl), and 74% of the interviewed participants no longer had insomnia diagnosis after 36 mo. ICBT-ctrl used significantly more sleep medication (P = 0.017) and underwent significantly more other insomnia treatments (P < 0.001) during the follow-up period. The large improvements in the ICBT-i group were maintained after 36 months, corroborating that CBT for insomnia has long-term effects. After 36 months, the groups did not differ in insomnia severity, but ICBT-ctrl had used more sleep medication and undergone more other additional insomnia treatments during the follow-up period. The trial was registered, together with a parallel trial, at Clinicaltrials.gov as "Internet-CBT for Insomnia" registration ID: NCT01256099. © 2016 Associated Professional Sleep Societies, LLC.

  10. Stability of Stellar Periods in the Hyades and Taurus

    NASA Astrophysics Data System (ADS)

    Rebull, Luisa M.; Stauffer, John R.; K2 Clusters Team

    2018-06-01

    K2 has opened to us the study of high-precision light curves from which we can derive stellar rotation periods. We have presented period distributions for the Pleiades, Praesepe, Upper Sco and Rho Oph. But, how stable are the periods we are deriving from them? Early ground-based work in Orion (Rebull 2001) suggested that, for the youngest stars, about half the stars had sufficiently different spot distributions in two consecutive years such that periods could not be recovered in the second year. However, now that we have K2, precision and diurnal windowing functions are no longer really much of a concern. For a handful of stars in Hyades and Taurus, the K2 spacecraft monitored them for two non-consecutive 70d windows (campaigns 4, 2015 Feb and 13, 2017 Mar). In this poster, we examine whether or not the light curves are similar in the two epochs, and how accurately the same period can be recovered.

  11. Rilonacept for the treatment of cryopyrin-associated periodic syndromes (CAPS).

    PubMed

    Hoffman, Hal M

    2009-04-01

    Cryopyrin-associated periodic syndromes (CAPS) encompass a group of rare inherited, autoinflammatory disorders that represent a spectrum of one disease with varying degrees of severity. Until recently, there was no effective treatment for CAPS, but identification of the genetic basis of CAPS highlighted the pathogenic role of IL-1beta. Rilonacept is a recently FDA approved biologic therapy for CAPS with high affinity for IL-1beta. Limited pharmacological data has been reported to date. A review of the phamacokinetics and pharmacodynamics data as well as the results of a pilot study and Phase III placebo-controlled trials of rilonacept in CAPS. Unpublished data on an open-label extension study in adult and pediatric subjects is also reviewed. Rilonacept produced rapid and profound improvements in symptoms and also reduced high-sesitivity C-reactive protein levels and normalized elevated serum amyloid A concentrations, an important risk factor for amyloidosis. The primary adverse events were injection- site reactions and upper respiratory tract infections. Rilonacept, the only IL-1 Trap, is the first of many novel IL-1-targeted therapies being developed. In a very short time it has changed the lives of CAPS patients.

  12. Effects of simvastatin treatment on serum adiponectin concentrations in patients with dislipidemia.

    PubMed

    Moezzi, Atefeh; Parizadeh, Seyyed Mohammad Reza; Tavallaie, Shima; Mazidi, Mohsen; Afzali, Fariba; Adab, Afrouz; Ferns, Gordon; Ghayour Mobarhan, Majid

    2014-08-01

    Adiponectin is an adipose tissue-derived protein with anti-inflammatory properties. Statins are a class of cholesterol-lowering drugs, widely used for treatment of cardiovascular diseases. In the current study, we aimed to assess the effects of simvastatin on serum levels of adiponectin in patients with dyslipidemia, recruited from Ghaem Hospital, Mashhad, Iran. A total of 102 patients with dyslipidemia were treated with simvastatin or placebo during a double-blind, cross-over, placebo-controlled trial. The adiponectin levels were measured before and after each treatment period. Seventy seven participants completed the study. There was a significant reduction in serum total cholesterol (approxmately 21%), low density lipoprotein-cholesterol (LDL-C) (approxmately 28%), and triglycerides (approxmately 11%), after four weeks of treatment with simvastatin (P < 0.001). No significant change in serum adiponectin concentrations was observed after treatment with simvastatin. This may be because of the relatively short duration of treatment and longer treatment duration may be necessary to investigation in future studies.

  13. Plasticity of the Intrinsic Period of the Human Circadian Timing System

    PubMed Central

    Scheer, Frank A.J.L.; Wright, Kenneth P.; Kronauer, Richard E.; Czeisler, Charles A.

    2007-01-01

    Human expeditions to Mars will require adaptation to the 24.65-h Martian solar day-night cycle (sol), which is outside the range of entrainment of the human circadian pacemaker under lighting intensities to which astronauts are typically exposed. Failure to entrain the circadian time-keeping system to the desired rest-activity cycle disturbs sleep and impairs cognitive function. Furthermore, differences between the intrinsic circadian period and Earth's 24-h light-dark cycle underlie human circadian rhythm sleep disorders, such as advanced sleep phase disorder and non-24-hour sleep-wake disorders. Therefore, first, we tested whether exposure to a model-based lighting regimen would entrain the human circadian pacemaker at a normal phase angle to the 24.65-h Martian sol and to the 23.5-h day length often required of astronauts during short duration space exploration. Second, we tested here whether such prior entrainment to non-24-h light-dark cycles would lead to subsequent modification of the intrinsic period of the human circadian timing system. Here we show that exposure to moderately bright light (∼450 lux; ∼1.2 W/m2) for the second or first half of the scheduled wake episode is effective for entraining individuals to the 24.65-h Martian sol and a 23.5-h day length, respectively. Estimations of the circadian periods of plasma melatonin, plasma cortisol, and core body temperature rhythms collected under forced desynchrony protocols revealed that the intrinsic circadian period of the human circadian pacemaker was significantly longer following entrainment to the Martian sol as compared to following entrainment to the 23.5-h day. The latter finding of after-effects of entrainment reveals for the first time plasticity of the period of the human circadian timing system. Both findings have important implications for the treatment of circadian rhythm sleep disorders and human space exploration. PMID:17684566

  14. Optimal recall period for caregiver-reported illness in risk factor and intervention studies: a multicountry study.

    PubMed

    Arnold, Benjamin F; Galiani, Sebastian; Ram, Pavani K; Hubbard, Alan E; Briceño, Bertha; Gertler, Paul J; Colford, John M

    2013-02-15

    Many community-based studies of acute child illness rely on cases reported by caregivers. In prior investigations, researchers noted a reporting bias when longer illness recall periods were used. The use of recall periods longer than 2-3 days has been discouraged to minimize this reporting bias. In the present study, we sought to determine the optimal recall period for illness measurement when accounting for both bias and variance. Using data from 12,191 children less than 24 months of age collected in 2008-2009 from Himachal Pradesh in India, Madhya Pradesh in India, Indonesia, Peru, and Senegal, we calculated bias, variance, and mean squared error for estimates of the prevalence ratio between groups defined by anemia, stunting, and underweight status to identify optimal recall periods for caregiver-reported diarrhea, cough, and fever. There was little bias in the prevalence ratio when a 7-day recall period was used (<10% in 35 of 45 scenarios), and the mean squared error was usually minimized with recall periods of 6 or more days. Shortening the recall period from 7 days to 2 days required sample-size increases of 52%-92% for diarrhea, 47%-61% for cough, and 102%-206% for fever. In contrast to the current practice of using 2-day recall periods, this work suggests that studies should measure caregiver-reported illness with a 7-day recall period.

  15. Occurrence of periodic oscillations in the differential blood counts of congenital, idiopathic, and cyclical neutropenic patients before and during treatment with G-CSF.

    PubMed

    Haurie, C; Dale, D C; Mackey, M C

    1999-03-01

    Using techniques developed in astrophysics to deal with unequally sampled data sets, we have analyzed serial differential cell counts from 45 congenital, idiopathic, and cyclic neutropenic patients before and during treatment with recombinant human G-CSF (rhG-CSF). Our results show that the occurrence of significant cycling in the absolute neutrophil count (ANC) of neutropenics not classified as cyclical is much more prevalent than had been previously thought, and that not all the patients classified as cyclic show significant ANC periodicity. In these patients, cycling in more than one cell line may be involved. The range of periods encountered in these patients is much broader (between 11 and 52 days) than is usually associated with classical cyclical neutropenia, and there is no obvious connection between the range of periods and the patient's diagnostic category. Administration of rhG-CSF is able to induce significant cycling in neutropenic patients that were not cycling prior to treatment. In patients who had significant cycling before treatment, rhG-CSF may either decrease the period to between 11 and 14 days, or may obliterate any statistical evidence of cycling.

  16. The role of periodically varying discharge on river plume structure and transport

    NASA Astrophysics Data System (ADS)

    Yuan, Yeping; Horner-Devine, Alexander R.; Avener, Margaret; Bevan, Shaun

    2018-04-01

    We present results from laboratory experiments that simulate the effects of periodically varying discharge on buoyant coastal plumes. Freshwater is discharged into a two meter diameter tank filled with saltwater on a rotating table. The mean inflow rate, tank rotation period and density of the ambient salt water are varied to simulate a range of inflow Froude and Rossby numbers. The amplitude and the period of the inflow modulation are varied across a range that simulates variability due to tides and storms. Using the optical thickness method, we measure the width and depth of the plume, plume volume and freshwater retention rate in the plume. With constant discharge, freshwater is retained in a growing anticyclonic bulge circulation near the river mouth, as observed in previous studies. When the discharge is varied, the bulge geometry oscillates between a circular plume structure that extends mainly in the offshore direction, and a compressed plume structure that extends mainly in the alongshore direction. The oscillations result in periodic variations in the width and depth of the bulge and the incidence angle formed where the bulge flow re-attaches with the coastal wall. The oscillations are more pronounced for longer modulation periods, but are relatively insensitive to the modulation amplitude. A phase difference between the time varying transport within the bulge and bulge geometry determines the fraction of the bulge flow discharged into the coastal current. As a result, the modulation period determines the variations in amount of freshwater that returns to the bulge. Freshwater retention in the bulge is increased in longer modulation periods and more pronounced for larger modulation amplitudes.

  17. Halos on Mars Could Mean a Longer Life-Friendly Past

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

    None

    Lighter-toned bedrock that surrounds fractures and comprises high concentrations of silica—called “halos”—has been found in Gale crater on Mars, indicating that the planet had liquid water much longer than previously believed.

  18. High levels of anomalous self-experience are associated with longer duration of untreated psychosis.

    PubMed

    Haug, Elisabeth; Øie, Merete; Andreassen, Ole A; Bratlien, Unni; Nelson, Barnaby; Melle, Ingrid; Møller, Paul

    2017-04-01

    To investigate the relationship between anomalous self-experiences and duration of untreated psychosis in a sample of patients with first-episode schizophrenia spectrum disorders. Anomalous self-experiences were assessed by means of the Examination of Anomalous Self-Experience manual in 55 patients referred to their first adequate treatment for schizophrenia. Diagnoses, symptom severity, functioning and childhood trauma were assessed using the Structured Clinical Interview for the Positive and Negative Syndrome Scale, Premorbid Adjustment Scale, Social Functioning Scale and Childhood Trauma Questionnaire. Substance misuse was measured with the Drug Use Disorder Identification Test, and alcohol use was measured with the Alcohol Use Disorder Identification Test. Duration of untreated psychosis was measured in accordance with a standardized procedure. High levels of anomalous self-experiences are significantly associated with longer duration of untreated psychosis, an association which held after correcting for other variables associated with long duration of untreated psychosis. The field of early detection in psychosis is in need of additional clinical perspectives to make further progress. Improved understanding and assessment of anomalous self-experiences may help clinicians to detect these important phenomena and provide earlier help, and thus reduce treatment delay. © 2015 Wiley Publishing Asia Pty Ltd.

  19. Long-period oxygen-rich optical Miras in the solar neighborhood

    NASA Technical Reports Server (NTRS)

    Jura, M.; Yamamoto, A.; Kleinmann, S. G.

    1993-01-01

    The spatial distribution of the oxygen-rich Miras with periods longer than 400 days in the neighborhood of the sun were determined using available survey and the K-band period luminosity relationship. It is found that the exponential scale height of these stars is near 240 pc. There is a marked contrast between the Mira population at about 1 kpc from the Galactic center where there are nearly as many long-period oxygen-rich Miras as intermediate-period oxygen-rich Miras. It is hypothesized that, at about 1 kpc from the Galactic center, the main sequence stars with masses larger than 1 solar mass have higher metallicities than main-sequence stars with the same masses in the solar neighborhood. In the solar neighborhood such main sequence stars become carbon-rich on the AGB and in the region near the Galactic center they become long-period oxygen-rich Miras.

  20. Clinical evaluation of the Trauma Outcome Profile (TOP) in the longer-term follow-up of polytrauma patients.

    PubMed

    Attenberger, Corinna; Amsler, Felix; Gross, Thomas

    2012-09-01

    No sufficiently validated disease-specific instrument is available to assess patient outcome after polytrauma. The aim of this investigation was to test the recently published Trauma Outcome Profile (TOP) in the longer-term outcome of multiply injured patients. Single centre validation study on the TOP in comparison with objective and subjective measures of patient, injury or treatment characteristics and longer-term outcome (e.g. medical outcomes study Short Form-36, SF-36; Nottingham Health Profile, NHP; working capacity), at least 2 years following trauma in 117 survivors of polytrauma (injury severity score, ISS>16), using comparative analysis and correlation testing of prospectively collected data. Patients' mean weighted self-rating with regard to the 10 single TOP dimensions of Health Related Quality of Life (HRQoL, 0-100) ranged from lowest values for mental functioning (52.6+33.5) to highest values for daily activities (79.0+27.5). The rate of persons who indicated an abnormal level of function or pain increased significantly from pre-injury status (2% and 5%, resp.) to 46% for both values at longer-term follow-up (p<0.001). Observed associations between single dimensions or TOP component summary scores with the corresponding values from general HRQol instruments, such as the SF-36, resulted in R (Pearson) up to 0.85. Survivors of polytrauma who presented with a reduced working capacity (RWC) at longer-term follow-up in all TOP dimensions included a significantly higher rate of patients conspicuous for a relevantly reduced outcome compared with those with a non reduced working capacity (NRWC) (posttraumatic stress disease, PTSD: p<0.05; all other dimensions: p<0.001). Patients with a RWC were characterised by an almost fivefold probability of reduced outcome with regard to the TOP dimensions 'social interaction' or 'satisfaction' (odds ratio, OR 12.4 (95% CI 5.1-30.1) and 12.5 (4.0-39.0), resp.). This first clinical and methodological evaluation in a well

  1. Nutritional regimens with periodically recurring phases of dietary restriction extend lifespan in Drosophila.

    PubMed

    Romey-Glüsing, Renja; Li, Yang; Hoffmann, Julia; von Frieling, Jakob; Knop, Mirjam; Pfefferkorn, Roxana; Bruchhaus, Iris; Fink, Christine; Roeder, Thomas

    2018-04-01

    Nutritional interventions such as caloric and dietary restriction increase lifespan in various animal models. To identify alternative and less demanding nutritional interventions that extend lifespan, we subjected fruit flies ( Drosophila melanogaster) to weekly nutritional regimens that involved alternating a conventional diet with dietary restriction. Short periods of dietary restriction (up to 2 d) followed by longer periods of a conventional diet yielded minimal increases in lifespan. We found that 3 or more days of contiguous dietary restriction (DR) was necessary to yield a lifespan extension similar to that observed with persistent DR. Female flies were more responsive to these interventions than males. Physiologic changes known to be associated with prolonged DR, such as reduced metabolic rates, showed the same time course as lifespan extension. Moreover, concurrent transcriptional changes indicative of reduced insulin signaling were identified with DR. These physiologic and transcriptional changes were sustained, as they were detectable several days after switching to conventional diets. Taken together, diets with longer periods of DR extended lifespan concurrently with physiologic and transcriptional changes that may underlie this increase in lifespan.-Romey-Glüsing, R., Li, Y., Hoffmann, J., von Frieling, J., Knop, M., Pfefferkorn, R., Bruchhaus, I., Fink, C., Roeder, T. Nutritional regimens with periodically recurring phases of dietary restriction extend lifespan in Drosophila.

  2. The incubation period of cholera: a systematic review.

    PubMed

    Azman, Andrew S; Rudolph, Kara E; Cummings, Derek A T; Lessler, Justin

    2013-05-01

    Recent large cholera outbreaks highlight the need for improved understanding of the pathogenesis and epidemiology of cholera. The incubation period of cholera has important implications for clinical and public health decision-making, yet statements of the incubation period of cholera are often imprecise. Here we characterize the distribution of cholera's incubation period. We conducted a systematic review of the literature for statements of the incubation period of cholera and data that might aid in its estimation. We extracted individual-level data, parametrically estimated the distribution of toxigenic cholera's incubation period, and evaluated evidence for differences between strains. The incubation period did not differ by a clinically significant margin between strains (except O1 El Tor Ogawa). We estimate the median incubation period of toxigenic cholera to be 1.4 days (95% CI, 1.3-1.6). Five percent of cholera cases will develop symptoms by 0.5 days (95% CI 0.4-0.5), and 95% by 4.4 days (95% CI 3.9-5.0) after infection. We recommend that cholera investigations use a recall period of at least five days to capture relevant exposures; significantly longer than recent risk factor studies from the Haitian epidemic. This characterization of cholera's incubation period can help improve clinical and public health practice and advance epidemiologic research. Copyright © 2012 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  3. Heat waves and warm periods in Slovakia

    NASA Astrophysics Data System (ADS)

    Faško, Pavel; Bochníček, Oliver; Markovič, Ladislav; Švec, Marek

    2016-04-01

    The scenarios of climate change caused by human activity show that frequency of occurrence and extent of heat waves in the interior of Europe is increasing. Among the most exposed regions in this regard should the area of southeastern and eastern Austria and south-western Slovakia. The relatively faster increase in the number of heat waves in this area is related also to potential desertification in this region just east of the Alps, since during summer, weather fronts advancing from the west are consequently losing their original features and moderating influence. Summer weather patterns for this area should in the future more closely remind climate typical for some inland areas of southwestern, southern and southeastern Europe. A certain shift of climate zones from south to north should thus modify future climate and Slovakia. Despite the complex natural conditions the existing trends derived from results of meteorological measurements and observations are clear and they confirm warming of climate in this region. Observations and measurements in the recent years of the 21st century confirm, that heat waves are no longer rare phenomenon during summer, but are systematically appearing even in colder regions of northern Slovakia. What is very remarkable and will be necessary to pay more attention to, is the fact that these heat waves are expanding into previously unaffected areas, associated with the lack of rainfall and drought, on larger regional scale. In this study heat wave periods and individual heat events and days are statistically identified in the time series characteristics of air temperature at selected meteorological stations for the period from the mid-20th century until 2015, in case of available historical data even for longer period.

  4. Removal of alkylphenols and polybromodiphenylethers by a biofiltration treatment plant during dry and wet-weather periods.

    PubMed

    Gilbert, S; Gasperi, J; Rocher, V; Lorgeoux, C; Chebbo, G

    2012-01-01

    This paper investigates the occurrence of alkylphenols (APs) and polybromodiphenylethers (PBDEs) in raw wastewater during dry and wet-weather periods, and their removal by physico-chemical lamellar settling and biofiltration techniques. Due to in-sewer deposit erosion and, to a lesser extent, to external inputs, raw effluents exhibit from 1.5 to 5 times higher AP and PBDE concentrations during wet periods compared with dry ones. The lamellar settler obtains high removal of APs and PBDEs under both dry and wet-weather flows (>53% for Σ(6)AP and >89% for Σ(4)PBDE), confirming the insensitivity of this technique to varying influent conditions. Indeed, despite the higher pollutant concentrations observed in raw effluents under wet-weather flows, adjusting the addition of coagulant-flocculent allows for efficient removal. By combining physical and biological processes, the biofiltration unit treats nutrient pollution, as well as Σ(6)AP and Σ(4)PBDE contamination (58 ± 5% and 75 ± 6% respectively). Although the operating conditions of the biofiltration unit are modified during wet periods, the performance in nutrient pollution, APs and light PBDE congeners remains high. Nevertheless, lower efficiency has been noted in nitrogen pollution, i.e. no denitrification occurs, and BDE-209 (not removed during wet-weather periods). In conclusion, this study demonstrates that the combination of both techniques treats AP and PBDE pollution efficiently during dry periods, but that they are also suitable for stormwater treatment.

  5. On the implications of the period distributions of subclasses of cataclysmic variables

    NASA Astrophysics Data System (ADS)

    Verbunt, Frank

    1997-09-01

    The period distributions of dwarf novae and nova-like variables above the period gap are different if the VY Scl systems are classed with the nova-like variables, but the same when the VY Scl phenomenon is classed with the dwarf nova outbursts. For the remaining nova-like variables, the period gap is no longer significant. Classification of the VY Scl phenomenon with dwarf novae suggests that dwarf nova outbursts are caused by variation in mass transfer from the donor. Absence of the period gap obviates the need for models explaining it, and invalidates one piece of evidence for the importance of magnetic braking for the evolution of cataclysmic variables and of low-mass binaries in general.

  6. [Influence of three-level collaboration network of pediatric burns treatment in Anhui province on treatment effects of burn children].

    PubMed

    Xia, Z G; Zhou, X L; Kong, W C; Li, X Z; Song, J H; Fang, L S; Hu, D L; Cai, C; Tang, Y Z; Yu, Y X; Wang, C H; Xu, Q L

    2018-03-20

    transferred from January 2014 to December 2015 was 6.0% (4/67), and 3 children among them were cured. The incidence of shock of children with severe burns transferred from January 2016 to September 2017 was 3.9% (2/51), and both children were cured. The incidences and cures of shock of children with severe burns transferred from the two periods of time were close ( χ (2)=0.006, P >0.05). Incidence of shock of children with extremely severe burns transferred from January 2014 to December 2015 was 57.1% (32/56), significantly higher than that of burn children transferred from January 2016 to September 2017 [34.5% (10/29), χ (2)=3.925, P <0.05]. Shock of 25 children with extremely severe burns transferred from January 2014 to December 2015 were cured, and shock of 9 children with extremely severe burns transferred from January 2016 to September 2017 were cured. The cures of shock of children with extremely severe burns transferred from the two periods of time were close ( χ (2)=0.139, P >0.05). (5) Time of operative treatment of children with moderate, severe, and extremely severe burns transferred from January 2014 to December 2015 was obviously longer than that of burn children transferred from January 2016 to September 2017 ( t =2.335, 2.065, 2.310, P <0.05). Time of operative treatment of children with mild burns transferred from the two periods of time was close ( Z =-0.417, P >0.05). Costs of operative treatment of children with moderate and severe burns transferred from January 2014 to December 2015 were significantly more than those of burn children transferred from January 2016 to September 2017 ( Z =-3.324, t =2.167, P <0.05). Costs of operative treatment of children with mild and extremely severe burns transferred from the two periods of time were close ( t =0.627, 0.808, P >0.05). (6)Time of non-operative treatment of children with mild, moderate, and severe burns transferred from January 2014 to December 2015 was obviously longer than that of burn children

  7. The economic efficiency of allowing longer combination vehicles in Texas.

    DOT National Transportation Integrated Search

    2011-08-01

    This paper shows the economic efficiency of allowing longer combination vehicles in Texas. First, an : overview of the truck size and weight policies is explained, with an emphasis on those that affect : Texas. Next, LCV operations in other countries...

  8. 16. A LONGER VIEW OF THE SAME LAMP STANDARD, SHOWING ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    16. A LONGER VIEW OF THE SAME LAMP STANDARD, SHOWING THE OCTAGONAL PEBBLE AGGREGATE SHAFT. - County Line Bridge, Spanning St. Joseph River at State Route 219, 0.6 mile south of U.S. Route 20, Osceola, St. Joseph County, IN

  9. A Guide to Dental Care for the Early and Periodic Screening, Diagnosis, and Treatment Program (EPSDT) Under Medicaid.

    ERIC Educational Resources Information Center

    Lindahl, Roy L.; Young, Wesley O.

    This guide has been developed to assist administrators, providers of dental care, and others involved in carrying out the dental care provisions of the EPSDT program (Early and Periodic Screening, Diagnosis, and Treatment Program). It is intended to assist in the development of programs concerned with the unique characteristics of dental diseases…

  10. Restriction periods for carers, comforters and members of the public in the treatment of hyperthyroidism.

    PubMed

    Mínguez, Pablo; Genolla, José; Celeiro, José; Fombellida, José Cruz

    2013-01-01

    People treated for hyperthyroidism are normally outpatients who pose a potential radiological risk to some members of the public. In this study, measurements of the uptake in 30 patients were used to estimate the values of the activity of ¹³¹I in the whole body of patients, AWB, by using a model of two compartments. Restriction periods to be followed by patients for different values of the administered activity of ¹³¹I were calculated. To perform calculations, the following were used: the curve obtained for AWB; the value of the dose rate at one metre from patients after the administration of the treatment; and the estimated time that carers, comforters and members of the public will spend at certain distances from patients. Results show that protection from radiation for carers, comforters and members of the public related to patients treated for hyperthyroidism can become a cumbersome matter as patients may have to follow very long restriction periods.

  11. Thyrotoxic periodic paralysis

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

    Ferreiro, J.E.; Arguelles, D.J.; Rams, H. Jr.

    1986-01-01

    A case of thyrotoxic periodic paralysis is reported in a Hispanic man with an unusual recurrence six weeks after radioactive iodine treatment. Thyrotoxic periodic paralysis has now been well characterized in the literature: it occurs primarily in Orientals with an overwhelming male preponderance and a higher association of specific HLA antigens. Clinical manifestations include onset after high carbohydrate ingestion or heavy exertion, with progressive symmetric weakness leading to flaccid paralysis of the extremities and other muscle groups, lasting several hours. If hypokalemia is present, potassium administration may help abort the attack. Although propranolol can be efficacious in preventing further episodes,more » the only definitive treatment is establishing a euthyroid state. The pathophysiology is still controversial, but reflects altered potassium and calcium dynamics as well as certain morphologic characteristics within the muscle unit itself.« less

  12. Improved mechanical properties of retorted carrots by ultrasonic pre-treatments.

    PubMed

    Day, Li; Xu, Mi; Øiseth, Sofia K; Mawson, Raymond

    2012-05-01

    The use of ultrasound pre-processing treatment, compared to blanching, to enhance mechanical properties of non-starchy cell wall materials was investigated using carrot as an example. The mechanical properties of carrot tissues were measured by compression and tensile testing after the pre-processing treatment prior to and after retorting. Carrot samples ultrasound treated for 10 min at 60 °C provided a higher mechanical strength (P<0.05) to the cell wall structure than blanching for the same time period. With the addition of 0.5% CaCl(2) in the pre-treatment solution, both blanching and ultrasound treatment showed synergistic effect on enhancing the mechanical properties of retorted carrot pieces. At a relatively short treatment time (10 min at 60 °C) with the use of 0.5% CaCl(2), ultrasound treatment achieved similar enhancement to the mechanical strength of retorted carrots to blanching for a much longer time period (i.e. 40 min). The mechanism involved appears to be related to the stress responses present in all living plant matter. However, there is a need to clarify the relative importance of the potential stress mechanisms in order to get a better understanding of the processing conditions likely to be most effective. The amount of ultrasound treatment required is likely to involve low treatment intensities and there are indications from the structural characterisation and mechanical property analyses that the plant cell wall tissues were more elastic than that accomplished using low temperature long time blanching. Crown Copyright © 2011. Published by Elsevier B.V. All rights reserved.

  13. Weighing the potential effectiveness of various treatments for sleep bruxism.

    PubMed

    Huynh, Nelly; Manzini, Christiane; Rompré, Pierre H; Lavigne, Gilles J

    2007-10-01

    Sleep bruxism may lead to a variety of problems, but its pathophysiology has not been completely elucidated. As such, there is no definitive treatment, but certain preventive measures and/or drugs may be used in acute cases, particularly those involving pain. This article is intended to guide clinician scientists to the treatment most appropriate for future clinical studies. To determine the best current treatment, 2 measures were used to compare the results of 10 clinical studies on sleep bruxism, 3 involving oral devices and 7 involving pharmacologic therapy. The first measure, the number needed to treat (NNT), allows several randomized clinical studies to be compared and a general conclusion to be drawn. The second measure, effect size, allows evaluation of the impact of treatment relative to a placebo using different studies of similar design. Taking into account the NNT, the effect size and the power of each study, it can be concluded that the following treatments reduce sleep bruxism: mandibular advancement device, clonidine and occlusal splint. However, the first 2 of these have been linked to adverse effects. The occlusal splint is therefore the treatment of choice, as it reduces grinding noise and protects the teeth from premature wear with no reported adverse effects. The NNT could not be calculated for an alternative pharmacologic treatment, short-term clonazepam therapy, which had a large effect size and reduced the average bruxism index. However, the risk of dependency limits its use over long periods. Assessment of efficacy and safety of the most promising treatments will require studies with larger sample sizes over longer periods.

  14. Anorectal Complications During Neutropenic Period in Patients with Hematologic Diseases

    PubMed Central

    Solmaz, Soner; Korur, Aslı; Gereklioğlu, Çiğdem; Asma, Süheyl; Büyükkurt, Nurhilal; Kasar, Mutlu; Yeral, Mahmut; Kozanoğlu, İlknur; Boğa, Can; Ozdoğu, Hakan

    2016-01-01

    Background Neutropenic patients are susceptible to any anorectal disease, and symptomatic anorectal disease afflicts 2–32% of oncology patients. Perianal infections are the most feared complication, considering the lack of natural defense against infectious microorganisms. When septic complications develop, the anorectal disease is potentially fatal, especially in neutropenic patients in whom mortality rates range between 11–57%. Although anorectal diseases are a frequent complication with potentially fatal outcomes among patients with hematologic diseases, sufficient data are not available in the literature. In this study, we aimed to investigate the anorectal complications developing during the neutropenic period in patients with hematologic diseases. Methods A total of 79 patients whose neutropenic period (absolute neutrophil count <500/mcL) continued for 7 days, or longer were included in the study. Results A total of 34 patients out of 79 (43%) were detected to develop anorectal complications, of them 6 (7.6%) developed an anorectal infection. The patients were characterized according to the hematological disease and its status (active or not), the type of treatment and the presence of a history of an anorectal pathology before the onset of the hematologic disease. Nineteen (24.1%) patients had the history of anorectal disturbances before diagnosis of the hematologic disease, and recurrence of an anorectal pathology was found in 14 out of 19 patients(73.7%). In addition, the overall mortality rate was higher among the patients who developed anorectal complications compared to another group (41.2% vs. 22.2%, p=0.059). Conclusion Anorectal pathology is a common complication with high recurrence rate in neutropenic patients. Perianal infections are important as they can cause life-threatening outcomes although they are relatively rare among all anorectal complications. Therefore perianal signs and symptoms should be meticulously evaluated concerning early

  15. Estimating the incubation period of hand, foot and mouth disease for children in different age groups.

    PubMed

    Yang, Zhongzhou; Zhang, Qiqi; Cowling, Benjamin J; Lau, Eric H Y

    2017-11-28

    Hand, foot and mouth disease (HFMD) is a childhood disease causing large outbreaks frequently in Asia and occasionally in Europe and the US. The incubation period of HFMD was typically described as about 3-7 days but empirical evidence is lacking. In this study, we estimated the incubation period of HFMD from school outbreaks in Hong Kong, utilizing information on symptom onset and sick absence dates of students diagnosed with HFMD. A total of 99 HFMD cases from 12 schools were selected for analysis. We fitted parametric models accounting for interval censoring. Based on the best-fitted distributions, the estimated median incubation periods were 4.4 (95% CI 3.8-5.1) days, 4.7 (95% CI 4.5-5.1) days and 5.7 (95% CI 4.6-7.0) days for children in kindergartens, primary schools and secondary schools respectively. From the fitted distribution, the estimated incubation periods can be longer than 10 days for 8.8% and 23.2% of the HFMD cases in kindergarten and secondary schools respectively. Our results show that the incubation period of HFMD for secondary schools students can be longer than the ranges commonly described. An extended period of enhanced personal hygiene practice and disinfection of the environment may be needed to control outbreaks.

  16. Treatment of acute periprosthetic infections with prosthesis retention: Review of current concepts.

    PubMed

    Kuiper, Jesse Wp; Willink, Robin Tjeenk; Moojen, Dirk Jan F; van den Bekerom, Michel Pj; Colen, Sascha

    2014-11-18

    Periprosthetic joint infection (PJI) is a devastating complication after total joint arthroplasty, occurring in approximately 1%-2% of all cases. With growing populations and increasing age, PJI will have a growing effect on health care costs. Many risk factors have been identified that increase the risk of developing PJI, including obesity, immune system deficiencies, malignancy, previous surgery of the same joint and longer operating time. Acute PJI occurs either postoperatively (4 wk to 3 mo after initial arthroplasty, depending on the classification system), or via hematogenous spreading after a period in which the prosthesis had functioned properly. Diagnosis and the choice of treatment are the cornerstones to success. Although different definitions for PJI have been used in the past, most are more or less similar and include the presence of a sinus tract, blood infection values, synovial white blood cell count, signs of infection on histopathological analysis and one or more positive culture results. Debridement, antibiotics and implant retention (DAIR) is the primary treatment for acute PJI, and should be performed as soon as possible after the development of symptoms. Success rates differ, but most studies report success rates of around 60%-80%. Whether single or multiple debridement procedures are more successful remains unclear. The use of local antibiotics in addition to the administration of systemic antibiotic agents is also subject to debate, and its pro's and con's should be carefully considered. Systemic treatment, based on culture results, is of importance for all PJI treatments. Additionally, rifampin should be given in Staphylococcal PJIs, unless all foreign material is removed. The most important factors contributing to treatment failure are longer duration of symptoms, a longer time after initial arthroplasty, the need for more debridement procedures, the retention of exchangeable components, and PJI caused by Staphylococcus (aureus or

  17. EAO Supplement Working Group 4 - EAO CC 2015 Short implants versus sinus lifting with longer implants to restore the posterior maxilla: a systematic review.

    PubMed

    Thoma, D S; Zeltner, M; Hüsler, J; Hämmerle, C H F; Jung, R E

    2015-09-01

    clinical settings. The outcomes of the survey analyses demonstrated predictably high implant survival rates for short implants and longer implants placed in augmented sinus and their respective reconstructions. Given the higher number of biological complications, increased morbidity, costs and surgical time of longer dental implants in the augmented sinus, shorter dental implants may represent the preferred treatment alternative. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Initial North American experience with botulinum toxin type A for treatment of anismus.

    PubMed

    Joo, J S; Agachan, F; Wolff, B; Nogueras, J J; Wexner, S D

    1996-10-01

    Botulinum toxin type A (BTX-A), produced by Clostridium botulinum, is a potent neurotoxin. The purpose of this study was to evaluate the efficacy of BTX-A for treatment of anismus. All patients treated with BTX-A for anismus were evaluated. Eligibility criteria included a history of chronic assisted evacuation (laxatives, enemas, or suppositories), demonstration of anismus by cinedefecogram and electromyography, and failure of a minimum of three sessions of supervised biofeedback therapy (BF). Contingent on body mass, 6 to 15 units of BTX-A was injected bilaterally under electromyography guidance into the external sphincter or the puborectalis muscle. Treatment was repeated as necessary for a maximum of three sessions during a three-month period. Success was considered as discontinuation of evacuatory assistance and was evaluated between one and three months and again at up to one year. Between July 1994 and May 1995, four patients ranging from 29 to 82 years in age (2 females, 2 males) had anismus that failed to respond to between 3 and 15 biofeedback sessions. All patients improved between one and three months after BTX-A injection, and two had sustained improvement for a range of three months to one year. There was no morbidity or mortality associated with BTX-A injection. BTX-A is extremely successful for temporary treatment of anismus that is refractory to BF management. However, because the mechanism of action is short, longer term results are only 50 percent successful. Hopefully, modifications in the strain of BTX-A and dose administered will allow longer periods of success or a repeat trial of BF. Nonetheless, this preliminary report is very encouraging in offering a method of managing this recalcitrant condition.

  19. Retinal Wave Behavior through Activity-Dependent Refractory Periods

    PubMed Central

    Godfrey, Keith B; Swindale, Nicholas V

    2007-01-01

    In the developing mammalian visual system, spontaneous retinal ganglion cell (RGC) activity contributes to and drives several aspects of visual system organization. This spontaneous activity takes the form of spreading patches of synchronized bursting that slowly advance across portions of the retina. These patches are non-repeating and tile the retina in minutes. Several transmitter systems are known to be involved, but the basic mechanism underlying wave production is still not well-understood. We present a model for retinal waves that focuses on acetylcholine mediated waves but whose principles are adaptable to other developmental stages. Its assumptions are that a) spontaneous depolarizations of amacrine cells drive wave activity; b) amacrine cells are locally connected, and c) cells receiving more input during their depolarization are subsequently less responsive and have longer periods between spontaneous depolarizations. The resulting model produces waves with non-repeating borders and randomly distributed initiation points. The wave generation mechanism appears to be chaotic and does not require neural noise to produce this wave behavior. Variations in parameter settings allow the model to produce waves that are similar in size, frequency, and velocity to those observed in several species. Our results suggest that retinal wave behavior results from activity-dependent refractory periods and that the average velocity of retinal waves depends on the duration a cell is excitatory: longer periods of excitation result in slower waves. In contrast to previous studies, we find that a single layer of cells is sufficient for wave generation. The principles described here are very general and may be adaptable to the description of spontaneous wave activity in other areas of the nervous system. PMID:18052546

  20. Painful menstrual periods

    MedlinePlus

    ... exercise. If these self-care measures do not work, your health care provider may offer you treatment such as: Birth control pills Mirena IUD Prescription anti-inflammatory medicines Prescription pain relievers (including narcotics, for brief periods) Antidepressants Antibiotics When ...

  1. Clinical features and treatment outcomes of vancomycin-intermediate Staphylococcus aureus (VISA) and heteroresistant vancomycin-intermediate Staphylococcus aureus (hVISA) in a tertiary care institution in Singapore.

    PubMed

    Fong, R K C; Low, J; Koh, T H; Kurup, A

    2009-08-01

    This retrospective case-control study was undertaken to review the clinical features associated with heteroresistant vancomycin-intermediate Staphylococcus aureus (hVISA) and vancomycin-intermediate S. aureus (VISA) infections and the local impact they have on clinical outcome. Compared with vancomycin-susceptible S. aureus (n = 30), hVISA and VISA infections (n = 10) are found to be associated with a longer period of prior glycopeptide use (P = 0.01), bone/joint (P < 0.01) and prosthetic infections (P = 0.04), as well as treatment failure, as evidenced by longer bacteremic (P < 0.01) and culture positivity (P < 0.01) periods. This was observed to have resulted in longer hospital length of stay (P < 0.01) and total antibiotic therapy duration (P = 0.01). There was, however, no significant difference in the overall patient mortality or the hospitalization cost (P = 0.12) in both groups. Clinicians should be cognizant of the association between hVISA/VISA with high bacterial load deep-seated infections. We recommend targeted and even universal screening for hVISA/VISA in methicillin-resistant S. aureus (MRSA) infections.

  2. Linear-scaling explicitly correlated treatment of solids: periodic local MP2-F12 method.

    PubMed

    Usvyat, Denis

    2013-11-21

    Theory and implementation of the periodic local MP2-F12 method in the 3*A fixed-amplitude ansatz is presented. The method is formulated in the direct space, employing local representation for the occupied, virtual, and auxiliary orbitals in the form of Wannier functions (WFs), projected atomic orbitals (PAOs), and atom-centered Gaussian-type orbitals, respectively. Local approximations are introduced, restricting the list of the explicitly correlated pairs, as well as occupied, virtual, and auxiliary spaces in the strong orthogonality projector to the pair-specific domains on the basis of spatial proximity of respective orbitals. The 4-index two-electron integrals appearing in the formalism are approximated via the direct-space density fitting technique. In this procedure, the fitting orbital spaces are also restricted to local fit-domains surrounding the fitted densities. The formulation of the method and its implementation exploits the translational symmetry and the site-group symmetries of the WFs. Test calculations are performed on LiH crystal. The results show that the periodic LMP2-F12 method substantially accelerates basis set convergence of the total correlation energy, and even more so the correlation energy differences. The resulting energies are quite insensitive to the resolution-of-the-identity domain sizes and the quality of the auxiliary basis sets. The convergence with the orbital domain size is somewhat slower, but still acceptable. Moreover, inclusion of slightly more diffuse functions, than those usually used in the periodic calculations, improves the convergence of the LMP2-F12 correlation energy with respect to both the size of the PAO-domains and the quality of the orbital basis set. At the same time, the essentially diffuse atomic orbitals from standard molecular basis sets, commonly utilized in molecular MP2-F12 calculations, but problematic in the periodic context, are not necessary for LMP2-F12 treatment of crystals.

