Managing AVN following internal fixation: treatment options and clinical results.

PubMed

Hoskinson, Simon; Morison, Zachary; Shahrokhi, Shahram; Schemitsch, Emil H

2015-03-01

Avascular necrosis (AVN) after internal fixation of intracapsular hip fractures is a progressive multifactorial disease that ultimately results in local ischemia with ensuing osteocyte necrosis and structural compromise. This disease can cause significant clinical morbidity and affects patients of any age, including young and active patients. Effective treatment of this condition among young adults is challenging due to their high functional demands. The aim of managing AVN is to relieve pain, preserve range of movement and improve function. Treatment methods vary depending on the stage of the disease and can be broadly categorised into two options, hip preserving surgery and hip arthroplasty. Although, hip preserving techniques are attractive in the young adult, they may alter the morphology of the proximal femur and make subsequent arthroplasty more challenging. Conversely, arthroplasty in the young adult may require repeat revision procedures throughout the patient's life. Current evidence suggests that modifications of prevailing treatments, in addition to new technologies, have led to the development of management strategies that may be able to alter the course of femoral head osteonecrosis. This review aims to summarise the options available for treatment of AVN in the young adult and review the clinical results. Copyright © 2014 Elsevier Ltd. All rights reserved.

Fertility preservation during cancer treatment: clinical guidelines

PubMed Central

Rodriguez-Wallberg, Kenny A; Oktay, Kutluk

2014-01-01

The majority of children, adolescents, and young adults diagnosed with cancer today will become long-term survivors. The threat to fertility that cancer treatments pose to young patients cannot be prevented in many cases, and thus research into methods for fertility preservation is developing, aiming at offering cancer patients the ability to have biologically related children in the future. This paper discusses the current status of fertility preservation methods when infertility risks are related to surgical oncologic treatments, radiation therapy, or chemotherapy. Several scientific groups and societies have developed consensus documents and guidelines for fertility preservation. Decisions about fertility and imminent potentially gonadotoxic therapies must be made rapidly. Timely and complete information on the impact of cancer treatment on fertility and fertility preservation options should be presented to all patients when a cancer treatment is planned. PMID:24623991

Desire to Have Children Among Transgender People in Germany: A Cross-Sectional Multi-Center Study.

PubMed

Auer, Matthias K; Fuss, Johannes; Nieder, Timo O; Briken, Peer; Biedermann, Sarah V; Stalla, Günter K; Beckmann, Matthias W; Hildebrandt, Thomas

2018-05-01

Many trans individuals undergo medical interventions that result in irreversible loss of fertility. Little is known about their desire to have children and attitudes toward fertility preservation options. To study how the desire for children and the use of fertility preservation options varies among trans women and trans men in different transitioning stages in Germany. In this cross-sectional multi-center study, N = 99 trans women and N = 90 trans men were included. Of these, 26 of each sex were just about to start medical treatment. Outcome parameter were the prevalence and determinants of a desire to have children in trans persons. Before treatment, a desire for children was significantly higher in trans men compared to trans women (P = .016). In contrast, in those who had already started treatment, a current desire to have children was equally present in about one fourth of participants of both genders while the interest in having children in the future was significantly higher in trans women (69.9%) than in trans men (46.9%; P = .034). Although 76.1% of trans women and 76.6% of trans men indicated that they had at least thought about preserving germ cells before starting medical transition, only 9.6% of trans women and 3.1% of trans men had put this idea into practice. Most trans men in both groups indicated that insemination of a female partner with sperm from an unrelated donor was a suitable option to fulfill their child wish, potentially explaining their low interest in preserving their own germ cells. Finally, a logistic regression analysis accounting for potential confounders revealed that overall trans women were more than twice as likely to have a current desire to have children (odds ratio 2.58), and this wish was on average 5.3% lower with each year of increasing age. A low level of fertility preservation among trans persons is contrasted by a high level of desire for children. This highlights the importance of counseling trans individuals regarding fertility preservation options. To our knowledge, this is the first study that addresses desire to have children in a clinical sample of trans women. It is also the first that investigates this issue among trans men who have not started medical treatment, and the first comparison of both genders. A limitation for the generalization of our results is the special legal context in Germany that forbids oocyte donation for reciprocal in vitro fertilization. Reproductive desire is high among trans individuals, but the use of reproductive options is surprisingly low. Auer MK, Fuss J, Nieder TO, et al. Desire to Have Children Among Transgender People in Germany: A Cross-Sectional Multi-Center Study. J Sex Med 2018;15:757-767. Copyright © 2018 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Cracking the Egg: Preserving the College while Protecting the Core

ERIC Educational Resources Information Center

Goldstein, Michael B.

2010-01-01

There are currently three categories of independent colleges and universities: Those that are flush with resources, those that are stable but suffering from the effects of the recession, and those whose financial stress has been exacerbated to the breaking point. In this article, the author poses solutions that may represent useful options for…

How to diagnose and treat focal therapy failure and recurrence?

PubMed

Barret, Eric; Harvey-Bryan, Kadi-Ann; Sanchez-Salas, Rafael; Rozet, Francois; Galiano, Marc; Cathelineau, Xavier

2014-05-01

Focal therapy presents an alternative option for disease-targeted therapy while preserving erectile and urinary function without compromising oncological outcome. Such treatment, which preserves normal prostate parenchyma, presents a clinical challenge to the urologist, as typical disease surveillance parameters are not as reliable in post-ablation follow-up. We propose an integrated approach to post-ablation surveillance to identify treatment failure as well as recurrence. Post-ablation prostate-specific antigen kinetics, imaging based on multiparametric MRI and control biopsies are the tools currently used to follow patients after focal therapy. Good treatment response is indicated by a negative control biopsy, absence of persistent lesion on post-treatment imaging and a reduction in prostate-specific antigen of at least 50%. When histological evidence of therapeutic failure or recurrence is present, different options of management may be proposed to the patient including active surveillance, focal salvage therapy or radical salvage treatment, depending on the characteristics of the lesion found. A recommended post-ablation surveillance protocol is presented as well as a discussion of management strategies based on the data currently available.

Urolift - minimally invasive surgical BPH management.

PubMed

Pushkaran, Anish; Stainer, Victoria; Muir, Gordon; Shergill, Iqbal S

2017-03-01

An ideal treatment option for symptomatic Benign Prostatic Hyperplasia (BPH) should relieve lower urinary tract symptoms (LUTS) and restore Quality of Life (QoL). Currently available medical therapies and surgical options for symptomatic BPH have side effects that adversely affects quality of life. Prostatic urethral lift (PUL) is a novel endourology procedure that promises to relieve LUTS without the aforementioned side effects. Areas covered: We diligently reviewed all the published literature on PUL, till July 2016 using standard search criteria. Expert commentary: There is good quality evidence to establish the efficiency of PUL in treating symptomatic BPH without adversely affecting the QoL. Based on the current literature, PUL can be considered as an option for those symptomatic BPH patients with small or medium size prostates (< 80 ml) without median lobe enlargement, who failed on medical therapy or are intolerant to it and wish to preserve their sexual function.

A review of double-diffusion wood preservation suitable for Alaska.

Treesearch

K. Josephine Pavia

2006-01-01

Currently, all treated lumber used in Alaska is imported from the 48 contiguous states and Canada because there are no wood-treating facilities in Alaska. This report explores conventional and alternative wood-treating methods and reviews previous studies and laboratory tests on treated wood. In investigating wood treatment as a possible processing option for Alaska...

Noah’s Ark Conservation Will Not Preserve Threatened Ecological Communities under Climate Change

PubMed Central

Harris, Rebecca Mary Bernadette; Carter, Oberon; Gilfedder, Louise; Porfirio, Luciana Laura; Lee, Greg; Bindoff, Nathaniel Lee

2015-01-01

Background Effective conservation of threatened ecological communities requires knowledge of where climatically suitable habitat is likely to persist into the future. We use the critically endangered Lowland Grassland community of Tasmania, Australia as a case study to identify options for management in cases where future climatic conditions become unsuitable for the current threatened community. Methods We model current and future climatic suitability for the Lowland Themeda and the Lowland Poa Grassland communities, which make up the listed ecological community. We also model climatic suitability for the structurally dominant grass species of these communities, and for closely related grassland and woodland communities. We use a dynamically downscaled regional climate model derived from six CMIP3 global climate models, under the A2 SRES emissions scenario. Results All model projections showed a large reduction in climatically suitable area by mid-century. Outcomes are slightly better if closely related grassy communities are considered, but the extent of suitable area is still substantially reduced. Only small areas within the current distribution are projected to remain climatically suitable by the end of the century, and very little of that area is currently in good condition. Conclusions As the climate becomes less suitable, a gradual change in the species composition, structure and habitat quality of the grassland communities is likely. Conservation management will need to focus on maintaining diversity, structure and function, rather than attempting to preserve current species composition. Options for achieving this include managing related grassland types to maintain grassland species at the landscape-scale, and maximising the resilience of grasslands by reducing further fragmentation, weed invasion and stress from other land uses, while accepting that change is inevitable. Attempting to maintain the status quo by conserving the current structure and composition of Lowland Grassland communities is unlikely to be a viable management option in the long term. PMID:25881302

Noah's Ark conservation will not preserve threatened ecological communities under climate change.

PubMed

Harris, Rebecca Mary Bernadette; Carter, Oberon; Gilfedder, Louise; Porfirio, Luciana Laura; Lee, Greg; Bindoff, Nathaniel Lee

2015-01-01

Effective conservation of threatened ecological communities requires knowledge of where climatically suitable habitat is likely to persist into the future. We use the critically endangered Lowland Grassland community of Tasmania, Australia as a case study to identify options for management in cases where future climatic conditions become unsuitable for the current threatened community. We model current and future climatic suitability for the Lowland Themeda and the Lowland Poa Grassland communities, which make up the listed ecological community. We also model climatic suitability for the structurally dominant grass species of these communities, and for closely related grassland and woodland communities. We use a dynamically downscaled regional climate model derived from six CMIP3 global climate models, under the A2 SRES emissions scenario. All model projections showed a large reduction in climatically suitable area by mid-century. Outcomes are slightly better if closely related grassy communities are considered, but the extent of suitable area is still substantially reduced. Only small areas within the current distribution are projected to remain climatically suitable by the end of the century, and very little of that area is currently in good condition. As the climate becomes less suitable, a gradual change in the species composition, structure and habitat quality of the grassland communities is likely. Conservation management will need to focus on maintaining diversity, structure and function, rather than attempting to preserve current species composition. Options for achieving this include managing related grassland types to maintain grassland species at the landscape-scale, and maximising the resilience of grasslands by reducing further fragmentation, weed invasion and stress from other land uses, while accepting that change is inevitable. Attempting to maintain the status quo by conserving the current structure and composition of Lowland Grassland communities is unlikely to be a viable management option in the long term.

Counseling women with early pregnancy failure: utilizing evidence, preserving preference.

PubMed

Wallace, Robin R; Goodman, Suzan; Freedman, Lori R; Dalton, Vanessa K; Harris, Lisa H

2010-12-01

To apply principles of shared decision-making to EPF management counseling. To present a patient treatment priority checklist developed from review of available literature on patient priorities for EPF management. Review of evidence for patient preferences; personal, emotional, physical and clinical factors that may influence patient priorities for EPF management; and the clinical factors, resources, and provider bias that may influence current practice. Women have strong and diverse preferences for EPF management and report higher satisfaction when treated according to these preferences. However, estimates of actual treatment patterns suggest that current practice does not reflect the evidence for safety and acceptability of all options, or patient preferences. Multiple practice barriers and biases exist that may be influencing provider counseling about options for EPF management. Choosing management for EPF is a preference-sensitive decision. A patient-centered approach to EPF management should incorporate counseling about all treatment options. Providers can integrate a counseling model into EPF management practice that utilizes principles of shared decision-making and an organized method for eliciting patient preferences, priorities, and concerns about treatment options. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

[Oncofertility: a new focus in women health-care...].

PubMed

Chevalier, N; Dewailly, Didier; Fenichel, Patrick

2009-09-01

Although treatment and survival are the primary focus of health-care patients, with cancer survivors living longer it is now appropriate to consider their quality of life after treatment, including the possibility of becoming parents. There are several options for fertility preservation in cancer patients. Even though most of them are still experimental and their efficacy and reliability have not been determined, especially in women. The most successful alternative for female survivors is embryo cryopreservation, an approach not suitable for many single or virgin women or even possible for prepubertal girls. Reports of live birth after transplantation of human ovarian tissue have reinforced the clinical potential of ovarian tissue banking for fertility preservation. Many exciting studies are underway to improve the efficacy and solve the problems with current fertility preservation strategies, especially for in vitro culture of cryopreserved tissue or follicles. Continuous efforts to improve current strategies and to develop new strategies will benefit many women and children who are facing premature ovarian failure and sterility.

Selective progesterone receptor modulators for fertility preservation in women with symptomatic uterine fibroids†

PubMed Central

Ali, Mohamed

2017-01-01

Abstract Uterine fibroids (UFs, AKA leiomyoma) are the most important benign neoplastic threat to women's health, with costs up to hundreds of billions of health care dollars worldwide. Uterine fibroids caused morbidities exert a tremendous health toll, impacting the quality of life of women of all ethnicities, especially women of color. Clinical presentations include heavy vaginal bleeding, pelvic pain, bulk symptoms, subfertility, and obstetric complications. Current management strategies heavily lean toward surgical procedures; nonetheless, the choice of treatment is generally subject to patient's age and her desire to preserve future fertility. Women with UF who desire to maintain future fertility potential face a dilemma because of the limited treatment choices that are currently available to help them achieve that goal. Recently, ulipristal acetate the first of the promising family of oral selective progesterone receptor modulators has been approved for UF treatment in Europe, Canada, and several other countries and is under review for possible approval in the USA. In this review article, we discuss recent advances in the management options against UF with a bend toward oral effective long-term treatment alternatives who are particularly suited for those seeking to preserve their future fertility potential. We also explore the transformative concept of primary and secondary UF prevention using these new anti-UF agents. We envision a remarkable shift in the management of UF in future years from surgical/invasive treatment to orally administrated options; clearly, this potential shift will require additional intense clinical research. PMID:29025038

Menstrual management and reproductive concerns in adolescent and young adult women with underlying hematologic or oncologic disease.

PubMed

Quinn, Sheila M; Louis-Jacques, Jennifer

2016-08-01

Heavy menstrual bleeding is common among adolescent and young adult women, and can affect health-related quality of life. The cause of heavy menstrual bleeding is not uncommonly because of an underlying hematologic or oncologic disease process, which substantially influences the way patients are counseled and treated. Options for menstrual management are more numerous today than ever before and range from minimizing monthly blood loss to suppressing the cycle altogether. However, an underlying bleeding disorder or malignancy can introduce many nuances and limits in individual patient care, which this review highlights. Additionally, because survival rates for adolescent and young adult cancers are improving, more of these patients are planning for lives after their disease, which may include starting or adding to a family. Options for fertility preservation during cancer therapy regimens are solidifying and both primary practitioners and subspecialists should be aware of the possibilities. Patients with underlying hematologic or oncologic disease require management of menstrual bleeding, but also deserve a comprehensive evaluation and counseling regarding their individualized contraceptive needs and fertility preservation options during their reproductive years. This review employs the latest evidence from current literature to help guide clinicians caring for this unique demographic.

Freezing oocytes or embryos after controlled ovarian hyperstimulation in cancer patients: the state of the art.

PubMed

Bénard, Julie; Duros, Solène; El Hachem, Hady; Sonigo, Charlotte; Sifer, Christophe; Grynberg, Michaël

2016-07-01

Quality of life of young cancer survivors has become a major issue. However, anticancer therapies can have a detrimental impact on fertility. It is now well-established that all patients should receive information about the fertility risks associated with their cancer treatment and the fertility preservation options available. Currently, oocyte or embryo banking after controlled ovarian hyperstimulation represents the most effective method for preserving female fertility. Over the past years innovative protocols of ovarian stimulation have been developed to enable cancer patients to undergo oocyte or embryo cryopreservation irrespective of the phase of the cycle or without exogenous follicle-stimulating hormone-related increase in serum estradiol levels. The present article reviews the different protocols of ovarian hyperstimulation for cancer patients, candidates for fertility preservation.

Age-related macular degeneration: current treatments

PubMed Central

Hubschman, Jean Pierre; Reddy, Shantan; Schwartz, Steven D

2009-01-01

Purpose: Although important progress has been made in understanding age-related macular degeneration (AMD), management of the disease continues to be a challenge. AMD research has led to a widening of available treatment options and improved prognostic perspectives. This essay reviews these treatment options. Design: Interpretative essay. Methods: Literature review and interpretation. Results: Current treatments to preserve vision in patients with non-exudative AMD include antioxidant vitamins and mineral supplementations. Exudative AMD is currently most often treated monthly with anti-VEGF intravitreal injections. However, investigators are beginning to experiment with combination therapy and surgical approaches in an attempt to limit the number of treatment and reduce the financial burden on the health care system. Conclusion: By better understanding the basis and pathogenesis of AMD, newer therapies will continue to be developed that target specific pathways in patients with AMD, with the hoped for outcome of better management of the disease and improved visual acuity. PMID:19668560

Fertility preservation: a pilot study to assess previsit patient knowledge quantitatively.

PubMed

Balthazar, Ursula; Fritz, Marc A; Mersereau, Jennifer E

2011-05-01

To provide a quantitative assessment of patient knowledge about fertility and fertility preservation treatment options before the initial fertility preservation consultation at a university-based fertility preservation center. Prospective pilot survey containing 13 items assessing patient knowledge about fertility preservation, including the available treatment options and their requirements, success rates, and associated risks. University-based IVF center. Women aged 18 to 41 years with illnesses requiring treatments posing a serious threat to future fertility who were referred for fertility preservation consultation between April 2009 and June 2010. None. Knowledge score. Forty-one eligible patients were identified, and all completed surveys before their consultation. A knowledge score was generated for each patient with 1 point awarded for each correct answer. Overall, patients had poor previsit fertility preservation knowledge (mean score 5.9±2.7). Higher knowledge scores were correlated with personal experience with infertility and previous exposure to fertility preservation treatment information. There was no correlation between knowledge score and age, relationship status, pregnancy history, education, or income. Patients seen for fertility preservation consultation at our university-based center generally tend to be in their early 30s, white, well educated, and married. Previsit knowledge about fertility preservation treatment options was poor and did not correlate with age, education, and relationship status. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Guide for Use of Wood Preservatives in Historic Structures

Treesearch

Stan Lebow; Ronald W. Anthony

2012-01-01

This document provides guidance on wood preservation options in the context of historic preservation. Preserving wooden building materials is critical to historic preservation practitioners. Biodeterioration can be minimized through design, construction practices, maintenance, and, if necessary, by use of wood preservatives. Moisture is the primary cause of...

Food Preservation Mini-Modules Offer Options for Learners and Extension Staff

ERIC Educational Resources Information Center

Driessen, Suzanne

2013-01-01

Renewed interest in growing and purchasing locally grown foods quadrupled requests for food preservation classes. Economic times tightened budgets, decreasing staffing levels of Extension educators. Offering options via the Internet was a natural progression to meet the increased demand. Extension educators created 20 5-minute online video--like…

Free-flap harvesting from paralytic limbs of poliomyelitis patients--a safe and feasible option.

PubMed

Chan, R C L; Liu, H L; Chan, Y W

2012-06-01

Many patients who had childhood poliomyelitis are still suffering from the late sequalae of the condition. Free-flap harvesting from the paralytic limbs from these patients is a logical approach for functional preservation. However, concerns have been raised regarding its safety due to its hypoplastic vascular system and potential donor site healing problems. A 53-year-old man with known childhood poliomyelitis presented with left facial sarcoma. After wide excision, the defect was reconstructed with a dual-island fasciocutaneous-free anterolateral thigh flap harvested from his paralytic limb. The pedicle and perforators were found to be no different from those in normal limbs. His recovery was smooth without complications. On the basis of our experience and current evidence in the literature, we believe that free-flap harvesting from the paralytic lower limb in poliomyelitis patients is a safe option that incurs no additional risk and allows maximal function preservation. Copyright © 2011. Published by Elsevier Ltd.

Economic Benefits of Improved Water Quality: Public Perceptions of Option and Preservation Values

NASA Astrophysics Data System (ADS)

Bouwes, Nicolaas W., Sr.

The primary objective of this book is to report the authors‧ research approach to the estimation of benefits of water quality improvements in the South Platte River of northeastern Colorado. Benefits included a “consumer surplus” from enhanced enjoyment of water-based recreation, an “option value” of assured choice of future recreation use, and a “preservation value” of the ecosystem and its bequest to future generations. Concepts such as preservation and option value benefits have been often mentioned but seldom estimated in natural resources research. The authors have met their objective by providing the reader with a detailed description of their research without being tedious.

Knowledge regarding fertility preservation in cancer patients: a population-based survey among Brazilian people during the Pink October awareness event.

PubMed

Chehin, Mauricio B; Bonetti, Tatiana Cs; Serafini, Paulo C; Motta, Eduardo LA

2017-06-01

The aim of this study was to assess the knowledge about the risk of infertility in cancer patients after treatment, and the options for fertility preservation based on a survey carried out during the 2013 Pink October campaign. This survey was carried out during the 2013 Pink October event in the most important public park of São Paulo, Brazil. Approximately 900 people expressed interest in learning about breast cancer prevention and fertility preservation by participating in workshops, and 242 people filled out a questionnaire. Most of the respondents (78.5%) were women, and one-fourth (25%) had at least one relative with gynecological cancer. Among women over 40 years of age, 86.3% had been screened for breast cancer at some point. However, few participants (34.0%) were aware that cancer treatment can lead to infertility or had heard about fertility preservation options (22.0%). Having a relative with cancer did not influence their knowledge about fertility preservation (22.4% versus 21.3%; p=0.864). However, a higher educational level was significantly associated with more knowledge about the effects of cancer on fertility and options for fertility preservation. The majority of participants did not have knowledge about the impact of oncologic treatment on fertility and did not know that there are options to preserve fertility in cancer patients. Awareness of infertility risk factors is an essential first step to safeguard future fertility, and therefore, more educational initiatives are needed to spread knowledge about oncofertility.

What to do now? How women with breast cancer make fertility preservation decisions.

PubMed

Snyder, Karrie Ann; Tate, Alexandra Lee

2013-07-01

There has been increased attention paid to cancer-related infertility and fertility preservation. However, how cancer patients decide whether or not to pursue fertility preservation has not been fully examined. The data come from 34 interviews with women in the USA diagnosed with breast cancer prior to 40 years of age who contemplated fertility preservation prior to cancer treatment. Fully transcribed interviews were coded through a three-staged inductive process. Three sets of factors that shaped the decision-making process of the respondents regarding fertility preservation treatment options were identified: perceived benefits (e.g. ability to use 'younger' eggs in the future), inhibiting concerns (e.g. success rates) and influential relationships (e.g. physicians, parents and partners). Respondents saw their main fertility preservation decision as choosing whether or not to pursue egg/embryo banking. The decision-making process was complicated and included both health-related and personal considerations, with many respondents reporting a lack of support services for fertility issues. Findings suggest that greater attention needs to be placed on presenting patients with a wider range of options. Those who counsel patients regarding fertility preservation decisions should be aware of the influence of relationship dynamics, broader health care concerns, and fertility histories on these decisions. KEY MESSAGE POINTS: While fertility preservation has garnered greater attention, less is known about how cancer patients make fertility preservation decisions. Despite the range of choices for fertility preservation, respondents identified egg/embryo banking as their primary option. Many factors outside of cancer concerns inhibit and facilitate fertility preservation decisions including fertility history and family relationship dynamics.

Chapter 4- Fertility preservation in women with breast cancer

PubMed Central

Rodriguez-Wallberg, Kenny A.; Oktay, Kutluk

2010-01-01

Fertility preservation is an important issue for young women diagnosed with breast cancer. The most well-established options for fertility preservation in cancer patients, embryo and oocyte cryopreservation, have not been traditionally offered to breast cancer patients as estradiol rise during standard stimulation protocols may not be safe for those patients. Potentially safer stimulation protocols using tamoxifen and aromatase inhibitors induce lower levels of estradiol while similar results in terms of number of oocyte and embryo obtained to standard protocols. Cryopreservation of immature oocytes and ovarian cortical tissue, both still experimental methods, are also fertility preservation options for breast cancer patients. PMID:21048442

Male fertility preservation before gonadotoxic therapies

PubMed Central

Wyns, C.

2010-01-01

Background: Recent advances in cancer therapy have resulted in an increased number of long-term cancer survivors. Unfortunately, aggressive chemotherapy, radiotherapy and preparative regimens for bone marrow transplantation can severely affect male germ cells, including spermatogonial stem cells (SSCs), and lead to permanent loss of fertility. Different options for fertility preservation are dependent on the pubertal state of the patient. Methods: Relevant studies were identified by an extensive Medline search of English and French language articles. Results: Sperm cryopreservation prior to gonadotoxic treatment is a well established method after puberty. In case of ejaculation failure by masturbation, assisted ejaculation methods or testicular tissue sampling should be considered. Although no effective gonadoprotective drug is yet available for in vivo spermatogonial stem cell (SSC) protection in humans, current evidence supports the feasibility of immature testicular tissue (ITT) cryopreservation. The different cryopreservation protocols and available fertility restoration options from frozen tissue, i.e. cell suspension transplantation, tissue grafting and in vitro maturation, are presented. Results obtained in humans are discussed in the light of lessons learned from animal studies. Conclusion: Advances in reproductive technology have made fertility preservation a real possibility in young patients whose gonadal function is threatened by gonadotoxic therapies. The putative indications for such techniques, as well as their limitations according to disease, are outlined. PMID:25302103

Male fertility preservation before gonadotoxic therapies.

PubMed

Wyns, C

2010-01-01

Recent advances in cancer therapy have resulted in an increased number of long-term cancer survivors. Unfortunately, aggressive chemotherapy, radiotherapy and preparative regimens for bone marrow transplantation can severely affect male germ cells, including spermatogonial stem cells (SSCs), and lead to permanent loss of fertility. Different options for fertility preservation are dependent on the pubertal state of the patient. Relevant studies were identified by an extensive Medline search of English and French language articles. Sperm cryopreservation prior to gonadotoxic treatment is a well established method after puberty. In case of ejaculation failure by masturbation, assisted ejaculation methods or testicular tissue sampling should be considered. Although no effective gonadoprotective drug is yet available for in vivo spermatogonial stem cell (SSC) protection in humans, current evidence supports the feasibility of immature testicular tissue (ITT) cryopreservation. The different cryopreservation protocols and available fertility restoration options from frozen tissue, i.e. cell suspension transplantation, tissue grafting and in vitro maturation, are presented. RESULTS obtained in humans are discussed in the light of lessons learned from animal studies. Advances in reproductive technology have made fertility preservation a real possibility in young patients whose gonadal function is threatened by gonadotoxic therapies. The putative indications for such techniques, as well as their limitations according to disease, are outlined.

Fertility Preservation in Females with Turner Syndrome: A Comprehensive Review and Practical Guidelines

PubMed Central

Oktay, K; Bedoschi, G; Berkowitz, K; Bronson, R; Kashani, B; McGovern, P; Pal, L; Quinn, G; Rubin, K

2016-01-01

This article reviews the existing fertility preservation options for females diagnosed with Turner syndrome and provides practical guidelines for the practitioner. Turner syndrome is the most common sex chromosome abnormality in females, occurring in approximately one in 2500 live births. Women with Turner syndrome are at extremely high risk for primary ovarian insufficiency (POI) and infertility. Although about 70–80% have no spontaneous pubertal development and 90% experience primary amenorrhea, the remainder may possess a small residual of ovarian follicles at birth or early childhood. The present challenge is to identify these women as early in life as is possible, so as to allow them to benefit from a variety of existing fertility preservation options. To maximize the benefits of fertility preservation, all women with Turner syndrome should be evaluated by an expert as soon as possible in childhood as the vast majority will have their ovarian reserve depleted before adulthood. Cryopreservation of mature oocytes and embryos is a proven fertility preservation approach, while cryopreservation of ovarian tissue is a promising technique with a growing number of live births, but remain investigational. Oocyte cryopreservation has been performed in children with Turner syndrome as young as 13 and ovarian tissue cryopreservation in prepubertal children affected. However, current efficacy of these approaches is unknown in this cohort.. For those who have already lost their ovarian reserve, oocyte or embryo donation and adoption are strategies that allow fulfillment of desire for parenting. For those with Turner syndrome related cardiac contraindications to pregnancy, utilization of gestational surrogacy allows the possibility of biological parenting by using their own oocytes. Alternatively, gestational surrogacy can serve to carry pregnancy resulting from the use of donor oocytes or embryos, if needed. PMID:26485320

Mature Oocyte Cryopreservation for Fertility Preservation.