  3. Issues of using Longer Heavier Vehicles on Roads

    NASA Astrophysics Data System (ADS)

    Matuszkova, R.; Heczko, M.; Cepil, J.; Radimsky, M.

    2018-03-01

    Many logistics companies aim to save on freight costs. Recently, not only on Czech roads and on motorways, longer and heavier vehicles that exceed dimensions’ limits appeared. For these vehicles, it is necessary to apply for a special permit, which is, however, much more liberal than the permit for oversized and overweight load transport. This paper informs about checking routes of these vehicles by swept path analysis and finding locations on roads that can generate both safety risks and traffic fluency problems.

  4. Geographic variation in avian incubation periods and parental influences on embryonic temperature

    USGS Publications Warehouse

    Martin, T.E.; Auer, S.K.; Bassar, R.D.; Niklison, Alina M.; Lloyd, P.

    2007-01-01

    Theory predicts shorter embryonic periods in species with greater embryo mortality risk and smaller body size. Field studies of 80 passerine species on three continents yielded data that largely conflicted with theory; incubation (embryonic) periods were longer rather than shorter in smaller species, and egg (embryo) mortality risk explained some variation within regions, but did not explain larger differences in incubation periods among geographic regions. Incubation behavior of parents seems to explain these discrepancies. Bird embryos are effectively ectothermic and depend on warmth provided by parents sitting on the eggs to attain proper temperatures for development. Parents of smaller species, plus tropical and southern hemisphere species, commonly exhibited lower nest attentiveness (percent of time spent on the nest incubating) than larger and northern hemisphere species. Lower nest attentiveness produced cooler minimum and average embryonic temperatures that were correlated with longer incubation periods independent of nest predation risk or body size. We experimentally tested this correlation by swapping eggs of species with cool incubation temperatures with eggs of species with warm incubation temperatures and similar egg mass. Incubation periods changed (shortened or lengthened) as expected and verified the importance of egg temperature on development rate. Slower development resulting from cooler temperatures may simply be a cost imposed on embryos by parents and may not enhance offspring quality. At the same time, incubation periods of transferred eggs did not match host species and reflect intrinsic differences among species that may result from nest predation and other selection pressures. Thus, geographic variation in embryonic development may reflect more complex interactions than previously recognized. ?? 2007 The Author(s).

  5. Olfactory neuroblastoma: 14-year experience at an Australian tertiary centre and the role for longer-term surveillance.

    PubMed

    Schmidt, C; Potter, N; Porceddu, S; Panizza, B

    2017-07-01

    Olfactory neuroblastoma is a rare sinonasal malignancy, with poorly defined treatment protocols. Management at a tertiary centre was retrospectively evaluated to inform future treatment and follow up. Cases treated with curative intent (2000-2014) were included. Data were collected, and overall and disease-free survival rates were calculated. Eleven cases were identified, with a median follow up of 87 months. One patient was Kadish stage A, one was stage B, eight were stage C and one was stage D. The latter patient underwent chemoradiotherapy alone. The remaining patients proceeded to: endoscopic-assisted wide local excision (n = 2), anterior craniofacial resection (n = 4) or endoscopic craniofacial resection (n = 4). No patients had primary nodal disease or elective neck treatment. One patient had neoadjuvant chemoradiation. Six patients had post-operative radiotherapy; three received adjuvant chemotherapy. Two patients had late cervical node failure, and proceeded to neck dissection and post-operative radiotherapy. Two patients had late local recurrence. Ten-year overall and disease-free survival rates were 68.2 and 46.7 per cent, respectively. Longer-term follow up is supported given the incidence of late regional and local recurrence. Prophylactic treatment of cervical nodes in locally advanced disease is an area for further investigation.

  6. Minoxidil topical treatment may be more efficient if applied on damp scalp in comparison with dry scalp.

    PubMed

    Angelo, T; Barbalho, G N; Gelfuso, G M; Gratieri, T

    2016-09-01

    There is yet no consensus among prescribers whether minoxidil (MXD) formulations should be applied on wet/damp or dry scalp and no clear FDA guidelines on the matter. We hypothesized that the use of MXD on damp scalp may lead to higher drug penetration. First, because the drug diffusion and consequent deposition into the hair follicle may be favored when follicle cast is humid. Second, because humidity may also prevent drug crystallization and, therefore, maintain a higher thermodynamic activity for longer periods, which leads to increased penetration. Following in vitro experiments on rat and porcine skin we confirmed the hypothesis, which could markedly improve treatment effectiveness. © 2016 Wiley Periodicals, Inc.

  7. Laser treatment of infantile hemangioma: A systematic review.

    PubMed

    Chinnadurai, Sivakumar; Sathe, Nila A; Surawicz, Tanya

    2016-03-01

    treatment of IH primarily addressed different laser modalities compared with observation or other laser modalities. PDL was the most commonly studied laser type, but multiple variations in treatment protocols did not allow for demonstration of superiority of a single method. Most studies reported a higher success rate with longer pulse PDL compared to observation in managing the size of IH, although the magnitude of effect differed substantially. Studies generally found PDL more effective than other types of lasers for cutaneous lesions. When first introduced as a primary treatment for IH, various laser modalities generally offered superior outcomes compared with steroid therapy and observation. In the era of β-blocker therapy, laser treatment may retain an important role in the treatment of residual and refractory lesions. © 2015 Wiley Periodicals, Inc.

  8. Measles with a possible 23 day incubation period.

    PubMed

    Fitzgerald, Tove L; Durrheim, David N; Merritt, Tony D; Birch, Christopher; Tran, Thomas

    2012-09-30

    Measles virus (MV) eradication is biologically, technically and operationally feasible. An essential feature in understanding the chain of MV transmission is its incubation period, that is, the time from infection to the onset of symptoms. This period is important for determining the likely source of infection and directing public health measures to interrupt ongoing transmission. Long measles incubation periods have rarely been documented in the literature. We report on a previously healthy 11-year-old Australian boy who was confirmed with measles genotype D9 infection following travel in the Philippines. Epidemiological evidence supported an unusually long incubation period of at least 23 days and virological evidence was consistent with this finding. Although public health control measures such as post exposure prophylaxis, isolation and surveillance of susceptible individuals should continue to be based on the more common incubation period, a longer incubation period may occasionally explain an unexpected measles case. This work is copyright. Apart from any use as permitted under the Copyright Act 1968, no part may be reproduced by any process without prior written permission from the Commonwealth. Requests and inquiries concerning reproduction and rights should be addressed to the Commonwealth Copyright Administration, Attorney General's Department, Robert Garran Offices, National Circuit, Barton ACT 2600 or posted at http://www.ag.gov.au/cca.

  9. Fc-fusion proteins and FcRn: structural insights for longer-lasting and more effective therapeutics

    PubMed Central

    Rath, Timo; Baker, Kristi; Dumont, Jennifer A.; Peters, Robert T.; Jiang, Haiyan; Qiao, Shuo-Wang; Lencer, Wayne I.; Pierce, Glenn F.; Blumberg, Richard S.

    2016-01-01

    Nearly 350 IgG-based therapeutics are approved for clinical use or are under development for many diseases lacking adequate treatment options. These include molecularly engineered biologicals comprising the IgG Fc-domain fused to various effector molecules (so-called Fc-fusion proteins) that confer the advantages of IgG, including binding to the neonatal Fc receptor (FcRn) to facilitate in vivo stability, and the therapeutic benefit of the specific effector functions. Advances in IgG structure-function relationships and an understanding of FcRn biology have provided therapeutic opportunities for previously unapproachable diseases. This article discusses approved Fc-fusion therapeutics, novel Fc-fusion proteins and FcRn-dependent delivery approaches in development, and how engineering of the FcRn–Fc interaction can generate longer-lasting and more effective therapeutics. PMID:24156398

  10. Autonomic adaptation after traditional and reverse swimming training periodizations.

    PubMed

    Clemente-Suárez, Vicente Javier; Fernandes, R J; Arroyo-Toledo, J J; Figueiredo, P; González-Ravé, J M; Vilas-Boas, J P

    2015-03-01

    The objective of the present study was to analyze the autonomic response of trained swimmers to traditional and reverse training periodization models. Seventeen swimmers were divided in two groups, performing a traditional periodization (TPG) or a reverse periodization (RPG) during a period of 10 weeks. Heart rate variability and 50 m swimming performance were analyzed before and after the training programs. After training, the TPG decreased the values of the high frequency band (HF), the number of differences between adjacent normal R-R intervals longer than 50 ms (NN50) and the percentage of differences between adjacent normal R-R intervals more than 50 ms (pNN50), and the RPG increased the values of HF and square root of the mean of the sum of the squared differences between adjacent normal R-R intervals (RMSSD). None of the groups improved significantly their performance in the 50-m test. The autonomic response of swimmers was different depending on the periodization performed, with the reverse periodization model leading to higher autonomic adaption. Complementary, the data suggests that autonomic adaptations were not critical for the 50-m swimming performance.

  11. Periodic intensity variations in sulfur emissions from the Io plasma torus

    NASA Technical Reports Server (NTRS)

    Woodward, R. Carey, Jr.; Scherb, Frank; Roesler, Fred L.

    1994-01-01

    In November and December 1988, we acquired 157 spectra of (S II) lambda 6731 emissions from the Io plasma torus with a Fabry-Perot interferometer at the McMath-Pierce Solar Telescope facility on Kitt Peak. A major goal of this experiment was to extend our earlier studies of intensity variations in the plasma torus. Our earlier analysis (F. L. Roesler, F. Scherb, and R. J. Oliversen, 1984, of (S III) lambda 9531 emission spectra acquired in April 1982 had shown that the intensity of torus emissions varied periodically with a period of 10.20 +/- 0.06 hr (1-sigma uncertainty level), slightly longer than Jupiter's System 3 rotational period of 9.925 hr. We present here an reanalysis of our 1982 data revealing, in addition to the 10.20-hr period, a clear secondary periodicity at 9.95 +/- 0.906 hr. By constrast, we show that our new (S II) lambda 6731 data have a single period of 10.14 +/- 0.03 hr. which is neither the System 3 period nor the proposed 'System 4' period of 10.224 hr.

  12. Periodic intensity variations in sulfur emissions from the Io plasma torus

    NASA Astrophysics Data System (ADS)

    Woodward, R. Carey, Jr.; Scherb, Frank; Roesler, Fred L.; Oliversen, Ronald J.

    1994-09-01

    In November and December 1988, we acquired 157 spectra of (S II) lambda 6731 emissions from the Io plasma torus with a Fabry-Perot interferometer at the McMath-Pierce Solar Telescope facility on Kitt Peak. A major goal of this experiment was to extend our earlier studies of intensity variations in the plasma torus. Our earlier analysis (F. L. Roesler, F. Scherb, and R. J. Oliversen, 1984, of (S III) lambda 9531 emission spectra acquired in April 1982 had shown that the intensity of torus emissions varied periodically with a period of 10.20 +/- 0.06 hr (1-sigma uncertainty level), slightly longer than Jupiter's System 3 rotational period of 9.925 hr. We present here an reanalysis of our 1982 data revealing, in addition to the 10.20-hr period, a clear secondary periodicity at 9.95 +/- 0.906 hr. By constrast, we show that our new (S II) lambda 6731 data have a single period of 10.14 +/- 0.03 hr. which is neither the System 3 period nor the proposed 'System 4' period of 10.224 hr.

  13. Complete recovery from undertreated Wernicke-Korsakoff syndrome following aggressive thiamine treatment.

    PubMed

    Paparrigopoulos, Thomas; Tzavellas, Elias; Karaiskos, Dimitris; Kouzoupis, Anastasios; Liappas, Ioannis

    2010-01-01

    Wernicke-Korsakoff syndrome (WKS) is a neuropsychiatric condition which results from thiamine deficiency, most commonly due to alcohol abuse. The prognosis of WKS is poor and its outcome depends mainly on prompt treatment. A 52-year-old male with a ten-year history of heavy alcohol abuse was admitted in hospital and treated for WKS. Ataxic and oculomotor symptoms promptly reversed following standard treatment but no change was observed in higher mental functioning. Although the protracted WK symptoms made the patient's improvement unlikely, aggressive treatment with thiamine (600 mg/day orally and 300 mg/day intramuscularly) fully reversed the condition within two months. Even though prolongation of undertreatment of WKS typically precludes significant improvement of symptoms due to irreversible damage of the brain, at least in some cases, higher thiamine doses (over 500 mg/day) for a longer period (at least three months) than usually recommended should be tried.

  14. SPECTROSCOPIC ORBITAL PERIODS FOR 29 CATACLYSMIC VARIABLES FROM THE SLOAN DIGITAL SKY SURVEY

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

    Thorstensen, John R.; Taylor, Cynthia J.; Peters, Christopher S.

    2015-04-15

    We report follow-up spectroscopy of 29 cataclysmic variables from the Sloan Digital Sky Survey (SDSS), 22 of which were discovered by SDSS and seven of which are previously known systems that were recovered in SDSS. The periods for 16 of these objects were included in the tabulation by Gänsicke et al. While most of the systems have periods less than 2 hr, only one has a period in the 80–86 minutes “spike” found by Gänsicke et al., and 11 have periods longer than 3 hr, indicating that the present sample is skewed toward longer-period, higher-luminosity objects. Seven of the objectsmore » have spectra resembling dwarf novae, but have apparently never been observed in outburst, suggesting that many cataclysmics with relatively low variability amplitude remain to be discovered. Some of the objects are notable. SDSS J07568+0858 and SDSS J08129+1911 were previously known to have deep eclipses; in addition to spectroscopy, we use archival data from the Catalina Real Time Transient Survey to refine their periods. We give a parallax-based distance of 195 (+54, −39) pc for LV Cnc (SDSS J09197+0857), which at P{sub orb} = 81 m has the shortest orbital period in our sample. SDSS J08091+3814 shows both the spectroscopic phase offset and phase-dependent absorption found in SW Sextantis stars. The average spectra of SDSS J08055+0720 and SDSS J16191+1351 show contributions from K-type secondaries, and SDSS J080440+0239 shows a contribution from an early M star. We use these to constrain the distances. SDSS J09459+2922 has characteristics typical of a magnetic system. SDSS11324+6249 may be a novalike variable, and if so, its orbital period (99 minutes) is unusually short for that subclass.« less

  15. Risks of antibiotic residues in milk following intramammary and intramuscular treatments in dairy sheep.

    PubMed

    Pengov, A; Kirbis, A

    2009-04-01

    Very few drugs on the market are approved for use in lactating ewes. Veterinarians in the European Union are allowed to prescribe drugs in an off-label manner but are then obligated to assure that residues do not enter the food chain. In case of mastitis treatment in dairy ewes antibiotic preparations designed and authorized for the bovine mammary gland are usually used. Due to inter-species differences, available bovine data cannot be accurately extrapolated for use in the dairy ewe. The objective of the study was therefore to determine appropriate withdrawal periods for ewe's milk following mastitis treatment with two commercial lactating cow products. For the detection of all components standard agar plate diffusion techniques were used. Regardless of the therapy regime and the product used, residues of antibiotics in milk were detected up to 192h after the last infusion. These results indicate that the required withholding periods for ewe's milk are considerably longer than recommended on the label for bovine milk.

  16. Factors associated with prolonged time to treatment failure with fulvestrant 500 mg in patients with post-menopausal estrogen receptor-positive advanced breast cancer: a sub-group analysis of the JBCRG-C06 Safari study.

    PubMed

    Kawaguchi, Hidetoshi; Masuda, Norikazu; Nakayama, Takahiro; Aogi, Kenjiro; Anan, Keisei; Ito, Yoshinori; Ohtani, Shoichiro; Sato, Nobuaki; Saji, Shigehira; Takano, Toshimi; Tokunaga, Eriko; Nakamura, Seigo; Hasegawa, Yoshie; Hattori, Masaya; Fujisawa, Tomomi; Morita, Satoshi; Yamaguchi, Miki; Yamashita, Hiroko; Yamashita, Toshinari; Yamamoto, Yutaka; Yotsumoto, Daisuke; Toi, Masakazu; Ohno, Shinji

    2018-01-01

    The JBCRG-C06 Safari study showed that earlier fulvestrant 500 mg (F500) use, a longer time from diagnosis to F500 use, and no prior palliative chemotherapy were associated with significantly longer time to treatment failure (TTF) among Japanese patients with estrogen receptor-positive (ER+) advanced breast cancer (ABC). The objective of this sub-group analysis was to further examine data from the Safari study, focusing on ER + and human epidermal growth factor receptor-negative (HER2-) cases. The Safari study (UMIN000015168) was a retrospective, multi-center cohort study, conducted in 1,072 patients in Japan taking F500 for ER + ABC. The sub-analysis included only patients administered F500 as second-line or later therapy (n = 960). Of these, 828 patients were HER2-. Results Multivariate analysis showed that advanced age (≥65 years; p = .035), longer time (≥3 years) from ABC diagnosis to F500 use (p < .001), no prior chemotherapy (p < .001), and F500 treatment line (p < .001) were correlated with prolonged TTF (median = 5.39 months). In ER+/HER2- patients receiving F500 as a second-line or later therapy, treatment line, advanced age, no prior palliative chemotherapy use, and a longer period from ABC diagnosis to F500 use were associated with longer TTF.

  17. Sex and age differences in hibernation patterns of common hamsters: adult females hibernate for shorter periods than males.

    PubMed

    Siutz, Carina; Franceschini, Claudia; Millesi, Eva

    2016-08-01

    In this study, we investigated the timing and duration of hibernation as well as body temperature patterns in free-ranging common hamsters (Cricetus cricetus) with regard to sex and age differences. Body temperature was recorded using subcutaneously implanted data loggers. The results demonstrate that although immergence and vernal emergence sequences of sex and age groups resembled those of most hibernators, particularly adult females delayed hibernation onset until up to early January. Thus, in contrast to other hibernators, female common hamsters hibernated for shorter periods than males and correspondingly spent less time in torpor. These sex differences were absent in juvenile hamsters. The period between the termination of hibernation and vernal emergence varied among individuals but did not differ between the sex and age groups. This period of preemergence euthermy was related to emergence body mass: individuals that terminated hibernation earlier in spring and had longer euthermic phases prior to emergence started the active season in a better condition. In addition, males with longer periods of preemergence euthermy had larger testes at emergence. In conclusion, females have to rely on sufficient food stores but may adjust the use of torpor in relation to the available external energy reserves, whereas males show a more pronounced energy-saving strategy by hibernating for longer periods. Nonetheless, food caches seem to be important for both males and females as indicated by the euthermic preemergence phase and the fact that some individuals, mainly yearlings, emerged with a higher body mass than shortly before immergence in autumn.

  18. Percutaneous Treatment of Splenic Cystic Echinococcosis: Results of 12 Cases

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

    Akhan, Okan, E-mail: akhano@tr.net; Akkaya, Selçuk, E-mail: selcuk.akkaya85@gmail.com; Dağoğlu, Merve Gülbiz, E-mail: drmgkartal@gmail.com

    PurposeCystic echinococcosis (CE) in the spleen is a rare disease even in endemic regions. The aim of this study was to examine the efficacy of percutaneous treatment for splenic CE.Materials and MethodsTwelve patients (four men, eight women) with splenic CE were included in this study. For percutaneous treatment, CE1 and CE3A splenic hydatid cysts were treated with either the PAIR (puncture, aspiration, injection, respiration) technique or the catheterization technique.ResultsEight of the hydatid cysts were treated with the PAIR technique and four were treated with catheterization. The volume of all cysts decreased significantly during the follow-up period. No complication occurred inmore » seven of 12 patients. Abscess developed in four patients. Two patients underwent splenectomy due to cavity infection developed after percutaneous treatment, while the spleen was preserved in 10 of 12 patients. Total hospital stay was between 1 and 18 days. Hospital stay was longer and the rate of infection was higher in the catheterization group. Follow-up period was 5–117 months (mean, 44.8 months), with no recurrence observed.ConclusionThe advantages of the percutaneous treatment are its minimal invasive nature, short hospitalization duration, and its ability to preserve splenic tissue and function. As the catheterization technique is associated with higher abscess risk, we suggest that the PAIR procedure should be the first percutaneous treatment option for splenic CE.« less

  19. Consumption, Retirement and Social Security: Evaluating the Efficiency of Reform that Encourages Longer Careers*

    PubMed Central

    Laitner, John; Silverman, Dan

    2012-01-01

    This paper proposes and analyzes a Social Security reform in which individuals no longer face the OASI payroll tax after, say, age 54 or a career of 34 years, and their subsequent earnings have no bearing on their benefits. We first estimate parameters of a life–cycle model. Our specification includes non-separable preferences and possible disability. It predicts a consumption–expenditure change at retirement. We use the magnitude of the expenditure change, together with households’ retirement–age decisions, to identify key structural parameters. The estimated magnitude of the change in consumption–expenditure depends importantly on the treatment of consumption by adult children of the household. Simulations indicate that the reform could increase retirement ages one year or more, equivalent variations could average more than $4,000 per household, and income tax revenues per household could increase by more than $14,000. PMID:23729902

  20. The PRCI study: design of a randomized clinical trial to evaluate a coping intervention for medical waiting periods used by women undergoing a fertility treatment.

    PubMed

    Ockhuijsen, Henrietta D L; van den Hoogen, Agnes; Macklon, Nickolas S; Boivin, Jacky

    2013-09-03

    Many medical situations necessitate a stressful period of waiting for potentially threatening test results. The medical waiting period is often associated with negative anticipatory anxiety and rumination about the outcome of treatment. Few evidence-based self-help coping interventions are available to assist individuals manage these periods. Theory and research suggest that positive reappraisal coping strategies may be particularly useful for this type of unpredictable and uncontrollable stressful context. The objective of this study is to investigate the effects of a Positive Reappraisal Coping Intervention (PRCI) on psychological well-being of women waiting for the outcome of their fertility treatment cycle. In a three-armed randomized controlled trial, the effectiveness of the PRCI will be tested. Consecutive patients undergoing in vitro fertilisation in a Dutch university hospital and meeting selection criteria will be invited to participate. Those who agree will be randomized to one of three experimental groups (N=372). The PRCI Intervention group will receive the intervention that comprises an explanatory leaflet and the 10 statements designed to promote positive reappraisal coping, to be read at least once in the morning, once in the evening. To capture the general impact of PRCI on psychological wellbeing patients will complete questionnaires before the waiting period (pre-intervention), on day ten of the 14-day waiting period (intervention) and six weeks after the start of the waiting period (post-intervention). To capture the specific effects of the PRCI during the waiting period, patients will also be asked to monitor daily their emotions and reactions during the 14-day waiting period. The primary outcome is general anxiety, measured by the Hospital Anxiety and Depression Scale. Secondary outcomes are positive and negative emotions during the waiting period, depression, quality of life, coping and treatment outcome. During recruitment for the RCT it was

  1. [Forensic (flexible) assertive community treatment: client characteristics and treatment outcomes].

    PubMed

    Neijmeijer, L; Verwoerd, J; van Vugt, M; Place, C; Kroon, H

    (Flexible) Assertive community treatment ((f)act) is applied increasingly to forensic psychiatric clients. However, evidence about the effectiveness of forensic (f)act is scanty. To investigate to what extent (subgroups of) clients receiving care from forensic (f)act teams show, after a year, changes in their social and psychological functioning and are subjected to fewer justicial outcome measures. Between 2009 and 2011, eight forensic (f)act teams collected, at two measurement moments separated by an average of 12 months, data relating to client characteristics and outcomes of care. The study involved 202 clients. After a year clients showed significant improvements in psychological and social functioning, and had fewer confrontations with the police and the law. They were detained less often and for shorter periods and were considered to be less likely to reoffend. The number of admissions to mental health care and to addiction and forensic care remained constant. Clients with a psychiatric disorder and likely to display criminal behaviour showed improvement while being treated by forensic (f)act teams. Further research is needed to prove whether forensic (f)act treatment will have the desired effects in the longer term and will enjoy the status of being regarded as evidence based practice.

  2. EPSDT: Child Health. Child Health Information for Workers in the Medicaid Early and Periodic Screening Diagnosis and Treatment Program.

    ERIC Educational Resources Information Center

    Manela, Roger; And Others

    One of six information booklets with accompanying training materials for the Medicaid Early and Periodic Screening Diagnosis and Treatment (EPSDT) program, this booklet describes the stages of child growth and development and some of the health problems which EPSDT clients might have. Section I describes tests commonly included in an EPSDT…

  3. Diminish electrostatic in piezoresponse force microscopy through longer or ultra-stiff tips

    NASA Astrophysics Data System (ADS)

    Gomez, A.; Puig, T.; Obradors, X.

    2018-05-01

    Piezoresponse Force Microscopy is a powerful but delicate nanoscale technique that measures the electromechanical response resulting from the application of a highly localized electric field. Though mechanical response is normally due to piezoelectricity, other physical phenomena, especially electrostatic interaction, can contribute to the signal read. We address this problematic through the use of longer ultra-stiff probes providing state of the art sensitivity, with the lowest electrostatic interaction and avoiding working in high frequency regime. In order to find this solution we develop a theoretical description addressing the effects of electrostatic contributions in the total cantilever vibration and its quantification for different setups. The theory is subsequently tested in a Periodically Poled Lithium Niobate (PPLN) crystal, a sample with well-defined 0° and 180° domains, using different commercial available conductive tips. We employ the theoretical description to compare the electrostatic contribution effects into the total phase recorded. Through experimental data our description is corroborated for each of the tested commercially available probes. We propose that a larger probe length can be a solution to avoid electrostatic forces, so the cantilever-sample electrostatic interaction is reduced. Our proposed solution has great implications into avoiding artifacts while studying soft biological samples, multiferroic oxides, and thin film ferroelectric materials.

  4. Autoinflammatory Diseases with Periodic Fevers.

    PubMed

    Sag, Erdal; Bilginer, Yelda; Ozen, Seza

    2017-07-01

    One purpose of this review was to raise awareness for the new autoinflammatory syndromes. These diseases are increasingly recognized and are in the differential diagnosis of many disease states. We also aimed to review the latest recommendations for the diagnosis, management, and treatment of these patients. Familial Mediterranean fever (FMF), cryopyrin-associated periodic syndrome (CAPS), tumor necrosis factor receptor-associated periodic fever syndrome (TRAPS), and hyperimmunoglobulinemia D and periodic fever syndrome/mevalonate kinase deficiency (HIDS/MVKD) are the more common autoinflammatory diseases that are characterized by periodic fevers and attacks of inflammation. Recently much collaborative work has been done to understand the characteristics of these patients and to develop recommendations to guide the physicians in the care of these patients. These recent recommendations will be summarized for all four diseases. FMF is the most common periodic fever disease. We need to further understand the pathogenesis and the role of single mutations in the disease. Recently, the management and treatment of the disease have been nicely reviewed. CAPS is another interesting disease associated with severe complications. Anti-interleukin-1 (anti-IL-1) treatment provides cure for these patients. TRAPS is characterized by the longest delay in diagnosis; thus, both pediatricians and internists should be aware of the characteristic features and the follow-up of these patients. HIDS/MVKD is another autoinflammatory diseases characterized with fever attacks. The spectrum of disease manifestation is rather large in this disease, and we need further research on biomarkers for the optimal management of these patients.

  5. Treatment-resistant Late-life Depression: Challenges and Perspectives

    PubMed Central

    Knöchel, Christian; Alves, Gilberto; Friedrichs, Benedikt; Schneider, Barbara; Schmidt-Rechau, Anna; Wenzlera, Sofia; Schneider, Angelina; Prvulovic, David; Carvalho, André F.; Oertel-Knöchel, Viola

    2015-01-01

    The current Review article provides a narrative review about the neurobiological underpinnings and treatment of treatment resistant late-life depression (TRLLD). The manuscript focuses on therapeutic targets of late-life depression, which include pharmacological, psychological, biophysical and exercise treatment approaches. Therefore, we summarize available evidences on that kind of therapies for patients suffering from late-life depression. The search for evidences of therapeutic options of late-life depression were done using searching websites as “pubmed”, and using the searching terms “depression”, “late-life depression”, “treatment”, “biophysical therapy”, “exercise therapy”, “pharmacological therapy” and “psychological therapy”. To the end, we summarize and discuss current data, providing some directions for further research. Treatment recommendations for elderly depressive patients favour a multimodal approach, containing psychological, pharmacological and secondary biophysical therapeutic options. Particularly, a combination of psychotherapy and antidepressant medication reflects the best therapeutic option. However, mostly accepted and used is the pharmacological treatment although evidence suggests that the drug therapy is not as effective as it is in younger depressive patients. Further studies employing larger samples and longer follow-up periods are necessary and may focus on comparability of study designs and involve novel approaches to establish the validity and reliability of multimodal treatment programs. PMID:26467408

  6. Higher cost of single incision laparoscopic cholecystectomy due to longer operating time. A study of opportunity cost based on meta-analysis

    PubMed Central

    GIRABENT-FARRÉS, M.

    2018-01-01

    Background We aimed to calculate the opportunity cost of the operating time to demonstrate that single incision laparoscopic cholecystectomy (SILC) is more expensive than classic laparoscopic cholecystectomy (CLC). Methods We identified studies comparing use of both techniques during the period 2008–2016, and to calculate the opportunity cost, we performed another search in the same period of time with an economic evaluation of classic laparoscopy. We performed a meta-analysis of the items selected in the first review considering the cost of surgery and surgical time, and we analyzed their differences. We subsequently calculated the opportunity cost of these time differences based on the design of a cost/time variable using the data from the second literature review. Results Twenty-seven articles were selected from the first review: 26 for operating time (3.138 patients) and 3 for the cost of surgery (831 patients), and 3 articles from the second review. Both techniques have similar operating costs. Single incision laparoscopy surgery takes longer (16.90min) to perform (p <0.00001) and this difference represents an opportunity cost of 755.97 € (cost/time unit factor of 44.73 €/min). Conclusions SILC costs the same as CLC, but the surgery takes longer to perform, and this difference involves an opportunity cost that increases the total cost of SILC. The value of the opportunity cost of the operating time can vary the total cost of a surgical technique and it should be included in the economic evaluation to support the decision to adopt a new surgical technique. PMID:29549678

  7. Effects of Simvastatin Treatment on Serum Adiponectin Concentrations in Patients With Dislipidemia

    PubMed Central

    Moezzi, Atefeh; Parizadeh, Seyyed Mohammad Reza; Tavallaie, Shima; Mazidi, Mohsen; Afzali, Fariba; Adab, Afrouz; Ferns, Gordon; Ghayour Mobarhan, Majid

    2014-01-01

    Background: Adiponectin is an adipose tissue-derived protein with anti-inflammatory properties. Statins are a class of cholesterol-lowering drugs, widely used for treatment of cardiovascular diseases. Objectives: In the current study, we aimed to assess the effects of simvastatin on serum levels of adiponectin in patients with dyslipidemia, recruited from Ghaem Hospital, Mashhad, Iran. Materials and Methods: A total of 102 patients with dyslipidemia were treated with simvastatin or placebo during a double-blind, cross-over, placebo-controlled trial. The adiponectin levels were measured before and after each treatment period. Seventy seven participants completed the study. Results: There was a significant reduction in serum total cholesterol (approxmately 21%), low density lipoprotein-cholesterol (LDL-C) (approxmately 28%), and triglycerides (approxmately 11%), after four weeks of treatment with simvastatin (P < 0.001). Conclusions: No significant change in serum adiponectin concentrations was observed after treatment with simvastatin. This may be because of the relatively short duration of treatment and longer treatment duration may be necessary to investigation in future studies. PMID:25389496

  8. Periods of vertebral column sensitivity to boric acid treatment in CD-1 mice in utero.

    PubMed

    Cherrington, Jana W; Chernoff, Neil

    2002-01-01

    Boric acid (BA) has many uses as an industrial compound and is widely distributed in the environment. BA has been shown to produce rib agenesis, a rare effect in laboratory animals. This study was conducted to determine if there is a period of sensitivity to this unusual effect. BA (500 or 750 mg/kg) was administered p.o. to pregnant CD-1 mice once daily on gestational days (GDs) 6-10. A reduction of 13th rib length occurred at both dose levels. BA 400mg/kg was also administered twice daily on GD 6, 7, 8, 9, or 10 or on GDs 6-8. A significant decrease in average fetal weight was observed in all treatment groups. Significant increases in the incidence of cervical ribs/ossifications resulted from treatments on GD 7 and GDs 6-8. Rib agenesis occurred with treatment on GD 8 and GDs 6-8. Reduced rib length, a decreased incidence of supernumerary ribs (SNR), and an increased incidence of fused and/or branched ribs occurred when dams were treated GDs 6-8. Doses of 750 mg/kg given twice on day 8 produced significant increases in several thoracic skeletal anomalies. Further studies of pathogenesis are necessary to determine the earliest perturbations and the processes that are affected. The sensitivity of embryos to treatment on GD 8 to rib agenesis suggests that BA is affecting early processes such as gastrulation and presomitic mesoderm formation and patterning in this area.

  9. Conservative treatment of intraosseous hemangiomas in the mandible: case report with a 17-year follow-up period.

    PubMed

    Frizzera, Fausto; Beccalli, Ivette; Maia, Rosa Maria Lourenço Carlos; Tonetto, Mateus Rodrigues; Zanetti, Liliane Scheidegger da Silva; de Barros, Liliana Pimenta Aparecida

    2014-05-01

    Intraosseous hemangiomas in the jaws are rare lesions and may lead to several complications. The authors present a case of a 12-year-old girl with a radiolucent periapical lesion between tooth 35 and 36 where nocturnal exsanguinating bleeding started to occur from periodontal sulcus during orthodontic treatment. Diagnosis of an intraosseous hemangioma in the mandible was based on positive needle aspiration for blood, computed tomography and arteriography. At first the family chose to only follow-up the lesion but episodes of nocturnal hemorrhage were becoming more frequent and a treatment was requested. Embolization and dental extraction were performed in order to treat the lesion. After a follow-up period of 17 years no more cases of hemorrhage occurred and lesion regressed.

  10. [Asthenic syndrome in clinical course of acute period of brain concussion during complex treatment using nootropic agents].

    PubMed

    Tkachov, A V

    2008-01-01

    The comparative analysis of a complex examination of 108 persons aged from 16 till 60 years in acute period of closed craniocerebral injury (CCCT) has been done. Every participants have been divided into 2 groups depending on a nootrop medication they receive in a complex treatment. A control group consisted of 30 practically healthy people. Objective examination by means of tests was done on the 1-st, 10-th that 30-th day of treatment. Patients of 1-st (37 persons) group received piracetam in complex treatment and patients of the 2-nd group (71 persons) pramistar. Patients of the first group received a base treatment (analgetics, tranquilizers, vitamins of group B, magnesium sulfate, diuretic preparations) as well as piracetam at dosage 0.2, two tablets three times per day. The Patients of the 2-nd group received a base treatment as well as pramistar at dosage 0.6, one tablet 2 times per day. Specially developed multiaspects scales and questionnaires, MRT of the brain and EEG have been used for objectification of patient, complaints. During a complex clinico-neuropsychological examination it was found that all cases of concussion of the brain are accompanied by those or other asthenic disorders.

  11. Maintaining functional properties of shell eggs by ultrasound treatment.

    PubMed

    Caner, Cengiz; Yuceer, Muhammed

    2015-11-01

    Ultrasonic treatment is an emerging technique that could be an alternative to existing thermal processing techniques in foods. Ultrasonic treatments may also be used to extend the shelf life of egg during storage period in ambient temperature. The effectiveness of ultrasound treatment with different power levels (200 W, 300 W, 450 W) and treatment times (2 min and 5 min) was evaluated for enhancing the functional properties of eggs during storage at 24 ° C for 6 weeks. Ultrasound treatment power and treatment time had significant effects on Haugh unit, yolk index, albumen pH, dry matter, relative whipping capacity, and albumen viscosity resulting in extended shelf life. Attributes such as yolk index, Haugh unit, pH, whipping capacity, dry matter for 300 W and 450 W treatments were better than control and 200 W treatments. Longer treatment time and power showed a significant influence on functional properties. Power levels of 300 W and 450 W of ultrasound treatments had improved internal quality of fresh eggs during storage, but negative effect on shell strength. The study showed that ultrasound treatment could be an alternative and effective technique for maintaining the internal qualities of fresh eggs during long-term storage while Fourier transform near infrared spectroscopy could be used as a new tool for the assessment of freshness. © 2014 Society of Chemical Industry.

  12. Effect of pelvic floor muscle exercises in the treatment of urinary incontinence during pregnancy and the postpartum period.

    PubMed

    Dinc, Ayten; Kizilkaya Beji, Nezihe; Yalcin, Onay

    2009-10-01

    The aim of this study was to determine the effectiveness of pelvic floor muscle exercises on urinary incontinence during pregnancy and the postpartum period. The study was carried out on 80 pregnant women (study group, 40 subjects; control group, 40 subjects).The study group was trained by the researcher on how to do the pelvic floor muscle exercises. Both groups were evaluated for pelvic floor muscle strength and urinary complaints in their 36th to 38th week of pregnancy and postpartum sixth to eighth week. The study group had a significant decrease in urinary incontinence episodes during pregnancy and in the postpartum period, and their pelvic floor muscle strength increased to a larger extent. Control group had an increase in the postpartum muscle strength and decrease in the incontinence episodes in the postpartum period. Pelvic floor muscle exercises are quite effective in the augmentation of the pelvic floor muscle strength and consequently in the treatment of urinary incontinence.

  13. Viral meningitis: current issues in diagnosis and treatment.

    PubMed

    McGill, Fiona; Griffiths, Michael J; Solomon, Tom

    2017-04-01

    The purpose of this review is to give an overview of viral meningitis and then focus in on some of the areas of uncertainty in diagnostics, treatment and outcome. Bacterial meningitis has been declining in incidence over recent years. Over a similar time period molecular diagnostics have increasingly been used. Because of both of these developments viral meningitis is becoming relatively more important. However, there are still many unanswered questions. Despite improvements in diagnostics many laboratories do not use molecular methods and even when they are used many cases still remain without a proven viral aetiology identified. There are also no established treatments for viral meningitis and the one potential treatment, aciclovir, which is effective in vitro for herpes simplex virus, has never been subjected to a clinical trial. Viruses are in increasingly important cause of meningitis in the era of declining bacterial disease. The exact viral aetiology varies according to age and country. Molecular diagnostics can not only improve the rate of pathogen detection but also reduce unnecessary antibiotics use and length of hospitalization. Further research is required into treatments for viral meningitis and the impact in terms of longer term sequelae.

  14. U32: vehicle stability and dynamics longer combination vehicles final report.

    DOT National Transportation Integrated Search

    2011-09-01

    This study investigated the safety and stability of longer combination vehicles (LCVs), in particular a triple trailer combination behind a commercial tractor, which has more complicated dynamics than the more common tractor in combination with a sin...