PubMed

Liang, Tina; Motan, Tarek

2016-01-01

In recent decades, advances in cancer treatment have led to a dramatic improvement in long term survival. This has led to an increasing focus on quality of life after surviving cancer treatment, with fertility being an important aspect. Given the known reproductive risks of cancer therapies, there has been a growing interest in the field of fertility preservation (also referred to as oncofertility). Mature oocyte cryopreservation is no longer considered experimental and has become a realistic option for reproductive aged women prior to undergoing cancer treatment. Additionally, as cryopreservation techniques improve, mature oocyte cryopreservation is increasing being marketed to healthy women without cancer wishing to delay child bearing, also termed "social egg freezing". This chapter provides a review of the current technology, use, and outcomes of mature oocyte cryopreservation. It also outlines the ethical debate surrounding social egg freezing and directions for future research in female fertility preservation.

Fertility Preservation: A Key Survivorship Issue for Young Women with Cancer

PubMed Central

Angarita, Ana Milena; Johnson, Cynae A.; Fader, Amanda Nickles; Christianson, Mindy S.

2016-01-01

Fertility preservation in the young cancer survivor is recognized as a key survivorship issue by the American Society of Clinical Oncology and the American Society of Reproductive Medicine. Thus, health-care providers should inform women about the effects of cancer therapy on fertility and should discuss the different fertility preservation options available. It is also recommended to refer women expeditiously to a fertility specialist in order to improve counseling. Women’s age, diagnosis, presence of male partner, time available, and preferences regarding use of donor sperm influence the selection of the appropriate fertility preservation option. Embryo and oocyte cryopreservation are the standard techniques used while ovarian tissue cryopreservation is new, yet promising. Despite the importance of fertility preservation for cancer survivors’ quality of life, there are still communication and financial barriers faced by women who wish to pursue fertility preservation. PMID:27200291

21 CFR 145.134 - Canned preserved figs.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 2 2013-04-01 2013-04-01 false Canned preserved figs. 145.134 Section 145.134 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD... Canned preserved figs. (a) Canned preserved figs is the food prepared from one of the optional fig...

21 CFR 145.134 - Canned preserved figs.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 2 2014-04-01 2014-04-01 false Canned preserved figs. 145.134 Section 145.134 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD... Canned preserved figs. (a) Canned preserved figs is the food prepared from one of the optional fig...

21 CFR 145.134 - Canned preserved figs.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 2 2012-04-01 2012-04-01 false Canned preserved figs. 145.134 Section 145.134 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD... Canned preserved figs. (a) Canned preserved figs is the food prepared from one of the optional fig...

21 CFR 145.134 - Canned preserved figs.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 2 2011-04-01 2011-04-01 false Canned preserved figs. 145.134 Section 145.134 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD... Canned preserved figs. (a) Canned preserved figs is the food prepared from one of the optional fig...

Fertility Preservation and Pregnancy in Women With and Without BRCA Mutation–Positive Breast Cancer

PubMed Central

Rodriguez-Wallberg, Kenny A.

2012-01-01

Women with breast cancer face many challenges when considering fertility preservation. Delayed referral results in the limitation of fertility preservation options because most established methods, such as embryo and oocyte cryopreservation, require several weeks to complete. Women with BRCA mutations, on the other hand, may be more aware of fertility issues and motivated to see fertility preservation specialists earlier. Fear of exposure to estrogen limits access to fertility preservation via embryo or oocyte cryopreservation; however, the use of aromatase inhibitors as ovarian stimulants reduces such concern. Ovarian cryopreservation can be used when there is insufficient time to perform ovarian stimulation because this technique does not require hormonal stimulation, but there are safety concerns both in women with BRCA mutations and in patients with hormone receptor–positive disease as well. There does not seem to be a proven ovarian suppression strategy to preserve fertility in women with breast cancer. Pregnancy appears to be safe for breast cancer survivors but studies specific for women with BRCA mutations are lacking. Women with BRCA mutations may elect to use preimplantation genetic diagnosis during in vitro fertilization to avoid transmitting the mutation, but there may be psychosocial difficulties in entertaining this option. Overall, the last decade has brought many options for women with breast cancer considering fertility preservation, but numerous challenges remain. The presence of BRCA mutations further contributes to these challenges. PMID:23006497

Reducing Long-Term Costs While Preserving a Robust Strategic Airlift Fleet: Options for the Current Fleet and Next-Generation Aircraft

DTIC Science & Technology

2013-01-01

Ghashghai, Jeff Hagen, Thomas Hamilton, Gregory G. Hildebrandt , Yool Kim, Robert S. Leonard, Rosalind Lewis, Elvira N. Loredo, Daniel M. Norton, David T...Joan Cornuet, Mel Eisman, Chris Fitzmartin, Jean R. Gebman, Elham Ghashghai, Jeff Hagen, Thomas Hamilton, Gregory G. Hildebrandt , Yool Kim, Robert...Hagen, Thomas Hamilton, Gregory G. Hildebrandt , Yool Kim, Robert S. Leonard, Rosa- lind Lewis, Elvira N. Loredo, Daniel M. Norton, David T. Orletsky

Treatment of low-grade endometrial stromal sarcoma in a nulligravid woman.

PubMed

Michael Straughn, J; Boitano, Teresa; Smith, Haller J; Dilley, Sarah E; Liang, Margaret I; Novak, Lea

2018-06-07

A 32 year-old nulligravid woman with a uterine mass underwent exploratory laparotomy with myomectomy. Final pathology revealed a low-grade endometrial stromal sarcoma (ESS) with positive margins. She subsequently underwent definitive robotic hysterectomy and bilateral salpingectomy with ovarian preservation. She was diagnosed with a stage IB low-grade ESS. She is currently undergoing observation. Discussion of classification, surgical options, and adjuvant therapy is presented. Copyright © 2018 Elsevier Inc. All rights reserved.

Anal cancer – a review

PubMed Central

Salati, Sajad Ahmad; Al Kadi, Azzam

2012-01-01

Anal cancer accounts for only 1.5% of gastrointestinal malignancies but this disease has shown a steady increase in incidence particularly in HIV positive males. The understanding of pathophysiology and treatment of anal cancer has changed radically over last thirty years. Risk factors have been identified and organ preservation by chemoradiotherapy has become a standard. This article aims to review the clinical presentation, diagnostic evaluation, and treatment options for anal cancer in the light of current literature. PMID:23580899

Knowledge, attitudes and awareness regarding fertility preservation among oncologists and clinical practitioners in Lebanon.

PubMed

Ghazeeri, Ghina; Zebian, Dina; Nassar, Anwar H; Harajly, Sally; Abdallah, Alain; Hakimian, Stephanie; Skaiff, Bassem; Abbas, Hussein A; Awwad, Johnny

2016-06-01

Fertility preservation (FP) aims to help individuals overcome the infertility associated with cancer treatments such as chemotherapy and radiation. The objective of this study was to assess the awareness, attitudes and knowledge of oncologists' and clinical practitioners' (CPs) about fertility preservation and its options in Lebanon. This was a cross-sectional study with surveys carried out between March 2012 and February 2013 on CPs at the American University of Beirut Medical Centre and Saint Jude's Children Cancer Centre as well as all registered oncologists in Lebanon. Ninety percent of CPs (n = 88) and 94% of oncologists (n = 53) agreed that fertility preservation should be discussed with patient before their cancer treatment. Our data showed a gender bias in relation to patients being informed of their FP options, as well as conflicting knowledge of FP options available in Lebanon among oncologists. The CPs were more likely to have accurate knowledge of FP options and treatment than oncologists. A proactive approach is required to: (1) increase the awareness and knowledge of FP; (2) improve attitudes towards FP; and (3) encourage its communication between CPs, oncologists and patients in Lebanon. Increased education programs, awareness campaigns and development of dedicated FP centres are needed.

Hearing preservation cochlear implantation in children: The HEARRING Group consensus and practice guide.

PubMed

Rajan, Gunesh; Tavora-Vieira, Dayse; Baumgartner, Wolf-Dieter; Godey, Benoit; Müller, Joachim; O'Driscoll, Martin; Skarzynski, Henryk; Skarzynski, Piotr; Usami, Shin-Ichi; Adunka, Oliver; Agrawal, Sumit; Bruce, Iain; De Bodt, Marc; Caversaccio, Marco; Pilsbury, Harold; Gavilán, Javier; Hagen, Rudolf; Hagr, Abdulrahman; Kameswaran, Mohan; Karltorp, Eva; Kompis, Martin; Kuzovkov, Vlad; Lassaletta, Luis; Yongxin, Li; Lorens, Artur; Manoj, Manikoth; Martin, Jane; Mertens, Griet; Mlynski, Robert; Parnes, Lorne; Pulibalathingal, Sasidharan; Radeloff, Andreas; Raine, Christopher H; Rajeswaran, Ranjith; Schmutzhard, Joachim; Sprinzl, Georg; Staecker, Hinrich; Stephan, Kurt; Sugarova, Serafima; Zernotti, Mario; Zorowka, Patrick; Van de Heyning, Paul

2018-01-01

To provide multidisciplinary cochlear implant teams with a current consensus statement to support hearing preservation cochlear implantation (HPCI) in children, including those children with symptomatic partial deafness (PD) where the intention is to use electric-acoustic stimulation (EAS). The main objectives are to provide guidelines on who is a candidate, how to assess these children and when to implant if Med-El Flex electrode arrays are chosen for implantation. The HEARRING group reviewed the current evidence and practice regarding the management of children to be considered for HPCI surgery emphasizing the assessment needed prior to implantation in order to demonstrate the benefits in these children over time. The consensus statement addresses following three key questions: (1) Should these children be treated? (2) How to identify these children? (3) How to manage these children? The HEARRING group concludes that irrespective of the degree of residual hearing present, the concepts of hearing and structure preservation should be applied in every child undergoing cochlear implantation and that HPCI is a safe and reliable treatment option. Early detection and multidisciplinary assessment are key to the identification of children with symptomatic PD, these children should undergo HPCI as early as possible.

[Head and neck paragangliomas: An interdisciplinary challenge].

PubMed

Künzel, J; Bahr, K; Hainz, M; Rossmann, H; Matthias, C

2015-12-01

Current treatment strategies for head and neck paragangliomas are moving away from radical resection and toward surgical tumor reduction, in order to preserve function and reduce morbidity. Radiotherapy modalities are alternative primary treatment options. A PubMed search of the relevant literature on genetics and treatment of head and neck paragangliomas was conducted. The rapid progress made in genetic research was mainly triggered by two factors: firstly, the establishment of central registries for paraganglioma patients and secondly, the availability of next-generation sequencing methods. Exome sequencing and a gene-panel sequencing approach have already been successfully applied to paraganglioma syndromes. The latter method in particular is rapid and cost-effective, and may soon replace complex genotyping algorithms. The literature provides good evidence that diversified modern treatment options are available to realize individual treatment concepts for almost all paraganglioma manifestations. Generally, small and symptomatic tumors should be completely resected, particularly in younger patients. Considering the patient's age, symptoms, morbidity risk, and comorbidities, larger tumors should be surgically treated in a function-preserving manner. In these cases, primary radiotherapy is an equivalent alternative option. A "wait and scan" strategy is possible in selected cases. The potential morbidity of surgical treatment must be weighed against the expectable quality of life. Comprehensive consultation with the patient about possible treatment modalities is mandatory. Treatment decision making should involve a multidisciplinary team of experts.

Listening through narratives: using a narrative approach when discussing fertility preservation options with young cancer patients

PubMed Central

Roher, S.I.G.; Gibson, J.; Gibson, B.E.; Gupta, A.A.

2017-01-01

Despite clinical practice guideline recommendations mandating that fertility preservation be discussed with young cancer patients, many providers fail to initiate such discussions with adolescents. Researchers and clinicians often focus on system-level changes to improve access to fertility preservation for adolescents and young adults in Canada. However, little of the available information considers the way in which health care providers approach those discussions. Research has shown that, even when fertility preservation options are broached with adolescents, survivors often report dissatisfaction with those conversations, thus raising additional concerns about their content and quality. Here, we consider how a narrative approach—and the Frank narrative typology in particular—could improve the quality of such conversations by helping providers to more accurately and thoughtfully respond to the needs of adolescent patients when discussing the possibility of fertility preservation. Based on findings from a qualitative research project, we provide concrete suggestions for how to more sensitively approach fertility preservation conversations with male adolescent cancer patients and survivors. PMID:28270719

Compensation for Distributed Solar. A Survey of Options to Preserve Stakeholder Value

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

Flores-Espino, Francisco

2015-09-01

Compensation mechanisms for electricity generation systems installed behind the meter are under scrutiny in several jurisdictions in the United States. Legislators in 29 states introduced bills to amend net metering provisions in 2014, and in 33 states in the 2015 legislative session as of August 20, 2015. Some utilities have also sought to increase the revenue they receive from net-metered customers through rate redesign. The circumstances that have triggered the recent push for change include a growing percentage of net-metered customers, potential effects of distributed generation on cost allocation, decreasing photovoltaic (PV) system costs, the challenges of integrating high levelsmore » of solar generation in the distribution network, and increasing pressure on utility business models. This report presents a survey of options to charge and compensate PV customers, as well as options that may preserve utility revenues in scenarios with increased DG. These options could be used as building blocks to create a distributed generation (DG) compensation policy that may preserve the value of the different stakeholders and balance their interests.« less

New advances in ovarian autotransplantation to restore fertility in cancer patients

PubMed Central

2016-01-01

Human ovary autotransplantation is a promising option for fertility preservation of young women and girls undergoing gonadotoxic treatments for cancer or some autoimmune diseases. Although experimental, it resulted in at least 42 healthy babies worldwide. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic literature review was performed for all relevant full-text articles published in English from 1 January 2000 to 01 October 2015 in PubMed to explore the latest clinical and research advances of human ovary autotransplantation. Human ovary autotransplantation involves ovarian tissue extraction, freezing/thawing, and transplantation back into the same patient. Three major forms of human ovary autotransplantation exist including (a) transplantation of cortical ovarian tissue, (b) transplantation of whole ovary, and (c) transplantation of ovarian follicles (artificial ovary). According to the recent guidelines, human ovary autotransplantation is still considered experimental; however, it has unique advantages in comparison to other options of female fertility preservation. Human ovary autotransplantation (i) does not need prior ovarian stimulation, (ii) allows immediate initiation of cancer therapy, (iii) can restore both endocrine and reproductive ovarian functions, and (iv) may be the only fertility preservation option suitable for prepubertal girls or for young women with estrogen-sensitive malignancies. As any other fertility preservation option, human ovary autotransplantation has both advantages and disadvantages and may not be feasible for all cases. The major challenges facing this option are how to avoid the risk of reintroducing malignant cells and how to prolong the lifespan of ovarian transplant as well as how to improve artificial ovary results. PMID:26589603

New advances in ovarian autotransplantation to restore fertility in cancer patients.

PubMed

Salama, Mahmoud; Woodruff, Teresa K

2015-12-01

Human ovary autotransplantation is a promising option for fertility preservation of young women and girls undergoing gonadotoxic treatments for cancer or some autoimmune diseases. Although experimental, it resulted in at least 42 healthy babies worldwide. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic literature review was performed for all relevant full-text articles published in English from 1 January 2000 to 01 October 2015 in PubMed to explore the latest clinical and research advances of human ovary autotransplantation. Human ovary autotransplantation involves ovarian tissue extraction, freezing/thawing, and transplantation back into the same patient. Three major forms of human ovary autotransplantation exist including (a) transplantation of cortical ovarian tissue, (b) transplantation of whole ovary, and (c) transplantation of ovarian follicles (artificial ovary). According to the recent guidelines, human ovary autotransplantation is still considered experimental; however, it has unique advantages in comparison to other options of female fertility preservation. Human ovary autotransplantation (i) does not need prior ovarian stimulation, (ii) allows immediate initiation of cancer therapy, (iii) can restore both endocrine and reproductive ovarian functions, and (iv) may be the only fertility preservation option suitable for prepubertal girls or for young women with estrogen-sensitive malignancies. As any other fertility preservation option, human ovary autotransplantation has both advantages and disadvantages and may not be feasible for all cases. The major challenges facing this option are how to avoid the risk of reintroducing malignant cells and how to prolong the lifespan of ovarian transplant as well as how to improve artificial ovary results.

Fertility Preservation for Children Diagnosed with Cancer

MedlinePlus Videos and Cool Tools

... for Children Diagnosed with Cancer Ask Your Doctor Information for Patients Many adult survivors of childhood cancer ... study approved by an IRB . Resources For more information about infertility risk and fertility preservation options for ...

Biomedicine's Electronic Publishing Paradigm Shift

PubMed Central

Markovitz, Barry P.

2000-01-01

Biomedical publishing stands at a crossroads. The traditional print, peer-reviewed, subscription journal has served science well but is now being called into question. Because of spiraling print journal costs and the worldwide acceptance of the Internet as a valid publication medium, there is a compelling opportunity to re-examine our current paradigm and future options. This report illustrates the conflicts and restrictions inherent in the current publishing model and examines how the single act of permitting authors to retain copyright of their scholarly manuscripts may preserve the quality-control function of the current journal system while allowing PubMed Central, the Internet archiving system recently proposed by the director of the National Institutes of Health, to simplify and liberate access to the world's biomedical literature. PMID:10833158

Preserving the Whole: A Two-Track Approach to Rescuing Social Science Data and Metadata.

ERIC Educational Resources Information Center

Green, Ann; Dionne, JoAnn; Dennis, Martin

Focusing on the experience of the Yale University (Connecticut) social science data preservation project, this document presents a case study of migration as a preservation strategy, exploring options for migrating data stored in a technically obsolete format and their associated documentation stored on paper. The first section provides background…

Fertility Preservation in Women with Turner Syndrome: A Comprehensive Review and Practical Guidelines.

PubMed

Oktay, Kutluk; Bedoschi, Giuliano; Berkowitz, Karen; Bronson, Richard; Kashani, Banafsheh; McGovern, Peter; Pal, Lubna; Quinn, Gwendolyn; Rubin, Karen

2016-10-01

In this article we review the existing fertility preservation options for women diagnosed with Turner syndrome and provide practical guidelines for the practitioner. Turner syndrome is the most common sex chromosome abnormality in women, occurring in approximately 1 in 2500 live births. Women with Turner syndrome are at extremely high risk for primary ovarian insufficiency and infertility. Although approximately 70%-80% have no spontaneous pubertal development and 90% experience primary amenorrhea, the remainder might possess a small residual of ovarian follicles at birth or early childhood. The present challenge is to identify these women as early in life as is possible, to allow them to benefit from a variety of existing fertility preservation options. To maximize the benefits of fertility preservation, all women with Turner syndrome should be evaluated by an expert as soon as possible in childhood because the vast majority will have their ovarian reserve depleted before adulthood. Cryopreservation of mature oocytes and embryos is a proven fertility preservation approach, and cryopreservation of ovarian tissue is a promising technique with a growing number of live births, but remains investigational. Oocyte cryopreservation has been performed in children with Turner syndrome as young as 13 years of age and ovarian tissue cryopreservation in affected prepubertal children. However, current efficacy of these approaches is unknown in this cohort. For those who have already lost their ovarian reserve, oocyte or embryo donation and adoption are strategies that allow fulfillment of the desire for parenting. For those with Turner syndrome-related cardiac contraindications to pregnancy, use of gestational surrogacy allows the possibility of biological parenting using their own oocytes. Alternatively, gestational surrogacy can serve to carry pregnancy resulting from the use of donor oocytes or embryos, if needed. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Features and selection of vascular access devices.

PubMed

Sansivero, Gail Egan

2010-05-01

To review venous anatomy and physiology, discuss assessment parameters before vascular access device (VAD) placement, and review VAD options. Journal articles, personal experience. A number of VAD options are available in clinical practice. Access planning should include comprehensive assessment, with attention to patient participation in the planning and selection process. Careful consideration should be given to long-term access needs and preservation of access sites. Oncology nurses are uniquely suited to perform a key role in VAD planning and placement. With knowledge of infusion therapy, anatomy and physiology, device options, and community resources, nurses can be key leaders in preserving vascular access and improving the safety and comfort of infusion therapy. Copyright 2010 Elsevier Inc. All rights reserved.

Spermatogonial stem cells as a therapeutic alternative for fertility preservation of prepubertal boys

PubMed Central

Galuppo, Andrea Giannotti

2015-01-01

ABSTRACT Spermatogonial stem cells, which exist in the testicles since birth, are progenitors cells of male gametes. These cells are critical for the process of spermatogenesis, and not able to produce mature sperm cells before puberty due to their dependency of hormonal stimuli. This characteristic of the reproductive system limits the preservation of fertility only to males who are able to produce an ejaculate. This fact puts some light on the increase in survival rates of childhood cancer over the past decades because of improvements in the diagnosis and effective treatment in pediatric cancer patients. Therefore, we highlight one of the most important challenges concerning male fertility preservation that is the toxic effect of cancer therapy on reproductive function, especially the spermatogenesis. Currently, the experimental alternative for fertility preservation of prepubertal boys is the testicular tissue cryopreservationfor, for future isolation and spermatogonial stem cells transplantation, in order to restore the spermatogenesis. We present a brief review on isolation, characterization and culture conditions for the in vitro proliferation of spermatogonial stem cells, as well as the future perspectives as an alternative for fertility preservation in prepubertal boys. The possibility of restoring male fertility constitutes a research tool with an huge potential in basic and applied science. The development of these techniques may be a hope for the future of fertility preservation in cases that no other options exist, e.g, pediatric cancer patients. PMID:26761559

WSDOT chip seals : optimal timing, design and construction considerations.

DOT National Transportation Integrated Search

2014-12-01

The Washington State Department of Transportation (WSDOT) does not have sufficient pavement : preservation funding to keep up with inflation and pavement needs. This has caused WSDOT to : emphasize in its preservation program lower-cost options such ...

Ovarian tissue cryopreservation and transplantation among alternatives for fertility preservation in the Nordic countries - compilation of 20 years of multicenter experience.

PubMed

Rodriguez-Wallberg, Kenny A; Tanbo, Tom; Tinkanen, Helena; Thurin-Kjellberg, Ann; Nedstrand, Elizabeth; Kitlinski, Margareta Laczna; Macklon, Kirsten T; Ernst, Erik; Fedder, Jens; Tiitinen, Aila; Morin-Papunen, Laure; Einarsson, Snorri; Jokimaa, Varpu; Hippeläinen, Maritta; Lood, Mikael; Gudmundsson, Johannes; Olofsson, Jan I; Andersen, Claus Yding

2016-09-01

The aim of this study is to report the current status of ovarian tissue cryopreservation among alternatives for fertility preservation in the Nordic countries. A questionnaire was sent to 14 Nordic academic reproductive centers with established fertility preservation programs. It covered fertility preservation cases performed up to December 2014, standard procedures for ovarian tissue cryopreservation and oocyte cryopreservation and reproductive outcomes following ovarian tissue transplantation. Among the Nordic countries, Denmark and Norway practice ovarian tissue cryopreservation as a clinical treatment (822 and 164 cases, respectively) and their programs are centralized. In Sweden (457 cases), ovarian tissue cryopreservation is practiced at five of six centers and in Finland at all five centers (145 cases). Nearly all considered ovarian tissue cryopreservation to be experimental. In Iceland, embryo cryopreservation is the only option for fertility preservation. Most centers use slow-freezing methods for ovarian tissue cryopreservation. Most patients selected for ovarian tissue cryopreservation were newly diagnosed with cancer and the tissue was predominantly retrieved laparoscopically by unilateral oophorectomy. Only minor complications were reported. In total, 46 women have undergone ovarian tissue transplantation aiming at recovering fertility, 17 healthy children have been born and several additional pregnancies are currently ongoing. Whenever patients' clinical condition is permissive, oocyte cryopreservation after hormonal stimulation is preferred for fertility preservation. Between 2012 and 2014, a smaller proportion of females have undergone fertility preservation in the Nordic centers, in comparison to males (1:3). Overall, ovarian tissue cryopreservation was reported to be safe. Slow freezing methods are still preferred. Promising results of recovery of fertility have been reported in Nordic countries that have initiated ovarian tissue transplantation procedures. © 2016 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).

Fertility preservation for social indications: a cost-based decision analysis.

PubMed

Hirshfeld-Cytron, Jennifer; Grobman, William A; Milad, Magdy P

2012-03-01

Age-related infertility remains a problem that assisted reproductive techniques (ART) have limited ability to overcome. Correspondingly, because an increasing number of women are choosing to delay childbearing, fertility preservation strategies, initially intended for patients undergoing gonadotoxic therapies, are being applied to this group of healthy women. Studies supporting the effectiveness of this practice are lacking. Decision analytic techniques. We compared the cost-effectiveness of three strategies for women planning delayed childbearing until age 40: oocyte cryopreservation at age 25, ovarian tissue cryopreservation (OTC) at age 25, and no assisted reproduction until spontaneous conception had been attempted. Not applicable. Not applicable. Cost-effectiveness, which was defined as the cost per live birth. In this analysis, the strategy of foregoing fertility preservation at age 25 and then choosing ART only after not spontaneously conceiving at age 40 was the most cost-effective option. OTC was dominated by the other strategies. Sensitivity analyses demonstrated the robustness of the model; no analysis existed in which OTC was not dominated by oocyte cryopreservation. Increasing the cost of an IVF cycle beyond $22,000 was the only situation in which oocyte cryopreservation was the most preferred strategy. Neither oocyte cryopreservation nor OTC appear to be cost-effective under current circumstances for otherwise healthy women planning delayed childbearing. This analysis should give pause to the current practice of offering fertility preservation based only on the desire for delayed childbearing. Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

CONTAMINANTS AND REMEDIAL OPTIONS AT WOOD PRESERVING SITES

EPA Science Inventory

This document provides information that facilitates characterization of the site and selection of treatment technologies at wood preserving sites, to meet the regulations’ acceptable cleanup levels. It does not provide risk-assessment information or policy guidance related to det...

Pulpal and periradicular response to caries: current management and regenerative options.

PubMed

Chogle, Sami M A; Goodis, Harold E; Kinaia, Bassam Michael

2012-07-01

The pulp-dentin complex is a strategic and dynamic barrier to various insults that plague the dentition. Researchers have yet to understand the complete potential of this shifting junction and its components. The most common cause of injury to the pulp-dentin complex is carious breakdown of enamel and dentin. In recent years, there has been a change in restorative management of caries. The emphasis is on strategies to preserve dentin and protect the pulp. This article provides a brief review of the effect of caries on the pulp, of subsequent events on the periradicular tissues, and of current understanding of treatment modalities. Copyright © 2012 Elsevier Inc. All rights reserved.

Treatment planning of implants in posterior quadrants.

PubMed

Jivraj, S; Chee, W

2006-07-08

Differences in anatomy and biomechanics make treatment of posterior quadrants with dental implants substantially different to that of anterior areas. Without implants, when posterior teeth were lost, treatment options included a long span fixed partial denture or a removable prosthesis, especially when no terminal abutment was available. Today, with the use of implants, options are available that allow preservation of unrestored teeth.(1) When teeth are missing, implant supported restorations can be considered the treatment of choice from the perspective of occlusal support, preservation of adjacent teeth and avoidance of a removable partial denture.

Health and economic consequences of different options for timing the coordinated global cessation of the three oral poliovirus vaccine serotypes.