  15. Treatment options for severe pulmonary embolism during pregnancy and the postpartum period: a systematic review.

    PubMed

    Martillotti, G; Boehlen, F; Robert-Ebadi, H; Jastrow, N; Righini, M; Blondon, M

    2017-10-01

    Essentials The evidence on how to manage life-threatening pregnancy-related pulmonary embolism (PE) is scarce. We systematically reviewed all available cases of (sub)massive PE until December 2016. Thrombolysis in such severe PE was associated with a high maternal survival (94%). The major bleeding risk was much greater in the postpartum (58%) than antepartum period (18%). Background Massive pulmonary embolism (PE) during pregnancy or the postpartum period is a rare but dramatic event. Our aim was to systematically review the evidence to guide its management. Methods We searched Pubmed, Embase, conference proceedings and the RIETE registry for published cases of severe (submassive/massive) PE treated with thrombolysis, percutaneous or surgical thrombectomy and/or extracorporeal membrane oxygenation (ECMO), occurring during pregnancy or within 6 weeks of delivery. Main outcomes were maternal survival and major bleeding, premature delivery, and fetal survival and bleeding. Results We found 127 cases of severe PE (at least 83% massive; 23% with cardiac arrest) treated with at least one modality. Among 83 women with thrombolysis, survival was 94% (95% CI, 86-98). The risk of major bleeding was 17.5% during pregnancy and 58.3% in the postpartum period, mainly because of severe postpartum hemorrhages. Fetal deaths possibly related to PE or its treatment occurred in 12.0% of cases treated during pregnancy. Among 36 women with surgical thrombectomy, maternal survival and risk of major bleeding were 86.1% (95% CI, 71-95) and 20.0%, with fetal deaths possibly related to surgery in 20.0%. About half of severe postpartum PEs occurred within 24 h of delivery. Conclusions Published cases of thrombolysis for massive PE during pregnancy and the postpartum period suggest a high maternal and fetal survival (94% and 88%). In the postpartum period, given the high risk of major bleeding with thrombolysis, other therapeutic options (catheter [or surgical] thrombectomy, ECMO) may be

  16. Alternative approaches to treatment of Central Sleep Apnea

    PubMed Central

    2013-01-01

    Synopsis Divergent approaches to treatment of hypocapnic central sleep apnea syndromes reflect the difficulties in taming a hyperactive respiratory chemoreflex. As both sleep fragmentation and a narrow CO2 reserve or increased loop gain drive the disease, sedatives (to induce longer periods of stable non-rapid eye movement (NREM) sleep and reduce the destabilizing effects of arousals in NREM sleep) and CO2-based stabilization approaches are logical. Adaptive ventilation reduces mean hyperventilation yet can induce ventilator-patient dyssynchrony, while enhanced expiratory rebreathing space (EERS, dead space during positive pressure therapy) and CO2 manipulation directly stabilize respiratory control by moving CO2 above the apnea threshold. Carbonic anhydrase inhibition can provide further adjunctive benefits. Provent and Winx may be less likely to trigger central apneas or periodic breathing in those with a narrow CO2 reserve. An oral appliance can meaningfully reduce positive pressure requirements and thus enable treatment of complex apnea. Novel pharmacological approaches may target mediators of carotid body glomus cell excitation, such as the balance between gas neurotransmitters. In complex apnea patients, single mode therapy is not always successful, and multi-modality therapy might need to be considered. Phenotyping of sleep apnea beyond conventional scoring approaches is the key to optimal management. PMID:24772053

  17. Alternative approaches to treatment of Central Sleep Apnea.

    PubMed

    Thomas, Robert Joseph

    2014-03-01

    Divergent approaches to treatment of hypocapnic central sleep apnea syndromes reflect the difficulties in taming a hyperactive respiratory chemoreflex. As both sleep fragmentation and a narrow CO 2 reserve or increased loop gain drive the disease, sedatives (to induce longer periods of stable non-rapid eye movement (NREM) sleep and reduce the destabilizing effects of arousals in NREM sleep) and CO 2 -based stabilization approaches are logical. Adaptive ventilation reduces mean hyperventilation yet can induce ventilator-patient dyssynchrony, while enhanced expiratory rebreathing space (EERS, dead space during positive pressure therapy) and CO 2 manipulation directly stabilize respiratory control by moving CO 2 above the apnea threshold. Carbonic anhydrase inhibition can provide further adjunctive benefits. Provent and Winx may be less likely to trigger central apneas or periodic breathing in those with a narrow CO 2 reserve. An oral appliance can meaningfully reduce positive pressure requirements and thus enable treatment of complex apnea. Novel pharmacological approaches may target mediators of carotid body glomus cell excitation, such as the balance between gas neurotransmitters. In complex apnea patients, single mode therapy is not always successful, and multi-modality therapy might need to be considered. Phenotyping of sleep apnea beyond conventional scoring approaches is the key to optimal management.

  18. Cars with antilock brakes no longer are overinvolved in fatal crashes

    DOT National Transportation Integrated Search

    2000-04-15

    New tests suggest that cars with antilock braking system no longer are disproportionately involved in certain types of fatal crashes, but antilocks still are not producing reductions in overall fatal crash risk. Since the poor experience of cars with...

  19. ASA24-2014, 2012, and 2011, all versions (no longer available)

    Cancer.gov

    Researchers can no longer register new studies to use ASA24-2014, ASA24-Canada-2014 and ASA24-2011; however, all of these versions of the ASA24® system are available for data collection until March 2017.

  20. Incubation period for outbreak-associated, non-typhoidal salmonellosis cases, Minnesota, 2000-2015.

    PubMed

    Eikmeier, D; Medus, C; Smith, K

    2018-03-01

    Incubation period for non-typhoidal Salmonella (NTS) infections is generally reported as 6-72 h despite numerous reports of foodborne NTS outbreaks with median incubation periods >3 days. We summarised 16 years of Minnesota foodborne NTS outbreaks to better estimate the expected range of incubation periods for NTS infections. Of the 1517 NTS outbreak cases, 725 had enough data to calculate a precise incubation period. The median incubation period was 45 h; 77 (11%) cases had incubations ⩽12 h and 211 (29%) cases had incubations >72 h. Incubation period length varied by outbreak vehicle type, Salmonella serotype and outbreak setting. Based on our data, a more accurate description would be that the incubation of NTS infection is usually from 12 to 96 h, that incubations in >96 to 144 h (>4 to 6-day) range are not unusual and that incubations from 7 to 9 days and occasionally longer also occur.

  1. Exploratory randomised controlled clinical study to evaluate the comparative efficacy of two occluding toothpastes - a 5% calcium sodium phosphosilicate toothpaste and an 8% arginine/calcium carbonate toothpaste - for the longer-term relief of dentine hypersensitivity.

    PubMed

    Hall, Claire; Mason, Stephen; Cooke, Jonathan

    2017-05-01

    To compare the longer-term clinical efficacy of two occlusion-technology toothpastes - a 5% calcium sodium phosphosilicate (CSPS) toothpaste and a commercially available 8% arginine/calcium carbonate toothpaste - in relieving dentine hypersensitivity (DH). Efficacy was also compared with that of a regular fluoride toothpaste control. This was an exploratory, randomised, examiner-blind, parallel-group, 11-week, controlled study in healthy adults with self-reported and clinically diagnosed DH. After an acclimatisation period, subjects were randomised to one of three study treatments with which they brushed their teeth twice daily. Sensitivity was assessed at baseline and after 1, 2, 4, 6 and 11 weeks treatment in response to evaporative (air) and tactile stimuli (measured by the Schiff Sensitivity Scale/visual analogue scale and tactile threshold, respectively). A total of 135 subjects were randomised to treatment. The two occlusion-technology toothpastes performed similarly over the 11-week treatment period. All study treatments showed statistically significant reductions from baseline in DH at all timepoints for all measures (p<0.05). Statistically significant and clinically relevant sensitivity relief was observed for both occluding formulations compared with the regular fluoride toothpaste: for evaporative (air) sensitivity within 1 week and for tactile sensitivity at Week 11. No significant differences were detected between the two occluding formulations at any timepoint, for any endpoint. Study treatments were generally well tolerated. In this exploratory study, a 5% CSPS occluding toothpaste was effective in relieving DH compared with a regular fluoride toothpaste; an 8% arginine/calcium carbonate anti-sensitivity toothpaste provided similar benefits. Improvements in DH continued throughout the 11-week study. Dentine hypersensitivity (DH) is a common and painful condition. Twice-daily use of a 5% calcium sodium phosphosilicate toothpaste reduces DH within 1

  2. The effects of short work vs. longer work periods within intermittent exercise on V̇o2p kinetics, muscle deoxygenation, and energy system contribution.

    PubMed

    McCrudden, Michael C; Keir, Daniel A; Belfry, Glen R

    2017-06-01

    We examined the effects of inserting 3-s recovery periods during high-intensity cycling exercise at 25-s and 10-s intervals on pulmonary oxygen uptake (V̇o 2p ), muscle deoxygenation [deoxyhemoglobin (HHb)], their associated kinetics (τ), and energy system contributions. Eleven men (24 ± 3 yr) completed two trials of three cycling protocols: an 8-min continuous protocol (CONT) and two 8-min intermittent exercise protocols with work-to-rest periods of 25 s to 3 s (25INT) and 10 s to 3 s (10INT). Each protocol began with a step-transition from a 20-W baseline to a power output (PO) of 60% between lactate threshold and maximal V̇o 2p (Δ60). This PO was maintained for 8 min in CONT, whereas 3-s periods of 20-W cycling were inserted every 10 s and 25 s after the transition to Δ60 in 10INT and 25INT, respectively. Breath-by-breath gas exchange measured by mass spectrometry and turbine and vastus lateralis [HHb] measured by near-infrared spectroscopy were recorded throughout. Arterialized-capillary lactate concentration ([Lac - ]) was obtained before and 2 min postexercise. The τV̇o 2p was lowest ( P < 0.05) for 10INT (24 ± 4 s) and 25INT (23 ± 5 s) compared with CONT (28 ± 4 s), whereas HHb kinetics did not differ ( P > 0.05) between conditions. Postexercise [Lac - ] was lowest ( P < 0.05) for 10INT (7.0 ± 1.7 mM), was higher for 25INT (10.3 ± 1.9 mM), and was greatest in CONT (14.3 ± 3.1 mM). Inserting 3-s recovery periods during heavy-intensity exercise speeded V̇o 2p kinetics and reduced overall V̇o 2p , suggesting an increased reliance on PCr-derived phosphorylation during the work period of INT compared with an identical PO performed continuously. NEW & NOTEWORTHY We report novel observations on the effects of differing heavy-intensity work durations between 3-s recovery periods on pulmonary oxygen uptake (V̇o 2p ) kinetics, muscle deoxygenation, and energy system contributions. Relative to continuous exercise, V̇o 2p

  3. Is longer treatment better? A comparison study of 3 versus 6 months cognitive remediation in schizophrenia.

    PubMed

    Buonocore, Mariachiara; Bosia, Marta; Bechi, Margherita; Spangaro, Marco; Cavedoni, Silvia; Cocchi, Federica; Guglielmino, Carmelo; Bianchi, Laura; Mastromatteo, Antonella Rita; Cavallaro, Roberto

    2017-05-01

    Despite its extensive use for treating cognitive deficits in schizophrenia, computer-assisted cognitive remediation (CACR) currently lacks a standardized protocol. Duration is an important feature to be defined, as it may contribute to heterogeneous outcome. This study compares 2 treatment durations, 3 versus 6 months, to analyze their effects on both cognition and daily functioning. Fifty-seven outpatients with schizophrenia received 3 months of CACR and 41 received 6 months of CACR. All patients were assessed at baseline and after 3 and 6 months with the Brief Assessment for Cognition in Schizophrenia and with the Quality of Life Scale (QLS). Repeated measures ANOVA showed significant improvements in all cognitive domains after 3 months. A significant effect of treatment duration was observed only for executive functions, with significantly higher scores among patients treated for 6 months. Significant improvements in QLS were also observed after 6 months in both groups, with a significant time by treatment interaction for QLS Total Score. Results confirm the efficacy of 3-months CACR in terms of both cognitive and functional improvements, suggesting that an extended intervention may lead to further benefits in executive functions and daily functioning. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  4. Can longer forest harvest intervals increase summer streamflow for salmon recovery?

    EPA Science Inventory

    The Mashel Streamflow Modeling Project in the Mashel River Basin, Washington, is using a watershed-scale ecohydrological model to assess whether longer forest harvest intervals can remediate summer low flow conditions that have contributed to sharply reduced runs of spawning Chin...

  5. LPI Thresholds in Longer Scale Length Plasmas Driven by the Nike Laser*

    NASA Astrophysics Data System (ADS)

    Weaver, J.; Oh, J.; Phillips, L.; Afeyan, B.; Seely, J.; Kehne, D.; Brown, C.; Obenschain, S.; Serlin, V.; Schmitt, A. J.; Feldman, U.; Holland, G.; Lehmberg, R. H.; McLean, E.; Manka, C.

    2010-11-01

    The Krypton-Fluoride (KrF) laser is an attractive driver for inertial confinement fusion due to its short wavelength (248nm), large bandwidth (1-3 THz), and beam smoothing by induced spatial incoherence. Experiments with the Nike KrF laser have demonstrated intensity thresholds for laser plasma instabilities (LPI) higher than reported for other high power lasers operating at longer wavelengths (>=351 nm). The previous Nike experiments used short pulses (350 ps FWHM) and small spots (<260 μm FWHM) that created short density scale length plasmas (Ln˜50-70 μm) from planar CH targets and demonstrated the onset of two-plasmon decay (2φp) at laser intensities ˜2x10^15 W/cm^2. This talk will present an overview of the current campaign that uses longer pulses (0.5-4.0 ns) to achieve greater density scale lengths (Ln˜100-200 μm). X-rays, emission near ^1/2φo and ^3/2φo harmonics, and reflected laser light have been monitored for onset of 2φp. The longer density scale lengths will allow better comparison to results from other laser facilities. *Work supported by DoE/NNSA and ONR.

  6. Effect of nutritional immunomodulation and heat stress during the dry period on subsequent performance of cows.

    PubMed

    Fabris, Thiago F; Laporta, Jimena; Corra, Fabiana N; Torres, Yazielis M; Kirk, David J; McLean, Derek J; Chapman, J D; Dahl, Geoffrey E

    2017-08-01

    among treatments in hematocrit, total protein, and body condition score. Cows offered CLOG, CL, and HTOG treatments had greater body weight during the dry period (794.9 ± 17.9, 746.8 ± 16.7, and 762.9 ± 14.9 kg, respectively) than HT cows (720 ± 16.2 kg). Gestation length was approximately 4 d longer for CL cows compared with HT cows. Cows offered CLOG, CL, and HTOG treatments produced more milk (41.3 ± 1.6, 40.7 ± 1.6, and 40.5 ± 1.6 kg/d, respectively) than HT treatment (35.9 ± 1.6 kg/d). Body weight after parturition and DMI were evaluated up to 60 DIM and averaged 661.5 ± 15.8 and 19.4 ± 0.7 kg/d, respectively, with no differences observed among treatments. These results confirm that exposure of dry cows to heat stress negatively affects milk yield in the subsequent lactation. Active cooling of dry cows and OG supplementation can reduce the negative effects of heat stress in the dry period on subsequent performance. Copyright © 2017 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  7. Duration of surgical-orthodontic treatment.

    PubMed

    Häll, Birgitta; Jämsä, Tapio; Soukka, Tero; Peltomäki, Timo

    2008-10-01

    To study the duration of surgical-orthodontic treatment with special reference to patients' age and the type of tooth movements, i.e. extraction vs. non-extraction and intrusion before or extrusion after surgery to level the curve of Spee. The material consisted files of 37 consecutive surgical-orthodontic patients. The files were reviewed and gender, diagnosis, type of malocclusion, age at the initiation of treatment, duration of treatment, type of tooth movements (extraction vs. non-extraction and levelling of the curve of Spee before or after operation) and type of operation were retrieved. For statistical analyses two sample t-test, Kruskal-Wallis and Spearman rank correlation tests were used. Mean treatment duration of the sample was 26.8 months, of which pre-surgical orthodontics took on average 17.5 months. Patients with extractions as part of the treatment had statistically and clinically significantly longer treatment duration, on average 8 months, than those without extractions. No other studied variable seemed to have an impact on the treatment time. The present small sample size prevents reliable conclusions to be made. However, the findings suggest, and patients should be informed, that extractions included in the treatment plan increase chances of longer duration of surgical-orthodontic treatment.

  8. Effects of intermittent feeding of tylosin phosphate during the finishing period on feedlot performance, carcass characteristics, antimicrobial resistance, and incidence and severity of liver abscesses in steers.

    PubMed

    Müller, H C; Van Bibber-Krueger, C L; Ogunrinu, O J; Amachawadi, R G; Scott, H M; Drouillard, J S

    2018-04-27

    feeding tylosin phosphate intermittently during the finishing phase decreases the total percentage of LA and maintains feedlot performance and carcass characteristics to the same extent as feeding tylosin phosphate throughout the finishing phase; further, we hypothesize that enteric antimicrobial resistance is a result of longer term antibiotic usage in a particular environment rather than a direct short-term result of the treatment during any given feeding period.

  9. Transit Precovery: Determining Ephemerides for Long-Period TESS Detections with KELT Photometry

    NASA Astrophysics Data System (ADS)

    Yao, Xinyu; Pepper, Joshua; KELT Collaboration

    2018-01-01

    The majority of the known exoplanets were discovered by using the transit method such as with Kepler and the upcoming TESS mission. Unlike the Kepler mission which observed stars for several years, 74% of the area to be observed by TESS will only have an observational baseline of 27 days. For those planets with periods longer than 13 days, TESS can only capture one or two transits which means the true ephemerides are difficult to determine. Since the ground based all sky survey project KELT has much longer observation baseline (up to ten years) and monitors fields that overlap with TESS fields, by using KELT photometric data the ephemerides of the single and double-transit events that will be detected by TESS can be determined precisely. By conducting a simulation process to insert transits into KELT light curves and recover periods, we find that KELT photometry can be used to confirm ephemerides with high accuracy for planets of Neptune size or larger with orbital periods as long as a year, and therefore across a wide range of planet equilibrium temperatures. The resulting periods of the signals can then be used by follow-up teams, whether part of the TESS mission or the community-organized TFOP project, to plan and coordinate follow-up observations to confirm these cases as planets, eclipsing binaries, or other false positives, as well as conduct detailed transit observations with facilities like JWST or HST.This project makes use of data from the KELT survey, including support from The Ohio State University, Vanderbilt University, and Lehigh University.

  10. Treatment of Anxiety and Depression in the Preschool Period

    PubMed Central

    Luby, Joan L.

    2013-01-01

    Objective Empirical studies have now established that clinical anxiety and depressive disorders may arise in preschool children as early as age 3.0. As empirical studies validating and characterizing these disorders in preschoolers are relatively recent, less work has been done on the development and testing of age-appropriate treatments. Method A comprehensive literature search revealed several small randomized controlled trials (RCTs) of psychotherapeutic treatments for preschool anxiety and depression. The literature also contains case series of behavioral and psychopharmacologic interventions for specific anxiety disorders. However, to date, no large-scale RCTs of treatment for any anxiety or depressive disorder specifically targeting preschool populations have been published. Results Several age-adapted forms of cognitive behavioral therapy have been developed and preliminarily tested in small RCTs, and appear promising for a variety of forms of preschool anxiety disorders. Notably, these adaptations centrally involve primary caregivers and utilize age-adjusted methodology such as cartoon-based materials and co-constructed drawing or narratives. Modified forms of Parent Child Interaction Therapy (PCIT) have been tested and appear promising for both anxiety and depression. While preventive interventions that target parenting have shown significant promise in anxiety, these methods have not been explored in area of early childhood depression. Studies of the impact of parental treatment on infants suggest that direct treatment of the youngest children may be necessary to affect long-term change. Conclusions Recommendations are made for clinical treatment of these disorders where psychotherapy is the first line of intervention. PMID:23582866

  11. Predicting Full Enteral Feeding in the Postoperative Period in Infants with Congenital Diaphragmatic Hernia.

    PubMed

    Zozaya, Carlos; Triana, Miryam; Madero, Rosario; Abrams, Steven; Martinez, Leopoldo; Amesty, Maria Virginia; Pipaón, Miguel Sáenz de

    2017-10-01

    Introduction  The objective of the study is to examine the factors associated with time to achieve full enteral feeding after repair of congenital diaphragmatic hernia. Materials and Methods  Demographic, clinical, and therapeutic data were retrospectively assessed, and uni- and multivariate Cox regression were performed to examine factors predictive of achieving full enteral feeding that was defined as time to achieve120 mL/kg/d after surgical repair. Results  Of 78 infants, 66 underwent intervention before hospital discharge. All infants who survived had reached full enteral feeding at the time of hospital discharge by a median of 22 days (range: 2-119 days) after surgery and 10 days (range: 1-91) after initiation of postoperative enteral feedings. Independent risk factors associated with a longer time to reach full enteral feeding achievement included gastroesophageal reflux and days of antibiotics in the postoperative period. Daily stool passage preoperatively predicted earlier enteral tolerance. Conclusion  Infants who survive congenital diaphragmatic hernia generally are able to achieve full enteral feedings after surgical repair. A longer time to full feeding is needed in the most severe cases, but some specific characteristics can be used to help identify patients at higher risk. Although some of these characteristics are unavoidable, others including rational antibiotic usage and active gastroesophageal reflux prevention and treatment are feasible and may improve enteral tolerance. Georg Thieme Verlag KG Stuttgart · New York.

  12. Endoscopic treatment of urethrodeferential reflux in children.

    PubMed

    Fernández Bautista, B; Parente Hernández, A; Ortiz Rodríguez, R; Burgos Lucena, L; Angulo Madero, J M

    2018-03-01

    Urethrodeferential reflux is an underdiagnosed condition, and there is no consensus on its treatment. Our objective is to show our experience in the minimally invasive treatment of this disease using endoscopy. We present 8 patients with recurrent suppurative orchitis due to urethrodeferential reflux treated endoscopically during the period 2008-2013. All patients presented unilateral orchitis. The minimum number of episodes of orchitis per patient prior to the operation was 3. The endoscopic treatment consists of ureteroscopy, locating the ejaculatory orifices and conducting an intraoperative contrast study to demonstrate the urethrodeferential reflux. Subejaculatory dextranomer/hyaluronic acid was subsequently injected in all the cases. The mean surgical time was 15min, and the procedure was outpatient for all patients. There were no postoperative complications, and the patients had good clinical progression. Only one case required a second injection of dextranomer/hyaluronic acid. The follow-up of these patients showed a complete resolution of the epididymitis and good testicular development, with a follow-up longer than 4 years in all cases. We propose this form of treatment as a minimally invasive, easily reproducible alternative that shows good long-term results in our small series of patients. Copyright © 2017 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Cutting-Balloon Angioplasty in Transplant Renal Artery Stenosis as First-Line Treatment in the Early Postoperative Period

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

    Ucar, Adem, E-mail: ucaradem@yahoo.com; Yahyayev, Aghakishi, E-mail: aghakishi@yahoo.com; Bakkaloglu, Huseyin, E-mail: drhuseyin@yahoo.com

    2011-02-15

    Percutaneous transluminal angioplasty has been successfully used for the treatment of transplant renal artery stenosis (RAS). Cutting-balloon angioplasty (CBA) is being used as a second option in pressure-resistant stenosis. It is thought that CBA is less traumatic and therefore restenosis occurs less frequently than in conventional angioplasty. This case report describes the unusual use of a cutting balloon in transplant RAS as a first option in the early postoperative period. Long-term follow-up data are also presented.

  14. Predictability of short implants (< 10 mm) as a treatment option for the rehabilitation of atrophic maxillae. A systematic review

    PubMed Central

    García-Sala-Bonmatí, Fernando; Martínez-González, Amparo; García-Dalmau, Carlos; Mañes-Ferrer, José-Félix; Brotons-Oliver, Alejandro

    2016-01-01

    Background Short implants (< 10 mm) are one of the treatment options available in cases of limited vertical bone. A purpose of this paper is to evaluate the predictability of short implants as an alternative to technically molthough such implants are now widely used, there is controversy regarding their clinical reliability. There complex treatments in patients with atrophic maxillae, based on a systematic review of the literature and the analysis of the implant survival rates, changes in peri-implant bone level, and associated complications. It is postulated that short implants offer clinical results similar to those of longer implants. Material and Methods A Medline-PubMed search was made covering the period between January 2004 and December 2014 (both included). Studies in English published in indexed journals, involving at least 20 implants and with a follow-up period of at least 12 months were considered. A manual search in four high impact journals was also conducted. Results A total of 37 studies meeting the inclusion criteria were included in this review. 9792 implants placed in over 5000 patients were analyzed. Conclusions Based on the results of this review, short implants are seen to offer clinical results in terms of survival, bone loss and complications similar to those of longer implants. Key words:Survival rate, clinical results, dental implants, oral implants, short implants, short lengt PMID:26946199

  15. Periodic health examination, 1995 update: 2. Prevention of dental caries. The Canadian Task Force on the Periodic Health Examination.

    PubMed Central

    Lewis, D W; Ismail, A I

    1995-01-01

    OBJECTIVE: To make recommendations, based on current evidence, for practising physicians and dentists on interventions for the prevention of dental caries in their patients. OPTIONS: Systemic fluoride administration, professionally administered fluoride, use of fluoride mouth rinses, fissure sealants, oral-hygiene practices, dietary practices, identification of groups at a high risk of dental caries, and early diagnosis and treatment. OUTCOMES: Reduced prevalence of dental caries and fluorosis, longer retention of teeth and lower treatment costs. EVIDENCE: Several MEDLINE searches were conducted for articles published from January 1980 to December 1992, including relevant review articles. VALUES: Relevant clinical findings were evaluated and categorized with the use of the evidence-based methods and values of the Canadian Task Force on the Periodic Health Examination. Recommendations were developed for each method of caries prevention, with reduced incidence of dental caries and improved prevalence of caries-free teeth given high values. BENEFITS, HARMS AND COSTS: The potential benefits of these measures in the long-term are a lower incidence of tooth decay, longer retention of teeth and prevention of fluorosis. The cost saving can be considerable for patients and insurers; however, implementation of some recommendations will be difficult, since the traditional preventive practices of dentists and dental hygienists are not easily changed. RECOMMENDATIONS: There is good evidence that the following manoeuvres are effective in preventing dental caries: use of dentifrices containing fluoride, fluoridation of drinking water, fluoride supplements for patients in areas where there is a low level (0.3 ppm or less) of fluoride in the drinking water, professionally applied topical fluoride and the use of fluoride mouth rinses for patients with very active decay or at a high risk of dental caries and selective use of professionally applied fissure sealants on permanent molar

  16. Lesion progression in post-treatment persistent endodontic lesions.

    PubMed

    Yu, Victoria Soo Hoon; Messer, Harold Henry; Shen, Liang; Yee, Robert; Hsu, Chin-ying Stephen

    2012-10-01

    Radiographic lesions related to root-filled teeth may persist for long periods after treatment and are considered to indicate failure of initial treatment. Persistent lesions are found in a proportion of cases, but information on lesion progression is lacking. This study examined the incidence of lesion improvement, remaining unchanged, and deterioration among persistent lesions in a group of patients recruited from a university-based clinic and identified potential predictors for lesion progression. Patients of a university clinic with persistent endodontic lesions at least 4 years since treatment and with original treatment radiographs available were recruited with informed consent. Data were obtained by interview and from dental records and clinical and radiographic examinations. Univariate and multivariate statistical analyses were carried out by using SPSS (version 19). One hundred fifty-one persistent lesions were identified in 114 patients. A majority of the lesions (107, 70.9%) received treatment between 4 and 5 years prior. Eighty-six lesions (57.0%) improved, 18 (11.9%) remained unchanged, and 47 (31.1%) deteriorated since treatment. Potential predictors for lesions that did not improve included recall lesion size, pain on biting at recall examination, history of a postobturation flare-up, and a non-ideal root-filling length (P < .05). Lesions that had persisted for a longer period appeared less likely to be improving (relative risk, 1.038; 95% confidence interval, 1.000-1.077). A specific time interval alone should not be used to conclude that a lesion will not resolve without intervention. This study identified several clinical factors that are associated with deteriorating persistent lesions, which should aid in identifying lesions that require further intervention. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  17. [Treatment of pain with peridural administration of opioids].

    PubMed

    Chrubasik, S; Senninger, N; Chrubasik, J

    1996-07-01

    The advantages and disadvantages associated with epidural opioids require careful selection of the opioid and its dosage. There is presently no ideal opioid available for epidural use. Comparative pharmacokinetic data help to select the appropriate epidural opioid. Morphine (provided it is given in small doses and volumes) is very appropriate for epidural pain treatment, especially for longer periods of treatment, due to excellent analgesia and very low systemic morphine concentrations. The faster onset of analgesia with epidural pethidine, alfentanil und fentanyl make these opioids recommendable. However, due to the increased risk of respiratory depression during continuous treatment, these drugs should not be given over extended periods. Epidural administration of methadone, sufentanil und buprenorphine cannot be recommended since the advantages over systemic use do not outweigh the risks. Epidural tramadol may be useful in clinical routine, if opioids are not available and supervision of the patient is not guaranteed, because tramadol is not restricted by law and has a low potential for central depressive effects. The safety of the patients should be paramount. If patients are harmed by inappropriate opioids or dose regimens this will discredit a valuable for treating postoperative pain. Postoperative epidural dosages should be as low as possible and be titrated to the patient's individual needs for analgesia. Epidural morphine treatment is an alternative to step 4 of the WHO treatment regimen for patients with intractable pain or those suffering from systemic opioid side effects. Careful selection of patients helps to increase successful treatment. If implantable devices (ports or pumps, according to the life expectancy) are employed, the intrathecal route of administration is preferable to the epidural route, as the latter has a 10 times higher morphine dose requirement.

  18. Duration of treatment for asymptomatic bacteriuria during pregnancy.

    PubMed

    Villar, J; Lydon-Rochelle, M T; Gülmezoglu, A M; Roganti, A

    2000-01-01

    A Cochrane systematic review has shown that drug treatment of asymptomatic bacteriuria in pregnant women substantially decreases the risk of pyelonephritis and reduces the risk of preterm delivery. However, it is not clear whether single dose therapy is as effective as longer conventional antibiotic treatment. The objective of this review was to assess the effects of different durations of treatment for asymptomatic bacteriuria in pregnancy. We searched the Cochrane Pregnancy and Childbirth Group trials register, the Cochrane Controlled Trials Register and the reference lists of articles. Randomised and quasi-randomised trials comparing antimicrobial therapeutic regimens that differed in duration (particularly comparing single dose with longer duration regimens) in pregnant women diagnosed with asymptomatic bacteriuria. Trial quality was assessed and data were extracted independently by the reviewers. Eight studies involving over 400 women were included. All were comparisons of single dose treatment with four to seven day treatments. The trials were generally of poor quality. No difference in 'no-cure' rate was detected between single dose and short course (4-7 day) treatment for asymptomatic bacteriuria in pregnant women (relative risk 1.13, 95% confidence interval 0.82 to 1.54) as well as in the recurrent asymptomtic bacteriuria (relative risk 1.08, 95% confidence interval 0.70 to 1.66). However these results showed significant heterogeneity. No differences were detected for preterm births and pyelonephritis although sample size of trials was small. Longer duration treatment was associated with an increase in reports of adverse effects (relative risk 0.53, 95% confidence interval 0.31 to 0.91). There is not enough evidence to evaluate whether single dose or longer duration doses are more effective in treating asymptomatic bacteriuria in pregnant women. Because single dose has lower cost and increases compliance, this comparison should be explored in a properly

  19. Efficacy of cocaine contingency management in heroin-assisted treatment: Results of a randomized controlled trial.

    PubMed

    Blanken, Peter; Hendriks, Vincent M; Huijsman, Ineke A; van Ree, Jan M; van den Brink, Wim

    2016-07-01

    To determine the efficacy of contingency management (CM), targeting cocaine use, as an add-on intervention for heroin dependent patients in supervised heroin-assisted treatment (HAT) with frequent cocaine use. Multi-center, open-label, parallel group, randomized controlled trial. Twelve specialized addiction treatment centers for HAT in The Netherlands; April 2006-January 2011. 214 chronic, treatment-refractory heroin dependent patients in HAT, with frequent cocaine use. Routine, daily supervised diacetylmorphine treatment, co-prescribed with oral methadone (HAT), with and without 6 months contingency management for cocaine use as an add-on intervention; HAT+CM and HAT-only, respectively. Primary outcome was the longest, uninterrupted duration of cocaine abstinence, based upon laboratory urinalysis. Secondary outcome measures included other cocaine-related measures, treatment retention in HAT, and multi-domain health-related treatment response. In an intention-to-treat analysis, HAT+CM was more effective than HAT-only in promoting longer, uninterrupted duration of cocaine abstinence (3.7 weeks versus 1.6 weeks; negative binomial regression: Exp(B)=2.34, 95%-CI: 1.70-3.23; p<0.001). This result remained significant in sensitivity analyses and was supported by all secondary, cocaine-related outcome measures. Treatment retention in HAT was high (91.6%) with no difference between the groups. The improvement in multi-domain health-related treatment response during the trial was numerically higher in HAT+CM (from 37.4% to 53.1%; +15.7%) than in HAT-only (from 44.5% to 46.5%; +2.0%), but this difference was statistically not significant. Contingency management is an effective add-on intervention to promote longer, uninterrupted periods of cocaine abstinence in chronic, treatment-refractory heroin dependent patients in heroin-assisted treatment with frequent cocaine use. The trial has been registered in The Netherlands National Trial Register under clinical trial

  20. Does telomere elongation lead to a longer lifespan if cancer is considered?

    NASA Astrophysics Data System (ADS)

    Masa, Michael; Cebrat, Stanisław; Stauffer, Dietrich

    2006-05-01

    As cell proliferation is limited due to the loss of telomere repeats in DNA of normal somatic cells during division, telomere attrition can possibly play an important role in determining the maximum life span of organisms as well as contribute to the process of biological ageing. With computer simulations of cell culture development in organisms, which consist of tissues of normal somatic cells with finite growth, we obtain an increase of life span and life expectancy for longer telomeric DNA in the zygote. By additionally considering a two-mutation model for carcinogenesis and indefinite proliferation by the activation of telomerase, we demonstrate that the risk of dying due to cancer can outweigh the positive effect of longer telomeres on the longevity.

  1. A longer vernal window: the role of winter coldness and snowpack in driving spring transitions and lags.

    PubMed

    Contosta, Alexandra R; Adolph, Alden; Burchsted, Denise; Burakowski, Elizabeth; Green, Mark; Guerra, David; Albert, Mary; Dibb, Jack; Martin, Mary; McDowell, William H; Routhier, Michael; Wake, Cameron; Whitaker, Rachel; Wollheim, Wilfred

    2017-04-01

    Climate change is altering the timing and duration of the vernal window, a period that marks the end of winter and the start of the growing season when rapid transitions in ecosystem energy, water, nutrient, and carbon dynamics take place. Research on this period typically captures only a portion of the ecosystem in transition and focuses largely on the dates by which the system wakes up. Previous work has not addressed lags between transitions that represent delays in energy, water, nutrient, and carbon flows. The objectives of this study were to establish the sequence of physical and biogeochemical transitions and lags during the vernal window period and to understand how climate change may alter them. We synthesized observations from a statewide sensor network in New Hampshire, USA, that concurrently monitored climate, snow, soils, and streams over a three-year period and supplemented these observations with climate reanalysis data, snow data assimilation model output, and satellite spectral data. We found that some of the transitions that occurred within the vernal window were sequential, with air temperatures warming prior to snow melt, which preceded forest canopy closure. Other transitions were simultaneous with one another and had zero-length lags, such as snowpack disappearance, rapid soil warming, and peak stream discharge. We modeled lags as a function of both winter coldness and snow depth, both of which are expected to decline with climate change. Warmer winters with less snow resulted in longer lags and a more protracted vernal window. This lengthening of individual lags and of the entire vernal window carries important consequences for the thermodynamics and biogeochemistry of ecosystems, both during the winter-to-spring transition and throughout the rest of the year. © 2016 The Authors Global Change Biology Published by John Wiley & Sons Ltd.

  2. SPECTROSCOPIC EVIDENCE FOR A 5.4 MINUTE ORBITAL PERIOD IN HM CANCRI

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

    Roelofs, Gijs H. A.; Rau, Arne; Marsh, Tom R.

    2010-03-10

    HM Cancri is a candidate ultracompact binary white dwarf with an apparent orbital period of only 5.4 minutes, as suggested by X-ray and optical light-curve modulations on that period, and by the absence of longer-period variability. In this Letter, we present Keck-I spectroscopy which shows clear modulation of the helium emission lines in both radial velocity and amplitude on the 5.4 minute period and no other. The data strongly suggest that the binary is emitting He I 4471 from the irradiated face of the cooler, less massive star, and He II 4686 from a ring around the more massive star.more » From their relative radial velocities, we measure a mass ratio q = 0.50 {+-} 0.13. We conclude that the observed 5.4 minute period almost certainly represents the orbital period of an interacting binary white dwarf. We thus confirm that HM Cnc is the shortest period binary star known: a unique test for stellar evolution theory, and one of the strongest known sources of gravitational waves for LISA.« less

  3. Prosthetic complications in fixed endosseous implant-borne reconstructions after an observations period of at least 40 months.

    PubMed

    De Boever, A L; Keersmaekers, K; Vanmaele, G; Kerschbaum, T; Theuniers, G; De Boever, J A

    2006-11-01

    One hundred and seventy-two fixed reconstructions (317 prosthetic units), made on 283 ITI implants in 105 patients (age range 25-86 years) with a minimum follow-up period of 40 months, were taken into the study to analyse technical complication rate, complication type and costs for repair. The mean evaluation time was 62.5 +/- 25.3 months. Eighty were single crowns and 92 different types of fixed partial dentures (FPDs). In 45 cases the construction was screw retained and in 127 cases cemented with zinc phosphate cement or an acrylic-based cement. Complications occurred after a minimum period of 2 months and a maximum period of 100 months (mean: 35.9 +/- 21.4 months). Fifty-five prosthetic interventions were needed on 44 constructions (25%) of which 88% in the molar/premolar region. The lowest percentage of complications occurred in single crowns (25%), the highest in 3-4 unit FPDs (35%) and in FPDs with an extension (44%). Of the necessary clinical repair, 36% was recementing and 38% tightening the screws. Of all interventions, 14% were classified as minor (no treatment or <10 min chair time), 70% as moderate (>10 min but <60 min chair time) and 14% as major interventions (>60 min and additional costs for replacement of parts and/or laboratory). For seven patients the additional costs ranged from euro 28 to euro 840. Bruxing seemed to play a significant role in the frequency of complications. Longer constructions seemed to be more prone to complications. The relatively high occurrence of technical complications should be discussed with the patient before the start of the treatment.

  4. What is the incubation period for listeriosis?

    PubMed

    Goulet, Véronique; King, Lisa A; Vaillant, Véronique; de Valk, Henriette

    2013-01-10

    Listeriosis is a foodborne infection with a low incidence but a high case fatality rate. Unlike common foodborne diseases, the incubation period can be long. The first incubation periods were documented during a large listeriosis outbreak published in 1987 by Linnan and al. in the New England Journal of Medicine (range: 3 days to 70 days). Data on the incubation period of listeriosis are scarce. Our study aim was to estimate precisely the incubation period of listeriosis using available data since 1987. We estimated the incubation period of listeriosis using available published data and data from outbreak investigations carried out by the French National Institute for Public Health Surveillance. We selected cases with an incubation period calculated when a patient had a single exposure to a confirmed food source contaminated by Listeria monocytogenes. We identified 37 cases of invasive listeriosis (10 cases with central nervous system involvement (CNS cases), 15 bacteraemia cases and 12 pregnancy-associated cases) and 9 outbreaks with gastroenteritis. The overall median incubation period of invasive listeriosis was 8 days (range: 1-67 days) and differed significantly by clinical form of the disease (p<0.0001). A longer incubation period was observed for pregnancy-associated cases (median: 27.5 days; range: 17-67 days) than for CNS cases (median: 9 days; range: 1-14 days) and for bacteraemia cases (median: 2 days; range: 1-12 days). For gastroenteritis cases, the median incubation period was 24 hours with variation from 6 to 240 hours. This information has implications for the investigation of food borne listeriosis outbreaks as the incubation period is used to determine the time period for which a food history is collected. We believe that, for listeriosis outbreaks, adapting the exposure window for documenting patients' food histories in accordance with the clinical form of infection will facilitate the identification of food products as the source of

  5. Cost profiles and budget impact of rechargeable versus non-rechargeable sacral neuromodulation devices in the treatment of overactive bladder syndrome.