PubMed

Thompson, Kimberly M; Duintjer Tebbens, Radboud J

2015-09-17

World leaders remain committed to globally-coordinated oral poliovirus vaccine (OPV) cessation following successful eradication of wild polioviruses, but the best timing and strategy for implementation depend on existing and emerging conditions. Using an existing integrated global poliovirus risk management model, we explore alternatives to the current timing plan of coordinated cessation of each OPV serotype (i.e., OPV1, OPV2, and OPV3 cessation for serotypes 1, 2, and 3, respectively). We assume the current timing plan involves OPV2 cessation in 2016 followed by OPV1 and OPV3 cessation in 2019 and we compare this to alternative timing options, including cessation of all three serotypes in 2018 or 2019, and cessation of both OPV2 and OPV3 in 2017 followed by OPV1 in 2019. If Supplemtal Immunization Activity frequency remains sufficiently high through cessation of the last OPV serotype, then all OPV cessation timing options prevent circulating vaccine-derived poliovirus (cVDPV) outbreaks after OPV cessation of any serotype. The various OPV cessation timing options result in relatively modest differences in expected vaccine-associated paralytic poliomyelitis cases and expected total of approximately 10-13 billion polio vaccine doses used. However, the expected amounts of vaccine of different OPV formulations needed changes dramatically with each OPV cessation timing option. Overall health economic impacts remain limited for timing options that only change the OPV formulation but preserve the currently planned year for cessation of the last OPV serotype and the global introduction of inactivated poliovirus vaccine (IPV) introduction. Earlier cessation of the last OPV serotype or later global IPV introduction yield approximately $1 billion in incremental net benefits due to saved vaccination costs, although the logistics of implementation of OPV cessation remain uncertain and challenging. All countries should maintain the highest possible levels of population immunity to transmission for each poliovirus serotype prior to the coordinated cessation of the OPV serotype to manage cVDPV risks. If OPV2 cessation gets delayed, then global health leaders should consider other OPV cessation timing options.

49 CFR 262.15 - Environmental assessment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... FRA to approve a project for physical construction. FRA's “Procedures for Considering Environmental... and historic preservation review requirements. (b) States have two options for proceeding with environmental/historic preservation reviews. A State may file an application under subsection § 262.11 seeking...

Young adult female cancer survivors' unmet information needs and reproductive concerns contribute to decisional conflict regarding posttreatment fertility preservation.

PubMed

Benedict, Catherine; Thom, Bridgette; N Friedman, Danielle; Diotallevi, Debbie; M Pottenger, Elaine; J Raghunathan, Nirupa; Kelvin, Joanne F

2016-07-01

Many young adult female cancer survivors (YAFCS) are at risk of experiencing premature menopause. The current study characterized the posttreatment fertility information needs, reproductive concerns, and decisional conflict regarding future options for posttreatment fertility preservation (FP) among YAFCS. Participants completed a Web-based, anonymous survey between February and March 2015. The survey included investigator-designed questions of perceived information needs, the Reproductive Concerns After Cancer Scale, and the Decisional Conflict Scale. Analyses included Pearson correlation coefficients, independent-sample Student t tests, and multiple regression. There was a total of 346 participants with an average age of 29.9 years (SD = 4.1 years) who were 4.9 years from treatment (SD = 5.4 years [range, 0-27 years]). The main analyses focused on a subgroup of YAFCS with uncertain fertility status who had not previously undergone/attempted FP and either wanted future children or were unsure (179 women). Across fertility information topics, 43% to 62% of participants reported unmet information needs. The greatest reproductive concerns were related to fertility potential and the health of future offspring. The regression model controlled for a priori covariates including current age, age at treatment completion, income, relationship status, nulliparity, and prior fertility evaluation. Greater unmet information needs were found to be related to greater decisional conflict (β = .43; p<.001); greater reproductive concerns were associated at the trend level (β = .14, p = .08; F[8,118] = 6.42, p<.001). YAFCS with limited awareness or knowledge of their risk of experiencing premature menopause and FP options reported higher levels of decisional conflict regarding future FP. Posttreatment survivorship care should include comprehensive reproductive health counseling, including posttreatment FP options and family-building alternatives. Cancer 2016;122:2101-9. © 2016 American Cancer Society. © 2016 American Cancer Society.

Transgenderism and reproduction.

PubMed

TʼSjoen, Guy; Van Caenegem, Eva; Wierckx, Katrien

2013-12-01

The development of new reproductive medicine techniques creates opportunities for preserving fertility in transgender persons. Before, losing fertility was accepted as the price to pay for transitioning. The desire for children is present in many trans persons, as in the general population. Ethical concerns are sometimes raised against the preservation of fertility; however, the only unique aspect of this group is the gender transition of one of the parents. All other elements such as same sex parenthood, use of donor gametes, social stigma, etc., can be found in other groups of parents. Not all reproductive options for all trans persons are equal because not only the gametes are of importance, but also the sex of the (future) partner. In trans women, the best option to preserve gametes is cryopreservation of sperm by preference initiated before starting hormonal therapy. In trans men, donor sperm is most often used, but in theory, there are three options available to preserve fertility: oocyte banking, embryo banking and banking of ovarian tissue. Fertility is possible for both trans men and women, but it requires timely cryopreservation of gametes or stopping cross-sex hormones and possible fertility treatments which are costly and may be unpleasant. Centers should elucidate their policy and inform trans persons on the possibilities and limitations.

Phase II drugs currently being investigated for the treatment of hypogonadism.

PubMed

Udedibia, Emeka; Kaminetsky, Jed

2014-12-01

Hypogonadism is the most common endocrine disorder, which affects men of all age groups. Recent shifts in public awareness, increased screening and recognition of symptoms and updated diagnostic criteria have led to an increase in men diagnosed as hypogonadal, including middle-aged and older men who previously would have been considered eugonadal. The increase in testosterone replacement therapy (TRT) has paralleled an increase in advancements of treatment options. Although current therapies are highly efficacious for many men, there remains a need for newer therapies that are more cost-effective, preserve ease of use and administration, mitigate undesirable effects and closely mimic physiological levels of testosterone. In this review, the authors discuss current TRTs and therapies in development for the treatment of hypogonadism. The focus is on therapies under Phase II investigation or those who have recently completed Phase II study. With several new therapies in development, the authors expect advancements in achieving treatment benchmarks that meet the needs of the individual symptomatic hypogonadal male. Increased public awareness of hypogonadism and TRT has led to a welcomed expansion in the choice of TRT options. These include new delivery systems, formulations, routes of administration and non-testosterone modalities.

Cell-based therapeutic strategies for replacement and preservation in retinal degenerative diseases

PubMed Central

Jones, Melissa K.; Lu, Bin; Girman, Sergey; Wang, Shaomei

2017-01-01

Cell-based therapeutics offer diverse options for treating retinal degenerative diseases, such as age-related macular degeneration (AMD) and retinitis pigmentosa (RP). AMD is characterized by both genetic and environmental risks factors, whereas RP is mainly a monogenic disorder. Though treatments exist for some patients with neovascular AMD, a majority of retinal degenerative patients have no effective therapeutics, thus indicating a need for universal therapies to target diverse patient populations. Two main cell-based mechanistic approaches are being tested in clinical trials. Replacement therapies utilize cell-derived retinal pigment epithelial (RPE) cells to supplant lost or defective host RPE cells. These cells are similar in morphology and function to native RPE cells and can potentially supplant the responsibilities of RPE in vivo. Preservation therapies utilize supportive cells to aid in visual function and photoreceptor preservation partially by neurotrophic mechanisms. The goal of preservation strategies is to halt or slow the progression of disease and maintain remaining visual function. A number of clinical trials are testing the safety of replacement and preservation cell therapies in patients; however, measures of efficacy will need to be further evaluated. In addition, a number of prevailing concerns with regards to the immune-related response, longevity, and functionality of the grafted cells will need to be addressed in future trials. This review will summarize the current status of cell-based preclinical and clinical studies with a focus on replacement and preservation strategies and the obstacles that remain regarding these types of treatments. PMID:28111323

Fertility after breast cancer treatment.

PubMed

Kasum, Miro; Beketić-Orešković, Lidija; Peddi, Parvin F; Orešković, Slavko; Johnson, Rebecca H

2014-02-01

In many countries of the developed world, there is an increasing trend toward delay in childbearing from 30 to 40 years of age for various reasons. This is unfortunately concordant with an increasing incidence of breast cancer in women who have not yet completed their family. The current choice for premenopausal women with breast cancer is adjuvant therapy which includes cytotoxic chemotherapy, ovarian ablation (by surgery, irradiation, or chemical ovarian suppression), anti-estrogen therapy, or any combination of these. Although the use of adjuvant therapies with cytotoxic drugs can significantly reduce mortality, it raises issues of the long-term toxicity, such as induction of an early menopause and fertility impairment. The risk of infertility is a potential hardship to be faced by the patients following treatment of breast cancer. The offspring of patients who became pregnant after completion of chemotherapy have shown no adverse effects and congenital anomalies from the treatment, but sometimes high rates of abortion (29%) and premature deliveries with low birth weight (40%) have been demonstrated. Therefore, the issue of recent cytotoxic treatment remains controversial and further research is required to define a "safety period" between cessation of treatment and pregnancy. Preservation of fertility in breast cancer survivors of reproductive age has become an important issue regarding the quality of life. Currently, there are several potential options, including all available assisted technologies, such as in vitro fertilization and embryo transfer, in vitro maturation, oocyte and embryo cryopreservation, and cryopreservation of ovarian tissue. Because increased estrogen levels are thought to be potentially risky in breast cancer patients, recently developed ovarian stimulation protocols with the aromatase inhibitor letrozole and tamoxifen appear to provide safe stimulation with endogenous estrogen. Embryo cryopreservation seems to be the most established fertility preservation strategy, providing a 25-35% chance of pregnancy. In addition, oocyte freezing can be considered as an alternative in patients who are single and in those who do not wish a sperm donor. Although ovarian tissue harvesting appears to be safe, experience regarding ovarian transplantation is still limited due to low utilization, so the true value of this procedure remains to be determined. Nevertheless, in clinical situations in which chemotherapy needs to be started in young patients facing premature ovarian failure, ovarian tissue preservation seems to be a promising option for restoring fertility, especially in conjunction with other options like immature oocyte retrieval, in vitro maturation of oocytes, oocyte vitrification, or embryo cryopreservation. It seems that in vitro maturation is a useful strategy because it improves oocyte or cryopreservation outcome in breast cancer patients undergoing ovarian stimulation for fertility preservation. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Preservation of Digital Information. Proceedings of the Membership Meeting of the Association of Research Libraries (131st, Washington, DC, October 15-17, 1997).

ERIC Educational Resources Information Center

Barrett, Jaia, Ed.; Wetzel, Karen A., Ed.

The 131st meeting of the Association of Research Libraries (ARL) focused on preservation of digital information. The ARL Preservation Committee convened three panels of experts to highlight major issues raised by the archiving of digital resources, and to encourage discussion about options for operating models and criteria for digital archives.…

Comparison of Patient-Reported Outcome from Neck-Preserving, Short-Stem Arthroplasty and Resurfacing Arthroplasty in Younger Osteoarthritis Patients

PubMed Central

Dettmer, Marius; Pourmoghaddam, Amir; Kreuzer, Stefan W.

2015-01-01

Hip resurfacing has been considered a good treatment option for younger, active osteoarthritis patients. However, there are several identified issues concerning risk for neck fractures and issues related to current metal-on-metal implant designs. Neck-preserving short-stem implants have been discussed as a potential alternative, but it is yet unclear which method is better suited for younger adults. We compared hip disability and osteoarthritis outcome scores (HOOS) from a young group of patients (n = 52, age 48.9 ± 6.1 years) who had received hip resurfacing (HR) with a cohort of patients (n = 73, age 48.2 ± 6.6 years) who had received neck-preserving, short-stem implant total hip arthroplasty (THA). Additionally, durations for both types of surgery were compared. HOOS improved significantly preoperatively to last followup (>1 year) in both groups (p < 0.0001, η 2 = 0.69); there were no group effects or interactions. Surgery duration was significantly longer for resurfacing (104.4 min ± 17.8) than MiniHip surgery (62.5 min ± 14.8), U = 85.0, p < 0.0001, η 2 = 0.56. The neck-preserving short-stem approach may be preferable to resurfacing due to the less challenging surgery, similar outcome, and controversy regarding resurfacing implant designs. PMID:26101669

Fertility preservation in women--a practical guide to preservation techniques and therapeutic strategies in breast cancer, Hodgkin's lymphoma and borderline ovarian tumours by the fertility preservation network FertiPROTEKT.

PubMed

von Wolff, Michael; Montag, Markus; Dittrich, Ralf; Denschlag, Dominik; Nawroth, Frank; Lawrenz, Barbara

2011-08-01

Fertility preservation methods are playing an increasing role in women up to the age of 40 years because of rising survival rates in those affected by cancer. However, balanced practical recommendations concerning all relevant fertility preservation, to support doctors in counselling and treating patients, are still rare. These recommendations were prepared by the network FertiPROTEKT ( http://www.fertiprotect.eu ), a collaboration of around 70 centres in Germany, Switzerland and Austria. The recommendations were developed by specialists in reproductive medicine, reproductive biology and oncology, which gave a comprehensive overview of all named techniques as well as their benefits and risks. Furthermore, practice-orientated recommendations for the individual use of fertility preservation methods for various indications such as breast cancer, Hodgkin's lymphoma and borderline ovarian tumours are given. Various options such as ovarian stimulation and cryopreservation of unfertilised or fertilised oocytes, cryopreservation and transplantation of ovarian tissue, GnRH-agonist administration and transposition of the ovaries can be offered. All the techniques can be performed alone or in combination within a maximum of 2 weeks with low risk and different success rates. Fertility preservation in women has become an option with realistic chances to become pregnant after cytotoxic therapies. The information provided allows a well balanced and realistic counselling and treatment.

Fertility preservation in Turner syndrome.

PubMed

Grynberg, Michaël; Bidet, Maud; Benard, Julie; Poulain, Marine; Sonigo, Charlotte; Cédrin-Durnerin, Isabelle; Polak, Michel

2016-01-01

Premature ovarian insufficiency is a relatively rare condition that can appear early in life. In a non-negligible number of cases the ovarian dysfunction results from genetic diseases. Turner syndrome (TS), the most common sex chromosome abnormality in females, is associated with an inevitable premature exhaustion of the follicular stockpile. The possible or probable infertility is a major concern for TS patients and their parents, and physicians are often asked about possible options to preserve fertility. Unfortunately, there are no recommendations on fertility preservation in this group. The severely reduced follicle pool even during prepubertal life represents the major limit for fertility preservation and is the root of numerous questions regarding the competence of gametes or ovarian tissue crybanked. In addition, patients suffering from TS show higher than usual rates of spontaneous abortion, fetal anomaly, and maternal morbidity and mortality, which should be considered at the time of fertility preservation and before reutilization of the cryopreserved gametes. Apart from fulfillment of the desire of becoming genetic parents, TS patients may be potential candidates for egg donation, gestational surrogacy, and adoption. The present review discusses the different options for preserving female fertility in TS and the ethical questions raised by these approaches. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Manchester Coding Option for SpaceWire: Providing Choices for System Level Design

NASA Technical Reports Server (NTRS)

Rakow, Glenn; Kisin, Alex

2014-01-01

This paper proposes an optional coding scheme for SpaceWire in lieu of the current Data Strobe scheme for three reasons. First reason is to provide a straightforward method for electrical isolation of the interface; secondly to provide ability to reduce the mass and bend radius of the SpaceWire cable; and thirdly to provide a means for a common physical layer over which multiple spacecraft onboard data link protocols could operate for a wide range of data rates. The intent is to accomplish these goals without significant change to existing SpaceWire design investments. The ability to optionally use Manchester coding in place of the current Data Strobe coding provides the ability to DC balanced the signal transitions unlike the SpaceWire Data Strobe coding; and therefore the ability to isolate the electrical interface without concern. Additionally, because the Manchester code has the clock and data encoded on the same signal, the number of wires of the existing SpaceWire cable could be optionally reduced by 50. This reduction could be an important consideration for many users of SpaceWire as indicated by the already existing effort underway by the SpaceWire working group to reduce the cable mass and bend radius by elimination of shields. However, reducing the signal count by half would provide even greater gains. It is proposed to restrict the data rate for the optional Manchester coding to a fixed data rate of 10 Megabits per second (Mbps) in order to make the necessary changes simple and still able to run in current radiation tolerant Field Programmable Gate Arrays (FPGAs). Even with this constraint, 10 Mbps will meet many applications where SpaceWire is used. These include command and control applications and many instruments applications with have moderate data rate. For most NASA flight implementations, SpaceWire designs are in rad-tolerant FPGAs, and the desire to preserve the heritage design investment is important for cost and risk considerations. The Manchester coding option can be accommodated in existing designs with only changes to the FPGA.

Shapes of a Renewable Society.

ERIC Educational Resources Information Center

Deudney, Daniel; Flavin, Christopher

1983-01-01

To rely on coal and nuclear power as sources of energy is to narrow society's future options and to present numerous problems. Renewable solar energy, on the other hand, can preserve rather than reduce options. More jobs, rising self-reliance, and new equalities between nations will be the result. (RM)

Random Start Ovarian Stimulation for Oocyte or Embryo Cryopreservation in Women Desiring Fertility Preservation Prior to Gonadotoxic Cancer Therapy.

PubMed

Danis, Rachel B; Pereira, Nigel; Elias, Rony T

2017-11-10

Women of reproductive age diagnosed with cancer are often interested in preserving gametes or reproductive tissue that would allow for future genetic parenthood. Preservation of fertility is often accomplished in young cancer patients via ovarian stimulation followed by oocyte or embryo cryopreservation. Conventional stimulation protocols, however, require 2-4 weeks to complete ovarian stimulation, oocyte retrieval and possible fertilization. Such a strategy may not be feasible in patients requiring urgent cancer treatment. Recent studies have highlighted that random start ovarian stimulation can be initiated irrespective of the phase of the menstrual cycle and is an attractive alternative to conventional ovarian stimulation. The primary aim of the current review is to discuss the feasibility and success of random start ovarian stimulation for oocyte or embryo cryopreservation in women desiring fertility preservation prior to gonadotoxic cancer therapy. We performed a systematic review of medical literature published between January 2000 to June 2017 reporting the utility of random start ovarian stimulation for fertility preservation. Search terms included "fertility preservation," "cancer," "ovarian stimulation," "random-start ovarian stimulation," "embryo cryopreservation, and" "oocyte cryopreservation." Publications were included in this review only if patients underwent random start ovarian stimulation prior to cancer therapy. Nineteen publications were identified and perused by the authors. Most publications described the utility of random start ovarian stimulation in the setting of breast cancer. Radom-start stimulation was associated with a reduced time interval between ovarian stimulation initiation and oocyte or embryo cryopreservation. The yield of mature oocytes and their developmental potential into embryos was comparable between conventional and random-start protocols, albeit with higher gonadotropin doses in the latter. The current review suggests that random start ovarian stimulation can shorten the interval between ovarian stimulation and oocyte retrieval, with the yield of oocytes and embryos being comparable to conventional stimulation protocols. Thus, random start ovarian stimulation may serve as a better option for fertility preservation in patients requiring urgent cancer treatment. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Antiretroviral treatment sequencing strategies to overcome HIV type 1 drug resistance in adolescents and adults in low-middle-income countries.

PubMed

De Luca, Andrea; Hamers, Raphael L; Schapiro, Jonathan M

2013-06-15

Antiretroviral treatment (ART) is expanding to human immunodeficiency virus type 1 (HIV-1)-infected persons in low-middle income countries, thanks to a public health approach. With 3 available drug classes, 2 ART sequencing lines are programmatically foreseen. The emergence and transmission of viral drug resistance represents a challenge to the efficacy of ART. Knowledge of HIV-1 drug resistance selection associated with specific drugs and regimens and the consequent activity of residual drug options are essential in programming ART sequencing options aimed at preserving ART efficacy for as long as possible. This article determines optimal ART sequencing options for overcoming HIV-1 drug resistance in resource-limited settings, using currently available drugs and treatment monitoring opportunities. From the perspective of drug resistance and on the basis of limited virologic monitoring data, optimal sequencing seems to involve use of a tenofovir-containing nonnucleoside reverse-transcriptase inhibitor-based first-line regimen, followed by a zidovudine-containing, protease inhibitor (PI)-based second-line regimen. Other options and their consequences are explored by considering within-class and between-class sequencing opportunities, including boosted PI monotherapies and future options with integrase inhibitors. Nucleoside reverse-transcriptase inhibitor resistance pathways in HIV-1 subtype C suggest an additional reason for accelerating stavudine phase out. Viral load monitoring avoids the accumulation of resistance mutations that significantly reduce the activity of next-line options. Rational use of resources, including broader access to viral load monitoring, will help ensure 3 lines of fully active treatment options, thereby increasing the duration of ART success.

Fertility preservation and cancer: How many persons are concerned?

PubMed

Le Bihan-Benjamin, Christine; Hoog-Labouret, Natalie; Lefeuvre, Delphine; Carré-Pigeon, Frédérique; Bousquet, Philippe Jean

2018-06-01

A significant proportion of cancer survivors experience chronic health sequelae, one of them being fertility impairment. However, even if many reports, guidelines and positions papers focus on fertility preservation and its needs, access to fertility preservation is not currently offered to all the patients concerned, and the targeted population is not well counted. A cross sectional study was conducted using the French cancer cohort, a cohort covering the whole French population and including around 7 million of cancer patients. Women under the age of 40 and men under the age of 60 included in the cancer cohort in 2013 who had, in the first year, cancer surgery, chemotherapy or radiotherapy were considered. Patients treated by surgery alone for cancers in locations distant from the reproductive organs, or being treated for a cancer the past 3 years were excluded. The number of patients concerned by fertility preservation was estimated at a national and regional level, and by cancer types. 40,000 patients - 30,000 men under the age of 60 years and 10,000 women under the age of 40 years - were identified. A second estimation concerning women under the age of 35 and men under 50 reduced the number of patients to 17,200-10,400 men and 6800 women. The most frequent locations were malignant neoplasm of lymphoid and hematopoietic tissue, lung cancer, cervix uteri, prostate and colorectal cancer. In 2014, around 5 400 persons had a preservation. Around 17,200 cancer patients of reproductive age should be informed about the fertility preservation options available. Medical professionals have to better integrate in their daily practice fertility preservation. Copyright © 2018 Elsevier B.V. All rights reserved.

Preservation of the nipple-areola complex in skin-sparing mastectomy for early breast cancer.

PubMed

Miyake, Ryo; Kinoshita, Satoki; Shimada, Naoko; Uchida, Ken; Takeyama, Hiroshi; Morikawa, Toshiaki

2018-06-01

Skin-sparing mastectomy (SSM) enables a radical cure of breast cancer while overcoming the cosmetic issues related to surgery. We review our experience of performing SSMs and assess whether preservation of the nipple-areola complex (NAC) could have been an option for some patients who underwent SSM. The subjects of this retrospective study were women who underwent SSM that utilized four incision types; namely, the so-called tennis racket incision, a periareolar and midaxillary incision, an areola-sparing and midaxillary incision, and a small transverse elliptical incision. We assessed whether preservation of the NAC would have been an option in SSM, based on histologic examination of three serial cut surfaces of the specimen around the nipple, ruling out the option when evidence of the malignant lesion/s was found in at least one of the following locations: in the nipple, within a 1-cm radius from the base of the nipple, or within 1 cm from the surface of the NAC. We performed 193 SSMs. The cumulative 10-year local disease-free survival rate was 98%, with 89% of patients reporting levels of satisfaction with the reconstructed breast, of excellent, very good, or good. We evaluated that 70 of the 193 procedures could have been performed as nipple-sparing mastectomy (NSM). The outcomes of SSM in this series were excellent and NSM might have been an option for about one-third of the patients.

Rematching AGS Booster synchrotron injection lattice for smaller transverse beam emittances

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

Liu, C.; Beebe-Wang, J.; Brown, K.

2017-01-25

The polarized proton beam is injected into the booster via the charge-exchange (H- to H+) scheme. The emittance growth due to scattering at the stripping foil is proportional to the beta functions at the foil. It was demonstrated that the current scheme of reducing the beta functions at the stripping foil preserves the emittance better; however the betatron tunes are above but very close to half integer. Due to concern of space charge and half integer in general, options of lattice designs aimed towards reducing the beta functions at the stripping foil with tunes at more favorable places are explored.

Current Status and Future Prospects for Esophageal Cancer Treatment

PubMed Central

Kuwano, Hiroyuki

2016-01-01

The local control effect of esophagectomy with three-field lymph node dissection (3FLD) is reaching its limit pending technical advancement. Minimally invasive esophagectomy (MIE) by thoracotomy is slowly gaining acceptance due to advantages in short-term outcomes. Although the evidence is slowly increasing, MIE is still controversial. Also, the results of treatment by surgery alone are limiting, and multimodality therapy, which includes surgical and non-surgical treatment options including chemotherapy, radiotherapy, and endoscopic treatment, has become the mainstream therapy. Esophagectomy after neoadjuvant chemotherapy (NAC) is the standard treatment for clinical stages II/III (except for T4) esophageal cancer, whereas chemoradiotherapy (CRT) is regarded as the standard treatment for patients who wish to preserve their esophagus, those who refuse surgery, and those with inoperable disease. CRT is also usually selected for clinical stage IV esophageal cancer. On the other hand, with the spread of CRT, salvage esophagectomy has traditionally been recognized as a feasible option; however, many clinicians oppose the use of surgery due to the associated unfavorable morbidity and mortality profile. In the future, the improvement of each treatment result and the establishment of individual strategies are important although esophageal cancer has many treatment options. PMID:28003586

Temporary ovarian suppression during chemotherapy to preserve ovarian function and fertility in breast cancer patients: A GRADE approach for evidence evaluation and recommendations by the Italian Association of Medical Oncology.

PubMed

Lambertini, Matteo; Cinquini, Michela; Moschetti, Ivan; Peccatori, Fedro A; Anserini, Paola; Valenzano Menada, Mario; Tomirotti, Maurizio; Del Mastro, Lucia

2017-01-01

The development of premature ovarian failure and subsequent infertility are possible consequences of chemotherapy use in pre-menopausal women with early-stage breast cancer. Among the available strategies for fertility preservation, pharmacological protection of the ovaries using luteinising hormone-releasing hormone analogues (LHRHa) during chemotherapy has the potential to restore ovarian function and fertility after anticancer treatments; however, the possible efficacy and clinical application of this strategy has been highly debated in the last years. Following the availability of new data on this controversial topic, the Panel of the Italian Association of Medical Oncology (AIOM) Clinical Practice Guideline on fertility preservation in cancer patients decided to apply the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) methodology around the relevant and current question on the clinical utility of temporary ovarian suppression with LHRHa during chemotherapy as a strategy to preserve ovarian function and fertility in breast cancer patients. To answer this question, preservation of ovarian function and fertility were judged as critical outcomes for the decision-making. Three possible outcomes of harm were identified: LHRHa-associated toxicities, potential antagonism between concurrent LHRHa and chemotherapy, and lack of the prognostic impact of chemotherapy-induced premature ovarian failure. According to the GRADE evaluation conducted, the result was a strong positive recommendation in favour of using this option to preserve ovarian function and fertility in breast cancer patients. The present manuscript aims to update and summarise the evidence for the use of this strategy in light of the new data published up to January 2016, according to the GRADE process. Copyright © 2016 Elsevier Ltd. All rights reserved.

Fertility preservation knowledge, counseling, and actions among adolescent and young adult patients with cancer: A population-based study.

PubMed

Shnorhavorian, Margarett; Harlan, Linda C; Smith, Ashley Wilder; Keegan, Theresa H M; Lynch, Charles F; Prasad, Pinki K; Cress, Rosemary D; Wu, Xiao-Cheng; Hamilton, Ann S; Parsons, Helen M; Keel, Gretchen; Charlesworth, Sarah E; Schwartz, Stephen M

2015-10-01

The fertility of adolescent and young adult (AYA) patients with cancer can be threatened by treatments, but to the authors' knowledge little is known regarding the extent to which providers discuss this with patients or recommend fertility preservation, or the patient and physician characteristics associated with these interactions. Questionnaires from 459 AYA patients with cancer who were diagnosed between 2007 and 2008 and recruited through 7 US population-based cancer registries were analyzed using sex-specific multivariable models. The authors assessed characteristics associated with not discussing therapy effects on fertility or fertility preservation options, and not making fertility preservation arrangements. Males without a medical oncologist were more likely not to be told that therapy might affect fertility than those with a medical oncologist (male odds ratio [OR], 2.28; 95% confidence interval [95% CI], 1.03-5.00). Individuals without insurance (male OR, 2.91 [95% CI, 1.41-5.91] and female OR, 5.46 [95% CI, 1.59-18.72]); those raising children aged <18 years; and, among males only, those who received treatment posing no or a low fertility risk (OR, 3.39; 95% CI, 1.60-7.16) were more likely not to discuss fertility preservation with providers. Finally, among males, those without a college degree (OR, 1.98; 95% CI, 1.00-3.97), lacking private insurance (OR, 2.97; 95% CI, 1.16-7.63), and raising children aged <18 years (OR, 3.53; 95% CI, 1.63-7.65) were more likely to not make fertility preservation arrangements; too few females had made fertility preservation arrangements for similar analyses to be performed. Discussion and action surrounding fertility preservation for AYA patients with cancer are associated with medical factors, patient socioeconomic data, and child-rearing status. These results highlight the need for insurance coverage for fertility preservation and increased awareness of fertility preservation options. © 2015 American Cancer Society.