    PubMed

    Noblett, Karen L; Dmochowski, Roger R; Vasavada, Sandip P; Garner, Abigail M; Liu, Shan; Pietzsch, Jan B

    2017-03-01

    Sacral neuromodulation (SNM) is a guideline-recommended third-line treatment option for managing overactive bladder. Current SNM devices are not rechargeable, and require neurostimulator replacement every 3-6 years. Our study objective was to assess potential cost effects to payers of adopting a rechargeable SNM neurostimulator device. We constructed a cost-consequence model to estimate the costs of long-term SNM-treatment with a rechargeable versus non-rechargeable device. Costs were considered from the payer perspective at 2015 reimbursement levels. Adverse events, therapy discontinuation, and programming rates were based on the latest published data. Neurostimulator longevity was assumed to be 4.4 and 10.0 years for non-rechargeable and rechargeable devices, respectively. A 15-year horizon was modeled, with costs discounted at 3% per year. Total budget impact to the United States healthcare system was estimated based on the computed per-patient cost findings. Over the 15-year horizon, per-patient cost of treatment with a non-rechargeable device was $64,111 versus $36,990 with a rechargeable device, resulting in estimated payer cost savings of $27,121. These cost savings were found to be robust across a wide range of scenarios. Longer analysis horizon, younger patient age, and longer rechargeable neurostimulator lifetime were associated with increased cost savings. Over a 15-year horizon, adoption of a rechargeable device strategy was projected to save the United States healthcare system up to $12 billion. At current reimbursement rates, our analysis suggests that rechargeable neurostimulator SNM technology for managing overactive bladder syndrome may deliver significant cost savings to payers over the course of treatment. Neurourol. Urodynam. 36:727-733, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  6. Maintenance of smoking cessation in the postpartum period: which interventions work best in the long-term?

    PubMed

    Su, Anny; Buttenheim, Alison M

    2014-04-01

    Smoking during pregnancy has been linked to a variety of adverse outcomes for both maternal and child health. Decades of studies have sought to increase cessation antepartum and reduce relapse postpartum. A number of effective interventions exist to significantly reduce smoking rates during pregnancy; however, less is known about how to prevent relapse in the postpartum period. This review investigates interventions to prevent relapse in the long-term postpartum period. We focus specifically on nonspontaneous quitters (individuals who quit smoking as a result of an external intervention) to reveal differences in long-term response to interventions for this population compared to spontaneous quitters. A systematic literature search yielded 32 relevant studies of pharmacological, behavioral, and incentives-based interventions. Results were compiled, analyzed, and compared in order to evaluate success factors in maintaining cessation postpartum. Though intervention groups showed consistently higher quit rates during pregnancy than control groups, none of the intervention types were effective at preventing relapse in the longer-term postpartum period. One study maintained significantly higher abstinence in the longer-term period postpartum using a mix of behavioral and incentives strategies. Additional research in this area is needed to identify optimal intervention strategies to reduce long-term postpartum relapse, particularly for nonspontaneous quitters.

  7. Strongyle egg reappearance period after moxidectin treatment and its relationship with management factors in UK equine populations.

    PubMed

    Tzelos, Thomas; Barbeito, Jessica S G; Nielsen, Martin K; Morgan, Eric R; Hodgkinson, Jane E; Matthews, Jacqueline B

    2017-04-15

    Parasitic nematodes, particularly cyathostomins, are ubiquitous in grazing horses world-wide. Considerable burdens of cyathostomin larvae can encyst in the large intestinal wall. The most recommended treatment against these pathogenic stages is moxidectin. Information is required on how effective moxidectin is against cyathostomin populations in different regions. The objectives here were to determine the efficacy of moxidectin treatment and estimate the strongyle egg reappearance period (ERP) after treatment in several equine populations, to confirm the type of strongyle nematodes present and to identify other (i.e. management) factors associated with shortened ERP. Eight yards were recruited and moxidectin in combination with praziquantel administered to all horses (n=261). Faecal egg count (FEC) analysis was performed at weeks 0, 2, 6, 10 and 12 after treatment to determine efficacy and ERP. The ERP was estimated using two previously published methods. Morphological identification of cultured third stage larvae from the sample population was compared to a Strongylus vulgaris-specific end-point PCR to examine the presence of S. vulgaris in samples before and after treatment. Strongyle egg shedding patterns were also compared to worm management practices at each site. At 2 weeks post-treatment, moxidectin was highly effective (faecal egg count reduction range, 99.9-100%). The strongyle ERP ranged from 6 weeks to >12 weeks depending on the calculation method applied. Only cyathostomin larvae were detected by morphological identification. The results from the coprocultures and PCR showed that S. vulgaris was absent before and after treatment. Analysis revealed that regular faecal removal from pasture was associated with lower average FEC and lower prevalence of egg shedding. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Periodic Bursts of Jovian Non-Io Decametric Radio Emission

    NASA Technical Reports Server (NTRS)

    Panchenko, M.; Rucker, H O.; Farrell, W. M.

    2013-01-01

    During the years 2000-2011 the radio instruments onboard Cassini, Wind and STEREO spacecraft have Recorded a large amount of the Jovian decametric radio emission (DAM). In this paper we report on the analysis of the new type of Jovian periodic radio bursts recently revealed in the decametric frequency range. These bursts, which are non-Io component of DAM, are characterized by a strong periodic reoccurrence over several Jovian days with a period approx. = 1:5% longer than the rotation rate of the planet's magnetosphere (System III). The bursts are typically observed between 4 and 12 MHz and their occurrence probability has been found to be significantly higher in the sector of Jovian Central Meridian Longitude between 300 deg. and 60 deg. (via 360 deg.). The stereoscopic multispacecraft observations have shown that the radio sources of the periodic bursts radiate in a non-axisymmetric hollow cone-like pattern and sub-corotate with Jupiter remaining active during several planet's rotations. The occurrence of the periodic non-Io DAM bursts is strongly correlated with pulses of the solar wind ram pressure at Jupiter. Moreover the periodic bursts exhibit a tendency to occur in groups every approx. 25 days. The polarization measurements have shown that the periodic bursts are right hand polarized radio emission associated with the Northern magnetic hemisphere of Jupiter. We suggest that periodic non-Io DAM bursts may be connected with the interchange instability in Io plasma torus triggered by the solar wind.

  9. Periodic bursts of Jovian non-Io decametric radio emission

    PubMed Central

    Panchenko, M.; Rucker, H.O.; Farrell, W.M.

    2013-01-01

    During the years 2000–2011 the radio instruments onboard Cassini, Wind and STEREO spacecraft have recorded a large amount of the Jovian decametric radio emission (DAM). In this paper we report on the analysis of the new type of Jovian periodic radio bursts recently revealed in the decametric frequency range. These bursts, which are non-Io component of DAM, are characterized by a strong periodic reoccurrence over several Jovian days with a period ≈1.5% longer than the rotation rate of the planet's magnetosphere (System III). The bursts are typically observed between 4 and 12 MHz and their occurrence probability has been found to be significantly higher in the sector of Jovian Central Meridian Longitude between 300° and 60° (via 360°). The stereoscopic multispacecraft observations have shown that the radio sources of the periodic bursts radiate in a non-axisymmetric hollow cone-like pattern and sub-corotate with Jupiter remaining active during several planet's rotations. The occurrence of the periodic non-Io DAM bursts is strongly correlated with pulses of the solar wind ram pressure at Jupiter. Moreover the periodic bursts exhibit a tendency to occur in groups every ∼25 days. The polarization measurements have shown that the periodic bursts are right hand polarized radio emission associated with the Northern magnetic hemisphere of Jupiter. We suggest that periodic non-Io DAM bursts may be connected with the interchange instability in Io plasma torus triggered by the solar wind. PMID:23585696

  10. SU-C-210-03: Impact of Breathing Irregularities On Gated Treatments

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

    Schiuma, D; Arheit, M; Schmelzer, P

    2015-06-15

    Purpose: To evaluate the effect of breathing irregularities on target location in gated treatments using amplitude and phase gating. Methods: 111 breathing patterns acquired using RPM system were categorized based on period and amplitude STD as regular (STD period ≤ 0.5 s, STD amplitude ≤ 1.5 mm), medium (0.5 s < STD period ≤ 1 s, 1.5 mm < STD amplitude ≤ 3 mm) and irregular (STD period > 1 s, STD amplitude > 3 mm). One pattern representative of the average defined population was selected per category and corresponding target motion reproduced using Quasar Respiratory Motion Phantom. Phantom inmore » motion underwent 4D-CT scan with phase reconstruction. Gated window was defined at end of exhale and DRRs reconstructed in treatment planning at 40% (beam on) and 60% phase (beam off). Target location uncertainty was assessed by comparing gated kV triggered images continuously acquired at beam on/off on a True Beam 2.0 with corresponding DRRs. Results: Average target uncertainty with amplitude gating was in [0.4 – 1.9] mm range for the different scenarios with maximum STD of 1.2 mm for the irregular pattern. Average target uncertainty with phase gating was [1.1 – 2.2] mm for regular and medium patterns, while it increased to [3.6 – 9.6] mm for the irregular pattern. Live gated motion was stable with amplitude gating, while increasing with phase gating for the irregular pattern. Treatment duration range was [68 – 160] s with amplitude and [70 – 74] s with phase gating. Conclusion: Breathing irregularities were found to affect gated treatments only when using phase gating. For regular and medium patterns no significant difference was found between the two gating strategies. Amplitude gating ensured stable gated motion within the different patterns, thus reducing intra-fraction target location variability for the irregular pattern and resulting in longer treatment duration.« less

  11. Results of a longer than 10-year follow-Up of patients with rheumatoid arthritis treated by occipitocervical fusion.

    PubMed

    Matsunaga, S; Ijiri, K; Koga, H

    2000-07-15

    Evaluation of results a longer than 10-year follow-up of patients with upper cervical lesions due to rheumatoid arthritis who underwent occipitocervical fusion. To determine the final outcome of patients with upper cervical lesions due to rheumatoid arthritis treated by occipitocervical fusion. There are few studies reporting the final outcome of patients with rheumatoid arthritis treated by occipitocervical fusion and observed for longer than 10 years. The subjects were 16 patients with rheumatoid arthritis with myelopathy who underwent occipitocervical fusion with a rectangular rod more than 10 years ago. All 16 patients had irreducible atlantoaxial dislocation, and 11 also had vertical dislocation of the axis. All patients had preoperative nuchal pain, and were classified into Class II (two patients), Class IIIA (nine patients), and class IIIB (five patients) according to Ranawat's preoperative neurologic classification. The atlas-dens interval remained the same as immediately after surgery. Vertical dislocation returned to the preoperative condition, despite successful surgical correction. Preoperative occipital pain disappeared or was reduced in all cases. Myelopathy improved in 12 of the 16 patients (75%) by more than one class in the Ranawat preoperative neurologic classification. Survival rate at 10 years after surgery was 38%; mean age at death was 70.7 years. The postoperative periods during which patients could walk by themselves ranged from 6 months to 13 years (mean, 7.5 years). Occipitocervical fusion for patients with rheumatoid arthritis is useful for decreasing nuchal pain, reducing myelopathy, and improving prognosis.

  12. Implementation of an automated system for monitoring adherence to hemodialysis treatment: a report of seven years of experience.

    PubMed

    Bellazzi, Riccardo; Sacchi, Lucia; Caffi, Ezio; de Vincenzi, Amedeo; Nai, Maurizio; Manicone, Francesco; Larizza, Cristiana; Bellazzi, Roberto

    2012-05-01

    In this paper we present the clinical deployment and evaluation of a computerized system, EMOSTAT, aimed at improving the quality of hemodialysis sessions. EMOSTAT automatically imports data from the hemodialysis monitoring software tools and analyzes the delivered treatment looking at six clinically relevant parameters. Failures-to-adhere (FtAs) to the planned treatment are detected and reported to the care-givers. EMOSTAT has been used for more than seven years in the management of a dialysis service located in Mede, Italy. A total of 72 patients were monitored and 21251 dialyses were collected. Data analysis is performed on the periods 2002-2005 and 2005-2008, corresponding to two different software releases. The system had been exploited into everyday clinical practice for the entire considered period. The number of FtAs significantly decreased along the first period: the bulk blood flow FtAs decreased after the introduction of the system. Hemodialysis sessions lasted longer in the second period. Co-occurring FtAs, highlighting the presence of complex FtAs patterns, were also detected. EMOSTAT provides an effective way to re-focus the attention of the dialysis department on the treatment plan and on its implementation. The automatic data collection and the design philosophy of EMOSTAT allowed the routine use of the system. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  13. The effect of a positive reappraisal coping intervention and problem-solving skills training on coping strategies during waiting period of IUI treatment: An RCT.

    PubMed

    Ghasemi, Marzieh; Kordi, Masoumeh; Asgharipour, Negar; Esmaeili, Habibollah; Amirian, Maliheh

    2017-11-01

    Waiting period of fertility treatment is stressful, therefore it is necessary to use effective coping strategies to cope with waiting period of intrauterine insemination (IUI) treatment. The aim of this study was comparing the effect of the positive reappraisal coping intervention (PRCI) with the problem-solving skills training (PSS) on the coping strategies of IUI waiting period, in infertile women referred to Milad Infertility Center in Mashhad. In this randomized clinical trial, 108 women were evaluated into three groups. The control group received the routine care, but in PRCI group, two training sessions were held and they were asked to review the coping thoughts cards and fill out the daily monitoring forms during the waiting period, and in PSS group problem-solving skill were taught during 3 sessions. The coping strategies were compared between three groups on the 10 th day of IUI waiting period. Results showed that the mean score for problem-focused were significantly different between the control (28.54±9.70), PSS (33.71±9.31), and PRCI (30.74±10.96) (p=0.025) groups. There were significant differences between the PSS group and others groups, and mean emotion-focused were significantly different between the control (32.09±11.65), PSS (29.20±9.88), and PRCI (28.74±7.96) (p=0.036) groups. There were significant differences between the PRCI and the control group (p=0.047). PSS was more effective to increase problem-focused coping strategies than PRCI, therefore it is recommended that this intervention should be used in infertility treatment centers.

  14. The effect of a positive reappraisal coping intervention and problem-solving skills training on coping strategies during waiting period of IUI treatment: An RCT

    PubMed Central

    Ghasemi, Marzieh; Kordi, Masoumeh; Asgharipour, Negar; Esmaeili, Habibollah; Amirian, Maliheh

    2017-01-01

    Background: Waiting period of fertility treatment is stressful, therefore it is necessary to use effective coping strategies to cope with waiting period of intrauterine insemination (IUI) treatment. Objective: The aim of this study was comparing the effect of the positive reappraisal coping intervention (PRCI) with the problem-solving skills training (PSS) on the coping strategies of IUI waiting period, in infertile women referred to Milad Infertility Center in Mashhad. Materials and Methods: In this randomized clinical trial, 108 women were evaluated into three groups. The control group received the routine care, but in PRCI group, two training sessions were held and they were asked to review the coping thoughts cards and fill out the daily monitoring forms during the waiting period, and in PSS group problem-solving skill were taught during 3 sessions. The coping strategies were compared between three groups on the 10th day of IUI waiting period. Results: Results showed that the mean score for problem-focused were significantly different between the control (28.54±9.70), PSS (33.71±9.31), and PRCI (30.74±10.96) (p=0.025) groups. There were significant differences between the PSS group and others groups, and mean emotion-focused were significantly different between the control (32.09±11.65), PSS (29.20±9.88), and PRCI (28.74±7.96) (p=0.036) groups. There were significant differences between the PRCI and the control group (p=0.047). Conclusion: PSS was more effective to increase problem-focused coping strategies than PRCI, therefore it is recommended that this intervention should be used in infertility treatment centers. PMID:29404530

  15. Intellectual maturity and longevity: late-blooming composers and writers live longer than child prodigies

    PubMed Central

    Hafkamp, Maurits P.J.; Slaets, Joris P.J.; van Bodegom, David

    2017-01-01

    Life history theory links human physical and sexual development to longevity. However, there have been no studies on the association of intellectual development with longevity. This observational study investigates the relationship between the onset of intellectual maturity and lifespan through the life histories of composers and creative writers, whose intellectual development can be gauged through their compositions and writings. In these groups we model the relationship between the age at first creative work, and age at death using multilevel regression, adjusting for sex, date of birth, and nationality. Historical biographical records on 1110 musical composers and 1182 creative writers, born in the period 1400 AD through 1915 AD, were obtained from the Oxford Companion to Music and the Oxford Companion to English Literature. Composers and creative writers lived, respectively 0.16 (p = 0.02) and 0.18 (p < 0.01) years longer for each later year of age at first work. When completion of the first creative work is interpreted as a proxy for the onset of intellectual maturity in composers and creative writers, our findings indicate that a later onset of intellectual maturity is associated with higher longevity. PMID:28562321

  16. Intellectual maturity and longevity: late-blooming composers and writers live longer than child prodigies.

    PubMed

    Hafkamp, Maurits P J; Slaets, Joris P J; van Bodegom, David

    2017-05-30

    Life history theory links human physical and sexual development to longevity. However, there have been no studies on the association of intellectual development with longevity. This observational study investigates the relationship between the onset of intellectual maturity and lifespan through the life histories of composers and creative writers, whose intellectual development can be gauged through their compositions and writings. In these groups we model the relationship between the age at first creative work, and age at death using multilevel regression, adjusting for sex, date of birth, and nationality. Historical biographical records on 1110 musical composers and 1182 creative writers, born in the period 1400 AD through 1915 AD, were obtained from the Oxford Companion to Music and the Oxford Companion to English Literature. Composers and creative writers lived, respectively 0.16 ( p = 0.02) and 0.18 ( p < 0.01) years longer for each later year of age at first work. When completion of the first creative work is interpreted as a proxy for the onset of intellectual maturity in composers and creative writers, our findings indicate that a later onset of intellectual maturity is associated with higher longevity.

  17. Sexual selection on receptor organ traits: younger females attract males with longer antennae

    NASA Astrophysics Data System (ADS)

    Johnson, Tamara L.; Symonds, Matthew R. E.; Elgar, Mark A.

    2017-06-01

    Sexual selection theory predicts that female choice may favour the evolution of elaborate male signals. Darwin also suggested that sexual selection can favour elaborate receiver structures in order to better detect sexual signals, an idea that has been largely ignored. We evaluated this unorthodox perspective by documenting the antennal lengths of male Uraba lugens Walker (Lepidoptera: Nolidae) moths that were attracted to experimentally manipulated emissions of female sex pheromone. Either one or two females were placed in field traps for the duration of their adult lives in order to create differences in the quantity of pheromone emissions from the traps. The mean antennal length of males attracted to field traps baited with a single female was longer than that of males attracted to traps baited with two females, a pattern consistent with Darwin's prediction assuming the latter emits higher pheromone concentrations. Furthermore, younger females attracted males with longer antennae, which may reflect age-specific changes in pheromone emission. These field experiments provide the first direct evidence of an unappreciated role for sexual selection in the evolution of sexual dimorphism in moth antennae and raise the intriguing possibility that females select males with longer antennae through strategic emission of pheromones.

  18. Neither hereditary periodic fever nor periodic fever, aphthae, pharingitis, adenitis: Undifferentiated periodic fever in a tertiary pediatric center

    PubMed Central

    De Pauli, Silvia; Lega, Sara; Pastore, Serena; Grasso, Domenico Leonardo; Bianco, Anna Monica Rosaria; Severini, Giovanni Maria; Tommasini, Alberto; Taddio, Andrea

    2018-01-01

    AIM To describe the frequency and clinical characteristics of patients with undifferentiated periodic fever (UPF) and to investigate whether a clinical classification of UPF based on the PRINTO-Eurofever score can help predicting the response to treatment and the outcome at follow-up. METHODS Clinical and therapeutic information of patients with recurrent fever who presented at a single pediatric rheumatology center from January 2006 through April 2016 were retrospectively collected. Patients with a clinical suspicion of hereditary periodic fever (HPF) syndrome and patients with clinical picture of periodic fever, aphthae, pharingitis, adenitis (PFAPA) who were refractory to tonsillectomy underwent molecular analysis of five HPF-related genes: MEFV (NM_000243.2), MVK (NM_000431.3), TNFRSF1A (NM_001065.3), NLRP3 (NM_001079821.2), NLRP12 (NM_001277126.1). All patients who had a negative genetic result were defined as UPF and further investigated. PRINTO-Eurofever score for clinical diagnosis of HPF was calculated in all cases. RESULTS Of the 221 patients evaluated for periodic fever, twelve subjects with a clinical picture of PFAPA who were refractory to tonsillectomy and 22 subjects with a clinical suspicion of HPF underwent genetic analysis. Twenty-three patients (10.4%) resulted negative and were classified as UPF. The median age at presentation of patients with UPF was 9.5 mo (IQR 4-24). Patients with UPF had a higher frequency of aphthae (52.2% vs 0%, P = 0.0026) and musculoskeletal pain (65.2% vs 18.2%, P = 0.0255) than patients with genetic confirmed HPF. Also, patients with UPF had a higher frequency of aphthous stomatitis (52.2% vs 10.7%, P < 0.0001), musculoskeletal pain (65.2% vs 8,0%, P < 0.0001), and abdominal pain (52.2% vs 4.8%, P < 0.0001) and a lower frequency of pharyngitis (56.6% vs 81.3%, P = 0.0127) compared with typical PFAPA in the same cohort. Twenty-one of 23 patients with UPF (91.3%) received steroids, being effective in 16; 13 (56.2%) were

  19. Economic performance of lactating dairy cows submitted for first service timed artificial insemination after a voluntary waiting period of 60 or 88 days.

    PubMed

    Stangaferro, M L; Wijma, R; Masello, M; Thomas, Mark J; Giordano, J O

    2018-05-23

    The objective of this study was to evaluate the economic performance of dairy cows managed with a voluntary waiting period (VWP) of 60 or 88 d. A secondary objective was estimating variation in cash flow under different input pricing scenarios through stochastic Monte Carlo simulations. Lactating Holstein cows from 3 commercial farms were blocked by parity group and total milk yield in their previous lactation and then randomly assigned to a VWP of 60 (VWP60; n = 1,352) or 88 d (VWP88; n = 1,359). All cows received timed-artificial insemination (TAI) for first service after synchronization of ovulation with the Double-Ovsynch protocol. For second and greater services, cows received artificial insemination (AI) after detection of estrus or the Ovsynch protocol initiated 32 ± 3 d after AI. Two analyses were performed: (1) cash flow per cow for the calving interval of the experimental lactation and (2) cash flow per slot occupied by each cow enrolled in the experiment for an 18-mo period after calving in the experimental lactation. Extending the VWP from 60 to 88 d delayed time to pregnancy during lactation (~20 d) and increased the risk of leaving the herd for multiparous cows (hazard ratio = 1.21). As a result, a smaller proportion of multiparous cows calved again and had a subsequent lactation (-6%). The shift in time to pregnancy combined with the herd exit dynamics resulted in longer lactation length for primiparous (22 d) but not multiparous cows. Longer lactations led to greater milk income over feed cost and a tendency for greater cash flow during the experimental lactation for primiparous but not multiparous cows in the VWP88 group. On the other hand, profitability per slot for the 18-mo period was numerically greater ($68 slot/18 mo) for primiparous cows but numerically reduced (-$85 slot/18 mo) for multiparous cows in the VWP88 treatment. For primiparous cows most of the difference in cash flow was explained by replacement cost, whereas for multiparous

  20. Effect of dry period length on the effect of an intramammary teat sealant on the risk of mastitis in cattle treated with antibiotics at drying off.

    PubMed

    Laven, R A; Balcomb, C C; Tulley, W T; Lawrence, K E

    2014-07-01

    herd antibiotic treatment at drying off. Teat sealant reduced risk of clinical mastitis in cattle with dry periods substantially longer than 100 days, and there was no evidence that this effect changed as dry period length increased.

  1. [Retrospective Analysis of Diabetics with Regard to Treatment Duration and Costs].

    PubMed

    Pscherer, S; Nüssler, A; Bahrs, C; Reumann, M; Ihle, C; Stöckle, U; Ehnert, S; Freude, T; Ochs, B G; Flesch, I; Ziegler, P

    2017-02-01

    significantly longer for diabetics than for non-diabetics (9.98 days [D] vs. 6.43 days [ND] p < 0.001). Because of the longer time in hospital, treatment costs were higher by € 1,932,929.42 during the investigated time period. Conclusion: Because of their comorbidities, diabetics need to be categorised at an early stage as high-risk patients in traumatological and orthopaedic departments. Hospitalisation and the associated increased treatment costs, as well as postoperative complications, could be minimised in patients with diabetes by implementing an interdisciplinary treatment concept. Georg Thieme Verlag KG Stuttgart · New York.

  2. Combining epidemiological and genetic networks signifies the importance of early treatment in HIV-1 transmission.

    PubMed

    Zarrabi, Narges; Prosperi, Mattia; Belleman, Robert G; Colafigli, Manuela; De Luca, Andrea; Sloot, Peter M A

    2012-01-01

    Inferring disease transmission networks is important in epidemiology in order to understand and prevent the spread of infectious diseases. Reconstruction of the infection transmission networks requires insight into viral genome data as well as social interactions. For the HIV-1 epidemic, current research either uses genetic information of patients' virus to infer the past infection events or uses statistics of sexual interactions to model the network structure of viral spreading. Methods for a reliable reconstruction of HIV-1 transmission dynamics, taking into account both molecular and societal data are still lacking. The aim of this study is to combine information from both genetic and epidemiological scales to characterize and analyse a transmission network of the HIV-1 epidemic in central Italy.We introduce a novel filter-reduction method to build a network of HIV infected patients based on their social and treatment information. The network is then combined with a genetic network, to infer a hypothetical infection transmission network. We apply this method to a cohort study of HIV-1 infected patients in central Italy and find that patients who are highly connected in the network have longer untreated infection periods. We also find that the network structures for homosexual males and heterosexual populations are heterogeneous, consisting of a majority of 'peripheral nodes' that have only a few sexual interactions and a minority of 'hub nodes' that have many sexual interactions. Inferring HIV-1 transmission networks using this novel combined approach reveals remarkable correlations between high out-degree individuals and longer untreated infection periods. These findings signify the importance of early treatment and support the potential benefit of wide population screening, management of early diagnoses and anticipated antiretroviral treatment to prevent viral transmission and spread. The approach presented here for reconstructing HIV-1 transmission networks

  3. A clinical study of autogenic training-based behavioral treatment for panic disorder.

    PubMed

    Sakai, M

    1996-03-01

    The present study investigated the effect of autogenic training-based behavioral treatment for panic disorder and identified the predictors of treatment outcome. Thirty-four patients meeting DSM-III-R criteria for panic disorder received autogenic training-based behavioral treatment from October 1981 to December 1994. They were treated individually by the author. The medical records of the patients were investigated for the purpose of this study. The results showed that this autogenic training-based behavioral treatment had successful results. Fifteen patients were cured, nine much improved, five improved, and five unchanged at the end of the treatment. Improvement trends were found as for the severity of panic attack and the severity of agoraphobic avoidance. No consistent findings about predictors emerged when such pretreatment variables as demographics and severity of symptoms were used to predict the outcome. Also, three treatment variables showed useful predictive power. First, practicing the second standard autogenic training exercise satisfactorily predicted better outcomes. Second, application of in vivo exposure was found to be positively associated with the treatment outcome in patients with agoraphobic avoidance. Third, longer treatment periods were associated with better outcomes. These findings suggested that the autogenic training-based behavioral treatment could provide relief to the majority of panic disorder patients.

  4. Systematic search for wide periodic windows and bounds for the set of regular parameters for the quadratic map.

    PubMed

    Galias, Zbigniew

    2017-05-01

    An efficient method to find positions of periodic windows for the quadratic map f(x)=ax(1-x) and a heuristic algorithm to locate the majority of wide periodic windows are proposed. Accurate rigorous bounds of positions of all periodic windows with periods below 37 and the majority of wide periodic windows with longer periods are found. Based on these results, we prove that the measure of the set of regular parameters in the interval [3,4] is above 0.613960137. The properties of periodic windows are studied numerically. The results of the analysis are used to estimate that the true value of the measure of the set of regular parameters is close to 0.6139603.

  5. The endogenous circadian temperature period length (tau) in delayed sleep phase disorder compared to good sleepers.

    PubMed

    Micic, Gorica; de Bruyn, Amanda; Lovato, Nicole; Wright, Helen; Gradisar, Michael; Ferguson, Sally; Burgess, Helen J; Lack, Leon

    2013-12-01

    The currently assumed aetiology for delayed sleep phase disorder (DSPD) is a delay of the circadian system. Clinicians have sought to use bright light therapy, exogenous melatonin or chronotherapy to correct the disorder. However, these treatments have achieved unreliable outcomes for DSPD patients and, as such, one suggestion has been that the disorder may be caused by a longer than normal circadian rhythm period length (i.e. tau). The present study investigated this premise using a 78-h ultradian, ultra-short sleep-wake cycle. This constant bedrest routine was used to simulate a series of 1-h long 'days' by alternating 20-min sleep opportunities and 40 min of enforced wakefulness. Thirteen participants were recruited for the study including, six people diagnosed with DSPD according to the International Classification of Sleep Disorders-2 [mean age = 22.0, standard deviation (SD) = 3.3] and seven good sleepers (mean age = 23.1, SD = 3.9) with normal sleep timing. The DSPD participants' core temperature rhythm tau (mean = 24 h 54 min, SD = 23 min) was significantly longer (t = -2.33, P = 0.04, Cohen's d = 1.91) than the good sleepers' (mean 24 h 29 min, SD = 16 min). The temperature rhythm of the DSPD participants delayed more rapidly (i.e. >25 min day(-1) ) than the good sleepers'. These findings provide an explanation for the difficulty that DSPD patients have in phase advancing to a more conventional sleep time and their frequent relapse following treatment. The outcomes of this study support a vigorous and continued application of chronobiological and behavioural therapies to entrain DSPD patients to their desired earlier sleep times. © 2013 European Sleep Research Society.

  6. Intensive short course chemotherapy for treatment of Greek children with tuberculosis.

    PubMed

    Tsakalidis, D; Pratsidou, P; Hitoglou-Makedou, A; Tzouvelekis, G; Sofroniadis, I

    1992-12-01

    This prospective study with an 18-month posttreatment follow-up evaluated the efficacy of intensive short course chemotherapy in Greek children with pulmonary or extrapulmonary tuberculosis. Between November, 1988, and March 1991 a 2-month regimen of rifampin, 10 to 12 mg/kg/day, isoniazid, 10 to 12 mg/kg/day, and pyrazinamide, 30 to 35 mg/kg/day, followed by rifampin and isoniazid for the remaining 4 months, was administered orally to 36 children with tuberculosis. Twenty-three boys and 13 girls ages 8 months to 12 years (mean, 5 1/2 years) were enrolled in the study. The diagnostic criteria for establishing tuberculosis were tuberculin skin test reactivity, radiographic findings compatible with tuberculosis, epidemiological data and clinical and laboratory findings. Four children had extrapulmonary and 32 had pulmonary tuberculosis; 9 of the latter were asymptomatic. Among the pulmonary cases there were 2 children with pleural effusion. Clinical response to therapy was apparent within 7 to 14 days; the pleural effusions resolved in 2 to 6 weeks and the pulmonary infiltrates cleared in 2 to 6 months. Hilar adenopathy regressed within 18 months or longer. No serious problems with drug tolerance or toxicity were noted during the treatment period. Temporary hyperuricemia and transient elevation in serum transaminases were observed in 11 patients but no drug modification was required. There were no posttreatment relapses. These findings suggest that intensive short course chemotherapy for the treatment of Greek children with pulmonary or extrapulmonary tuberculosis appears to be effective, safe, of good patient compliance and comparable to the longer treatment regimens.

  7. [Experience of systematization on the treatment of patients with upper jaws fractures, during the period 1991-2000].

    PubMed

    Khinkov, D

    2005-01-01

    A retrospecive analysis was done of the 128 patients with fractures in a upper jaw, treated during the period 1991-2000. The treatment of the patients with partial fractures in a alveolar part of maxilla and frontal wall of maxillary sinus, consist of debridement on the open wound, primery stiched and stabilization by arch bar of perspective teeth. In the cases with fractures of tuber maxilla and opening of maxillary sinus they tray to clouse it by Rhermann technique, with or without radical antrothomy by Caldwell-Luc technique. On the patients by total upper jaw fractures they try lead by princip of duble stage fixation: from one side-of intact upper bone structures and the other side-on a mandible. On the cases of upper jaw fractures, combine with barain traums. was treated conservativly - the specialize treatment of facial injures was postpoun until stabilization of brain status.

  8. Meaning of leprosy for people who have experienced treatment during the sulfonic and multidrug therapy periods 1

    PubMed Central

    Santos, Karen da Silva; Fortuna, Cinira Magali; Santana, Fabiana Ribeiro; Gonçalves, Marlene Fagundes Carvalho; Marciano, Franciele Maia; Matumoto, Silvia

    2015-01-01

    Abstract Objective: to analyze the meanings of leprosy for people treated during the sulfonic and multidrug therapy periods. Method: qualitative nature study based on the Vigotski's historical-cultural approach, which guided the production and analysis of data. It included eight respondents who have had leprosy and were submitted to sulfonic and multidrug therapy treatments. The participants are also members of the Movement for Reintegration of People Affected by Leprosy. Results: the meanings were organized into three meaning cores: spots on the body: something is out of order; leprosy or hanseniasis? and leprosy from the inclusion in the Movement for Reintegration of People Affected by Leprosy. Conclusion: the meanings of leprosy for people submitted to both regimens point to a complex construction thereof, indicating differences and similarities in both treatments. Health professionals may contribute to the change of the meanings, since these are socially constructed and the changes are continuous. PMID:26444163

  9. Benefit–Cost in the California Treatment Outcome Project: Does Substance Abuse Treatment “Pay for Itself”?

    PubMed Central

    Ettner, Susan L; Huang, David; Evans, Elizabeth; Rose Ash, Danielle; Hardy, Mary; Jourabchi, Mickel; Hser, Yih-Ing

    2006-01-01

    Objective To examine costs and monetary benefits associated with substance abuse treatment. Data Sources Primary and administrative data on client outcomes and agency costs from 43 substance abuse treatment providers in 13 counties in California during 2000–2001. Study Design Using a social planner perspective, the estimated direct cost of treatment was compared with the associated monetary benefits, including the client's costs of medical care, mental health services, criminal activity, earnings, and (from the government's perspective) transfer program payments. The cost of the client's substance abuse treatment episode was estimated by multiplying the number of days that the client spent in each treatment modality by the estimated average per diem cost of that modality. Monetary benefits associated with treatment were estimated using a pre–posttreatment admission study design, i.e., each client served as his or her own control. Data Collection Treatment cost data were collected from providers using the Drug Abuse Treatment Cost Analysis Program instrument. For the main sample of 2,567 clients, information on medical hospitalizations, emergency room visits, earnings, and transfer payments was obtained from baseline and 9-month follow-up interviews, and linked to information on inpatient and outpatient mental health services use and criminal activity from administrative databases. Sensitivity analyses examined administrative data outcomes for a larger cohort (N=6,545) and longer time period (1 year). Principal Findings On average, substance abuse treatment costs $1,583 and is associated with a monetary benefit to society of $11,487, representing a greater than 7:1 ratio of benefits to costs. These benefits were primarily because of reduced costs of crime and increased employment earnings. Conclusions Even without considering the direct value to clients of improved health and quality of life, allocating taxpayer dollars to substance abuse treatment may be a wise

  10. State Medicaid Early and Periodic Screening, Diagnosis, and Treatment guidelines: adherence to professionally recommended best oral health practices.

    PubMed

    Hom, Jacqueline M; Lee, Jessica Y; Silverman, Janice; Casamassimo, Paul S

    2013-03-01

    The authors evaluated the adherence of state Medicaid Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) guidelines to recommended best oral health practices for infants and toddlers. The authors obtained state EPSDT guidelines via the Internet or from the Medicaid-CHIP State Dental Association, Washington. They identified best oral health practices through the American Academy of Pediatric Dentistry (AAPD), Chicago. They evaluated each EPSDT dental periodicity schedule with regard to the timing and content of seven key oral health domains. Thirty-two states and the District of Columbia (D.C.) had EPSDT dental periodicity schedules. With the exception of the dentist referral domain, 29 states (88 percent) adhered to the content and timing of best oral health practices, as established by the AAPD guideline. For the dentist referral domain, 31 of the 32 states and D.C. (94 percent) required referral of children to a dentist, but only 11 states (33 percent) adhered to best oral health practices by requiring referral by age 1 year. With the exception of the timing of the first dentist referral, there was high adherence to best oral health practices for infants and toddlers among states with separate EPSDT dental periodicity schedules. States with low adherence to best oral health practices, especially regarding the dental visit by age 1 year, can strengthen the oral health content of their EPSDT schedules by complying with the AAPD recommendations.

  11. Economic feasibility of longer management regimes in the Douglas-fir region.

    Treesearch

    Richard Haynes

    2005-01-01

    The financial returns associated with extended management regimes have been the subject of recurring debate in the Pacific Northwest. Proponents argue that the amount and value of higher quality timber associated with older trees will offset the costs associated with longer management regimes. Land managers and owners express concerns about diminished financial returns...

  12. Impact of periodic health examination on surgical treatment for uterine fibroids in Beijing: a case-control study.

    PubMed

    Wu, Hai-Yun; Yang, Ling-Ling; Zhou, Shan

    2010-12-07

    During the past 2 decades, there has been a rapid proliferation of "health examination center (HEC)" across China. The effects of their services on public's health have not been systemically investigated. This study aimed to assess the impact of periodic health examination (PHE) at HEC on surgical treatment for uterine fibroids in Beijing residents. We identified 224 patients with a primary diagnosis of uterine fibroids who had surgical treatment at four Level-1 general hospitals in Beijing, from June 1, 2009 to October 20, 2009. Controls were women who did not have surgery for uterine fibroids, matched (1:1 ratio) for age (within 2 years). A standard questionnaire was used to inquire about whether participants had PHE at HEC during the previous 2 years. PHE at HEC within 2 years were associated with surgical treatment for uterine fibroids. Odds ratios was 4.05 (95% CI, 2.61-6.29 P < 0.001), after adjustment for marital status, whether have children, annual family income, health insurance, education level and self-rated uterine fibroids-related symptom severity. Our study showed PHE currently provided at HEC in China were associated with significantly increased use of surgical treatment for uterine fibroids in women. Further studies are needed to assess the effects of PHE on clinical as well as on broad societal outcomes in Chinese in contemporary medical settings.

  13. Chemotherapeutic agents for the treatment of metastatic breast cancer: An update.

    PubMed

    Abotaleb, Mariam; Kubatka, Peter; Caprnda, Martin; Varghese, Elizabeth; Zolakova, Barbora; Zubor, Pavol; Opatrilova, Radka; Kruzliak, Peter; Stefanicka, Patrik; Büsselberg, Dietrich

    2018-05-01

    Breast cancer is the second greatest cause of death among women worldwide; it comprises a group of heterogeneous diseases that evolves due to uncontrolled cellular growth and differentiation and the loss of normal programmed cell death. There are different molecular sub-types of breast cancer; therefore, various options are selected for treatment of different forms of metastatic breast cancer. However, the use of chemotherapeutic drugs is usually accompanied by deleterious side effects and the development of drug resistance when applied for a longer period. This review offers a classification of these chemotherapeutic agents according to their modes of action and therefore improves the understanding of molecular targets that are affected during treatment. Overall, it will allow the clinician to identify more specific targets to increase the effectiveness of a drug and to reduce general toxicity, resistance and other side effects. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  14. [25 year experience with using surgical correction of dislipidemia in treatment of patients with atherosclerosis].

    PubMed

    Sedov, V M; Mirchuk, K K; Sedletskiĭ, Iu I

    2011-01-01

    An analysis of results of using partial ileoshunting for the treatment of dislipidemia in 159 patients with atherosclerosis has shown that operation of partial ileoshunting has an obligatory, pronounced and lifelong lipidcorrecting effect. An antiatherogenic effect of the operation of partial ileoshunting is manifested as the improvement of the clinical course of the disease caused by atherosclerosis, by less number of thrombotic complications of atherosclerosis and less lethality from cardio-vascular diseases. At a longer follow-up period, the efficiency of partial ileoshunting as a means of secondary prophylactics of atherosclerosis is confirmed but in case of liquidation after operation of dislipoproteidemia.

  15. Deciphering Periodic Methanol Masers

    NASA Astrophysics Data System (ADS)

    Stecklum, Bringfried; Caratti o Garatti, Alessio; Henning, Thomas; Hodapp, Klaus; Hopp, Ulrich; Kraus, Alex; Linz, Hendrik; Sanna, Alberto; Sobolev, Andrej; Wolf, Verena

    2018-05-01

    Impressive progress has been made in recent years on massive star formation, yet the involved high optical depths even at submm/mm wavelengths make it difficult to reveal its details. Recently, accretion bursts of massive YSOs have been identified to cause flares of Class II methanol masers (methanol masers for short) due to enhanced mid-IR pumping. This opens a new window to protostellar accretion variability, and implies that periodic methanol masers hint at cyclic accretion. Pinning down the cause of the periodicity requires joint IR and radio monitoring. We derived the first IR light curve of a periodic maser host from NEOWISE data. The source, G107.298+5.639, is an intermediate-mass YSO hosting methanol and water masers which flare every 34.5 days. Our recent joint K-band and radio observations yielded first but marginal evidence for a phase lag between the rise of IR and maser emission, respectively, and revealed that both NEOWISE and K-band light curves are strongly affected by the light echo from the ambient dust. Both the superior resolution of IRAC over NEOWISE and the longer wavelengths compared to our ground-based imaging are required to inhibit the distractive contamination by the light echo. Thus, we ask for IRAC monitoring of G107 to cover one flare cycle, in tandem with 100-m Effelsberg and 2-m Wendelstein radio and NIR observations to obtain the first high-quality synoptic measurements of this kind of sources. The IR-maser phase lag, the intrinsic shape of the IR light curves and their possible color variation during the cycle allow us to constrain models for the periodic maser excitation. Since methanol masers are signposts of intermediate-mass and massive YSOs, deciphering their variability offers a clue to the dynamics of the accretion-mediated growth of massive stars and their feedback onto the immediate natal environment. The Spitzer light curve of such a maser-hosting YSO would be a legacy science product of the mission.

  16. 20 CFR 220.181 - The month in which the Board will find that the annuitant is no longer disabled.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... the annuitant is no longer disabled. 220.181 Section 220.181 Employees' Benefits RAILROAD RETIREMENT... will find that the annuitant is no longer disabled. If the evidence shows that the annuitant is no longer disabled, the Board will find that his or her disability ended in the earliest of the following...

  17. 20 CFR 220.181 - The month in which the Board will find that the annuitant is no longer disabled.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... the annuitant is no longer disabled. 220.181 Section 220.181 Employees' Benefits RAILROAD RETIREMENT... will find that the annuitant is no longer disabled. If the evidence shows that the annuitant is no longer disabled, the Board will find that his or her disability ended in the earliest of the following...

  18. 20 CFR 220.181 - The month in which the Board will find that the annuitant is no longer disabled.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... the annuitant is no longer disabled. 220.181 Section 220.181 Employees' Benefits RAILROAD RETIREMENT... will find that the annuitant is no longer disabled. If the evidence shows that the annuitant is no longer disabled, the Board will find that his or her disability ended in the earliest of the following...

  19. 20 CFR 220.181 - The month in which the Board will find that the annuitant is no longer disabled.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... the annuitant is no longer disabled. 220.181 Section 220.181 Employees' Benefits RAILROAD RETIREMENT... will find that the annuitant is no longer disabled. If the evidence shows that the annuitant is no longer disabled, the Board will find that his or her disability ended in the earliest of the following...

  20. 20 CFR 220.181 - The month in which the Board will find that the annuitant is no longer disabled.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... the annuitant is no longer disabled. 220.181 Section 220.181 Employees' Benefits RAILROAD RETIREMENT... will find that the annuitant is no longer disabled. If the evidence shows that the annuitant is no longer disabled, the Board will find that his or her disability ended in the earliest of the following...

  1. Period-dependent source rupture behavior of the 2011 Tohoku earthquake estimated by multi period-band Bayesian waveform inversion

    NASA Astrophysics Data System (ADS)

    Kubo, H.; Asano, K.; Iwata, T.; Aoi, S.

    2014-12-01

    Previous studies for the period-dependent source characteristics of the 2011 Tohoku earthquake (e.g., Koper et al., 2011; Lay et al., 2012) were based on the short and long period source models using different method. Kubo et al. (2013) obtained source models of the 2011 Tohoku earthquake using multi period-bands waveform data by a common inversion method and discussed its period-dependent source characteristics. In this study, to achieve more in detail spatiotemporal source rupture behavior of this event, we introduce a new fault surface model having finer sub-fault size and estimate the source models in multi period-bands using a Bayesian inversion method combined with a multi-time-window method. Three components of velocity waveforms at 25 stations of K-NET, KiK-net, and F-net of NIED are used in this analysis. The target period band is 10-100 s. We divide this period band into three period bands (10-25 s, 25-50 s, and 50-100 s) and estimate a kinematic source model in each period band using a Bayesian inversion method with MCMC sampling (e.g., Fukuda & Johnson, 2008; Minson et al., 2013, 2014). The parameterization of spatiotemporal slip distribution follows the multi-time-window method (Hartzell & Heaton, 1983). The Green's functions are calculated by the 3D FDM (GMS; Aoi & Fujiwara, 1999) using a 3D velocity structure model (JIVSM; Koketsu et al., 2012). The assumed fault surface model is based on the Pacific plate boundary of JIVSM and is divided into 384 subfaults of about 16 * 16 km^2. The estimated source models in multi period-bands show the following source image: (1) First deep rupture off Miyagi at 0-60 s toward down-dip mostly radiating relatively short period (10-25 s) seismic waves. (2) Shallow rupture off Miyagi at 45-90 s toward up-dip with long duration radiating long period (50-100 s) seismic wave. (3) Second deep rupture off Miyagi at 60-105 s toward down-dip radiating longer period seismic waves then that of the first deep rupture. (4) Deep

  2. Extending 3D Near-Cloud Corrections from Shorter to Longer Wavelengths

    NASA Technical Reports Server (NTRS)

    Marshak, Alexander; Evans, K. Frank; Varnai, Tamas; Guoyong, Wen

    2014-01-01

    Satellite observations have shown a positive correlation between cloud amount and aerosol optical thickness (AOT) that can be explained by the humidification of aerosols near clouds, and/or by cloud contamination by sub-pixel size clouds and the cloud adjacency effect. The last effect may substantially increase reflected radiation in cloud-free columns, leading to overestimates in the retrieved AOT. For clear-sky areas near boundary layer clouds the main contribution to the enhancement of clear sky reflectance at shorter wavelengths comes from the radiation scattered into clear areas by clouds and then scattered to the sensor by air molecules. Because of the wavelength dependence of air molecule scattering, this process leads to a larger reflectance increase at shorter wavelengths, and can be corrected using a simple two-layer model. However, correcting only for molecular scattering skews spectral properties of the retrieved AOT. Kassianov and Ovtchinnikov proposed a technique that uses spectral reflectance ratios to retrieve AOT in the vicinity of clouds; they assumed that the cloud adjacency effect influences the spectral ratio between reflectances at two wavelengths less than it influences the reflectances themselves. This paper combines the two approaches: It assumes that the 3D correction for the shortest wavelength is known with some uncertainties, and then it estimates the 3D correction for longer wavelengths using a modified ratio method. The new approach is tested with 3D radiances simulated for 26 cumulus fields from Large-Eddy Simulations, supplemented with 40 aerosol profiles. The results showed that (i) for a variety of cumulus cloud scenes and aerosol profiles over ocean the 3D correction due to cloud adjacency effect can be extended from shorter to longer wavelengths and (ii) the 3D corrections for longer wavelengths are not very sensitive to unbiased random uncertainties in the 3D corrections at shorter wavelengths.

  3. Depression and anxiety during pregnancy and the postpartum period in women with epilepsy: A review of frequency, risks and recommendations for treatment.

    PubMed

    H Bjørk, Marte; Veiby, Gyri; A Engelsen, Bernt; Gilhus, Nils Erik

    2015-05-01

    To review available data and provide treatment recommendations concerning peripartum depression, anxiety and fear of birth in women with epilepsy (WWE). The PubMed, the LactMed, the DART and the Cochrane database were searched for original articles concerning psychiatric disease in the peripartum period in WWE. Point prevalence of depression from 2nd trimester to 6 months postpartum ranged from 16 to 35% in women with epilepsy compared to 9-12% in controls. The highest estimates were found early in pregnancy and in the perinatal period. Anxiety symptoms 6 months postpartum were reported by 10 and 5%, respectively. Fear of birth symptoms were increased in primiparous WWE compared to controls. Previous psychiatric disease, sexual/physical abuse, antiepileptic drug (AED) polytherapy, and high seizure frequency emerged as strong risk factors. Depressed WWE rarely used antidepressive medication during pregnancy. No evidence was available concerning treatment effects or impact on the developing child. Peripartum depression is frequent in WWE and seldom medically treated. Health personnel should screen WWE for psychiatric disease and risk factors during pre-pregnancy planning, pregnancy and postpartum follow up. Treatment decisions should rely on efficacy and safety data in peripartum patients without epilepsy and non-pregnant people with epilepsy. Consequences of in utero exposure to AED therapy in combination with antidepressants are not known, and non-pharmacological treatment should be tried first. Copyright © 2015. Published by Elsevier Ltd.

  4. Occurrence of Sustained Treatment Following Enhanced Anaerobic Bioremediation at Chlorinated Solvent Sites

    NASA Astrophysics Data System (ADS)

    Burcham, M.; Bedient, P.; McGuire, T.; Adamson, D.; Newell, C. J.

    2012-12-01

    Chlorinated solvents are among the most prevalent groundwater contaminants found in the United States, located at nearly 80% of all Superfund sites, and at more than 3,000 Department of Defense sites. Responsible parties in the U.S. spend several billion dollars per year on environmental restoration with much of these funds targeting remediation of chlorinated solvents in groundwater. To make this large investment in groundwater remediation technologies more effective, end-users need quantitative, accurate, and reliable performance data for commonly used remediation technologies. One such technology that has been used increasingly for remediation of chlorinated solvent sites is enhanced anaerobic bioremediation (EAB). A previous study of remediation performance of various technologies indicated that EAB has the potential for sustained treatment several years after injection of an EAB substrate. This benefit is attributed to the recycling of decaying biomass (endogenous decay) and/or the formation of reactive mineral species, and it serves to mitigate the incidence of concentration rebound during the post-treatment period that is commonly-observed with other technologies. The current study expands on the previous study by focusing on the occurrence of sustained treatment at EAB sites through analysis of groundwater concentration data for longer post-treatment periods than were available for the previous study (up to 9 years), along with site characteristics such as hydrogeology, geochemistry, and microbiology. The objective is to determine whether relationships exist that can aid in determining when sustained treatment following EAB might occur for a given site. To date, data from over 17 distinct sites applying EAB have been collected. The dataset includes over 50 monitoring wells within EAB treatment zones, with concentration data extending from before treatment began to more than 3 to 9 years following treatment. Efforts are underway to continue this data mining

  5. Adaptive influence of extrinsic and intrinsic factors on variation of incubation periods among tropical and temperate passerines

    USGS Publications Warehouse

    Martin, Thomas E.; Ton, Riccardo; Oteyza, Juan C.

    2018-01-01

    Understanding intrinsic (physiological) and extrinsic (e.g., temperature) causes of variation in embryonic development time (incubation period) is important because they can have different impacts on individual quality. Robert Ricklefs and colleagues have argued that longer incubation periods result primarily from intrinsic physiological programs that increase individual quality and adult survival. They claim that incubation periods are largely invariant and that extrinsic factors like temperature have little impact. We have argued that adult survival may be a cause rather than a consequence of much of the variation in embryonic development time. A reduction in extrinsic sources of annual adult mortality (e.g., migration, predation, nonbreeding-season mortality) favors reduced parental effort during incubation to minimize costs to future reproduction and survival. Reduced parental effort, in turn, manifests as cooler average egg temperatures that yield longer incubation periods. Ricklefs and colleagues mischaracterized our hypothesis and deconstructed their own incorrect version, while also making some incorrect statements. We show that reevaluation of previous evidence provided by this group actually supports a role of egg temperature for the variation in incubation periods. We also summarize other observational and experimental evidence that incubation periods are not invariant and that egg temperature has a strong causal influence on variation within and among species. In fact, egg temperature explains ∼60% of the difference in incubation periods among species. The remaining ∼40% reflects intrinsic physiological programs and other factors, potentially providing intrinsic benefits. Ultimately, annual adult mortality explains substantial variation in parental effort and egg temperature, and the latter strongly explains variation in incubation periods. Both intrinsic programs and extrinsic temperature effects need to be considered in attempts to understand

  6. Doxycycline assay hair samples for testing long-term compliance treatment.

    PubMed

    Angelakis, Emmanouil; Armstrong, Nicholas; Nappez, Claude; Richez, Magalie; Chabriere, Eric; Raoult, Didier

    2015-11-01

    Many patients undergoing long-term doxycycline treatment do not regularly take their treatment because of photosensitivity. Our objective was to create an assay for determining doxycycline levels and to use hair samples for monitoring the compliance over a longer period of time. We tested sera and hair samples from patients treated with doxycycline by a suitable ultra-high performance liquid chromatography (UHPLC) based assay. We estimated that the speed of hair growth is roughly 1.25 cm per month and we were able to determine doxycycline levels over a 6-month period. We tested 14 patients treated with doxycycline and we found similar levels of doxycycline in the serum and the hair samples representing the last 4 months. Linear regression analysis revealed that the level of doxycycline in the serum remained stable over time (p = 0.7) but the level of doxycycline in the hair decreased significantly over time (p = 0.03) indicating a degradation of this molecule in the hair. We detected two patients who did not have antibiotic in the hair, indicating a lack of compliance that was also confirmed by interview. Hair samples can be used to test long-term compliance in patients to explain failures or relapses. Copyright © 2015 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  7. Orbital period determination in an eclipsing dwarf nova HT Cas

    NASA Astrophysics Data System (ADS)

    Bąkowska, Karolina; Olech, Arkadiusz

    2014-09-01

    HT Cassiopeiae was discovered over seventy years ago (Hoffmeister 1943). Unfortunately, for 35 years this object did not receive any attention, until the eclipses of HT Cas were observed by Bond. After a first analysis, Patterson (1981) called HT Cas "a Rosetta stone among dwarf novae". Since then, the literature on this star is still growing, reaching several dozens of publications. We present an orbital period determination of HT Cas during the November 2010 super-outburst, but also during a longer time span, to check its stability.

  8. The unintended consequences of maternity leaves: How agency interventions mitigate the negative effects of longer legislated maternity leaves.

    PubMed

    Hideg, Ivona; Krstic, Anja; Trau, Raymond N C; Zarina, Tanya

    2018-06-07

    To support women in the workplace, longer legislated maternity leaves have been encouraged in Scandinavian countries and recently in Canada. Yet, past research shows that longer legislated maternity leaves (i.e., 1 year and longer) may unintentionally harm women's career progress. To address this issue, we first sought to identify one potential mechanism underlying negative effects of longer legislated maternity leaves: others' lower perceptions of women's agency. Second, we utilize this knowledge to test interventions that boost others' perceptions of women's agency and thus mitigate negative effects of longer legislated maternity leaves. We test our hypotheses in three studies in the context of Canadian maternity leave policies. Specifically, in Study 1, we found that others' lower perceptions of women's agency mediated the negative effects of a longer legislated maternity leave, that is, 1 year (vs. shorter, i.e., 1 month maternity leave) on job commitment. In Study 2, we found that providing information about a woman's agency mitigates the unintended negative effects of a longer legislated maternity leave on job commitment and hireability. In Study 3, we showed that use of a corporate program that enables women to stay in touch with the workplace while on maternity leave (compared to conditions in which no such program was offered; a program was offered but not used by the applicant; and the program was offered, but there was no information about its usage by the applicant) enhances agency perceptions and perceptions of job commitment and hireability. Implications for theory and practice are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  9. Methadone treatment and risk of HIV infection in drug users without legal access to clean injection equipment.

    PubMed

    Wietlisbach, V; Meystre-Agustoni, G; Martin, J

    1995-01-01

    The particular situation of the Swiss canton of Vaud (population 550,000) provides favourable observational conditions to assess the efficacy of a methadone treatment scheme in reducing the risk of human immunodeficiency virus (HIV) infection among drug users. On the one hand, the canton has a long tradition of methadone treatment dispensed by medical practitioners. On the other hand, no legal access to clean injection equipment was provided up to 1989. For the 754 drug addicts having entered at least one course of treatment at the end of 1988, HIV status was assessed through two surveys conducted at mid-1986 and at end 1988 among the private practitioners and in the screening centers, hospitals, medico-social institutions and prisons. The overall annual HIV seroconversion rate shifted only slightly from 13% in the first study period (1984 to mid-1986) to 11% in the second period (mid-1986 to end 1988). In both periods, patients no longer on treatment, mostly stable abstainers, were the less exposed to HIV infection with a relative risk of 0.65 (p < 0.05). For those still on treatment, the risk of infection was associated directly (p < 0.001) with the frequency of courses and inversely (p < 0.001) with the duration. Between patients with more than 18 months spent on treatment and those with less than 6 months, the relative risk gradient was 0.8 and 1.4 before mid-1986 and widened out to 0.3 and 2.1 later on. This is mainly due to an increasing HIV incidence among newcomers into treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

  10. Dissemination of English Culture in Chinua Achebe's "No Longer at Ease"

    ERIC Educational Resources Information Center

    Zarrinjooee, Bahman; Khatar, Shahla

    2016-01-01

    This paper deals with Chinua Achebe's (1930-2013) "No Longer at Ease" (1960) which depicts the dissemination of English culture in Nigeria and its effects on the life and identity of Obi Okonkwo, the Western educated male protagonist. The focus of this paper is on the dissemination of English culture and submission of Nigerian culture in…

  11. Short-term antibiotic treatment has differing long-term impacts on the human throat and gut microbiome

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

    Jakobsson, H.; Jernberg, C.; Andersson, A.F.

    Antibiotic administration is the standard treatment for the bacterium Helicobacter pylori, the main causative agent of peptic ulcer disease and gastric cancer. However, the long-term consequences of this treatment on the human indigenous microbiota are relatively unexplored. Here we studied short- and long-term effects of clarithromycin and metronidazole treatment, a commonly used therapy regimen against H. pylori, on the indigenous microbiota in the throat and in the lower intestine. The bacterial compositions in samples collected over a four year period were monitored by analyzing the 16S rRNA gene using 454-based pyrosequencing and terminal-restriction fragment length polymorphism (T-RFLP). While the microbialmore » communities of untreated control subjects were relatively stable over time, dramatic shifts were observed one week after antibiotic treatment with reduced bacterial diversity in all treated subjects in both locations. While the microbiota of the different subjects responded uniquely to the antibiotic treatment some general trends could be observed; such as a dramatic decline in Actinobacteria in both throat and feces immediately after treatment. Although the diversity of the microbiota subsequently recovered to resemble the pre treatment states, the microbiota remained perturbed in some cases for up to four years post treatment. In addition, four years after treatment high levels of the macrolide resistance gene erm(B) were found, indicating that antibiotic resistance, once selected for, can persist for longer periods of time than previously recognized. This highlights the importance of a restrictive antibiotic usage in order to prevent subsequent treatment failure and potential spread of antibiotic resistance.« less

  12. Stage selection and restricted oviposition period improves cryopreservation of dipteran embryos.

    PubMed

    Rajamohan, Arun; Rinehart, Joseph P; Leopold, Roger A

    2015-04-01

    Embryos of two dipteran species (Musca domestica and Lucilia sericata) were assessed for an effective sampling time that would result in the highest post-cryopreservation hatch rate, with a primary goal to define species-specific egg collection periods and the effects of manual stage selection on post cryopreservation yield. The effects of the time taken to collect eggs on, (a) the proportion of embryos reaching a specific developmental stage between 17 and 20 h of development, and (b) the post-cryopreservation hatch rate were assessed. Permeabilization treatment applied at any stage of embryonic development did not significantly reduce embryo viability. Eggs collected over longer durations significantly reduced the number of embryos available in a specific developmental stage amenable to cryopreservation. Hatch percentage after cryopreservation of the embryos of M. domestica collected over a 60 min period was 10.7 ± 8.7% compared to 31 ± 5% for the eggs collected for just 15 min. Similarly, percent hatch in L. sericata resulted in 17.0 ± 3.9 and <2% for 15 and 60 min samples, respectively. Significantly higher hatching rates were obtained for cryopreservation after manual selection of specific embryonic developmental stages from the dechorionated samples. Post-cryopreservation hatching rate for stage-selected M. domestica embryos was 86.5 ± 5.5% compared to 33.3 ± 4.5% for embryos staged only by an overall visual confirmation. In the case of L. sericata, the hatching percentage was 79.0 ± 11.1 for stage-selected embryos compared to 17.0 ± 3.9% without individual selection. Published by Elsevier Inc.

  13. Effectiveness of an Extended Yoga Treatment for Women with Chronic Posttraumatic Stress Disorder

    PubMed Central

    Price, Maggi; Musicaro, Regina; Turner, Jennifer; Suvak, Michael; Emerson, David; van der Kolk, Bessel

    2017-01-01

    Abstract Background: Yoga has been found to be an effective posttraumatic stress disorder (PTSD) treatment for a variety of trauma survivors, including females with chronic PTSD. Aim/Purpose: The current study builds on extant research by examining an extended trauma-sensitive yoga treatment for women with chronic PTSD. The study sought to optimize the results of a treatment protocol examined in a recent randomized controlled trial with a shorter duration and without assignment or monitoring of home practice. Materials and Methods: The authors examined a 20-week trauma-sensitive yoga treatment in a non-randomized single-group treatment feasibility study for women with chronic treatment-resistant PTSD (N = 9). The authors examined PTSD and dissociation symptom reduction over several assessment periods. Results: The results indicate that participants experienced significant reductions in PTSD and dissociative symptomatology above and beyond similar treatments of a shorter duration. Conclusions: The findings suggest that more intensive trauma-sensitive yoga treatment characterized by longer duration and intentional assignment and monitoring of home practice may be more advantageous for individuals with severe and chronic PTSD. The implications of the findings for the potentially more substantial role of yoga as an intervention for a subset of adults with chronic treatment-resistant PTSD are discussed. PMID:28121466

  14. Effectiveness of an Extended Yoga Treatment for Women with Chronic Posttraumatic Stress Disorder.

    PubMed

    Price, Maggi; Spinazzola, Joseph; Musicaro, Regina; Turner, Jennifer; Suvak, Michael; Emerson, David; van der Kolk, Bessel

    2017-04-01

    Yoga has been found to be an effective posttraumatic stress disorder (PTSD) treatment for a variety of trauma survivors, including females with chronic PTSD. Aim/Purpose: The current study builds on extant research by examining an extended trauma-sensitive yoga treatment for women with chronic PTSD. The study sought to optimize the results of a treatment protocol examined in a recent randomized controlled trial with a shorter duration and without assignment or monitoring of home practice. The authors examined a 20-week trauma-sensitive yoga treatment in a non-randomized single-group treatment feasibility study for women with chronic treatment-resistant PTSD (N = 9). The authors examined PTSD and dissociation symptom reduction over several assessment periods. The results indicate that participants experienced significant reductions in PTSD and dissociative symptomatology above and beyond similar treatments of a shorter duration. The findings suggest that more intensive trauma-sensitive yoga treatment characterized by longer duration and intentional assignment and monitoring of home practice may be more advantageous for individuals with severe and chronic PTSD. The implications of the findings for the potentially more substantial role of yoga as an intervention for a subset of adults with chronic treatment-resistant PTSD are discussed.

  15. Assessment of beach and dune erosion and accretion using LiDAR: Impact of the stormy 2013-14 winter and longer term trends on the Sefton Coast, UK

    NASA Astrophysics Data System (ADS)

    Pye, Kenneth; Blott, Simon J.

    2016-08-01

    An important question for coastal management concerns the importance of individual storms and clusters of storms on longer term beach sediment budgets, beach and dune erosion, and coastal flood risk. Between October 2013 and March 2014 a series of deep Atlantic low pressure systems crossed the Northeast Atlantic, and strong winds, high waves and high water levels affected many coastal areas in the UK and other parts of western Europe. Net dune recession of up to 12.1 m occurred around Formby Point. On 5 December 2013 the highest water level ever recorded at Liverpool (6.22 m ODN) coincided with waves of Hs of 4.55 m and Tp of 9.3 s in Liverpool Bay. Wave trimming of the dune toe occurred along the entire length of the Sefton coast, but significant dune erosion occurred only where the upper beach (between the mean high water spring tide level and the dune toe) was < 25 m wide. Sediment budget calculations based on LiDAR surveys in October 2013 and May 2014 indicated a net loss of 127 × 103 m3 of sediment from the beach (above 0 m ODN) and a loss of 268 × 103 m3 from the frontal dune system, mostly at Formby Point. However, some parts of the beach to the south of Formby Point gained sediment, indicating net north to south transport over the winter. When considered in a longer term context, the 2013-14 winter represents only a small perturbation on the longer-term coast trend of erosion at Formby Point and progradation to the north and south. Analysis of LiDAR data over a longer time period 1999-2014 indicated upper beach and dune sediment loss of 780 × 103 m3 from the north-central part of Formby Point, with net gains of 806 × 103 m3 and 2116 × 103 m3 in areas to the north and south, respectively. This indicates a net onshore transport of 2142 × 103 m3 from Liverpool Bay towards the coast between Birkdale and Altcar, with a further net total of 210 × 103 m3 transported towards the shore between Altcar and Crosby. In view of the demonstrated value of airborne

  16. 20 CFR 411.171 - When does the period of using a ticket end?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... month in which your ticket is no longer assigned to an EN or State VR agency acting as an EN (see § 411... explanation of the 90-day extension period); or (d) If your ticket was in VR cost reimbursement status as described in § 411.166(j), the 90th day following the date the State VR agency closes your case, unless you...

  17. 20 CFR 411.171 - When does the period of using a ticket end?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... month in which your ticket is no longer assigned to an EN or State VR agency acting as an EN (see § 411... explanation of the 90-day extension period); or (d) If your ticket was in VR cost reimbursement status as described in § 411.166(j), the 90th day following the date the State VR agency closes your case, unless you...

  18. 20 CFR 411.171 - When does the period of using a ticket end?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... month in which your ticket is no longer assigned to an EN or State VR agency acting as an EN (see § 411... explanation of the 90-day extension period); or (d) If your ticket was in VR cost reimbursement status as described in § 411.166(j), the 90th day following the date the State VR agency closes your case, unless you...

  19. 20 CFR 411.171 - When does the period of using a ticket end?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... month in which your ticket is no longer assigned to an EN or State VR agency acting as an EN (see § 411... explanation of the 90-day extension period); or (d) If your ticket was in VR cost reimbursement status as described in § 411.166(j), the 90th day following the date the State VR agency closes your case, unless you...

  20. 20 CFR 411.171 - When does the period of using a ticket end?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... month in which your ticket is no longer assigned to an EN or State VR agency acting as an EN (see § 411... explanation of the 90-day extension period); or (d) If your ticket was in VR cost reimbursement status as described in § 411.166(j), the 90th day following the date the State VR agency closes your case, unless you...

  1. Clozapine potentiation of GABA mediated cortical inhibition in treatment resistant schizophrenia.

    PubMed

    Kaster, Tyler S; de Jesus, Danilo; Radhu, Natasha; Farzan, Faranak; Blumberger, Daniel M; Rajji, Tarek K; Fitzgerald, Paul B; Daskalakis, Zafiris J

    2015-07-01

    Cortical inhibition (CI) deficits have been demonstrated in schizophrenia using transcranial magnetic stimulation (TMS). These CI deficits may be related to decreased GABA activity which may be involved in schizophrenia pathophysiology. Previous cross-sectional studies have also demonstrated greater CI in patients treated with clozapine than other typical/atypical antipsychotics. However, it is not clear if these differences in CI are a result of treatment-resistant illness which necessitates clozapine or are related to clozapine treatment. TMS measures of CI (i.e., cortical silent period (CSP) and short-interval cortical inhibition (SICI)) were measured over the motor cortex in 16 patients with schizophrenia before starting clozapine, then 6 weeks and 6 months after starting clozapine. CSP was significantly longer after 6 weeks of treatment with clozapine (p=0.014). From 6 weeks to 6 months, there was no significant difference in CSP (p>0.05). Short-interval cortical inhibition (SICI) was not significantly different at any time after treatment with clozapine (p>0.05). This prospective-longitudinal study demonstrates that treatment with clozapine is associated with an increase in GABAB mediated inhibitory neurotransmission. Potentiation of GABAB may be a novel neurotransmitter mechanism that is involved in the pathophysiology and treatment of schizophrenia. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. What is the incubation period for listeriosis?

    PubMed Central

    2013-01-01

    Background Listeriosis is a foodborne infection with a low incidence but a high case fatality rate. Unlike common foodborne diseases, the incubation period can be long. The first incubation periods were documented during a large listeriosis outbreak published in 1987 by Linnan and al. in the New England Journal of Medicine (range: 3 days to 70 days). Data on the incubation period of listeriosis are scarce. Our study aim was to estimate precisely the incubation period of listeriosis using available data since 1987. Methods We estimated the incubation period of listeriosis using available published data and data from outbreak investigations carried out by the French National Institute for Public Health Surveillance. We selected cases with an incubation period calculated when a patient had a single exposure to a confirmed food source contaminated by Listeria monocytogenes. Results We identified 37 cases of invasive listeriosis (10 cases with central nervous system involvement (CNS cases), 15 bacteraemia cases and 12 pregnancy-associated cases) and 9 outbreaks with gastroenteritis. The overall median incubation period of invasive listeriosis was 8 days (range: 1–67 days) and differed significantly by clinical form of the disease (p<0.0001). A longer incubation period was observed for pregnancy-associated cases (median: 27.5 days; range: 17–67 days) than for CNS cases (median: 9 days; range: 1–14 days) and for bacteraemia cases (median: 2 days; range: 1–12 days). For gastroenteritis cases, the median incubation period was 24 hours with variation from 6 to 240 hours. Conclusions This information has implications for the investigation of food borne listeriosis outbreaks as the incubation period is used to determine the time period for which a food history is collected. We believe that, for listeriosis outbreaks, adapting the exposure window for documenting patients’ food histories in accordance with the clinical form of infection will facilitate the

  3. Lymphocytosis after treatment with dasatinib in chronic myeloid leukemia: Effects on response and toxicity.

    PubMed

    Schiffer, Charles A; Cortes, Jorge E; Hochhaus, Andreas; Saglio, Giuseppe; le Coutre, Philipp; Porkka, Kimmo; Mustjoki, Satu; Mohamed, Hesham; Shah, Neil P

    2016-05-01

    The proliferation of clonal cytotoxic T-cells or natural killer cells has been observed after dasatinib treatment in small studies of patients with chronic myeloid leukemia (CML). The incidence of lymphocytosis and its association with response, survival, and side effects were assessed in patients from 3 large clinical trials. Overall, 1402 dasatinib-treated patients with newly diagnosed CML in chronic phase (CML-CP), CML-CP refractory/intolerant to imatinib, or with CML in accelerated or myeloid-blast phase were analyzed. Lymphocytosis developed in 32% to 35% of patients and persisted for >12 months. This was not observed in the patients who received treatment with imatinib. Dasatinib-treated patients in all stages of CML who developed lymphocytosis were more likely to achieve a complete cytogenetic response, and patients who had CML-CP with lymphocytosis were more likely to achieve major and deep molecular responses. Progression-free and overall survival rates were significantly longer in patients with CML-CP who were refractory to or intolerant of imatinib and had lymphocytosis. Pleural effusions developed more commonly in patients with lymphocytosis. Overall, lymphocytosis occurred and persisted in many dasatinib-treated patients in all phases of CML. Its presence was associated with higher response rates, significantly longer response durations, and increased overall survival, suggesting an immunomodulatory effect. Prospective studies are warranted to characterize the functional activity of these cells and to assess whether an immunologic effect against CML is detectable. Cancer 2016;122:1398-1407. © 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. © 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

  4. Safety of two sequential whole bladder photodynamic therapy (WBPDT) treatments in the management of resistant bladder cancer

    NASA Astrophysics Data System (ADS)

    Nseyo, Unyime O.; Barnes, C. R.; Martin, Jessicca I.; Lamm, Donald L.; Carpenter, Cindy

    2003-06-01

    While 55 - 60% of newly diagnosed bladder cancers are superficial, a significant number recur as higher grade and/or stage tumors. WBPDT has been used to treat some of these recurrent superficial tumors, although its use has been associated with dose-dependent side effects. Preclinical investigation of three sequential WBPDT treatments using lower PDT dose in normal canine bladder resulted in a lack of permanent bladder contracture. Lower dose single PDT treatment has shown less durable tumor response; however, sequential WBPDT treatments with lower dose may result in durable tumor response. Five patients (4 male, 1 female), average age 65.6 (62-72 years), with recurrent or resistant superficial TCC of the bladder received two WBPDT treatments. First treatment occurred at baseline and the second treatment at 6 months. Photofrin (1.5 mg/kg) was given intravenously 48 hours prior to each cystoscopic treatment with laser light (630 nm, Coherent Lambda-Plus laser). Total light treatment doses were 1500 - 2500 Joules at baseline and 1000- 1500 Joules at 6 months. Moderate irritative bladder symptoms occurred in all patients the first week post PDT. No cases of bladder contracture have occurred. 4 of 5 patients showed no evidence of disease during the follow-up period (12 - 18 months post second treatment). One patient had a recurrence at 18 months post second treatment. Mean disease-free interval is 16.2 months. The safety of two sequential WBPDT treatments is suggested by this preliminary data. Assessment of efficacy will be possible wit a large number of patients and a longer follow-up period.

  5. CO2 lidar observations of Mount Pinatubo debris: FIRE 2 and longer-term measurements

    NASA Technical Reports Server (NTRS)

    Levinson, David H.; Post, Madison J.; Grund, Christian J.

    1993-01-01

    The volcanic debris in the stratosphere from the June 1991 eruption of Mt. Pinatubo first appeared over the NOAA Wave Propagation Laboratory (WPL) field site near Boulder, Colorado (40.15 N, 105.23 W), in July of 1991. The presence of the Pinatubo cloud has allowed us to characterize both the tropospheric and stratospheric aerosol backscatter using the NOAA/WPL CO2 Doppler lidar. The lidar has measured vertical backscatter profiles at lambda = 10.59 mu m for over a decade. Analysis of this dense set of profiles reveals the effects of atmospheric and microphysical processes during the buildup and decay of Mt. Pinatubo's clouds. Further information on the NOAA lidar, specifically calibrations using a hard target, can be found in Post and Cupp (1990). We present results of those measurements for June 15, 1991, through December 31, 1992. During that period of longer-term measurements, WPL took part in FIRE II (First ISCCP (International Satellite Cloud Climatology Project) Regional Experiment II), from November 12 through December 8, 1991, measuring vertical backscatter profiles almost daily. One of the mechanisms for purging stratospheric aerosols is tropopause folding, which occurs in cold-core extratropical cyclones. Tropospheric mass loading occurs during folding events which can substantially increase the amount of ice nuclei in the upper troposphere, and may affect the formation of cirrus in that region. Spring and fall are prominent times for tropopause folding events because of the migration of the subtropical and polar jet streams during the transition seasons. Sassen has suggested that the volcanic aerosols from Pinatubo played a role in the formation of cirrus during FIRE II, particularly during a period of moist subtropical flow on December 5-6, 1991.

  6. Dynamics of nitrifying bacterial communities in the Seine river and estuary as affected by changes in the treatment of Paris wastewater : a comparison of 2001-2003 vs 2012-2013 periods

    NASA Astrophysics Data System (ADS)

    Aissa Grouz, Najla; Billen, Gilles; Garnier, Josette; Mercier, Benjamin; Martinez, Anun

    2014-05-01

    wastewaters. We show that, although large amounts of ammonium oxidizing microbes are still released in large amounts with the treated effluents, they no longer grows up in the Seine water by lack of substrate in sufficiently high concentration. The same is true for nitrite oxidizing micro-organisms, which explains the slow disappearance of nitrites from the downstream sector of the Seine River. The maximum turbidity zone of the downstream estuary acts as a concentrator of particulate material. The concentration of nitrifying bacteria observed there is therefore a good indicator of the development of nitrifiers in the downstream sector of the Seine. Comparison of the levels observed in the 2000-2003 period and in 2012 fully confirms our interpretation. In August-September 2013, a dysfunction of the Seine-Aval treatment plant occurred, and large amounts of incompletely nitrified effluents were released, so that high ammonium concentrations were still observed in the river. Interestingly, the dynamics of nitrifying microbial populations recorded during this event, contrasted with that observed in the preceding months, and more closely resembled that observed ten year ago, before the implementation of the new treatment in the wastewater purification plant.

  7. Unilateral Nasal Obstruction during Later Growth Periods Affects Craniofacial Muscles in Rats

    PubMed Central

    Uchima Koecklin, Karin H.; Hiranuma, Maya; Kato, Chiho; Funaki, Yukiha; Kataguchi, Taku; Yabushita, Tadachika; Kokai, Satoshi; Ono, Takashi

    2017-01-01

    Nasal obstruction can occur at different life stages. In early stages of life the respiratory system is still under development, maturing during the growth period. Previous studies have shown that nasal obstruction in neonatal rats alters craniofacial function. However, little is known about the effects of nasal obstruction that develops during later growth periods. The aim of this study was to investigate the effects of nasal obstruction during later periods of growth on the functional characteristics of the jaw-opening reflex (JOR) and tongue-protruding muscles. In total, 102 6-day-old male Wistar rats were randomized into either a control or experimental group (both n = 51). In order to determine the appropriate timing of nasal obstruction, the saturation of arterial oxygen (SpO2) was monitored at 8 days, and at 3, 5, 7, 9, and 11 weeks in the control group. Rats in the experimental group underwent unilateral nasal obstruction at the age of 5 weeks. The SpO2 was monitored at 7, 9, and 11 weeks in the experimental group. The electromyographic responses of JOR and the contractile properties of the tongue-protruding muscles were recorded at 7, 9, and 11 weeks. In the control group, SpO2 decreased until 5 weeks of age, and remained relatively stable until 11 weeks of age. The SpO2 was significantly lower in the experimental group than in the control. In the experimental group, JOR changes included a longer latency and smaller peak-to-peak amplitude, while changes in the contractile properties of the tongue-protruding muscles included larger twitch and tetanic forces, and a longer half-decay time. These results suggest that nasal obstruction during later growth periods may affect craniofacial function. PMID:28119621

  8. Outcomes of limited period of adalimumab treatment in moderate to severe Crohn's disease patients: Taiwan Society of Inflammatory Bowel Disease Study

    PubMed Central

    Lin, Wei-Chen; Chou, Jen-Wei; Yen, Hsu-Heng; Hsu, Wen-Hung; Lin, Hung-Hsin; Lin, Jen-Kou; Chuang, Chiao-Hsiung; Huang, Tien-Yu; Wang, Horng-Yuan; Wong, Jau-Min

    2017-01-01

    Background/Aims In Taiwan, due to budget limitations, the National Health Insurance only allows for a limited period of biologics use in treating moderate to severe Crohn's disease (CD). We aimed to access the outcomes of CD patients following a limited period use of biologics, specifically focusing on the relapse rate and remission duration; also the response rate to second use when applicable. Methods This was a multicenter, retrospective, observational study and we enrolled CD patients who had been treated with adalimumab (ADA) according to the insurance guidelines from 2009 to 2015. Results A total of 54 CD patients, with follow-up of more than 6 months after the withdrawal of ADA, were enrolled. The average period of treatment with ADA was 16.7±9.7 months. After discontinuing ADA, 59.3% patients suffered a clinical relapse. In the univariate analysis, the reason for withdrawal was a risk factor for relapse (P=0.042). In the multivariate analysis, current smoker became an important risk factor for relapse (OR, 3.9; 95% CI, 1.2−14.8; P=0.044) and male sex was another risk factor (OR, 2.9; 95% CI, 1.1−8.6; P=0.049). For those 48 patients who received a second round of biologics, the clinical response was seen in 60.4%, and 1 anaphylaxis occurred. Conclusions Fifty-nine percent of patients experienced a relapse after discontinuing the limited period of ADA treatment, and most of them occurred within 1 year following cessation. Male sex and current smoker were risk factors for relapse. Though 60.4% of the relapse patients responded to ADA again. PMID:29142516

  9. Refractory periods and climate forcing in cholera dynamics.

    PubMed

    Koelle, Katia; Rodó, Xavier; Pascual, Mercedes; Yunus, Md; Mostafa, Golam

    2005-08-04

    Outbreaks of many infectious diseases, including cholera, malaria and dengue, vary over characteristic periods longer than 1 year. Evidence that climate variability drives these interannual cycles has been highly controversial, chiefly because it is difficult to isolate the contribution of environmental forcing while taking into account nonlinear epidemiological dynamics generated by mechanisms such as host immunity. Here we show that a critical interplay of environmental forcing, specifically climate variability, and temporary immunity explains the interannual disease cycles present in a four-decade cholera time series from Matlab, Bangladesh. We reconstruct the transmission rate, the key epidemiological parameter affected by extrinsic forcing, over time for the predominant strain (El Tor) with a nonlinear population model that permits a contributing effect of intrinsic immunity. Transmission shows clear interannual variability with a strong correspondence to climate patterns at long periods (over 7 years, for monsoon rains and Brahmaputra river discharge) and at shorter periods (under 7 years, for flood extent in Bangladesh, sea surface temperatures in the Bay of Bengal and the El Niño-Southern Oscillation). The importance of the interplay between extrinsic and intrinsic factors in determining disease dynamics is illustrated during refractory periods, when population susceptibility levels are low as the result of immunity and the size of cholera outbreaks only weakly reflects climate forcing.