Autosomal dominant polycystic kidney disease and pain - a review of the disease from aetiology, evaluation, past surgical treatment options to current practice.

PubMed

Badani, K K; Hemal, A K; Menon, M

2004-01-01

Autosomal Dominant Polycystic Kidney Disease (ADPKD), often referred to as "adult" polycystic kidney disease, is one of the commonest hereditary disorders. It affects approximately 4 to 6 million individuals worldwide. The disease progresses to end-stage renal disease and it accounts for 10-15% of patients requiring dialysis in the United States. A comprehensive Medline search for aetiology, evaluation, screening, cellular biology, and treatment was utilized to locate, extract, and synthesize relevant data with respect to this topic. Special attention was focused on urologic literature and surgical textbooks regarding operative treatment of pain associated with ADPKD. Now, patients with ADPKD have more treatment options. More specifically, several therapeutic alternatives are now available for the management of pain in these patients. A recent review of literature supports the performance of open or laparoscopic cyst decortication procedures for control of pain and infection without the worry of causing further renal impairment in those with preserved renal function.

Reconstruction Options for Pancreaticoduodenectomy in Patients with Prior Roux-en-Y Gastric Bypass.

PubMed

Shah, Mihir M; Martin, Benjamin M; Stetler, Jamil L; Patel, Ankit D; Davis, S Scott; Sarmiento, Juan M; Lin, Edward

2017-11-01

Patients with prior Roux-en-Y gastric bypass (RYGB) operations for weight loss present reconstruction challenges during a pancreaticoduodenectomy (PD). With over 60,000 RYGB performed annually, the increasing odds of encountering such patients during a PD make it imperative to understand the RYGB anatomy and anticipate reconstruction options. This article describes the possible reconstruction options and their rationale. We reviewed our PD reconstruction options, compared them to what have been described in the literature, and derived a consensus from internal conferences comprising bariatric and hepatopancreatobiliary surgeons to describe known reconstruction options. In general, reconstruction options can include one of three options: (1) remnant gastrectomy, (2) preservation of gastric remnant, or (3) reversal of gastric bypass. This article describes individualized reconstruction options for RYGB patients undergoing PD. The reconstruction options can be tailored to the needs of the patient.

Regulation of Cell and Gene Therapy Medicinal Products in Taiwan.

PubMed

Lin, Yi-Chu; Wang, Po-Yu; Tsai, Shih-Chih; Lin, Chien-Liang; Tai, Hsuen-Yung; Lo, Chi-Fang; Wu, Shiow-Ing; Chiang, Yu-Mei; Liu, Li-Ling

2015-01-01

Owing to the rapid and mature development of emerging biotechnology in the fields of cell culture, cell preservation, and recombinant DNA technology, more and more cell or gene medicinal therapy products have been approved for marketing, to treat serious diseases which have been challenging to treat with current medical practice or medicine. This chapter will briefly introduce the Taiwan Food and Drug Administration (TFDA) and elaborate regulation of cell and gene therapy medicinal products in Taiwan, including regulatory history evolution, current regulatory framework, application and review procedures, and relevant jurisdictional issues. Under the promise of quality, safety, and efficacy of medicinal products, it is expected the regulation and environment will be more flexible, streamlining the process of the marketing approval of new emerging cell or gene therapy medicinal products and providing diverse treatment options for physicians and patients.

Oocyte Cryopreservation for Fertility Preservation in Healthy Women.

PubMed

Stevenson, Eleanor L; Hurt, Melissa J; Trotter, Kathryn J

Advancements in methods of fertility preservation have resulted in more options available to women seeking to postpone reproduction. Preservation of unfertilized oocytes provides women with the possibility for reproduction even after age-related declines in fertility might make conceiving a child difficult to impossible. As oocyte cryopreservation rises in popularity among women, it is crucial for nurses and other clinicians to understand the background, process, ethical issues, and risks involved to help women make informed medical decisions. © 2017 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.

Uncemented three-dimensional-printed prosthetic reconstruction for massive bone defects of the proximal tibia.

PubMed

Lu, Minxun; Li, Yongjiang; Luo, Yi; Zhang, Wenli; Zhou, Yong; Tu, Chongqi

2018-03-06

Currently, it is challenging to treat massive bone defects of proximal tibia. Although numerous methods are available for reconstruction with epiphysis preservation, limitations in knee function and complications are noted with these methods. Our paper describes our attempt to reconstruct a marked defect in the proximal tibia with an uncemented three-dimensional (3D)-printed prosthesis and to evaluate the prosthesis design and short-term outcomes. A 15-year-old boy with metaphyseal osteosarcoma of the tibia underwent intercalary allograft reconstruction following wide tumour resection with epiphysis preservation. However, chronic allograft rejection and/or infection occurred after the surgery and a sinus tract was formed. The rejection and/or infection process was successfully stopped by the removal of the graft and implantation of an antibiotic-loaded cement spacer; however, the limb function was poor. Because of the irregular shape of the defect and the excessively short length of the residual proximal tibia, we used the 3D printing technology to design and fabricate a personalised prosthesis to reconstruct the defect, with the preservation of the knee joint. At the last follow-up at 26 months, the patient had satisfactory limb function. The 3D-printed prosthesis may be a feasible option in the reconstruction of tibial metaphyseal defects with the preservation of the knee joint. Moreover, it can result in good postoperative function and low complication rates. However, a long-term follow-up is required to clarify its long-term outcomes.

[Anti-doping control and public health: limits to the exposure of human health to risk in the name of sporting glory].

PubMed

Aith, Fernando Mussa Abujamra

2013-10-01

Given the current regulatory environment surrounding doping in the world, and in view of the recurring scandals linking leading athletes in a variety of sports with doping, this paper aims to provide some thoughts on the relationship between doping and public health, taking as base reference the risks doping poses to health and considering the regulatory options that have been adopted by the international community and the sports federations to control and supervise this unsporting and risky practice. The text seeks to reflect on the necessary balance between sport and health, as well as on the role of the state in preserving this balance.

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

Gonsalves, M., E-mail: michael.gonsalves@stgeorges.nhs.uk; Belli, A., E-mail: Anna.Belli@stgeorges.nhs.u

Obstetric hemorrhage remains a major cause of maternal morbidity and mortality worldwide. Traditionally, in cases of obstetric hemorrhage refractory to conservative treatment, obstetricians have resorted to major surgery with the associated risks of general anesthesia, laparotomy, and, in the case of hysterectomy, loss of fertility. Over the past two decades, the role of pelvic arterial embolization has evolved from a novel treatment option to playing a key role in the management of obstetric hemorrhage. To date, interventional radiology offers a minimally invasive, fertility-preserving alternative to conventional surgical treatment. We review current literature regarding the role of interventional radiology in postpartummore » hemorrhage, abnormal placentation, abortion, and cervical ectopic pregnancy. We discuss techniques, success rates, and complications.« less

Esthetic Rehabilitation of Anterior Teeth with Laminates Composite Veneers

PubMed Central

Riva, Giancarlo

2014-01-01

No- or minimal-preparation veneers associated with enamel preservation offer predictable results in esthetic dentistry; indirect additive anterior composite restorations represent a quick, minimally invasive, inexpensive, and repairable option for a smile enhancement treatment plan. Current laboratory techniques associated with a strict clinical protocol satisfy patients' restorative and esthetic needs. The case report presented describes minimal invasive treatment of four upper incisors with laminate nanohybrid resin composite veneers. A step-by-step protocol is proposed for diagnostic evaluation, mock-up fabrication and trial, teeth preparation and impression, and adhesive cementation. The resolution of initial esthetic issues, patient satisfaction, and nice integration of indirect restorations confirmed the success of this anterior dentition rehabilitation. PMID:25013730

Female Fertility Issues

Cancer.gov

Fertility issues are common in women getting cancer treatment. Fertility preservation options include egg freezing, embryo freezing, ovarian tissue freezing, ovarian shielding and ovarian transposition. Resources, support, and clinical trials are listed.

Male Fertility Issues

Cancer.gov

Fertility issues are common in boys and men getting cancer treatment. Fertility preservation options include sperm banking, testicular shielding, testicular sperm extraction (TESE), and testicular tissue freezing. Support and clinical trials are listed.

Recent advances in the field of ovarian tissue cryopreservation and opportunities for research.

PubMed

Ladanyi, Camille; Mor, Amir; Christianson, Mindy S; Dhillon, Namisha; Segars, James H

2017-06-01

The purpose of this study was to summarize the latest advances and successes in the field of ovarian tissue cryopreservation while identifying gaps in current knowledge that suggest opportunities for future research. A systematic review was performed according to PRISMA guidelines for all relevant full-text articles in PubMed published in English that reviewed or studied historical or current advancements in ovarian tissue cryopreservation and auto-transplantation techniques. Ovarian tissue auto-transplantation in post-pubertal women is capable of restoring fertility with over 80 live births currently reported with a corresponding pregnancy rate of 23 to 37%. The recently reported successes of live births from transplants, both in orthotopic and heterotopic locations, as well as the emerging methods of in vitro maturation (IVM), in vitro culture of primordial follicles, and possibility of in vitro activation (IVA) suggest new fertility options for many women and girls. Vitrification, as an ovarian tissue cryopreservation technique, has also demonstrated successful live births and may be a more cost-effective method to freezing with less tissue injury. Further, transplantation via the artificial ovary with an extracellular tissue matrix (ECTM) scaffolding as well as the effects of sphingosine-1-phosphate (SIP) and fibrin modified with heparin-binding peptide (HBP), heparin, and a vascular endothelial growth factor (VEGF) have demonstrated important advancements in fertility preservation. As a fertility preservation method, ovarian tissue cryopreservation and auto-transplantation are currently considered experimental, but future research may pave the way for these modalities to become a standard of care for women facing the prospect of sterility from ovarian damage.

Vaginal approach to vesicovaginal fistula and vaginal vault prolapse preserving sexual function by Latzko repair and sacrospinous suspension

PubMed Central

Crosby, Erin C.; Berger, Mitchell B.; DeLancey, John O. L.

2014-01-01

The combination of vesicovaginal fistula and complete vaginal vault prolapse is rare. The only published treatment recommendations concern partial colpocleisis; an option that precludes intercourse. In this case report, we describe successful repair of this problem with a Latzko fistula repair and concomitant Michigan four-wall sacrospinous ligament suspension: curing the fistula, correcting the prolapse and preserving sexual function. PMID:22983277

Fluconazole resistance in Candida species: a current perspective

PubMed Central

Berkow, Elizabeth L; Lockhart, Shawn R

2017-01-01

Candida albicans and the emerging non-albicans Candida spp. have significant clinical relevance among many patient populations. Current treatment guidelines include fluconazole as a primary therapeutic option for the treatment of these infections, but it is only fungistatic against Candida spp. and both inherent and acquired resistance to fluconazole have been reported. Such mechanisms of resistance include increased drug efflux, alteration or increase in the drug target, and development of compensatory pathways for producing the target sterol, ergosterol. While many mechanisms of resistance observed in C. albicans are also found in the non-albicans species, there are also important and unexpected differences between species. Furthermore, mechanisms of fluconazole resistance in emerging Candida spp., including the global health threat Candida auris, are largely unknown. In order to preserve the utility of one of our fundamental antifungal drugs, fluconazole, it is essential that we fully appreciate the manner by which Candida spp. manifest resistance to it. PMID:28814889

Combined pulmonary fibrosis and emphysema: an increasingly recognized condition* **

PubMed Central

Dias, Olívia Meira; Baldi, Bruno Guedes; Costa, André Nathan; Carvalho, Carlos Roberto Ribeiro

2014-01-01

Combined pulmonary fibrosis and emphysema (CPFE) has been increasingly recognized in the literature. Patients with CPFE are usually heavy smokers or former smokers with concomitant lower lobe fibrosis and upper lobe emphysema on chest HRCT scans. They commonly present with severe breathlessness and low DLCO, despite spirometry showing relatively preserved lung volumes. Moderate to severe pulmonary arterial hypertension is common in such patients, who are also at an increased risk of developing lung cancer. Unfortunately, there is currently no effective treatment for CPFE. In this review, we discuss the current knowledge of the pathogenesis, clinical characteristics, and prognostic factors of CPFE. Given that most of the published data on CPFE are based on retrospective analysis, more studies are needed in order to address the role of emphysema and its subtypes; the progression of fibrosis/emphysema and its correlation with inflammation; treatment options; and prognosis. PMID:25029654

Clinical applications of decellularized extracellular matrices for tissue engineering and regenerative medicine.

PubMed

Parmaksiz, Mahmut; Dogan, Arin; Odabas, Sedat; Elçin, A Eser; Elçin, Y Murat

2016-03-17

Decellularization is the process of removing the cellular components from tissues or organs. It is a promising technology for obtaining a biomaterial with a highly preserved extracellular matrix (ECM), which may also act as a biological scaffold for tissue engineering and regenerative therapies. Decellularized products are gaining clinical importance and market space due to their ease of standardized production, constant availability for grafting and mechanical or biochemical superiority against competing clinical options, yielding clinical results ahead of the ones with autografts in some applications. Current drawbacks and limitations of traditional treatments and clinical applications can be overcome by using decellularized or acellular matrices. Several companies are leading the market with versatile acellular products designed for diverse use in the reconstruction of tissues and organs. This review describes ECM-based decellularized and acellular products that are currently in use for different branches of clinic.