  10. Abortion Patients' Experience and Perceptions of Waiting Periods: Survey Evidence before Arizona's Two-visit 24-hour Mandatory Waiting Period Law.

    PubMed

    Karasek, Deborah; Roberts, Sarah C M; Weitz, Tracy A

    2016-01-01

    More than one-half of U.S. states now have laws requiring women to wait at least 24 hours between receiving information about abortion and the actual abortion procedure, with a few requiring longer waits, and one-fourth requiring that women receive this information in person. Although public discussions of waiting periods focus on how they affect women, we know little about abortion patients' perceptions of these requirements. We collected data from 379 women seeking abortion care at an abortion facility in Arizona before Arizona's 24-hour waiting period two-visit requirement went into effect. Surveys focused on patients' experiences receiving abortion care before the waiting period and perceptions about how the additional clinic visit would affect them. Most women reported one or more financial or logistical challenges in obtaining abortion care. More than two-thirds reported difficulty paying abortion appointment-related expenses. These expenses prevented or delayed almost one-half from paying other expenses, such as rent, bills, and food, with lower income women more affected. The majority expected that the additional visit would result in additional financial and logistical hardships and delay them in having an abortion, with 90% reporting that the waiting period would lead to at least one hardship. Eight percent reported that the waiting period would have a positive effect on emotional well-being, and more than one-half reported that it would have a negative effect on emotional well-being. Only a small minority of women seeking abortion care view a two-visit waiting period law as benefiting them; the overwhelming majority expect a waiting period to have adverse consequences. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  11. The hyperthermic intraoperative intraperitoneal chemotherapy in the treatment of advanced abdominopelvic cancer. Personal experience on 103 procedures during a seventeen year period in a single Italian center.

    PubMed

    Di Miceli, D; Cina, C; Fiorillo, C; Doglietto, G B; Alfieri, S

    2018-02-01

    Integration of different therapeutic strategies in cancer surgery in the last years has led from treating primary lesions to the surgical treatment of metastases. The purpose of this paper is to report a single Italian center experience of treatment of peritoneal carcinosis of the abdominopelvic malignancies. 103 HIPEC procedures were performed in 17 years on 94 selected patients affected by abdominopelvic cancer. The PCI score was calculated at laparotomy. The CC score was calculated before doing HIPEC. HIPEC was carried out according to the Coliseum technique. The surgical cytoreduction allowed 89 patients to be subjected to HIPEC treatment with a CC score 0; 9 patients with a CC 1; 3 patients with a CC 2 and 2 patients with a CC 3. In 22 patients postoperative complications were recorded. No operative mortality occurred. The median follow-up of 53 months shows a rate of survival equivalent to 49 %, with a relapse in 46 patients, 29 of them reached exitus. The surgical resection alone for patients affected by advanced cancer with peritoneal carcinomatosis cannot be considered a sufficient treatment any longer and HIPEC would help to prolong survival in these patients.

  12. Spore powder of Ganoderma lucidum for the treatment of Alzheimer disease: A pilot study.

    PubMed

    Wang, Guo-Hui; Wang, Li-Hua; Wang, Chen; Qin, Li-Hong

    2018-05-01

    This study explored the feasible efficacy and safety of the Spore Powder of Ganoderma Lucidum (SPGL) for treating patients with Alzheimer disease (AD). Forty-two eligible patients with AD were recruited. These patients were randomly allocated to an intervention group and a control group equally. The patients in the intervention group underwent SPGL, whereas the subjects in the control received placebo. All patients were treated for a total of 6 weeks. The primary outcome was measured by Alzheimer's disease Assessment Scale-Cognitive (ADAS-cog). The secondary outcomes were measured by the World Health Organization Quality of Life questionnaire (WHOQOL-BREF) and Neuropsychiatric Index (NPI). The adverse events were also recorded during the treatment period. At the end of the treatment, GLSP did not show more encouraging outcomes in symptoms improvement, measured by the ADAS-cog (P = .31), and NPI (P = .79); and quality of life enhancement, measured by the WHOQOL-BREF (physical, P = .62; psychological, P = .69; social relationships, P = .75; environment, P = .82; overall quality of life, P = .74), compared with the control group. In addition, all adverse events were mild, and no significant differences were found between 2 groups. The results of this study did not find the promising efficacy of SPGL for the treatment of AD after 6-week treatment. It may be because of the relative short-term of intervention. Future clinical trials with larger sample size and longer treatment period are urgently needed.

  13. Solar wind plasma periodicities observed at 1 AU by IMP 8

    NASA Technical Reports Server (NTRS)

    Paularena, K. I.; Szabo, A.; Lazarus, A. J.

    1995-01-01

    The IMP 8 spacecraft has been in Earth orbit since 1973, gathering plasma data over one complete 22-year solar cycle. These data are being examined to look for periodicities at time scales ranging from several hours to the entire span of the data set. A 1.3-year periodicity in the radial speed observed by IMP 8 and Voyager 2 has already been reported for the years from 1987 to 1993. The periodogram method, useful for unevenly sampled data such as the IMP 8 plasma data, has been used to search for other periods. It is interesting to note that the 13-year period is not present in the out-of-the-ecliptic component of the velocity (Vz), although a 1-year period is very obvious both visually and on the periodogram. Both components show a very strong peak associated with the 11-year solar cycle variation. This work will be extended to the thermal speed (a measure of the wind's temperature) and density, although the frequent correlations between these parameters and the velocity are expected to cause similar results. Additionally, the fine resolution data will be examined for shorter time periods than are visible using the hourly average data which are appropriate for longer periods. A comparison with periods observed at other spacecraft may also be made.

  14. Megasessions: Efficacy of Fewer, Longer Treatment Sessions for Fat Reduction in Noninvasive Body Contouring Using a Radiofrequency Based Device.

    PubMed

    Duncan, Diane

    2017-05-01

    While the field of noninvasive body contouring is booming, many patients still note a lesser result than they might achieve with a single session of liposuction or dermolipectomy. The duration of a noninvasive fat reduction treatment series can be daunting. Patients have questioned the worth of these procedures when the expected benefit is modest and the time they devote to the project is significant. An eight-patient mini-study was performed to see if two or three "megasessions" could be substituted for eight weekly sessions of bipolar radiofrequency based fat reduction treatments. Patients were randomized into a two session or three session group by drawing straws. The device used was the BodyFX bipolar RF device by InMode. This device employs a suction coupled vacuum that heats a section of skin and soft tissue in the treatment region and delivers a high voltage pulse. Each patient was treated for 2 hours per session, using the Body FX, more superficial Mini FX, and the Deep FX device in an effort to treat on a multilevel basis. Preoperative 2D and 3D Vectra photos were taken, and were repeated at 1 month and 3 months post-treatment. Volumetric analysis and patient assessment showed similar results with a two or three treatment "megasession" protocol when compared with the traditional protocol of eight weekly sessions. While the cohort number was not statistically significant, the photographs and measurements are compelling enough to warrant further investigation into this treatment protocol.

    J Drugs Dermatol. 2017;16(5):478-480.

    .

  15. Treatment of Highly Virulent Extraintestinal Pathogenic Escherichia coli Pneumonia With Bacteriophages.

    PubMed

    Dufour, Nicolas; Debarbieux, Laurent; Fromentin, Mélanie; Ricard, Jean-Damien

    2015-06-01

    To study the effect of bacteriophage treatment on highly virulent extraintestinal Escherichia coli pneumonia in mice and compare it with conventional antimicrobial treatment. Animal investigation. University research laboratory. Pathogen-free 8-week-old Balb/cJRj male mice. Two bacteriophages (536_P1 and 536_P7) were isolated from sewage using strain 536, a highly virulent extraintestinal E. coli. Their in vitro and in vivo efficacy against strain 536 and a ventilator-associated pneumonia E. coli were tested. The first group of mice were infected by intranasal instillation of bioluminescent strain 536 and received 536_P1 intranasally, ceftriaxone, or control. The second group of mice was infected with the ventilator-associated pneumonia strain and received 536_P7. Adaptation of 536_P7 to this clinical isolate was also evaluated in vitro and in vivo. In vivo efficacy of bacteriophage and antibiotic treatment were assessed by recording bioluminescence for short-time periods and by recording body weight and survival of mice for longer periods. Both treatments improved survival compared with control (100% vs 0%), and in vivo bioluminescence recordings showed a similar rapid decrease of emitted light, suggesting prompt bacterial clearance. The majority of mice infected by the ventilator-associated pneumonia strain were not rescued by treatment with 536_P7; however, in vitro adaptation of this bacteriophage toward the ventilator-associated pneumonia strain led to isolate a variant which significantly improved in vivo treatment efficacy (animal survival increased from 20% to 75%). Bacteriophage treatment was as effective as antibiotherapy to provide 100% survival rate in a lethal model of highly virulent E. coli pneumonia. Adaptation of a bacteriophage is a rapid solution to improve its efficacy toward specific strains. These results suggest that phage therapy could be a promising therapeutic strategy for ventilator-associated pneumonia.

  16. Effects of age, gender, and stimulus presentation period on visual short-term memory.

    PubMed

    Kunimi, Mitsunobu

    2016-01-01

    This study focused on age-related changes in visual short-term memory using visual stimuli that did not allow verbal encoding. Experiment 1 examined the effects of age and the length of the stimulus presentation period on visual short-term memory function. Experiment 2 examined the effects of age, gender, and the length of the stimulus presentation period on visual short-term memory function. The worst memory performance and the largest performance difference between the age groups were observed in the shortest stimulus presentation period conditions. The performance difference between the age groups became smaller as the stimulus presentation period became longer; however, it did not completely disappear. Although gender did not have a significant effect on d' regardless of the presentation period in the young group, a significant gender-based difference was observed for stimulus presentation periods of 500 ms and 1,000 ms in the older group. This study indicates that the decline in visual short-term memory observed in the older group is due to the interaction of several factors.

  17. Medicine in Balkans during the Roman Period

    PubMed Central

    Baykan, Daniş

    2017-01-01

    The aim of this study is to investigate the archaeological finds to enlighten the medical methods of treatments and operations applied in Balkans during Roman Period. Some independent local and regional find groups, taken from existing publications will be grouped together and a holistic point-of-view will be taken against medicine in Balkan Geography during Roman Period. Due to basic differences it contained, the data before Roman Period are excluded. Most of Greece and Aegean Islands are also excluded since the topic selected is “Medicine of Roman Period.” Greece and Aegean Islands should be evaluated in another study in connection with West Anatolia which is closer than the Balkan Geography in terms of social relations. The spread of medical tools in Balkans during Roman Period is concentrated around military garrisons, and in settlements built around military pathways, and in settlements containing an amphitheater associated with gladiators. This spread is verified by the studies on Bulgaria in general. The data is also compatible with the assertion suggesting that the amount of application of pharmaceutical treatment increases when one moves away from the military centres. PMID:28552838

  18. Medicine in Balkans during the Roman Period.

    PubMed

    Baykan, Daniş

    2017-08-04

    The aim of this study is to investigate the archaeological finds to enlighten the medical methods of treatments and operations applied in Balkans during Roman Period. Some independent local and regional find groups, taken from existing publications will be grouped together and a holistic point-of-view will be taken against medicine in Balkan Geography during Roman Period. Due to basic differences it contained, the data before Roman Period are excluded. Most of Greece and Aegean Islands are also excluded since the topic selected is "Medicine of Roman Period." Greece and Aegean Islands should be evaluated in another study in connection with West Anatolia which is closer than the Balkan Geography in terms of social relations. The spread of medical tools in Balkans during Roman Period is concentrated around military garrisons, and in settlements built around military pathways, and in settlements containing an amphitheater associated with gladiators. This spread is verified by the studies on Bulgaria in general. The data is also compatible with the assertion suggesting that the amount of application of pharmaceutical treatment increases when one moves away from the military centres.

  19. On fast X-ray rotators with long-term periodicities

    NASA Technical Reports Server (NTRS)

    Naranan, S.; Elsner, R. F.; Darbro, W.; Ramsey, B. D.; Leahy, D. A.; Weisskopf, M. C.; Williams, A. C.; Hardee, P. E.; Sutherland, P. G.; Grindlay, J. E.

    1985-01-01

    The support of previous SAS 3 spacecraft observations by new data gathered by the Monitor Proportional Counter aboard the HEAO 2 spacecraft indicates that the pulse period history of the 13.5 sec-pulsing X-ray source LMC X-4 is consistent with standard accretion and torque models only if LMC X-4 is a fast rotator for which the accretion torques nearly cancel. This result leads to a neutron star magnetic field strength estimate of about 1.2 x 10 to the 13th G. Strong evidence is noted for Her X-1's status as a fast rotator, while SMC X-1 is probably an intermediate-to-fast rotator. In the context of slaved disk models for these objects, it is noted that the precession periods expected for the companion stars are significantly longer than the observed 1-2 month time scales; slaved disk models are thereby undermined.

  20. Comparison between dopaminergic agents and physical exercise as treatment for periodic limb movements in patients with spinal cord injury.

    PubMed

    De Mello, M T; Esteves, A M; Tufik, S

    2004-04-01

    Randomized controlled trial of physical exercise and dopaminergic agonist in persons with spinal cord injury and periodic leg movement (PLM). The objective of the present study was to compare the effectiveness of physical exercise and of a dopaminergic agonist in reducing the frequency of PLM. Centro de Estudos em Psicobiologia e Exercício. Universidade Federal de São Paulo, Brazil. A total of 13 volunteers (mean age: 31.6+/-8.3 years) received L-DOPA (200 mg) and benserazide (50 mg) 1 h before sleeping time for 30 days and were then submitted to a physical exercise program on a manual bicycle ergometer for 45 days (3 times a week). Both L-DOPA administration (35.11-19.87 PLM/h, P<0.03) and physical exercise (35.11-18.53 PLM/h, P<0.012) significantly reduced PLM; however, no significant difference was observed between the two types of treatment. The two types of treatment were found to be effective in the reduction of PLM; however, physical exercise is indicated as the first treatment approach, while dopaminergic agonists or other drugs should only be recommended for patients who do not respond to this type of treatment.

  1. Economic benefits associated with beta blocker persistence in the treatment of hypertension: a retrospective database analysis.

    PubMed

    Chen, Stephanie; Swallow, Elyse; Li, Nanxin; Faust, Elizabeth; Kelley, Caroline; Xie, Jipan; Wu, Eric

    2015-04-01

    To assess the association between medical costs and persistence with beta blockers among hypertensive patients, and to quantify persistence related medical cost differences with nebivolol, which is associated with improved tolerability, versus other beta blockers. Adults who initiated hypertension treatment with a beta blocker were identified from the MarketScan * claims database (2008-2012). Patients were classified based on their first beta blocker use: nebivolol, atenolol, carvedilol, metoprolol, and other beta blockers. Patients with compelling indications for atenolol, carvedilol or metoprolol (acute coronary syndrome and congestive heart failure) were excluded. Patients enrolled in health maintenance organization or capitated point of service insurance plans were also excluded. Persistence was defined as continuous use of the index drug (<60 day gap). The average effect of persistence on medical costs (2012 USD) was estimated using generalized linear models (GLMs). Regression estimates were used to predict medical cost differences associated with persistence between nebivolol and the other cohorts. A total of 587,424 hypertensive patients met the inclusion criteria. Each additional month of persistence with any one beta blocker was associated with $152.51 in all-cause medical cost savings; continuous treatment for 1 year was associated with $1585.98 in all-cause medical cost savings. Patients treated with nebivolol had longer persistence during the 1 year study period (median: 315 days) than all other beta blockers (median: 156-292 days). Longer persistence with nebivolol translated into $305.74 all-cause medical cost savings relative to all other beta blockers. The results may not be generalizable to hypertensive patients with acute coronary syndrome or congestive heart failure. Longer persistence with beta blockers for the treatment of hypertension was associated with lower medical costs. There may be greater cost savings due to better persistence with

  2. [Prediction of the latency period by cervical ultrasonography in premature rupture of the membranes before term].

    PubMed

    Gabriel, R; Morille, C; Drieux, L; Bige, V; Leymarie, F; Quereux, C

    2002-11-01

    To assess the value of ultrasonographic measurement of cervical length for predicting the duration of the latency period from admission to delivery in women with preterm premature rupture of the membranes (PROM). Prospective study in 88 women with preterm PROM before 34 weeks of amenorrhea. The median gestational age at admission was of 30.1 weeks. The clinical management included: no digital examination of the uterine cervix, antenatal corticosteroids, antibiotics (amoxicillin & clavulanic acid) for 7 days, and hoding back until 34 weeks. Cervical length at admission was determined with transvaginal ultrasonography. The duration of the latency period was studied in relation with cervical length, serum C-reactive protein (CRP) level and white blood cell (WBC) count at admission. The median latency period was longer in women with a cervical length > or = 25 mm (10 vs 5 days; p = 0.04), but this was not associated with a significant increase in birth weight. The median latency period was also longer in women with CRP < 20 mg/l (10 vs 3 days; p < 0.001) and this was associated with a significant increase in birth weight (1716 +/- 549 vs 1201 +/- 485 g; p < 0.01). Moreover, increased CRP levels were more frequent in women with a cervical length < 25 mm, and cervical length was no more predictive of the duration of the latency period in the subgroup of women with CRP < 20 mg/l and WBC < 20,000 cells/mm3. In women with preterm PROM, the latency period from admission to delivery is shorter when cervical length is < 25 mm. However, the clinical value of transvaginal ultrasonography is limited in comparison with serum CRP.

  3. Measuring Outcome in the Treatment of Cocaine Dependence

    PubMed Central

    Crits-Christoph, Paul; Gallop, Robert; Gibbons, Mary Beth Connolly; Sadicario, Jaclyn S.; Woody, George

    2015-01-01

    Background Little in known about the extent to which outcome measures used in studies of the treatment of cocaine dependence are associated with longer-term use and with broader measures of clinical improvement. The current study examined reductions in use, and abstinence-oriented measures, in relation to functioning and longer-term clinical benefits in the treatment of cocaine dependence. Methods Overall drug use, cocaine use, and functioning in a number of addiction-related domains for 487 patients diagnosed with DSM-IV cocaine dependence and treated with one of four psychosocial interventions in the NIDA Cocaine Collaborative Treatment Study were assessed monthly during 6 months of treatment and at 9, 12, 15, and 18 month follow-up. Results Measures of during-treatment reduction in use were moderately correlated with drug and cocaine use measures 12 months, but showed non-significant or small correlations with measures of functioning at 12 months. Highest correlations were evident for abstinence measures (maximum consecutive days abstinence and completely abstinent) during treatment in relation to sustained (3 month) abstinence at 12 months. Latent class analysis of patterns of change over time revealed that most patients initially (months 1 to 4 of treatment) either became abstinent immediately or continued to use every month. Over the couse of follow-up, patients either maintained abstinence or used regularly – intermittent use was less common. Conclusions There were generally small associations between various measures of cocaine use and longer-term clinical benefits, other than abstinence was associated with continued abstinence. No one method of measuring outcome of treatment of cocaine dependence appears superior to others. PMID:26366427

  4. Longer and less overlapping food webs in anthropogenically disturbed marine ecosystems: confirmations from the past.

    PubMed

    Saporiti, Fabiana; Bearhop, Stuart; Silva, Laura; Vales, Damián G; Zenteno, Lisette; Crespo, Enrique A; Aguilar, Alex; Cardona, Luis

    2014-01-01

    The human exploitation of marine resources is characterised by the preferential removal of the largest species. Although this is expected to modify the structure of food webs, we have a relatively poor understanding of the potential consequences of such alteration. Here, we take advantage of a collection of ancient consumer tissues, using stable isotope analysis and SIBER to assess changes in the structure of coastal marine food webs in the South-western Atlantic through the second half of the Holocene as a result of the sequential exploitation of marine resources by hunter-gatherers, western sealers and modern fishermen. Samples were collected from shell middens and museums. Shells of both modern and archaeological intertidal herbivorous molluscs were used to reconstruct changes in the stable isotopic baseline, while modern and archaeological bones of the South American sea lion Otaria flavescens, South American fur seal Arctocephalus australis and Magellanic penguin Spheniscus magellanicus were used to analyse changes in the structure of the community of top predators. We found that ancient food webs were shorter, more redundant and more overlapping than current ones, both in northern-central Patagonia and southern Patagonia. These surprising results may be best explained by the huge impact of western sealing on pinnipeds during the fur trade period, rather than the impact of fishing on fish populations. As a consequence, the populations of pinnipeds at the end of the sealing period were likely well below the ecosystem's carrying capacity, which resulted in a release of intraspecific competition and a shift towards larger and higher trophic level prey. This in turn led to longer and less overlapping food webs.

  5. Women live longer than men even during severe famines and epidemics

    PubMed Central

    Zarulli, Virginia; Barthold Jones, Julia A.; Oksuzyan, Anna; Lindahl-Jacobsen, Rune; Christensen, Kaare; Vaupel, James W.

    2018-01-01

    Women in almost all modern populations live longer than men. Research to date provides evidence for both biological and social factors influencing this gender gap. Conditions when both men and women experience extremely high levels of mortality risk are unexplored sources of information. We investigate the survival of both sexes in seven populations under extreme conditions from famines, epidemics, and slavery. Women survived better than men: In all populations, they had lower mortality across almost all ages, and, with the exception of one slave population, they lived longer on average than men. Gender differences in infant mortality contributed the most to the gender gap in life expectancy, indicating that newborn girls were able to survive extreme mortality hazards better than newborn boys. Our results confirm the ubiquity of a female survival advantage even when mortality is extraordinarily high. The hypothesis that the survival advantage of women has fundamental biological underpinnings is supported by the fact that under very harsh conditions females survive better than males even at infant ages when behavioral and social differences may be minimal or favor males. Our findings also indicate that the female advantage differs across environments and is modulated by social factors. PMID:29311321

  6. Science 101: Why Does It Take Longer to Boil Potatoes at High Altitudes?

    ERIC Educational Resources Information Center

    Robertson, Bill

    2017-01-01

    Why Does It Take Longer to Boil Potatoes at High Altitudes? This column provides background science information for elementary teachers. This month's issue looks at why water boils at different temperatures at different altitudes.

  7. 20 CFR 416.930 - Need to follow prescribed treatment.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... you are a child, if the treatment can reduce your functional limitations so that they are no longer... the other eye resulting in a severe loss of vision and is not subject to improvement through treatment...

  8. Myo-inositol vs. D-chiro inositol in PCOS treatment.

    PubMed

    Formuso, C; Stracquadanio, M; Ciotta, L

    2015-08-01

    Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women in fertile age. It is an endocrine and metabolic disorder characterized by oligo-anovulation, hyperandrogenism and insulin-resistance. Various therapeutic approaches have been attempted in PCOS, including diet and the use of pharmacological agents such as oral contraceptives (OCs) or anti-androgens. Recently, the introduction of inositol in the treatment plan has proved to be as reasonable as useful in countering the endocrine-metabolic disorders of this syndrome. The aim of our study was to compare the clinical, endocrine and metabolic response after 6 months of therapy in 137 PCOS women characterized by oligomenorrhea and/or acne and/or mild hirsutism and insulin-resistance. The patients were treated with myo-inositol or with D-chiro-inositol or with placebo. Our study showed that both myo-inositol (MI-PG) and D-chiro inositol (DCI-PG) treatments are able to significantly improve the regularity of the menstrual cycle, the Acne Score, the endocrine and metabolic parameters and the insulin-resistence in young, overweight, PCOS patients. Definitely, we assumed that both treatments with myo-inositol and with D-chiro inositol could be proposed as a potential valid therapeutic approach for the treatment of patients with PCOS. Additionally, further examination and for a longer period of treatment are needed.

  9. Longer Sleep Durations Are Positively Associated With Finishing Place During a National Multiday Netball Competition.

    PubMed

    Juliff, Laura E; Halson, Shona L; Hebert, Jeffrey J; Forsyth, Peta L; Peiffer, Jeremiah J

    2018-01-01

    Juliff, LE, Halson, SL, Hebert, JJ, Forsyth, PL, and Peiffer, JJ. Longer sleep durations are positively associated with finishing place during a national multiday netball competition. J Strength Cond Res 32(1): 189-194, 2018-Sleep is often regarded as the single best recovery strategy available to an athlete, yet little is known about the quality and quantity of sleep in athletes during multiday competitions. This study objectively evaluated sleep characteristics of athletes during a national netball tournament. Using wrist actigraphy monitors and sleep diaries, 42 netballers from 4 state teams were monitored for the duration of a tournament (6 days) and 12 days before in home environments. Significant differences were found between teams based on final competition standings, suggesting enhanced sleep characteristics in athlete's whose team finished higher in the tournament standings. The top 2 placed teams when compared with the lower 2 placed teams slept longer (8:02 ± 36:43; 7:01 ± 27:33), had greater time in bed (9:03 ± 0:52; 7:59 ± 0:54) and reported enhanced subjective sleep ratings (2.6 ± 0.5; 2.3 ± 0.6). Sleep efficiency was no different between teams. A strong correlation (r = -0.68) was found indicating longer sleep durations during competition were associated with higher final tournament positions. Encouraging athletes to aim for longer sleep durations in competition, where possible, may influence the outcome in tournament style competitions.

  10. Pediatric Dentistry Specialty as Part of a Longer Continuum of Care: A Commentary.

    PubMed

    Waldman, H Barry; Rader, Rick; Sulkes, Stephen; Perlman, Steven P

    The transition of teenagers with special needs to young adulthood is a complex period for the children and their families. This transition is especially difficult when it comes to securing needed oral health care. The teenager is forced to transfer from the services of an age defined pediatric dental specialist with training to provide care for individuals with special needs, to 1) general practitioners with limited formal training and often unwillingness to provide care and 2) at a period when most states provide limited or lack of adult dental Medicaid programs. These issues and the need to expand pediatric dental specialist involvement in the general transitional period are reviewed. "Pediatric dentistry is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs."(1) "Our system of preparing and maintaining our abilities to provide oral health services for an increasing diverse population must be brought up to date to meet the challenges posed by the treatment of young adults with disabilities."(2) "Most responding dentists (to a national study of pediatric dentists) helped adolescents with and without SHCNs (Special Health Care Needs) make the transition into adult care, but the major barrier was the availability of general dentists and specialists."(3).

  11. Facebook usage among those who have received treatment for an eating disorder in a group setting.

    PubMed

    Saffran, Kristina; Fitzsimmons-Craft, Ellen E; Kass, Andrea E; Wilfley, Denise E; Taylor, Craig Barr; Trockel, Mickey

    2016-08-01

    This study explored Facebook use among individuals with a history of receiving treatment for an eating disorder (ED) in a group setting (e.g., inpatient, residential, outpatient group), focusing primarily on comparisons individuals make about their bodies, eating, or exercise to those of their peers from treatment on Facebook and the relation between these comparisons and ED pathology. Individuals (N = 415; mean age 28.15 years ± 8.41; 98.1% female) who self-reported receipt of ED treatment in a group setting were recruited via e-mail and social media to complete an online survey. Participants reported having an average of 10-19 Facebook friends from treatment and spending up to 30 min per day interacting on Facebook with individuals from treatment or ED-related organizations. More comparison to treatment peers on Facebook was associated with greater ED psychopathology and ED-related impairment. Conversely, positive interaction with treatment peers on Facebook was associated with lower ED psychopathology and ED-related impairment. Individuals who had been in treatment longer, more times, and more recently had more Facebook friends from treatment and ED-related organizations as well as spent more time in ED groups' pages on Facebook. Few participants (19.5%) reported that a therapist asked about the impact of Facebook on pathology. Interactions on Facebook could affect patients' recovery and potential for relapse. It may be helpful for treatment providers to discuss Facebook use and its potential benefits and drawbacks with patients preparing for discharge from group treatment. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:764-777). © 2016 Wiley Periodicals, Inc.

  12. Tropical Rainfall Variability on Interannual-to-Interdecadal/Longer-Time Scales Derived from the GPCP Monthly Product

    NASA Technical Reports Server (NTRS)

    Gu, Guojun; Adler, Robert F.; Huffman, George J.; Curtis, Scott

    2006-01-01

    Global and large regional rainfall variations and possible long-term changes are examined using the 26-year (1979-2004) GPCP monthly dataset (Adler et al., 2003). Our emphasis is to discriminate among variations due to ENSO, volcanic events, and possible long-term climate changes in the tropics. Although the global linear change of precipitation in the data set is near zero during the time period, an increase in tropical rainfall is noted, with a weaker decrease over northern hemisphere middle latitudes. Focusing on the tropics (25degS-25degN), the data set indicates an upward trend (0.06 mm/day/decade) and a downward trend (-0.02 mm/day/decade) over tropical ocean and land, respectively. This corresponds to an about 4.9% increase (ocean) and 1.6% decrease (land) during the entire 26-year time period. Techniques are applied to isolate and quantify variations due to ENSO and two major volcanic eruptions (El Chichon, March 1982; Pinatubo, June 1991) in order to examine longer time-scale changes. The ENSO events generally do not impact the tropical total rainfall, but, of course, induce significant anomalies with opposite signs over tropical land and ocean. The impact of the two volcanic eruptions is estimated to be about a 5% reduction in tropical rainfall over both land and ocean. A modified data set (with ENSO and volcano effects removed) retains the same approximate linear change slopes, but with reduced variance, thereby increasing the confidence levels associated with the long-term rainfall changes in the tropics 2

  13. Evaluating the effect of synchronized sea lice treatments in Chile.

    PubMed

    Arriagada, G; Stryhn, H; Sanchez, J; Vanderstichel, R; Campistó, J L; Rees, E E; Ibarra, R; St-Hilaire, S

    2017-01-01

    The sea louse is considered an important ectoparasite that affects farmed salmonids around the world. Sea lice control relies heavily on pharmacological treatments in several salmon-producing countries, including Chile. Among options for drug administration, immersion treatments represent the majority of antiparasitic control strategies used in Chile. As a topical procedure, immersion treatments do not induce a long lasting effect; therefore, re-infestation from neighbouring farms may undermine their efficacy. Synchronization of treatments has been proposed as a strategy to improve immersion treatment performance, but it has not been evaluated so far. Using a repeated-measures linear mixed-effect model, we evaluated the impact of treatment synchronization of neighbouring farms (within 10km seaway distance) on the adult lice mean abundance from weeks 2 to 8 post-treatment on rainbow trout and Atlantic salmon farms in Chile, while controlling for external and internal sources of lice before the treatments, and also for environmental and fish-related variables. Results indicate that treatment synchronization was significantly associated with lower adult lice levels from weeks 5 to 7 after treatment. This relationship appeared to be linear, suggesting that higher levels of synchronization may result in lower adult sea lice levels during these weeks. These findings suggest that synchronization can improve the performance of immersion delousing treatments by keeping sea lice levels low for a longer period of time. Our results may be applicable to other regions of the world where immersion treatments are widely used. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  14. Long-term follow-up of hypochondriasis after selective serotonin reuptake inhibitor treatment.

    PubMed

    Schweitzer, Pernilla J; Zafar, Uzma; Pavlicova, Martina; Fallon, Brian A

    2011-06-01

    : There is paucity of knowledge on the long-term outcome of hypochondriasis, with even less knowledge about the effect of treatment with a selective serotonin reuptake inhibitor (SSRI). : This prospective follow-up study included 58 patients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) hypochondriasis who had participated in a trial of SSRI treatment 4 to 16 years earlier (mean ± SD = 8.6 ± 4.5 years). : Information was obtained on 79.3% (n = 46) of the original group. At follow-up, 40% of the patients continued to meet full DSM-IV criteria for hypochondriasis. Persistence of hypochondriasis was individually predicted by longer duration of prior hypochondriasis (P = 0.003), history of childhood physical punishment (P = 0.01), and less usage of SSRIs during the interval period (P = 0.02). Remission status was not significantly predicted by demographic characteristics, baseline hypochondriasis severity, or psychiatric comorbidity. : A substantial proportion of patients with hypochondriasis who receive treatment with SSRIs achieve remission over the long term. Interim SSRI use may be a factor contributing to better prognosis.

  15. A systematic review and meta-analysis on the incubation period of Campylobacteriosis.

    PubMed

    Awofisayo-Okuyelu, A; Hall, I; Adak, G; Hawker, J I; Abbott, S; McCARTHY, N

    2017-08-01

    Accurate knowledge of pathogen incubation period is essential to inform public health policies and implement interventions that contribute to the reduction of burden of disease. The incubation period distribution of campylobacteriosis is currently unknown with several sources reporting different times. Variation in the distribution could be expected due to host, transmission vehicle, and organism characteristics, however, the extent of this variation and influencing factors are unclear. The authors have undertaken a systematic review of published literature of outbreak studies with well-defined point source exposures and human experimental studies to estimate the distribution of incubation period and also identify and explain the variation in the distribution between studies. We tested for heterogeneity using I 2 and Kolmogorov-Smirnov tests, regressed incubation period against possible explanatory factors, and used hierarchical clustering analysis to define subgroups of studies without evidence of heterogeneity. The mean incubation period of subgroups ranged from 2·5 to 4·3 days. We observed variation in the distribution of incubation period between studies that was not due to chance. A significant association between the mean incubation period and age distribution was observed with outbreaks involving only children reporting an incubation of 1·29 days longer when compared with outbreaks involving other age groups.

  16. Periodical oscillation of zonal wind velocities at the cloud top of Venus

    NASA Astrophysics Data System (ADS)

    Kouyama, T.; Imamura, T.; Nakamura, M.; Satoh, T.; Futaana, Y.

    2010-12-01

    phases of the variation were observed. The 260 day period is longer than the length of one day of Venus (~117 days) and somewhat longer than the orbital revolution period (~225 days) of Venus. In the equatorial region, the amplitude of this oscillation is about 12 m s-1 with the background zonal wind speed of about 95 m s-1. The oscillation period is shorter than the long-term oscillation reported by PVO. Such oscillation has not been reported most probably because previous Venus observations had limitations of observation chances to identify the oscillations with such a period.

  17. Postharvest treatments with salicylic acid, acetylsalicylic acid or oxalic acid delayed ripening and enhanced bioactive compounds and antioxidant capacity in sweet cherry.

    PubMed

    Valero, Daniel; Díaz-Mula, Huertas M; Zapata, Pedro Javier; Castillo, Salvador; Guillén, Fabián; Martínez-Romero, Domingo; Serrano, María

    2011-05-25

    Sweet cherry cultivars ('Cristalina' and 'Prime Giant') harvested at commercial ripening stage were treated with salicylic acid (SA), acetylsalicylic acid (ASA) or oxalic acid (OA) at 1 mM and then stored for 20 days under cold temperature. Results showed that all treatments delayed the postharvest ripening process, manifested by lower acidity, color changes and firmness losses, and maintained quality attributes for longer periods than controls. In addition, total phenolics, anthocyanins and antioxidant activity increased in untreated fruit during the first 10 days of storage and then decreased, while in fruits of all treatments, these parameters increased continuously during storage without significant differences among treatments. Thus, postharvest treatments with natural compounds, such as SA, ASA or OA, could be innovative tools to extend the storability of sweet cherry with higher content of bioactive compounds and antioxidant activity as compared with control fruits.

  18. 42 CFR 8.5 - Periodic evaluation of accreditation bodies.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... PROVISIONS CERTIFICATION OF OPIOID TREATMENT PROGRAMS Accreditation § 8.5 Periodic evaluation of... accreditation body are in compliance with the Federal opioid treatment standards. The evaluation will include a...

  19. 42 CFR 8.5 - Periodic evaluation of accreditation bodies.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... PROVISIONS CERTIFICATION OF OPIOID TREATMENT PROGRAMS Accreditation § 8.5 Periodic evaluation of... accreditation body are in compliance with the Federal opioid treatment standards. The evaluation will include a...

  20. 42 CFR 8.5 - Periodic evaluation of accreditation bodies.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... PROVISIONS CERTIFICATION OF OPIOID TREATMENT PROGRAMS Accreditation § 8.5 Periodic evaluation of... accreditation body are in compliance with the Federal opioid treatment standards. The evaluation will include a...

  1. Treatment of co-occurring food avoidance and alcohol use disorder in an adult: Possible avoidant restrictive food intake disorder?

    PubMed

    Steen, Eloisa; Wade, Tracey D

    2018-04-01

    This case report details the presentation and treatment of a 42-year-old male self-presenting for treatment who reported having been a restrictive eater since childhood; since adolescence he had failed to meet appropriate nutritional intake with one meal at night followed by around 10-20 standard alcoholic drinks. Ten sessions of cognitive behavioral therapy were offered emphasizing the need to adhere to regular eating patterns in conjunction with significant reduction of binge drinking. At the end of treatment, and 1-month follow-up, improvements in nutritional intake and alcohol intake were observed, accompanied by improvements in depression, anxiety, and stress. However, excessive alcohol intake had reoccurred at 3-month follow-up, accompanied by increases in negative affect and impairment due to eating, indicating that longer-term therapy may be required for this group of people. © 2018 Wiley Periodicals, Inc.

  2. Decentralised black water treatment by combined auto-thermal aerobic digestion and ammonia - A pilot study optimising treatment capacity.

    PubMed

    Nordin, A; Göttert, D; Vinnerås, B

    2018-02-01

    Partial heating of black water by auto-thermal aerobic digestion was combined with the addition of 1% w/w urea and monitoring of pathogens and indicator organisms over a 21-day period. After initial mixing, the 160 m 3 black water (60 m 3 heated and 100 m 3 non-heated) was left undisturbed. The urea was confirmed to be fully degraded into ammonia (5.1 g N L -1 ) first after 14 days, while the pH stabilised at around 9.2 after one week. The initial temperature of 17 °C fell by 6 °C during the study. E. coli and Salmonella spp., which are sensitive to ammonia, were inactivated during the first few days of the study, despite the urea only being partly hydrolysed. At day 14, f-RNA bacteriophages could also no longer be detected. The more persistent somatic coliphages, Enterococcus spp. and Ascaris eggs, showed significant but slow inactivation. The treatment proved to be efficient with regards to salmonella, which is a target pathogen in the Swedish context, but for parasite egg inactivation a higher temperature was required. The treatment would benefit from more frequent stirring to speed up the hydrolysis of urea and thus improve treatment efficiency. The alternative treatment scheme could increase capacity by 2.4 times, albeit with a 40% higher cost per volume due to the increased use of urea. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Canakinumab: a human anti-IL-1β monoclonal antibody for the treatment of cryopyrin-associated periodic syndromes.

    PubMed

    Church, Leigh D; McDermott, Michael F

    2010-11-01

    The cryopyrin-associated periodic syndromes (CAPS) are a group of rare inherited inflammatory diseases associated with overproduction of IL-1β. Canakinumab, developed by Novartis AG (Basel, Switzerland), is an intravenously or subcutaneously administered, fully human monoclonal antibody that neutralizes the bioactivity of human IL-1β. Canakinumab has promising clinical safety and pharmacokinetic properties, and has demonstrated potential for the treatment of CAPS. Canakinumab was recently granted EU orphan drug status for systemic-onset juvenile idiopathic arthritis, and early clinical trials have established that administration of canakinumab every 2 weeks is both safe and effective. Subcutaneous canakinumab (approved formulation) offers some advantages over the existing IL-1β-blocking treatment, anakinra, which must be injected daily and is often not well tolerated by patients. The long-term safety of all targeted anti-IL-1 therapies in CAPS remains an unanswered question owing to the relatively short clinical experience with these agents; as canakinumab produces sustained IL-1 suppression, vigilance is necessary to diagnose the development of adverse events, especially any associated infections.

  4. A new dental insurance scheme--effects on the treatment provided and costs.

    PubMed

    Andås, Charlotte Andrén; Ostberg, Anna-Lena; Berggren, Pontus; Hakeberg, Magnus

    2014-01-01

    The aim of this study was to investigate whether the revenues cover the costs in a pilot capitation plan, a dental insurance scheme, and to compare this capitation plan (CP) with the original fee-for-service system (FFS), in terms of the amount and type of dental care provided. Data was collected longitudinally over a period of three years from 1,650 CP patients in five risk groups at a test clinic, and from 1,609 (from the test clinic) and 3,434 (from a matched control clinic) FFS patients, in Göteborg, Sweden. The care investigated was the number of total treatments provided and the number of examinations by dentists and dental hygienists, together with preventive, restorative and emergency treatments. The economic outcome was positive from the administrator's perspective, in all risk groups for the three-year period. The amount and type of care provided differed between the payment models, as CP patients received more preventive treatments, less restorative treatments, and more examinations by dental hygienists than the FFS patients. Emergency treatment was performed more often on CP patients, and the difference was due to a higher frequency of such treatments among women in the CP group. The difference between clinics concerning certain treatment measures was sometimes greater than the difference between payment models. The results from this study indicate a net positive economic outcome for the pilot CP system over three years. The payment model and the clinic affiliation had impact on what type and amount of dental care the patients received. This might suggest that the risk of skewed selection and its consequences as well as the influence of clinic-specific practice need further investigation, to ensure economic sustainability in a longer perspective.

  5. Circadian periodicity of resistance to ionizing radiation in the pocket mouse.

    NASA Technical Reports Server (NTRS)

    Lindberg, R. G.; Hayden, P.; Gambino, J. J.

    1971-01-01

    Investigation of the response of pocket mice to Co 60 irradiation delivered at two times of day - namely, the predicted high and low points of the metabolic rate. The validity of torpor as an assay of the circadian period of body temperature in pocket mice and as a basis for selecting irradiation times is examined. A study is made of the mitotic activity in the pocket mouse intestinal epithelium as an example of a physiological rhythm which might influence radiation sensitivity. The results of tests in which pocket mice were exposed to ionizing radiation at two different times of day are cited. It is found that under the investigated conditions pocket mice irradiated during their metabolically active period (2330 hr) live significantly longer than those irradiated while their metabolic rate is low (0900 hr).

  6. Glucogenic treatment creates an optimal metabolic milieu for the conception period in ewes.

    PubMed

    Porcu, C; Pasciu, V; Succu, S; Baralla, E; Manca, M E; Serra, E; Leoni, G G; Dattena, M; Bomboi, G C; Molle, G; Naitana, S; Berlinguer, F

    2017-04-01

    This study determined the influence of a short-term glucogenic nutritional treatment on circulating concentrations of glucose, insulin, insulin-like growth factor 1 (IGF-1), nonesterified fatty acids (NEFA), and urea, and on their correspondent levels in follicular fluid (FF) collected 12 h after the end of the treatment. After estrous synchronization with intravaginal progestagen-impregnated sponges, 20 Sarda ewes were randomly allocated into two experimental groups (GLU and WAT) and, from day 7 to day 10 (day 0 = day of sponge removal), the GLU group was gavaged with a glycogenic mixture, whereas the WAT group was gavaged with water (control group). Follicular development was stimulated by FSH administration from day 8 to 10. At day 11, ovaries were collected and follicular fluid processed. Plasma changes were assessed from day 6 to 11. In GLU group, circulating concentration of glucose (P < 0.0001), insulin (P < 0.0001), and IGF-1 (P < 0.01) rose significantly, whereas NEFA and urea concentrations decreased (P < 0.0001), as compared with controls. In particular, in FF the higher glucose concentrations found in GLU ewes compared with controls (P < 0.0001) were not accompanied by any increase in insulin and IGF-1 concentrations. NEFA (P < 0.0001) and urea (P < 0.0001) were lower in FF of GLU than WAT group, although NEFA clearance in the ovary proved to be less efficient than at the systemic level. No significant difference between groups was found in FF concentrations of pregnancy-associated plasma protein A (a protease regulating the levels of free IGF-1 in follicles), glutathione, and in its total antioxidant capacity. These results suggest that glycogenic mixture administration creates a suitable follicular microenvironment for the conception period in dairy ewes. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Re-examination of population structure and phylogeography of hawksbill turtles in the wider Caribbean using longer mtDNA sequences.

    PubMed

    Leroux, Robin A; Dutton, Peter H; Abreu-Grobois, F Alberto; Lagueux, Cynthia J; Campbell, Cathi L; Delcroix, Eric; Chevalier, Johan; Horrocks, Julia A; Hillis-Starr, Zandy; Troëng, Sebastian; Harrison, Emma; Stapleton, Seth

    2012-01-01

    Management of the critically endangered hawksbill turtle in the Wider Caribbean (WC) has been hampered by knowledge gaps regarding stock structure. We carried out a comprehensive stock structure re-assessment of 11 WC hawksbill rookeries using longer mtDNA sequences, larger sample sizes (N = 647), and additional rookeries compared to previous surveys. Additional variation detected by 740 bp sequences between populations allowed us to differentiate populations such as Barbados-Windward and Guadeloupe (F (st) = 0.683, P < 0.05) that appeared genetically indistinguishable based on shorter 380 bp sequences. POWSIM analysis showed that longer sequences improved power to detect population structure and that when N < 30, increasing the variation detected was as effective in increasing power as increasing sample size. Geographic patterns of genetic variation suggest a model of periodic long-distance colonization coupled with region-wide dispersal and subsequent secondary contact within the WC. Mismatch analysis results for individual clades suggest a general population expansion in the WC following a historic bottleneck about 100 000-300 000 years ago. We estimated an effective female population size (N (ef)) of 6000-9000 for the WC, similar to the current estimated numbers of breeding females, highlighting the importance of these regional rookeries to maintaining genetic diversity in hawksbills. Our results provide a basis for standardizing future work to 740 bp sequence reads and establish a more complete baseline for determining stock boundaries in this migratory marine species. Finally, our findings illustrate the value of maintaining an archive of specimens for re-analysis as new markers become available.

  8. Monitoring a Prison Opioid Treatment Program Over a Period of Change to Clinical Governance Arrangements, 2007-2013.

    PubMed

    Larney, Sarah; Lai, Wilson; Dolan, Kate; Zador, Deborah

    2016-11-01

    Opioid substitution therapy (OST) is an effective treatment for opioid dependence that is provided in many correctional settings, including New South Wales (NSW), Australia. In 2011, changes to the clinical governance of the NSW prison OST program were implemented, including a more comprehensive assessment, additional specialist nurses, and centralization of program management and planning. This study aimed to document the NSW prison OST program, and assess the impact of the enhanced clinical governance arrangements on retention in treatment until release, the provision of an OST prescription to patients at release, and presentation to a community OST clinic within 48 hours of release from custody. Data from the NSW prison OST program were obtained for the calendar years 2007-2013. Outcomes were analyzed quarterly using log binomial segmented regression. 8577 people were treated with OST in NSW correctional centers, 2007-2013. Over the entire study period, patients were retained in OST until release in 82% of treatment episodes; a prescription for OST was able to be arranged prior to release in 90% of releases; and patients presented to a community clinic within 48 hours of release in 94% of releases with prescriptions. Following the introduction of the changes to clinical governance, there was a significant increasing trend in retention in OST until release, and in provision of an OST prescription at release. There was an initial increase, followed by a decreasing trend, in presentation to a community clinic within 48 hours of release. This large prison-based OST program has high rates of retention in treatment and continuity of care as patients transition from custody to the community. Strengthened clinical governance arrangements were associated with increased retention in treatment until release and increased provision of an OST prescription at release, but did not improve clinic attendance following release from custody. Copyright © 2016 Elsevier Inc. All

  9. Extended Treatment with Bupropion SR for Cigarette Smoking Cessation

    ERIC Educational Resources Information Center

    Killen, Joel D.; Fortmann, Stephen P.; Murphy, Greer M.; Hayward, Chris; Arredondo, Christina; Cromp, DeAnn; Celio, Maria; Abe, Laurie; Wang, Yun; Schatzberg, Alan F.

    2006-01-01

    The authors present results of a randomized clinical trial of the efficacy of extended treatment with bupropion SR in producing longer term cigarette smoking cessation. Adult smokers (N = 362) received open-label treatment (11 weeks) that combined relapse prevention training, bupropion SR, and nicotine patch followed by extended treatment (14…

  10. STOCHASTIC TRANSIENTS AS A SOURCE OF QUASI-PERIODIC PROCESSES IN THE SOLAR ATMOSPHERE

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

    Yuan, Ding; Walsh, Robert W.; Su, Jiangtao

    2016-06-01

    Solar dynamics and turbulence occur at all heights of the solar atmosphere and could be described as stochastic processes. We propose that finite-lifetime transients recurring at a certain place could trigger quasi-periodic processes in the associated structures. In this study, we developed a mathematical model for finite-lifetime and randomly occurring transients, and found that quasi-periodic processes with periods longer than the timescale of the transients, are detectable intrinsically in the form of trains. We simulate their propagation in an empirical solar atmospheric model with chromosphere, transition region, and corona. We found that, due to the filtering effect of the chromosphericmore » cavity, only the resonance period of the acoustic resonator is able to propagate to the upper atmosphere; such a scenario is applicable to slow magnetoacoustic waves in sunspots and active regions. If the thermal structure of the atmosphere is less wild and acoustic resonance does not take place, the long-period oscillations could propagate to the upper atmosphere. Such a case would be more likely to occur in polar plumes.« less

  11. Health-related quality of life trajectories of methamphetamine-dependent individuals as a function of treatment completion and continued care over a 1-year period.

    PubMed

    Gonzales, Rachel; Ang, Alfonso; Marinelli-Casey, Patricia; Glik, Deborah C; Iguchi, Martin Y; Rawson, Richard A

    2009-12-01

    This study applies a chronic illness framework to evaluate treatment outcomes among individuals dependent on methamphetamine (MA). Using growth curve modeling, health-related quality of life (HRQOL) trajectories of MA-dependent individuals (N = 723) were examined over a 1-year period. Results show greater improvements in mental HRQOL trajectories as a function of treatment completion and continued care, although fairly static trajectories in physical health status. Other factors affecting HRQOL trajectories included gender, psychosocial functioning, drug use severity, and health impairment. Results extend research on treatment evaluations for MA dependence, highlighting the importance of continued service utilization for improved quality of life outcomes.

  12. 2,3,3,3-tetrafluoropropene No Longer Regulated as a Volatile Organic Compound

    EPA Pesticide Factsheets

    The Environmental Protection Agency has issued a final rule that identified 2,3,3,3-tetrafluoropropene (also known as HFO-1234yf) as a chemical compound that will no longer be regulated as a VOC under the Clean Air Act.

  13. Quiescent period respiratory gating for PET∕CT

    PubMed Central

    Liu, Chi; Alessio, Adam; Pierce, Larry; Thielemans, Kris; Wollenweber, Scott; Ganin, Alexander; Kinahan, Paul

    2010-01-01

    Purpose: To minimize respiratory motion artifacts, this work proposes quiescent period gating (QPG) methods that extract PET data from the end-expiration quiescent period and form a single PET frame with reduced motion and improved signal-to-noise properties. Methods: Two QPG methods are proposed and evaluated. Histogram-based quiescent period gating (H-QPG) extracts a fraction of PET data determined by a window of the respiratory displacement signal histogram. Cycle-based quiescent period gating (C-QPG) extracts data with a respiratory displacement signal below a specified threshold of the maximum amplitude of each individual respiratory cycle. Performances of both QPG methods were compared to ungated and five-bin phase-gated images across 21 FDG-PET∕CT patient data sets containing 31 thorax and abdomen lesions as well as with computer simulations driven by 1295 different patient respiratory traces. Image quality was evaluated in terms of the lesion SUVmax and the fraction of counts included in each gate as a surrogate for image noise. Results: For all the gating methods, image noise artifactually increases SUVmax when the fraction of counts included in each gate is less than 50%. While simulation data show that H-QPG is superior to C-QPG, the H-QPG and C-QPG methods lead to similar quantification-noise tradeoffs in patient data. Compared to ungated images, both QPG methods yield significantly higher lesion SUVmax. Compared to five-bin phase gating, the QPG methods yield significantly larger fraction of counts with similar SUVmax improvement. Both QPG methods result in increased lesion SUVmax for patients whose lesions have longer quiescent periods. Conclusions: Compared to ungated and phase-gated images, the QPG methods lead to images with less motion blurring and an improved compromise between SUVmax and fraction of counts. The QPG methods for respiratory motion compensation could effectively improve tumor quantification with minimal noise increase. PMID

  14. [Hospitalization period and nutritional status in hospitalized patients].

    PubMed

    Merhi, V A Leandro; de Oliveira, Ma R Marques; Caran, A L; Tristão, T Menuzzo Graupner; Ambo, R Miante; Tanner, M A; Vergna, C Marton

    2007-01-01

    With the objective of studying the nutritional status and its relationship with hospitalization period, a cross-sectional study was done with patients from a private hospital representing a population with a better socioeconomic condition. The anthropometric data of 267 patients, 46% males and 54% females ranging from 20 to 80 years of age, were assessed on the second day of hospitalization. Hospitalization period associated with nutritional status. The data were analyzed by the software Excel and Sigma Stat, using Fisher's exact test and the chi-square test. The studied population presented a body mass index of 25.9 +/- 5.3 and most patients lost weight during hospitalization. The longest hospitalization periods were found among patients with lung diseases (13 days), some being pre-obese (40%) with a small prevalence of undernutrition (4%). The percentage distribution of nutritional status among the groups according to diagnosis was different (P < 0.01) when assessed by the Fisher's exact test and the percentage distribution in weight variation between men and women was different (P < 0.02) when assessed by the chi-square test. When the population was segmented according to age, the percentage distribution of the nutritional status between > 60 and < or = 60 did not present a difference when assessed by the chi-square test. The results of this study show that the nutritional status in some diseases deserves special attention given the greater risk found in these situations, contributing to a longer hospitalization period.

  15. Monitoring Period and Amplitude Changes in Classical Cepheids

    NASA Astrophysics Data System (ADS)

    Erickson, Mary; Engle, Scott; Guinan, Edward; Wells, Mark

    2018-01-01

    Classical Cepheids are a specific class of radially pulsating variable stars and are fundamentally important to Astronomy and Cosmology. Their pulsations can be used to determine accurate distances, both inside the Milky Way and to other galaxies throughout the Universe, via the well-studied Period-Luminosity Relationship (the Leavitt Law). This makes Cepheids “standard candles,” and they are helping Astronomers refine the expansion rate and age of the Universe.Though Cepheid pulsations were long-theorized to be completely stable, we now know that they undergo small but observable changes in their pulsation periods. The rates of the period change give us invaluable information on the Cepheids themselves, and the advent of reliable all-sky photometry surveys has allowed Cepheid pulsations to be monitored more easily than ever before.Five Cepheids were analyzed for this study – AA Gem, BB Gem, RZ Gem, AD Gem, and DX Gem. Photometric data were obtained from two sources: ASAS (the All-Sky Automated Survey) and the RCT (Robotically Controlled Telescope) at Kitt Peak National Observatory in Arizona, whose consortium Villanova is a member of. This photometry is combined with available data from the literature. The two instruments combined give a longer time span, and increased precision, from which period variations can be monitored. This gives us an excellent look at how the pulsations of these 5 Cepheids are evolving over time. The pulsation behavior of the 5 Cepheids studies will be presented, along with their calculated stellar parameters.

  16. Women live longer than men even during severe famines and epidemics.

    PubMed

    Zarulli, Virginia; Barthold Jones, Julia A; Oksuzyan, Anna; Lindahl-Jacobsen, Rune; Christensen, Kaare; Vaupel, James W

    2018-01-23

    Women in almost all modern populations live longer than men. Research to date provides evidence for both biological and social factors influencing this gender gap. Conditions when both men and women experience extremely high levels of mortality risk are unexplored sources of information. We investigate the survival of both sexes in seven populations under extreme conditions from famines, epidemics, and slavery. Women survived better than men: In all populations, they had lower mortality across almost all ages, and, with the exception of one slave population, they lived longer on average than men. Gender differences in infant mortality contributed the most to the gender gap in life expectancy, indicating that newborn girls were able to survive extreme mortality hazards better than newborn boys. Our results confirm the ubiquity of a female survival advantage even when mortality is extraordinarily high. The hypothesis that the survival advantage of women has fundamental biological underpinnings is supported by the fact that under very harsh conditions females survive better than males even at infant ages when behavioral and social differences may be minimal or favor males. Our findings also indicate that the female advantage differs across environments and is modulated by social factors. Copyright © 2018 the Author(s). Published by PNAS.

  17. The effect of long-term nitrate treatment on SRB activity, corrosion rate and bacterial community composition in offshore water injection systems.

    PubMed

    Bødtker, Gunhild; Thorstenson, Tore; Lillebø, Bente-Lise P; Thorbjørnsen, Bente E; Ulvøen, Rikke Helen; Sunde, Egil; Torsvik, Terje

    2008-12-01

    Biogenic production of hydrogen sulphide (H(2)S) is a problem for the oil industry as it leads to corrosion and reservoir souring. Continuous injection of a low nitrate concentration (0.25-0.33 mM) replaced glutaraldehyde as corrosion and souring control at the Veslefrikk and Gullfaks oil field (North Sea) in 1999. The response to nitrate treatment was a rapid reduction in number and activity of sulphate-reducing bacteria (SRB) in the water injection system biofilm at both fields. The present long-term study shows that SRB activity has remained low at < or =0.3 and < or =0.9 microg H(2)S/cm(2)/day at Veslefrikk and Gullfaks respectively, during the 7-8 years with continuous nitrate injection. At Veslefrikk, 16S rRNA gene based community analysis by PCR-DGGE showed that bacteria affiliated to nitrate-reducing sulphide-oxidizing Sulfurimonas (NR-SOB) formed major populations at the injection well head throughout the treatment period. Downstream of deaerator the presence of Sulfurimonas like bacteria was less pronounced, and were no longer observed 40 months into the treatment period. The biofilm community during nitrate treatment was highly diverse and relative stable for long periods of time. At the Gullfaks field, a reduction in corrosion of up to 40% was observed after switch to nitrate treatment. The present study show that nitrate injection may provide a stable long-term inhibition of SRB in sea water injection systems, and that corrosion may be significantly reduced when compared to traditional biocide treatment.

  18. Quasi-periodic Pulsations in the Most Powerful Solar Flare of Cycle 24

    NASA Astrophysics Data System (ADS)

    Kolotkov, Dmitrii Y.; Pugh, Chloe E.; Broomhall, Anne-Marie; Nakariakov, Valery M.

    2018-05-01

    Quasi-periodic pulsations (QPPs) are common in solar flares and are now regularly observed in stellar flares. We present the detection of two different types of QPP signals in the thermal emission light curves of the X9.3-class solar flare SOL2017-09-06T12:02, which is the most powerful flare of Cycle 24. The period of the shorter-period QPP drifts from about 12 to 25 s during the flare. The observed properties of this QPP are consistent with a sausage oscillation of a plasma loop in the flaring active region. The period of the longer-period QPP is about 4 to 5 minutes. Its properties are compatible with standing slow magnetoacoustic oscillations, which are often detected in coronal loops. For both QPP signals, other mechanisms such as repetitive reconnection cannot be ruled out, however. The studied solar flare has an energy in the realm of observed stellar flares, and the fact that there is evidence of a short-period QPP signal typical of solar flares along with a long-period QPP signal more typical of stellar flares suggests that the different ranges of QPP periods typically observed in solar and stellar flares is likely due to observational constraints, and that similar physical processes may be occurring in solar and stellar flares.

  19. Modified femoral pressuriser generates a longer lasting high pressure during cement pressurisation

    PubMed Central

    2011-01-01

    Background The strength of the cement-bone interface in hip arthroplasty is strongly related to cement penetration into the bone. A modified femoral pressuriser has been investigated, designed for closer fitting into the femoral opening to generate higher and more constant cement pressure compared to a commercial (conventional) design. Methods Femoral cementation was performed in 10 Sawbones® models, five using the modified pressuriser and five using a current commercial pressuriser as a control. Pressure during the cementation was recorded at the proximal and distal regions of the femoral implant. The peak pressure and the pressure-time curves were analysed by student's t-test and Two way ANOVA. Results The modified pressuriser showed significantly and substantially longer durations at higher cementation pressures and slightly, although not statistically, higher peak pressures compared to the conventional pressuriser. The modified pressuriser also produced more controlled cement leakage. Conclusion The modified pressuriser generates longer higher pressure durations in the femoral model. This design modification may enhance cement penetration into cancellous bone and could improve femoral cementation. PMID:22004662

  20. Group Treatment of Depression: Individual Predictors of Outcome.

    ERIC Educational Resources Information Center

    Hoberman, Harry M.; And Others

    1988-01-01

    Identified patient characteristics predictive of individual outcome in psychoeducational group treatment for unipolar depression, a coping with depression course. After treatment, 85 percent of the subjects no longer met diagnostic criteria for depressive disorders. Found the most robust predictors of outcome to be pretreatment depression level,…

  1. [Conservative and operative treatment of working age patients with gonarthritis. Economic considerations].

    PubMed

    Malzahn, J

    2014-06-01

    The development of the overall achievements for hospital performance since the introduction in Germany of the diagnosis-related groups (DRG) system in 2003 is the subject of healthcare political discussion. The field of prosthetics is often at the center of considerations. After consideration of the development of achievements with international and regional earnings, the question was investigated how the average expenditure for patients with gonarthritis developed in a time period of 1 year before and after implantation of total knee prostheses. The study was based on individual patient data from the accounting data of the AOK (General Regional Healthcare Insurance) from the categories, inpatient care, panel physician treatment, pharmaceuticals and medicines as well as disability leave periods. The data include the average expenditure and disability times calculated by the AOK for individual patients 12 months before and 12 months after implantation of a total knee prosthesis. The methods were selected because the international classification of diseases (ICD) coding does not allow a differentiation in the degree of severity and, therefore, a comparison of patients who were only conservatively treated within the scope of panel physicians which would have led to problems in risk adjustment. Due to a lack of coding guidelines for treatment by panel physicians, the accuracy of the diagnosis is also limited in comparison to inpatient treatment data. The expenditure and the average disability leave for gonarthritis patients were higher in the year following implantation of total knee prostheses than in the year prior to implantation. No conclusions can be drawn from the provision of service data with respect to the quality of life of the patients. Investigations over a longer time period seem to be necessary.

  2. The incubation period distribution of tuberculosis estimated with a molecular epidemiological approach.

    PubMed

    Borgdorff, Martien W; Sebek, Maruschka; Geskus, Ronald B; Kremer, Kristin; Kalisvaart, Nico; van Soolingen, Dick

    2011-08-01

    There is limited information on the distribution of incubation periods of tuberculosis (TB). In The Netherlands, patients whose Mycobacterium tuberculosis isolates have identical DNA fingerprints in the period 1993-2007 were interviewed to identify epidemiological links between cases. We determined the incubation period distribution in secondary cases. Survival analysis techniques were used to include secondary cases not yet symptomatic at diagnosis with weighting to adjust for lower capture probabilities of couples with longer time intervals between their diagnoses. In order to deal with missing data, we used multiple imputations. We identified 1095 epidemiologically linked secondary cases, attributed to 688 source cases with pulmonary TB. Of those developing disease within 15 years, the Kaplan-Meier probability to fall ill within 1 year was 45%, within 2 years 62% and within 5 years 83%. The incubation time was shorter in secondary cases who were men, young, those with extra-pulmonary TB and those not reporting previous TB or previous preventive therapy. Molecular epidemiological analysis has allowed a more precise description of the incubation period of TB than was possible in previous studies, including the identification of risk factors for shorter incubation periods.

  3. Multimodality Treatment of Gastric Lymphoma.

    PubMed

    Ikoma, Naruhiko; Badgwell, Brian D; Mansfield, Paul F

    2017-04-01

    Gastric lymphoma is rare, accounting for 3% of gastric neoplasms and 10% of lymphomas. Treatment should be stratified based on histologic type, stage, Helicobacter pylori infection, and t(11;18) translocation status. Surgery is no longer a mainstay for treatment and should be reserved for rare situations such as perforation, fistula formation, and severe bleeding. Multimodal treatment, including H pylori eradication, radiation therapy, chemotherapy, and immunotherapy, should be provided as appropriate and can result in excellent outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Zonally Symmetric Oscillations of the Thermosphere at Planetary Wave Periods

    NASA Astrophysics Data System (ADS)

    Forbes, Jeffrey M.; Zhang, Xiaoli; Maute, Astrid; Hagan, Maura E.

    2018-05-01

    New mechanisms for imposing planetary wave (PW) variability on the ionosphere-thermosphere system are discovered in numerical experiments conducted with the National Center for Atmospheric Research thermosphere-ionosphere-electrodynamics general circulation model. First, it is demonstrated that a tidal spectrum modulated at PW periods (3-20 days) entering the ionosphere-thermosphere system near 100 km is responsible for producing ±40 m/s and ±10-15 K PW period oscillations between 110 and 150 km at low to middle latitudes. The dominant response is broadband and zonally symmetric (i.e., "S0") over a range of periods and is attributable to tidal dissipation; essentially, the ionosphere-thermosphere system "vacillates" in response to dissipation of the PW-modulated tidal spectrum. In addition, some specific westward propagating PWs such as the quasi-6-day wave are amplified by the presence of the tidal spectrum; the underlying mechanism is hypothesized to be a second-stage nonlinear interaction. The S0 total neutral mass density (ρ) response at 325 km consists of PW period fluctuations of order ±3-4%, roughly equivalent to the day-to-day variability associated with low-level geomagnetic activity. The variability in ρ over short periods (˜< 9 days) correlates with temperature changes, indicating a response of hydrostatic origin. Over longer periods ρ is also controlled by composition and mean molecular mass. While the upper-thermosphere impacts are modest, they do translate to more significant changes in the F region ionosphere.

  5. Gluteus maximus contraction velocity assessed by tensiomyography improves following arthroscopic treatment of femoroacetabular impingement.

    PubMed

    Seijas, Roberto; Marín, Miguel; Rivera, Eila; Alentorn-Geli, Eduard; Barastegui, David; Álvarez-Díaz, Pedro; Cugat, Ramón

    2018-03-01

    Muscular impairment, particularly for the gluteus maximus (GM), has been observed in femoroacetabular impingement (FAI). The purpose of this study was to evaluate the tensiomyographic changes of the GM, rectus femoris (RF) and adductor longus (AL) before and after arthroscopic surgery for FAI. It was hypothesized that arthroscopic treatment of FAI would improve the preoperative muscular impairment. All patients undergoing arthroscopic treatment of FAI between January and July 2015 were approached for eligibility. Patients included had a tensiomyography (TMG) evaluation including maximal displacement (Dm) and contraction time (Tc) of these muscles in both lower extremities. TMG values between the injured and healthy sides were compared at the preoperative and post-operative (3, 6 and 12 months after surgery) periods. There were no significant differences for the RF and AL, and Dm of the GM for any of the comparisons (n.s.). However, GM Tc was significantly lower at 3 (p = 0.016), 6 (p = 0.008), and 12 (p = 0.049) months after surgery in the injured side compared to preoperatively. GM Tc of the healthy side was significantly lower than the injured side at the preoperative period (p = 0.004) and at 3 (p = 0.024) and 6 (p = 0.028) months after surgery, but these significant differences were no longer observed at 12 months after surgery (n.s.). There was a significant reduction of pain in the GM area at 1 year after surgery compared to preoperatively (p < 0.0001). Arthroscopic treatment of FAI and the subsequent rehabilitation improves contraction velocity of the GM of the injured side. Despite Tc is elevated in the GM of the injured compared to the healthy side preoperatively and at 3 and 6 months after surgery, differences in Tc between both sides are no longer significant at 12 months. Athletes with FAI participating in sports with great involvement of GM may benefit from arthroscopic treatment and its subsequent rehabilitation. TMG can be used as

  6. Examining the social status, risk factors and lifestyle changes of tuberculosis patients in Sri Lanka during the treatment period: a cross-sectional study.

    PubMed

    Senanayake, Madapathage Gayan Buddhika; Wickramasinghe, Sumudu Indika; Samaraweera, Sudath; De Silva, Pubudu; Edirippulige, Sisira

    2018-01-01

    Tuberculosis (TB) is a major global health problem, commonly seen in underdeveloped countries. The probability of contracting the disease is significantly higher among the economically vulnerable and the socially disadvantaged. Risk factors associated with TB can also change over time. In the Sri Lankan context, no study has explored how these factors impact patients. Therefore, we aimed to explore social status, associated risk factors and lifestyle changes during the treatment period of TB patients attending a tertiary respiratory center in Colombo, Sri Lanka. The descriptive cross-sectional study was conducted in 2011. The study population consisted of diagnosed tuberculosis patients above the age of 15 years. Patient records were retrieved from the TB patient registry for the Colombo district. Systematic sampling was used to identify patients to be invited to the study. An interviewer-administered questionnaire was used for data collection. Data were collected on social status (example, level of education, employment, and income), associated risk factors (example, smoking and alcohol consumption, contact history, narcotic drug use) and lifestyle changes during treatment (example, employment status, social interactions). The analysis included a logistic regression model to explore the association between social status and risk factors. The total number of patients included in the study was 425. Tuberculosis was found to be strongly prevalent among participants from the lower socio-economic status. It was also common in participants with a low level of education, unemployed, if employed, those who are engaged in unskilled employment and have low levels of income. Risk factors associated with the patients were smoking, alcohol consumptions, narcotic drug use, imprisonment, close contact history with active TB patients and chronic medical conditions. Changes in employment and the reduction of social-interactions were the main lifestyle changes of the participants

  7. Long-period grating and its cascaded counterpart in photonic crystal fiber for gas phase measurement.

    PubMed

    Tian, Fei; Kanka, Jiri; Du, Henry

    2012-09-10

    Regular and cascaded long period gratings (LPG, C-LPG) of periods ranging from 460 to 590 μm were inscribed in an endlessly single mode photonic crystal fiber (PCF) using CO(2) laser for sensing measurements of helium, argon and acetylene. High index sensitivities in excess of 1700 nm/RIU were achieved in both grating schemes with a period of 460 μm. The sharp interference fringes in the transmission spectrum of C-PCF-LPG afforded not only greatly enhanced sensing resolution, but also accuracy when the phase-shift of the fringe pattern is determined through spectral processing. Comparative numerical and experimental studies indicated LP(01) to LP(03) mode coupling as the principal coupling step for both PCF-LPG and C-PCF-LPG with emergence of multi-mode coupling at shorter grating periods or longer resonance wavelengths.

  8. Ruptured intracranial aneurysms: the outcome of surgical treatment in experienced hands in the period prior to the advent of endovascular coiling

    PubMed Central

    Lafuente, J; Maurice-Williams, R

    2003-01-01

    Objectives: To evaluate the results of treatment of patients with a ruptured intracranial aneurysm treated by a single experienced vascular neurosurgeon in the period prior to the introduction of endovascular coiling. Methods: Over a mean (SD) period of 9 (2) years, between January 1990 and June 1999, 245 consecutive patients with ruptured intracranial aneurysms were treated. Patients' details were obtained from a database that had been constructed prospectively. The patients consisted of all those patients treated by the senior author (Mr Maurice-Williams) over this period—that is, every third day on call at his unit. During this period, all patients under the age of 75 years with a diagnosis of subarachnoid haemorrhage were admitted to the neurosurgical unit as soon as was practicable regardless of clinical grade. Results: Of 245 patients, 190 (77.6%) underwent treatment by open surgery using standard microsurgical techniques. At 1 year, the mortality of the operated patients was 2.6%, while 89.5% of the patients had a Glasgow Outcome Score (GOS) of 4 and 5. The overall management outcome (all patients treated, including operated and non-operated cases) at 1 year was: 17.1 % dead while 74.3% had GOS 4 and 5. Of the 190 patients who underwent surgery, 38 (20%) required additional operations, totalling 72 operations in all. Of these, 32 were for hydrocephalus and 17 for the evacuation of intracranial haematomas/collections. Complications of surgery occurred in 56 patients (29.5%). Conclusion: Open surgery, despite good eventual results, is associated with a significant rate of re-operations and complications that would probably be largely avoided with endovascular treatment. Nevertheless, although endovascular coiling has these immediate advantages over surgery it is still not certain that the long term results will be superior to surgery which leads to permanent obliteration of the aneurysm. There may still be a need for open surgery in the future. PMID:14638889

  9. Economic comparisons of haul road construction versus forwarding versus longer skid distances

    Treesearch

    Michael D. Erickson; Curt C. Hassler; Chris B. LeDoux

    1992-01-01

    There currently exists no set of basic guidelines for Appalachian loggers to use in the decision making process for selecting the best way to harvest a tract of timber. Specifically, guidelines are needed for deciding between the alternatives of constructing truck haul roads to access an area or other alternatives such as skidding or forwarding timber longer distances...

  10. An improved method to quantitate mature plant microRNA in biological matrices using modified periodate treatment and inclusion of internal controls.

    PubMed

    Huang, Haiqiu; Roh, Jamin; Davis, Cindy D; Wang, Thomas T Y

    2017-01-01

    MicroRNAs (miRNAs) ubiquitously exist in microorganisms, plants, and animals, and appear to modulate a wide range of critical biological processes. However, no definitive conclusion has been reached regarding the uptake of exogenous dietary small RNAs into mammalian circulation and organs and cross-kingdom regulation. One of the critical issues is our ability to assess and distinguish the origin of miRNAs. Although periodate oxidation has been used to differentiate mammalian and plant miRNAs, validation of treatment efficiency and the inclusion of proper controls for this method were lacking in previous studies. This study aimed to address: 1) the efficiency of periodate treatment in a plant or mammalian RNA matrix, and 2) the necessity of inclusion of internal controls. We designed and tested spike-in synthetic miRNAs in various plant and mammalian matrices and showed that they can be used as a control for the completion of periodate oxidation. We found that overloading the reaction system with high concentration of RNA resulted in incomplete oxidation of unmethylated miRNA. The abundant miRNAs from soy and corn were analyzed in the plasma, liver, and fecal samples of C57BL/6 mice fed a corn and soy-based chow diet using our improved methodology. The improvement resulted in the elimination of the false positive detection in the liver, and we did not detect plant miRNAs in the mouse plasma or liver samples. In summary, an improved methodology was developed for plant miRNA detection that appears to work well in different sample matrices.

  11. An improved method to quantitate mature plant microRNA in biological matrices using modified periodate treatment and inclusion of internal controls

    PubMed Central

    Roh, Jamin; Davis, Cindy D.; Wang, Thomas T. Y.

    2017-01-01

    MicroRNAs (miRNAs) ubiquitously exist in microorganisms, plants, and animals, and appear to modulate a wide range of critical biological processes. However, no definitive conclusion has been reached regarding the uptake of exogenous dietary small RNAs into mammalian circulation and organs and cross-kingdom regulation. One of the critical issues is our ability to assess and distinguish the origin of miRNAs. Although periodate oxidation has been used to differentiate mammalian and plant miRNAs, validation of treatment efficiency and the inclusion of proper controls for this method were lacking in previous studies. This study aimed to address: 1) the efficiency of periodate treatment in a plant or mammalian RNA matrix, and 2) the necessity of inclusion of internal controls. We designed and tested spike-in synthetic miRNAs in various plant and mammalian matrices and showed that they can be used as a control for the completion of periodate oxidation. We found that overloading the reaction system with high concentration of RNA resulted in incomplete oxidation of unmethylated miRNA. The abundant miRNAs from soy and corn were analyzed in the plasma, liver, and fecal samples of C57BL/6 mice fed a corn and soy-based chow diet using our improved methodology. The improvement resulted in the elimination of the false positive detection in the liver, and we did not detect plant miRNAs in the mouse plasma or liver samples. In summary, an improved methodology was developed for plant miRNA detection that appears to work well in different sample matrices. PMID:28399134

  12. Influence of hepatic load from far-off dry period to early postpartum period on the first postpartum ovulation and accompanying subsequent fertility in dairy cows.

    PubMed

    Kawashima, Chiho; Ito, Nozomi; Nagashima, Shuntarou; Matsui, Motozumi; Sawada, Kumiko; Schweigert, Florian J; Miyamoto, Akio; Kida, Katsuya

    2016-06-17

    The aim of the present study was to investigate nutritional and metabolic parameters during the dry and early postpartum periods of ovulatory and anovulatory cows, as well as their postpartum reproductive performance. Blood samples from 20 multiparous Holstein cows were collected once a week from the far-off dry period to 3 weeks postpartum. Early postpartum (0-3 weeks) ovulation was confirmed using plasma progesterone concentration profiles, and cows were considered ovulatory if they had resumed luteal activity by this point (n = 9), whereas cows that had not were considered anovulatory (n = 11). Data from the ovulatory and anovulatory cows were analyzed separately for the far-off dry period (7-4 weeks prepartum), the close-up dry period (3-1 weeks prepartum), and the early postpartum period (0-3 weeks). Serum gamma-glutamyl transpeptidase activity (far-off, P = 0.065; close-up, P = 0.051; and early postpartum, P = 0.030) and aspartate aminotransferase (close-up, P = 0.050 and early postpartum, P = 0.087) activities were higher in anovulatory than in ovulatory cows. The days open period was longer (P = 0.019) in anovulatory than in ovulatory cows, and the number of artificial inseminations per conception (P = 0.025) was greater. In conclusion, we found that continuously high gamma-glutamyl transpeptidase activities in serum, which may be induced by liver disorders, prevent subsequent ovulation and affect subsequent fertility, even if cows obtain sufficient ovulation-related energy and β-carotene.

  13. Increased volume of distribution for recombinant activated factor VII and longer plasma-derived factor VII half-life may explain their long lasting prophylactic effect.

    PubMed

    Mathijssen, Natascha C J; Masereeuw, Rosalinde; Holme, Pal Andre; van Kraaij, Marian G J; Laros-van Gorkom, Britta A P; Peyvandi, Flora; van Heerde, Waander L

    2013-08-01

    Prophylaxis with plasma-derived or recombinant activated factor VII is beneficial in severe factor VII deficiency. To understand why prophylactic treatment with both products is efficacious, we conducted a pharmacokinetic study. Ten factor VII deficient patients were treated with either recombinant activated (20 μg/kg) or plasma-derived (25 IU/kg) factor VII in a cross-over design. Pharmacokinetic parameters were analyzed through activated factor VII activity, factor VII clotting activity, and factor VII antigen levels on depicted time points. Factor VII activity half-lifes, determined by non-compartmental and one-compartmental analysis (results in brackets), were shorter for recombinant activated (1.4h; 0.7h) than for plasma-derived factor VII (6.8h; 3.2h); both recombinant activated (5.1h; 2.1h and plasma-derived factor VII (5.8h; 3.2h) resulted in longer half-lives of factor VII antigen. Activated factor VII half-lives (based on activated factor VII activity levels) were significantly higher compared to factor VII clotting activity (1.6h; 0.9h). Volumes of distribution were significantly higher for activated factor VII (236 ml/kg; 175 ml/kg, measured by activated factor VII) as compared to plasma-derived factor VII (206 ml/kg; 64 ml/kg, measured by factor FVII activity), suggesting a plasma- and extracellular fluid distribution for recombinant activated factor VII. Recombinant activated factor VII showed significantly shorter half-lifes than plasma-derived factor VII. Volumes of distribution were significantly higher for treatment with recombinant activated factor VII. The longer half-life for plasma-derived factor VII, compared to recombinant activated factor VII, and the increased volume of distribution for recombinant activated factor VII, compared to plasma-derived factor VII may further elucidate the beneficial effect of prophylactic treatment of both products. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Why do boomers plan to work longer?

    PubMed

    Mermin, Gordon B T; Johnson, Richard W; Murphy, Dan P

    2007-09-01

    . Recent changes in retirement trends and patterns have raised questions about the likely retirement behavior of baby boomers, the large cohort born between 1946 and 1964. This study examined recent changes in retirement expectations and the factors that drove them. Using data from the Health and Retirement Study, the analysis compared self-reported probabilities of working full time past ages 62 and 65 among workers aged 51 to 56 in 1992 and 2004. The study modeled retirement expectations for both generations and used the estimated regression coefficients to identify the forces that accounted for generational differences. . Between 1992 and 2004, the mean self-reported probability of working full time past age 65 among workers aged 51 to 56 increased from 27% to 33%. Lower rates of retiree health insurance offers from employers, higher levels of educational attainment, and lower rates of defined benefit pension coverage accounted for most of the growth. Given the continued erosion in employer-sponsored retiree health benefits and defined benefit pension plans, boomers will likely remain at work longer than members of the previous generation. Lengthier careers will likely promote economic growth, increase government revenue, and improve individual financial security at older ages.

  15. Policy and programmatic considerations for introducing a longer-acting injectable contraceptive: perspectives of stakeholders from Kenya and Rwanda

    PubMed Central

    McKenna, Kevin; Arcara, Jennet; Rademacher, Kate H; Mackenzie, Caroline; Ngabo, Fidele; Munyambanza, Emmanuel; Wesson, Jennifer; Tolley, Elizabeth E

    2014-01-01

    ABSTRACT Background: More than 40 million women use injectable contraceptives to prevent pregnancy, and most current or previous injectable users report being satisfied with the method. However, while women may find injectables acceptable, they may not always find them accessible due to stock-outs and difficulties with returning to the clinic for reinjections. FHI 360 is spearheading efforts to develop a longer-acting injectable (LAI) contraceptive that could provide at least 6 months of protection against pregnancy. This article addresses systems-level considerations for the introduction of a new LAI. Methods: We conducted qualitative case studies in Kenya and Rwanda—two countries that have high levels of injectable use but with different service delivery contexts. Between June and September 2012, we conducted in-depth interviews with 27 service providers and 19 policy makers and program implementers focusing on 4 themes: systems-level barriers and facilitators to delivering LAI services; process for introducing an LAI; LAI distribution approaches; and potential LAI characteristics. We also obtained electronic feedback from 28 international family planning opinion leaders. Results: Respondents indicated strong interest in an LAI and thought it would appeal to existing injectable users as well as new family planning clients, both for spacing and for limiting births. Providers appreciated the potential for a lighter workload due to fewer follow-up visits, but they were concerned that fewer visits would also decrease their ability to help women manage side effects. The providers also appreciated the 1-month grace period for follow-up LAI injections; some seemed unaware of the latest international guidance that had increased the grace period from 2 weeks to 4 weeks for the currently available 3-month injectable. The majority of policy makers and program implementers were supportive of letting community health workers provide the method, but many nurses and midwives

  16. A randomized trial of a three-hour protected nap period in a medicine training program: sleep, alertness, and patient outcomes.

    PubMed

    Shea, Judy A; Dinges, David F; Small, Dylan S; Basner, Mathias; Zhu, Jingsan; Norton, Laurie; Ecker, Adrian J; Novak, Cristina; Bellini, Lisa M; Dine, C Jessica; Mollicone, Daniel J; Volpp, Kevin G

    2014-03-01

    Protected sleep periods for internal medicine interns have previously resulted in increased amount slept and improved cognitive alertness but required supplemental personnel. The authors evaluated intern and patient outcomes associated with protected nocturnal nap periods of three hours that are personnel neutral. Randomized trial at Philadelphia Veterans Affairs Medical Center (PVAMC) Medical Service and Hospital of the University of Pennsylvania (HUP) Oncology Unit. During 2010-2011, four-week blocks were randomly assigned to a standard intern schedule (extended duty overnight shifts of up to 30 hours), or sequential protected sleep periods (phone sign-out midnight to 3:00 AM [early shift] intern 1; 3:00 to 6:00 AM [late shift] intern 2). Participants wore wrist Actiwatches, completed sleep diaries, and performed daily assessments of behavioral alertness. Between-group comparisons of means and proportions controlled for within-person correlations. HUP interns had significantly longer sleep durations during both early (2.40 hours) and late (2.44 hours) protected periods compared with controls (1.55 hours, P < .0001). At PVAMC sleep duration was longer only for the late shift group (2.40 versus 1.90 hours, P < .036). Interns assigned to either protected period were significantly less likely to have call nights with no sleep and had fewer attentional lapses on the Psychomotor Vigilance Test. Differences in patient outcomes between standard schedule months versus intervention months were not observed. Protected sleep periods of three hours resulted in more sleep during call and reductions in periods of prolonged wakefulness, providing a plausible alternative to 16-hour shifts.

  17. Warming and elevated CO2 lead to longer growing season in temperate grassland

    USDA-ARS?s Scientific Manuscript database

    Observational data over time suggest that as climate has warmed the growing season has lengthened, although experimental warming shortens early-growing species’ life cycles. Are other plant species living longer? We found that experimental warming in a temperate, semi-arid grassland led to earlier l...

  18. Treatment of contact lens related dry eye with antibacterial honey.

    PubMed

    Wong, Daniel; Albietz, Julie M; Tran, Huan; Du Toit, Cimonette; Li, Anita Hui; Yun, Tina; Han, Jee; Schmid, Katrina L

    2017-12-01

    Contact lens induced dry eye affects approximately 50% of contact lens wearers. The aim was to assess the effects of Manuka (Leptospermum sp.) honey eye drops (Optimel, Melcare, Australia) on dry eye in contact lens wearers. The safety of the honey eye drops in contact lens wear and contact lens wearers' compliance were also evaluated. Prospective, randomised, cross over study, examiner masked, pilot treatment trial. Twenty-four participants aged 20 to 55 years with contact lens related dry eye were recruited and randomised to two treatment groups; 20 completed the study. One group used Optimel eye drops twice a day for two weeks followed by conventional lubricant (Systane Ultra, Alcon) therapy for two weeks; the other group completed the treatments in the reverse order. Before and after each treatment dry eye symptomology, ocular surface inflammation, and tear quantity and quality were assessed. Participants completed a daily log detailing their usage of treatments and any issues. Dry eye symptoms improved significantly after Optimel treatment. Patients with more severe symptoms at baseline showed a greater improvement in symptoms. No significant differences were observed in the objective signs of dry eye; presumably because of the short treatment duration. Seventy-five% of contact lens wearers reported good adherence to Optimel treatment and 95% reported no issues using this product. Optimel Eye Drops reduce the symptoms of dry eye in contact lens wearers and are safe to use. A longer treatment period to assess the effect on clinical signs of dry eye is required. Copyright © 2017 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  19. Transient anomalous diffusion in periodic systems: ergodicity, symmetry breaking and velocity relaxation

    PubMed Central

    Spiechowicz, Jakub; Łuczka, Jerzy; Hänggi, Peter

    2016-01-01

    We study far from equilibrium transport of a periodically driven inertial Brownian particle moving in a periodic potential. As detected for a SQUID ratchet dynamics, the mean square deviation of the particle position from its average may involve three distinct intermediate, although extended diffusive regimes: initially as superdiffusion, followed by subdiffusion and finally, normal diffusion in the asymptotic long time limit. Even though these anomalies are transient effects, their lifetime can be many, many orders of magnitude longer than the characteristic time scale of the setup and turns out to be extraordinarily sensitive to the system parameters like temperature or the potential asymmetry. In the paper we reveal mechanisms of diffusion anomalies related to ergodicity of the system, symmetry breaking of the periodic potential and ultraslow relaxation of the particle velocity towards its steady state. Similar sequences of the diffusive behaviours could be detected in various systems including, among others, colloidal particles in random potentials, glass forming liquids and granular gases. PMID:27492219

  20. Mammographic breast density in recent and longer-standing ethiopian immigrants to israel.

    PubMed

    Sklair-Levy, Miri; Segev, Anat; Sella, Tamar; Calderon-Margalit, Ronit; Zippel, Douglas

    2018-04-23

    High breast density is associated with an increased risk of breast cancer development. Little is known concerning ethnic variations in breast density and its relevant contributing factors. We aimed to study breast density among Ethiopian immigrants to Israel in comparison with Israeli-born women and to determine any effect on breast density of the length of residency in the immigrant population. Mammographic breast density using the BI-RADS system was estimated and compared between 77 women of Ethiopian origin who live in Israel and 177 Israeli-born controls. Logistic regression analysis was performed to estimate the odds ratios (OR) for high density (BI-RADS score ≥ 3) vs low density (BI-RADS score < 3) cases, comparing the 2 origin groups. Ethiopian-born women had a crude OR of 0.15 (95% CI: 0.08-0.26) for high breast density compared with Israeli-born women. Adjustments for various cofounders did not affect the results. Time since immigration to Israel seemed to modify the relationship, with a stronger association for women who immigrated within 2 years prior to mammography (OR:0.07, 95% CI: 0.03-0.17) as opposed to women with a longer residency stay in Israel (OR:0.23, 95% CI:0.10-0.50). Adjustments of various confounders did not alter these findings. Breast density in Ethiopian immigrants to Israel is significantly lower than that of Israeli-born controls. Our study suggests a positive association between time since immigration and breast density. Future studies are required to define the possible effects of dietary change on mammographic density following immigration. © 2018 Wiley Periodicals, Inc.

  1. Analysis of buprenorphine/naloxone dosing impact on treatment duration, resource use and costs in the treatment of opioid-dependent adults: a retrospective study of US public and private health care claims.

    PubMed

    Khemiri, Amine; Kharitonova, Elizaveta; Zah, Vladimir; Ruby, Jane; Toumi, Mondher

    2014-09-01

    The buprenorphine/naloxone combination is used to treat the chronic relapsing disorder of opioid dependence. Adequate dosing levels are important to control cravings, prevent withdrawal syndrome, and maintain patients in treatment. The objective of this study was to estimate the impact of dosing on treatment persistence, resource utilization, and total direct health care costs. A retrospective cohort analysis was performed using administrative claims extracted from the MarketScan and Clinformatics databases from January 2007 to June and November 2012. Patients initiating treatment with buprenorphine/naloxone were classified into 2 groups based on the prescribed average dose over the entire treatment period and matched by multiple criteria. The threshold for differentiating the dosing groups was set at 15 and 15.7 mg/day for publicly and privately insured patients, respectively. Resource utilization and related costs were calculated over the 12-month period after the treatment initiation. Patient characteristics at baseline were considerably different between the privately and publicly insured patients. Publicly insured patients were slightly younger (33.1 vs 34.3 years old for privately insured) and had a higher prevalence of mental disorders (70.9% vs 64.9%). In both groups, patients treated with higher doses (> 15 mg and > 15.7 mg per day for publicly and privately insured patients, respectively) had lower risk of discontinuation (public: 11% lower; private: 9% lower) and lower probability of a psychiatric hospitalization than patients treated with lower doses (public: 17% lower; private: 41% lower). Total costs were comparable between the 2 groups (public: $14 600; private: $21 000) despite the expected higher cost of pharmacy in the higher-dose group. Treatment with higher doses of buprenorphine/naloxone was associated with a longer time to treatment discontinuation, less resource use, and lower total medical costs despite higher pharmacy acquisition cost.

  2. Tranexamic acid-associated seizures: Causes and treatment.

    PubMed

    Lecker, Irene; Wang, Dian-Shi; Whissell, Paul D; Avramescu, Sinziana; Mazer, C David; Orser, Beverley A

    2016-01-01

    Antifibrinolytic drugs are routinely used worldwide to reduce the bleeding that results from a wide range of hemorrhagic conditions. The most commonly used antifibrinolytic drug, tranexamic acid, is associated with an increased incidence of postoperative seizures. The reported increase in the frequency of seizures is alarming, as these events are associated with adverse neurological outcomes, longer hospital stays, and increased in-hospital mortality. However, many clinicians are unaware that tranexamic acid causes seizures. The goal of this review is to summarize the incidence, risk factors, and clinical features of these seizures. This review also highlights several clinical and preclinical studies that offer mechanistic insights into the potential causes of and treatments for tranexamic acid-associated seizures. This review will aid the medical community by increasing awareness about tranexamic acid-associated seizures and by translating scientific findings into therapeutic interventions for patients. © 2015 The Authors Annals of Neurology published by Wiley Periodicals, Inc. on behalf of American Neurological Association.

  3. Muscle Channelopathies: the Nondystrophic Myotonias and Periodic Paralyses

    PubMed Central

    Statland, Jeffrey M.; Barohn, Richard J.

    2013-01-01

    Purpose of Review The muscle channelopathies are a group of rare inherited diseases caused by mutations in muscle ion channels. Mutations cause an increase or decrease in muscle membrane excitability, leading to a spectrum of related clinical disorders: the nondystrophic myotonias are characterized by delayed relaxation after muscle contraction, causing muscle stiffness and pain; the periodic paralyses are characterized by episodes of flaccid muscle paralysis. This review describes the clinical characteristics, molecular pathogenesis, and treatments of the nondystrophic myotonias and periodic paralyses. Recent Findings Advances have been made in both the treatment and our understanding of the molecular pathophysiology of muscle channelopathies: (1) a recent controlled trial showed that mexiletine was effective for reducing symptoms and signs of myotonia in nondystrophic myotonia; (2) the mechanisms by which hypokalemic periodic paralysis leads to a depolarized but unexcitable sarcolemma membrane have been traced to a novel gating pore current; and (3) an association was demonstrated between mutations in a potassium inward rectifier and patients with thyrotoxic periodic paralysis. Summary The muscle channelopathies are an expanding group of muscle diseases caused by mutations in sodium, chloride, potassium, and calcium ion channels that result in increased or decreased muscle membrane excitability. Recognizing patients with channelopathies and confirming the diagnosis is important, as treatment and management strategies differ based on mutation and clinical phenotype. PMID:24305449

  4. Increasing flux rate to shorten leaching period and ramp-up production

    NASA Astrophysics Data System (ADS)

    Ngantung, Billy; Agustin, Riska; Ravi'i

    2017-01-01

    J Resources Bolaang Mongondow (JBRM) has operated a dynamic heap leach in its Bakan Gold Mine since late 2013. After successfully surpassing its name plate capacity of 2.6 MT/annum in 2014, the clayey and transition ore become the next operational challenge. The presence of transition and clayey ore requires longer leaching period, hence reducing the leach pad capacity which then caused reduced production. Maintaining or even increasing production with such longer leaching ore types can be done by expanding the leach pad area which means an additional capital investment, and/or shortening the leaching cycle which compromise a portion of gold extraction. JBRM has been successfully increasing the leach pad production from 2.6 MT/annum to 3.8 MT/annum, whilst improving the gold extraction from around 70% to around 80%. This was achieved by managing the operation of the leach pad which is shortening the leach cycle by identifying and combining the optimal flux rate application versus the tonne processed in each cell, at no capital investment for expanding the cell capacity.

  5. Longer wings for faster springs - wing length relates to spring phenology in a long-distance migrant across its range.

    PubMed

    Hahn, Steffen; Korner-Nievergelt, Fränzi; Emmenegger, Tamara; Amrhein, Valentin; Csörgő, Tibor; Gursoy, Arzu; Ilieva, Mihaela; Kverek, Pavel; Pérez-Tris, Javier; Pirrello, Simone; Zehtindjiev, Pavel; Salewski, Volker

    2016-01-01

    In migratory birds, morphological adaptations for efficient migratory flight often oppose morphological adaptations for efficient behavior during resident periods. This includes adaptations in wing shape for either flying long distances or foraging in the vegetation and in climate-driven variation of body size. In addition, the timing of migratory flights and particularly the timely arrival at local breeding sites is crucial because fitness prospects depend on site-specific phenology. Thus, adaptations for efficient long-distance flights might be also related to conditions at destination areas. For an obligatory long-distance migrant, the common nightingale, we verified that wing length as the aerodynamically important trait, but not structural body size increased from the western to the eastern parts of the species range. In contrast with expectation from aerodynamic theory, however, wing length did not increase with increasing migration distances. Instead, wing length was associated with the phenology at breeding destinations, namely the speed of local spring green-up. We argue that longer wings are beneficial for adjusting migration speed to local conditions for birds breeding in habitats with fast spring green-up and thus short optimal arrival periods. We suggest that the speed of spring green-up at breeding sites is a fundamental variable determining the timing of migration that fine tune phenotypes in migrants across their range.

  6. Where are lengths of stay longer and total charges higher for pediatric burn patients?

    PubMed

    Myers, John; Lehna, Carlee

    2014-01-01

    Treatment of pediatric burn patients is costly and may require long length of stay in the hospital (LOS). Establishing where these LOS and charges are highest is warranted. The current study investigated whether pediatric burn patients had higher total charges and longer LOS when seen at teaching hospitals, when compared with nonteaching hospitals. The study reviewed inpatient admissions for pediatric burn patients in 2003, 2006, and 2009 by using the Kids' Inpatient Database, which is part of the Healthcare Cost and Utilization Project. International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes 940-947 were used to define burn injury, LOS, total charges, and type of hospital. The authors tested for differences between the LOS and total charges between children seen at three types of hospitals (pediatric, nonpediatric/teaching, nonpediatric/nonteaching) while adjusting for traditional risk factors (eg age, total burn surface area) by using generalized linear mixed-effects modeling. A total of N=28,777 children had burn injuries (n=16,115, 56.0% seen at pediatric hospitals; n=9353, 32.5% seen at nonpediatric/teaching hospitals; and n=3309, 11.5% seen at nonpediatric/nonteaching hospitals). Pediatric burn patients seen at pediatric hospitals, unadjusted, have significantly longer LOS (5.54 days vs 4.25 days and 4.00 days, P<.001) and more total charges in 2009 dollars ($31,319 vs $24,413 and $21,499, P<.001). In addition, patients seen at pediatric hospitals had significantly more total burn surface area (P<.001), more comorbidities (P=.021), and were younger (P<.001). After adjusting for total burn surface area, number of comorbidities, and age, no differences existed between teaching and nonteaching hospitals for LOS (P=.481) or total charges (P=.758). Although pediatric burn patients may have increased LOS and total charges when seen at teaching hospitals, when taking an unadjusted perspective, this may be an artifact that

  7. Contingency management for college student smokers: The role of drinking as a moderator and mediator of smoking abstinence during treatment.

    PubMed

    Cassidy, Rachel N; Jackson, Kristina M; Rohsenow, Damaris J; Tidey, Jennifer W; Tevyaw, Tracy O' L; Barnett, Nancy P; Monti, Peter M; Miller, Mollie E; Colby, Suzanne M

    2018-05-01

    Contingency management (CM) is effective for promoting smoking abstinence; however, moderators and mediators of CM treatment efficacy in young adult populations are under-explored. We leveraged fine-grained data from a large randomized controlled trial: 1) to determine whether early attainment of sustained abstinence mediated the effect of treatment on abstinence; 2) to test whether heavy drinking moderated the effect of treatment on abstinence; and 3) to test a serial mediation model of the effects of drinking during early treatment on sustained smoking abstinence. College student smokers (N=110) were randomized to receive either CM treatment or noncontingent reinforcement (NR) over a 21-day treatment period. All participants received $5 for providing twice-daily breath carbon monoxide (CO) samples. In CM, additional money was provided for samples that indicated smoking reduction (Initial Phase; first 7days), and for samples ≤5ppm (Abstinence Phase; following 14days). CM treatment led to greater sustained abstinence relative to NR. Longer sustained abstinence in the Initial Phase partially mediated the effect of treatment on sustained abstinence in the Abstinence Phase. Heavier pretreatment drinkers had shorter periods of sustained abstinence in the Abstinence Phase; this effect was greater in CM. A serial mediation model determined that increased drinking during the Initial Phase led to decreased sustained abstinence, which then led to decreased sustained abstinence in the Abstinence Phase. These data provide a greater understanding of how heavy drinking and early sustained abstinence may affect success during treatment in young adults undergoing contingency management treatment for smoking. Copyright © 2018. Published by Elsevier Ltd.

  8. Evaluation of alternatives to cautery disbudding of dairy goat kids using physiological measures of immediate and longer-term pain.

    PubMed

    Hempstead, Melissa N; Waas, Joseph R; Stewart, Mairi; Cave, Vanessa M; Sutherland, Mhairi A

    2018-06-01

    We evaluated alternatives to cautery disbudding of goat kids using physiological measures of immediate and longer-term pain. Fifty Saanen doe kids were randomly assigned to 1 of 5 treatments (n = 10/treatment): (1) cautery disbudding (CAUT), (2) caustic paste disbudding (CASP), (3) liquid nitrogen disbudding (CRYO), (4) clove oil injected into the horn bud (CLOV), or (5) sham disbudding (SHAM). Serum cortisol and haptoglobin concentrations were measured from blood samples collected immediately before treatment (baseline) and at 15, 30, 60, and 120 min and then again at 6 and 24 h post-treatment. An infrared thermography camera was used to take images of the horn buds 24 h pre- and 24, 48, and 72 h post-treatment to measure skin temperature. Body weight was measured daily for 1 wk to assess weight change post-treatment. Images of the horn buds were taken at d 1, 2, and 7 and at 6 wk post-treatment to assess tissue damage and wound healing. Mean cortisol concentrations were elevated in CASP kids 1 h post-treatment relative to CAUT kids. Cortisol concentrations of CRYO kids were higher than those of CAUT kids 30 min post-treatment; concentrations for CLOV kids were similar to CAUT kids post-treatment. Mean haptoglobin concentrations were similar across treatments over time; however, CLOV kids had higher concentrations at 24 h post-treatment than all other treatments. Skin temperatures of CASP and CLOV kids were elevated relative to CAUT kids at all time points post-treatment, and all disbudded kids had skin temperatures above those of SHAM kids at 72 h post-treatment. Treatment did not influence weight gain. The CAUT kids had large, open wounds exposing bone; small scabs were still evident 6 wk post-treatment. The CASP kids had red and open, raw wounds that generated large eschars, apparent for up to 6 wk. The CRYO kids had closed, dry wounds initially, but over time lesions appeared that caused open wounds; small scabs were present 6 wk post-treatment. The CLOV kids

  9. Longer leukocyte telomere length in Costa Rica's Nicoyan Peninsula: A population-based study

    PubMed Central

    Rehkopf, David H; Dow, William H; Rosero-Bixby, Luis; Lin, Jue; Epel, Elissa S; Blackburn, Elizabeth H

    2013-01-01

    Studies in humans suggest that leukocyte telomere length may act as a marker of biological aging. We investigated whether individuals in the Nicoya region of Costa Rica, known for exceptional longevity, had longer telomere length than those in other parts of the country. After controlling for age, age squared, rurality, rainy season and gender, mean leukocyte telomere length in Nicoya was substantially longer (81 base pairs, p<0.05) than in other areas of Costa Rica, providing evidence of a biological pathway to which this notable longevity may be related. This relationship remains unchanged (79 base pairs, p<0.05) after statistically controlling for nineteen potential biological, dietary and social and demographic mediators. Thus the difference in mean leukocyte telomere length that characterizes this unique region does not appear to be explainable by traditional behavioral and biological risk factors. More detailed examination of mean leukocyte telomere length by age shows that the regional telomere length difference declines at older ages. PMID:23988653

  10. 40 CFR 264.96 - Compliance period.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ....96 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Releases From Solid Waste Management Units § 264.96 Compliance period. (a) The Regional Administrator will...

  11. Persistent HIV-related stigma in rural Uganda during a period of increasing HIV incidence despite treatment expansion

    PubMed Central

    Chan, Brian T.; Weiser, Sheri D.; Boum, Yap; Siedner, Mark J.; Mocello, A. Rain; Haberer, Jessica E.; Hunt, Peter W.; Martin, Jeffrey N.; Mayer, Kenneth H.; Bangsberg, David R.; Tsai, Alexander C.

    2014-01-01

    Objective Program implementers have argued that the increasing availability of anti-retroviral therapy (ART) will reduce the stigma of HIV. We analyzed data from Uganda to assess how HIV-related stigma has changed during a period of ART expansion. Design Serial cross-sectional surveys. Methods We analyzed data from the Uganda AIDS Rural Treatment Outcomes (UARTO) study during 2007-2012 to estimate trends in internalized stigma among people living with HIV (PLHIV) at the time of treatment initiation. We analyzed data from the Uganda Demographic and Health Surveys (DHS) from 2006 and 2011 to estimate trends in stigmatizing attitudes and anticipated stigma in the general population. We fitted regression models adjusted for socio-demographic characteristics, with year of data collection as the primary explanatory variable. Results We estimated an upward trend in internalized stigma among PLHIV presenting for treatment initiation (adjusted b=0.18; 95% CI, 0.06 to 0.30). In the general population, the odds of reporting anticipated stigma were greater in 2011 compared to 2006 (adjusted OR=1.80; 95% CI, 1.51 to 2.13), despite an apparent decline in stigmatizing attitudes (adjusted OR=0.62; 95% CI, 0.52 to 0.74). Conclusions Internalized stigma has increased over time among PLHIV in the setting of worsening anticipated stigma in the general population. Further study is needed to better understand the reasons for increasing HIV-related stigma in Uganda and its impact on HIV prevention efforts. PMID:25268886

  12. An unusual very low-mass high-amplitude pre-main sequence periodic variable

    NASA Astrophysics Data System (ADS)

    Rodríguez-Ledesma, M. V.; Mundt, R.; Ibrahimov, M.; Messina, S.; Parihar, P.; Hessman, F. V.; Alves de Oliveira, C.; Herbst, W.

    2012-08-01

    Aims: We have investigated the nature of the variability of CHS 7797, an unusual periodic variable in the Orion Nebula Cluster. Methods: An extensive I-band photometric data set of CHS 7797 was compiled between 2004-2010 using various telescopes. Further optical data have been collected in R and z' bands. In addition, simultaneous observations of the ONC region including CHS 7797 were performed in the I,J,Ks & IRAC 3.6 and 4.5 μm bands over a time interval of ≈40 d. Results: CHS 7797 shows an unusual large-amplitude variation of ≈1.7 mag in the R,I, and z' bands with a period 17.786 ± 0.03 d (FAP = 1 × 10-15%). The amplitude of the brightness modulation decreases only slightly at longer wavelengths. The star is faint during ≈2/3 of the period and the shape of the phased light-curves for the seven different observing seasons shows minor changes and small-amplitude variations. Interestingly, there are no significant colour-flux correlations for λ ≲ 2 μm, while the object becomes redder when fainter at longer wavelengths. CHS 7797 has a spectral type of M 6 and an estimated mass between 0.04-0.1 M⊙. Conclusions: The analysis of the data suggests that the periodic variability of CHS 7797 is most probably caused by an orbital motion. Variability as a result of rotational brightness modulation by a hot spot is excluded by the lack of any colour-brightness correlation in the optical. The latter indicates that CHS 7797 is most probably occulted by circumstellar matter in which grains have grown from typical 0.1 μm to ≈1-2 μm sizes. We discuss two possible scenarios in which CHS 7797 is periodically eclipsed by structures in a disc, namely that CHS 7797 is a single object with a circumstellar disc, or that CHS 7797 is a binary system, similar to KH 15D, in which an inclined circumbinary disc is responsible of the variability. Possible reasons for the typical 0.3 mag variations in I-band at a given phase are discussed.

  13. Midterm Periodicity Analysis of the Mount Wilson Magnetic Indices Using the Synchrosqueezing Transform

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

    Feng, Song; Wang, Feng; Deng, Hui

    2017-08-10

    A novel time–frequency technique, called the synchrosqueezing transform (SST), is used to investigate the midterm periodic variations of magnetic fields on the solar surface. The Magnetic Plage Strength Index (MPSI) and the Mount Wilson Sunspot Index (MWSI), measured daily by the Mount Wilson Observatory between 1970 January 19 and 2012 January 22, are selected. Short-, mid, and longer-term periodicities are represented and decomposed by the SST with hardly any mode mixing. This demonstrates that the SST is a useful time–frequency analysis technique to characterize the periodic modes of helioseismic data. Apart from the fundamental modes of the annual periodicity, ∼27more » day rotational cycle and ∼11 year solar cycle, the SST reveals several midterm periodicities in the two magnetic activity indices, specifically, ∼157 days (i.e., Rieger-type periodicity), and ∼1.3 and 1.7 years. The periodic modes, with 116.4 and 276.2 day periodicity in the MPSI, 108.5 and 251.6 day periodicity in the MWSI, and 157.7 day periodicity in the two indices, are in better accord with those significant periodicities derived from the Rossby waves theoretical model. This study suggests that the modes are caused by Rossby waves. For the 1.30 and 1.71 year periodicity of the MPSI, and the 1.33 and 1.67 year periodicity of the MWSI, our analysis infers that they are related to those periodicities with the same timescale in the interior of the Sun and in the high atmospheric layers.« less

  14. Variability of collagen crosslinks: impact of sample collection period

    NASA Technical Reports Server (NTRS)

    Smith, S. M.; Dillon, E. L.; DeKerlegand, D. E.; Davis-Street, J. E.

    2004-01-01

    Because of the variability of collagen crosslinks, their use as markers for bone resorption is often criticized. We hypothesized that the variability could be reduced by collecting urine for 24 hours (or longer) instead of using single voids, and by not normalizing to creatinine. Urine samples were collected from 22 healthy subjects during two or more 24-hour periods. Each 24-hour pool and each 2nd void of the day were analyzed for N-telopeptide (NTX), pyridinium (PYD), and deoxypyridinoline (DPD) crosslinks. Data were analyzed by using linear regression. For NTX, R2 for the two, 2nd-void samples (n = 38) was 0.55, whereas R2 for the two 24-hour pools was 0.51 or 0.52, expressed per day or per creatinine. For PYD and DPD, R2 for the 2nd-void samples was 0.26 and 0.18, R2 for the 24-hour pools expressed per day was 0.58 and 0.74, and R2 for the 24-hour pools expressed per creatinine was 0.65 and 0.76, respectively. Regression of the 2nd void and the corresponding 24-hour pool, expressed per day, yielded R2 = 0.19, 0.19, and 0.08, for NTX, PYD, and DPD, respectively (n = 76 each). For the 2nd-void sample and its corresponding 24-hour pool, expressed per creatinine, R2 = 0.24, 0.33, and 0.08, respectively. In a separate study, the coefficient of variation for NTX was reduced (P < 0.05) when data from more than one 24-hour collection were combined. Thus, the variability inherent in crosslink determinations can be reduced by collecting urine for longer periods. In research studies, the high variability of single-void collections, compounded by creatinine normalization, may alter or obscure findings.

  15. Short dental implants: an emerging concept in implant treatment.

    PubMed

    Al-Hashedi, Ashwaq Ali; Taiyeb Ali, Tara Bai; Yunus, Norsiah

    2014-06-01

    Short implants have been advocated as a treatment option in many clinical situations where the use of conventional implants is limited. This review outlines the effectiveness and clinical outcomes of using short implants as a valid treatment option in the rehabilitation of edentulous atrophic alveolar ridges. Initially, an electronic search was performed on the following databases: Medline, PubMed, Embase, Cochrane Database of Systematic Reviews, and DARE using key words from January 1990 until May 2012. An additional hand search was included for the relevant articles in the following journals: International Journal of Oral and Maxillofacial Implants, Clinical Oral Implants Research, Journal of Clinical Periodontology, International Journal of Periodontics, Journal of Periodontology, and Clinical Implant Dentistry and Related Research. Any relevant papers from the journals' references were hand searched. Articles were included if they provided detailed data on implant length, reported survival rates, mentioned measures for implant failure, were in the English language, involved human subjects, and researched implants inserted in healed atrophic ridges with a follow-up period of at least 1 year after implant-prosthesis loading. Short implants demonstrated a high rate of success in the replacement of missing teeth in especially atrophic alveolar ridges. The advanced technology and improvement of the implant surfaces have encouraged the success of short implants to a comparable level to that of standard implants. However, further randomized controlled clinical trials and prospective studies with longer follow-up periods are needed.

  16. Long-term survival in trastuzumab-treated patients with HER2-positive metastatic breast cancer: real-world outcomes and treatment patterns in a whole-of-population Australian cohort (2001-2016).

    PubMed

    Daniels, Benjamin; Kiely, Belinda E; Lord, Sarah J; Houssami, Nehmat; Lu, Christine Y; Ward, Robyn L; Pearson, Sallie-Anne

    2018-05-07

    Patients treated with trastuzumab for HER2-positive metastatic breast cancer (HER2+MBC) are living longer, but there is little information on their outcomes and treatment experience beyond the median survival from clinical trials and real-world observational studies. We aim to describe the real-world treatment patterns and overall survival (OS) for women surviving five or more years from initiation of trastuzumab for HER2+MBC. This is a retrospective, whole-of-population cohort study of women initiating trastuzumab for HER2+MBC between 2001 and 2011, followed to 2016. We defined long-term survivors (LTS) as those patients surviving ≥ 5 years from trastuzumab initiation. We used dispensing claims to describe timing of cancer treatments used by LTS and to estimate time on and off HER2-targeted therapies, and OS from trastuzumab initiation for HER2+MBC. Of 4177 women initiating trastuzumab for HER2+MBC, 1082 (26%) survived ≥ 5 years. Median age for LTS was 54 years (IQR 46-63). At a median follow-up of 9.4 years, 36% of LTS died; their conditional probability of surviving an additional 5 years was 55%. Median time on trastuzumab and all HER2-targeted therapy was 58.9 months (27.6-88.1) and 69.1 months (35.6-124.5), respectively. 85% of LTS had a period off HER2 therapy, lasting a median of 30.4 months (8.2-NR). LTS generally receive HER2-targeted therapies for periods of time longer than in clinical trials, but most LTS also had breaks in treatment. More research is needed to understand the effects of long-term treatment and to identify patients who may be able to safely discontinue HER2-targeted therapy.

  17. Natural periodicities and Northern Hemisphere-Southern Hemisphere connection of temperature changes during the last glacial period: EPICA and NGRIP data sets revisited

    NASA Astrophysics Data System (ADS)

    Alberti, Tommaso; Lepreti, Fabio; Vecchio, Antonio; Bevacqua, Emanuele; Capparelli, Vincenzo; Carbone, Vincenzo

    2015-04-01

    We investigate both the European Project for Ice Coring in Antarctica Dronning Maud Land (EDML) and North Greenland Ice-Core Project (NGRIP) δ18O data sets to study both the time evolution of the so-called Dansgaard-Oeschger events and the dynamics at longer timescales during the last glacial period, considering the interval 20 - 120 kyr B.P., since this is the interval in which significant temperature changes, that are the focus of the present work, are observed. To identify the main periodicities and their amplitudes, we applied the Empirical Mode Decomposition (EMD), a technique designed to investigate non-stationary data, by which both the δ18O time series are decomposed into a finite number m of oscillating intrinsic mode functions (IMFs) as 18 mΣ-1 δ O = Cj(t)+ rm(t) j=0 (1) where Cj(t) are the IMFs and rm(t) is a residue which provides the mean trend. We extract the proper modes of both the data sets confirming that natural cycles of abrupt climate changes exist and their occurrence cannot be due to random fluctuations in time. It is shown that the time behavior at the typical timescales of Dansgaard-Oeschger events is captured through signal reconstructions obtained by summing five EMD modes for NGRIP and four EMD modes for EDML. The reconstructions obtained by summing the successive modes can be used to describe the climate evolution at longer timescales, characterized by intervals in which Dansgaard-Oeschger events happen and intervals when these are not observed. Using EMD signal reconstructions and a simple model based on the one-dimensional Langevin equation, it is argued that the occurrence of a Dansgaard-Oeschger event can be described as an excitation of the climate system within the same state, while the longer timescale behavior appears to be due to transitions between different climate states. Finally, on the basis of a cross correlation analysis performed to investigate the North-South asynchrony, it is found that the clearest correlation

  18. Natural periodicities and Northern Hemisphere-Southern Hemisphere connection of temperature changes during the last glacial period: EPICA and NGRIP data sets revisited

    NASA Astrophysics Data System (ADS)

    Alberti, Tommaso; Lepreti, Fabio; Vecchio, Antonio; Carbone, Vincenzo

    2016-04-01

    We investigate both the European Project for Ice Coring in Antarctica Dronning Maud Land (EDML) and North Greenland Ice-Core Project (NGRIP) δ18O data sets to study both the time evolution of the so-called Dansgaard-Oeschger events and the dynamics at longer timescales during the last glacial period, considering the interval 20 - 120 kyr B.P., since this is the interval in which significant temperature changes, that are the focus of the present work, are observed. To identify the main periodicities and their amplitudes, we applied the Empirical Mode Decomposition (EMD), a technique designed to investigate non-stationary data, by which both the δ18O time series are decomposed into a finite number m of oscillating intrinsic mode functions (IMFs) as 18 m∑-1 δ O = Cj(t)+ rm(t) j=0 (1) where Cj(t) are the IMFs and rm(t) is a residue which provides the mean trend. We extract the proper modes of both the data sets confirming that natural cycles of abrupt climate changes exist and their occurrence cannot be due to random fluctuations in time. It is shown that the time behavior at the typical timescales of Dansgaard-Oeschger events is captured through signal reconstructions obtained by summing five EMD modes for NGRIP and four EMD modes for EDML. The reconstructions obtained by summing the successive modes can be used to describe the climate evolution at longer timescales, characterized by intervals in which Dansgaard-Oeschger events happen and intervals when these are not observed. Using EMD signal reconstructions and a simple model based on the one-dimensional Langevin equation, it is argued that the occurrence of a Dansgaard-Oeschger event can be described as an excitation of the climate system within the same state, while the longer timescale behavior appears to be due to transitions between different climate states. Finally, on the basis of a cross correlation analysis performed to investigate the North-South asynchrony, it is found that the clearest correlation

  19. CEA monitoring of palliative treatment for colorectal carcinoma.

    PubMed Central

    Herrera, M A; Chu, T M; Holyoke, E D; Mittelman, A

    1977-01-01

    Palliative treatment was applied to 131 cases of unresectable or palliatively resected colorectal carcinoma being monitored with serial CEA determinations. There were 84 instances of disease progression with 67 (80%) of them showing an increase in CEA above pretreatment levels or maintaining high levels, and 17 (20%) showing a fall when compared to pretreatment values or maintaining low initial values. There was a clear-cut regression of the disease in only 9 instances. In all 9, the CEA clearly dropped or maintained low valles throughout the period of regression. No patient in regression had a rise or maintained an elevated CEA level. These changes in CEA followed closely the clinical response of our patient to the use of a particular agent, although for the Nitrosourea compounds there may be a tendency to lower the CEA regardless of the patient's tumor response to the drug. This could be due to the fact that the Nitrosoureas produce a diffuse block of cellular activity, both at the nucleous and cytoplasm; while other compounds act as alkylating agents or by inhibition of enzymes involved in the metabolism of nucleic acids (i.e., 5-FU inhibiting thymidylate synthetase). In general, longer survival was found in those patients who had initially lower levels of CEA as compared to those with high initial levels. The patients with a favorable CEA response to the treatment (falling CEA or maintained low value), even in many who did not show a clinical response had a longer survival than the group with rising or stable high levels. The main value in CEA monitoring of patients resides in its correlation with the amount of disease present and then its ability to detect progression of tumor mass which is not clinically measurable. PMID:64132

  20. Simulation of Post-Thyroidectomy Treatment Alternatives for Triiodothyronine or Thyroxine Replacement in Pediatric Thyroid Cancer Patients

    PubMed Central

    Ben-Shachar, Rotem; Huang, Stephen A.; DiStefano, Joseph J.

    2012-01-01

    Background As in adults, thyroidectomy in pediatric patients with differentiated thyroid cancer is often followed by 131I remnant ablation. A standard protocol is to give normalizing oral thyroxine (T4) or triiodothyronine (T3) after surgery and then withdraw it for 2 to 6 weeks. Thyroid remnants or metastases are treated most effectively when serum thyrotropin (TSH) is high, but prolonged withdrawals should be avoided to minimize hypothyroid morbidity. Methods A published feedback control system model of adult human thyroid hormone regulation was modified for children using pediatric T4 kinetic data. The child model was developed from data for patients ranging from 3 to 9 years old. We simulated a range of T4 and T3 replacement protocols for children, exploring alternative regimens for minimizing the withdrawal period, while maintaining normal or suppressed TSH during replacement. The results are presented with the intent of providing a quantitative basis to guide further studies of pediatric treatment options. Replacement was simulated for up to 3 weeks post-thyroidectomy, followed by various withdrawal periods. T4 vs. T3 replacement, remnant size, dose size, and dose frequency were tested for effects on the time for TSH to reach 25 mU/L (withdrawal period). Results For both T3 and T4 replacement, higher doses were associated with longer withdrawal periods. T3 replacement yielded shorter withdrawal periods than T4 replacement (up to 3.5 days versus 7–10 days). Higher than normal serum T3 concentrations were required to normalize or suppress TSH during T3 monotherapy, but not T4 monotherapy. Larger remnant sizes resulted in longer withdrawal periods if T4 replacement was used, but had little effect for T3 replacement. Conclusions T3 replacement yielded withdrawal periods about half those for T4 replacement. Higher than normal hormone levels under T3 monotherapy can be partially alleviated by more frequent, smaller doses (e.g., twice a day). LT4 may be the