Endpoints and cutpoints in head and neck oncology trials: methodical background, challenges, current practice and perspectives.

PubMed

Hezel, Marcus; von Usslar, Kathrin; Kurzweg, Thiemo; Lörincz, Balazs B; Knecht, Rainald

2016-04-01

This article reviews the methodical and statistical basics of designing a trial, with a special focus on the process of defining and choosing endpoints and cutpoints as the foundations of clinical research, and ultimately that of evidence-based medicine. There has been a significant progress in the treatment of head and neck cancer in the past few decades. Currently available treatment options can have a variety of different goals, depending e.g. on tumor stage, among other factors. The outcome of a specific treatment in clinical trials is measured using endpoints. Besides classical endpoints, such as overall survival or organ preservation, other endpoints like quality of life are becoming increasingly important in designing and conducting a trial. The present work is based on electronic research and focuses on the solid methodical and statistical basics of a clinical trial, on the structure of study designs and on the presentation of various endpoints.

Magnetic Resonance-Guided High-Intensity Focused Ultrasound (MRgHIFU) for Treatment of Symptomatic Uterine Fibroids: An Economic Analysis

PubMed Central

Babashov, V; Palimaka, S; Blackhouse, G; O'Reilly, D

2015-01-01

Background Uterine fibroids, or leiomyomas, are the most common benign tumours in women of childbearing age. Some women experience symptoms (e.g., heavy bleeding) that require aggressive forms of treatment such as uterine artery embolization (UAE), myomectomy, magnetic resonance-guided high-intensity focused ultrasound (MRgHIFU), and even hysterectomy. It is important to note that hysterectomy is not appropriate for women who desire future childbearing. Objectives The objective of this analysis was to evaluate the cost-effectiveness and budgetary impact of implementing MRgHIFU as a treatment option for symptomatic uterine fibroids in premenopausal women for whom drugs have been ineffective. Review Methods We performed an original cost-effectiveness analysis to assess the long-term costs and effects of MRgHIFU compared with hysterectomy, myomectomy, and UAE as a strategy for treating symptomatic uterine fibroids in premenopausal women aged 40 to 51 years. We explored a number of scenarios, e.g., comparing MRgHIFU with uterine-preserving procedures only, considering MRgHIFU-eligible patients only, and eliminating UAE as a treatment option. In addition, we performed a one-year budget impact analysis, using data from Ontario administrative sources. Four scenarios were explored in the budgetary impact analysis: MRgHIFU funded at 2 centres MRgHIFU funded at 2 centres and replacing only uterine-preserving procedures MRgHIFU funded at 6 centres MRgHIFU funded at 6 centres and replacing only uterine-preserving procedures Analyses were conducted from the Ontario public payer perspective. Results The base case determined that the uterine artery embolization (UAE) treatment strategy was the cost-effective option at commonly accepted willingness-to-pay values. Compared with hysterectomy, UAE was calculated as having an incremental cost-effectiveness ratio (ICER) of $46,480 per quality-adjusted life-year (QALY) gained. The MRgHIFU strategy was extendedly dominated by a combination of UAE and hysterectomy, and myomectomy was strictly dominated by MRgHIFU and UAE. In the scenario where only MRgHIFU-eligible patients were considered, MRgHIFU was the cost-effective option for a willingness-to-pay threshold of $50,000. In the scenario where only MRgHIFU-eligible patients were considered and where UAE was eliminated as a treatment option (due to its low historic utilization in Ontario), MRgHIFU was cost-effective with an incremental cost of $39,250 per additional QALY. The budgetary impact of funding MRgHIFU for treatment of symptomatic uterine fibroids was estimated at $1.38 million in savings when funded to replace all types of procedures at 2 centres, and $1.14 million when funded to replace only uterine-preserving procedures at 2 centres. The potential savings increase to $4.15 million when MRgHIFU is funded at 6 centres to treat all women eligible for the procedure. Potential savings at 6 centres decrease slightly, to $3.42 million, when MRgHIFU is funded to replace uterine-preserving procedures only. Conclusions Our findings suggest that MRgHIFU may be a cost-effective strategy at commonly accepted willingness-to-pay thresholds, after examining the uncertainty in model parameters and several likely scenarios. In terms of budget impact, the implementation of MRgHIFU could potentially result in one-year savings of $1.38 million and $4.15 million in the scenarios where MRgHIFU is implemented in 2 or 6 centres, respectively. From a patient perspective, it is important to consider that MRgHIFU is the least invasive of all fibroid treatment options for women who have not responded to pharmaceuticals; it is the only one that is completely noninvasive. Also important, from a societal point of view, is the potential benefit from faster recovery times. Despite these benefits, implementation of MRgHIFU beyond the 2 centres which currently offer the treatment faces logistical challenges (for example, competing demands for use of existing equipment), as well as financial challenges, with hospitals needing to fundraise to purchase new equipment. PMID:26357531

Nanosystems in Edible Coatings: A Novel Strategy for Food Preservation

PubMed Central

Zambrano-Zaragoza, María L.; González-Reza, Ricardo; Miranda-Linares, Verónica; Bernal-Couoh, Tania F.; Mendoza-Elvira, Susana; Quintanar-Guerrero, David

2018-01-01

Currently, nanotechnology represents an important tool and an efficient option for extending the shelf life of foods. Reducing particle size to nanometric scale gives materials distinct and improved properties compared to larger systems. For food applications, this technology allows the incorporation of hydrophilic and lipophilic substances with antimicrobial and antioxidant properties that can be released during storage periods to increase the shelf life of diverse products, including whole and fresh-cut fruits and vegetables, nuts, seeds, and cheese, among others. Edible coatings are usually prepared with natural polymers that are non-toxic, economical, and readily available. Nanosystems, in contrast, may also be prepared with biodegradable synthetic polymers, and liquid and solid lipids at room temperature. In this review, recent developments in the use of such nanosystems as nanoparticles, nanotubes, nanocomposites, and nanoemulsions, are discussed critically. The use of polymers as the support matrix for nanodispersions to form edible coatings for food preservation is also analyzed, but the central purpose of the article is to describe available information on nanosystems and their use in different food substrates to help formulators in their work. PMID:29494548

Inactivation of Cytomegalovirus in Breast Milk Using Ultraviolet-C Irradiation: Opportunities for a New Treatment Option in Breast Milk Banking

PubMed Central

Hod, Nurul; Jayaraman, Jothsna; Marchant, Elizabeth A.; Christen, Lukas; Chiang, Peter; Hartmann, Peter; Simmer, Karen

2016-01-01

Pasteurized donor human milk is provided by milk banks to very preterm babies where their maternal supply is insufficient or unavailable. Donor milk is currently processed by Holder pasteurization, producing a microbiologically safe product but significantly reducing immunoprotective components. Ultraviolet-C (UV-C) irradiation at 254 nm is being investigated as an alternative treatment method and has been shown to preserve components such as lactoferrin, lysozyme and secretory IgA considerably better than Holder pasteurization. We describe the inactivation of cytomegalovirus, a virus commonly excreted into breast milk, using UV-C irradiation. Full replication was ablated by various treatment doses. However, evidence of viral immediate early proteins within the cells was never completely eliminated indicating that some viral gene transcription was still occurring. In conclusion, UV-C may be a safe alternative to pasteurisation for the treatment of human donor milk that preserves the bioactivity. However, our data suggests that CMV inactivation will have to be carefully evaluated for each device designed to treat breast milk using UV-C irradiation. PMID:27537346

Nanosystems in Edible Coatings: A Novel Strategy for Food Preservation.

PubMed

Zambrano-Zaragoza, María L; González-Reza, Ricardo; Mendoza-Muñoz, Néstor; Miranda-Linares, Verónica; Bernal-Couoh, Tania F; Mendoza-Elvira, Susana; Quintanar-Guerrero, David

2018-03-01

Currently, nanotechnology represents an important tool and an efficient option for extending the shelf life of foods. Reducing particle size to nanometric scale gives materials distinct and improved properties compared to larger systems. For food applications, this technology allows the incorporation of hydrophilic and lipophilic substances with antimicrobial and antioxidant properties that can be released during storage periods to increase the shelf life of diverse products, including whole and fresh-cut fruits and vegetables, nuts, seeds, and cheese, among others. Edible coatings are usually prepared with natural polymers that are non-toxic, economical, and readily available. Nanosystems, in contrast, may also be prepared with biodegradable synthetic polymers, and liquid and solid lipids at room temperature. In this review, recent developments in the use of such nanosystems as nanoparticles, nanotubes, nanocomposites, and nanoemulsions, are discussed critically. The use of polymers as the support matrix for nanodispersions to form edible coatings for food preservation is also analyzed, but the central purpose of the article is to describe available information on nanosystems and their use in different food substrates to help formulators in their work.

Inactivation of Cytomegalovirus in Breast Milk Using Ultraviolet-C Irradiation: Opportunities for a New Treatment Option in Breast Milk Banking.

PubMed

Lloyd, Megan L; Hod, Nurul; Jayaraman, Jothsna; Marchant, Elizabeth A; Christen, Lukas; Chiang, Peter; Hartmann, Peter; Shellam, Geoffrey R; Simmer, Karen

2016-01-01

Pasteurized donor human milk is provided by milk banks to very preterm babies where their maternal supply is insufficient or unavailable. Donor milk is currently processed by Holder pasteurization, producing a microbiologically safe product but significantly reducing immunoprotective components. Ultraviolet-C (UV-C) irradiation at 254 nm is being investigated as an alternative treatment method and has been shown to preserve components such as lactoferrin, lysozyme and secretory IgA considerably better than Holder pasteurization. We describe the inactivation of cytomegalovirus, a virus commonly excreted into breast milk, using UV-C irradiation. Full replication was ablated by various treatment doses. However, evidence of viral immediate early proteins within the cells was never completely eliminated indicating that some viral gene transcription was still occurring. In conclusion, UV-C may be a safe alternative to pasteurisation for the treatment of human donor milk that preserves the bioactivity. However, our data suggests that CMV inactivation will have to be carefully evaluated for each device designed to treat breast milk using UV-C irradiation.

Fertility counseling and preservation practices in youth with lupus and vasculitis undergoing gonadotoxic therapy.

PubMed

Nahata, Leena; Sivaraman, Vidya; Quinn, Gwendolyn P

2016-11-01

To assess fertility counseling and preservation practices among children, adolescents, and young adults with rheumatic diseases undergoing cyclophosphamide (CTX) treatment. Retrospective chart review (2006-2016). Academic pediatric center. Male and female patients with systemic lupus erythematosus, Wegener's granulomatosis/granulomatosis with polyangiitis, or other vaculitides, receiving CTX treatment. None. Documentation of fertility counseling and fertility preservation. A total of 58 subjects met the inclusion criteria; 5 were excluded due to incomplete records, thus N = 53. Of these 75% were female (N = 40). Median age was 14 years at diagnosis and 15 years at first CTX treatment. A total of 51% of subjects (69% of males and 45% of females) had no documentation about potential fertility loss before CTX treatment. Among females where fertility counseling was documented, the only fertility preservation option discussed was leuprolide acetate (LA), which was pursued in all of these cases. Of 13 males (77% postpubertal), 3 were offered sperm banking, of whom 2 declined and the other attempted after treatment began and was azoospermic. Of 53 patients, 1 was referred to a fertility specialist. Mean cumulative CTX dose was 9.2 g in males and 8 g in females. Based on these findings, increasing awareness about infertility risk, fertility preservation options, and referral to fertility specialists is needed among pediatric rheumatologists. Prospective studies are needed to assess fertility outcomes in this patient population (including effectiveness of LA with regard to pregnancy rates [PRs]), as well as barriers/facilitators to fertility counseling and fertility preservation. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Prostate Cancer Patient Characteristics Associated With a Strong Preference to Preserve Sexual Function and Receipt of Active Surveillance.

PubMed

Broughman, James R; Basak, Ramsankar; Nielsen, Matthew E; Reeve, Bryce B; Usinger, Deborah S; Spearman, Kiayni C; Godley, Paul A; Chen, Ronald C

2018-04-01

Men with early-stage prostate cancer have multiple options that have similar oncologic efficacy but vary in terms of their impact on quality of life. In low-risk cancer, active surveillance is the option that best preserves patients' sexual function, but it is unknown if patient preference affects treatment selection. Our objectives were to identify patient characteristics associated with a strong preference to preserve sexual function and to determine whether patient preference and baseline sexual function level are associated with receipt of active surveillance in low-risk cancer. In this population-based cohort of men with localized prostate cancer, baseline patient-reported sexual function was assessed using a validated instrument. Patients were also asked whether preservation of sexual function was very, somewhat, or not important. Prostate cancer disease characteristics and treatments received were abstracted from medical records. A modified Poisson regression model with robust standard errors was used to compute adjusted risk ratio (aRR) estimates. All statistical tests were two-sided. Among 1194 men, 52.6% indicated a strong preference for preserving sexual function. Older men were less likely to have a strong preference (aRR = 0.98 per year, 95% confidence interval [CI] = 0.97 to 0.99), while men with normal sexual function were more likely (vs poor function, aRR = 1.59, 95% CI = 1.39 to 1.82). Among 568 men with low-risk cancer, there was no clear association between baseline sexual function or strong preference to preserve function with receipt of active surveillance. However, strong preference may differnetially impact those with intermediate baseline function vs poor function (Pinteraction = .02). Treatment choice may not always align with patients' preferences. These findings demonstrate opportunities to improve delivery of patient-centered care in early prostate cancer.

Radiotherapy for locally advanced resectable T3–T4 laryngeal cancer—does laryngeal preservation strategy compromise survival?

PubMed Central

Suzuki, Gen; Nakamura, Satoaki; Hirano, Shigeru; Yoshida, Ken; Konishi, Koji; Teshima, Teruki; Ogawa, Kazuhiko

2018-01-01

Abstract With the advancement of chemotherapy, a laryngeal preservation (LP) strategy was explored with the aim of improving maintenance of quality of life. Induction chemotherapy (ICT) following radiotherapy (RT) was considered a viable option because of its high initial response rate without hampering of overall survival (OS). Subsequently, concurrent chemoradiotherapy (CCRT) using CDDP became the standard of care for LP, showing the best LP ratio. For enhancing treatment intensity, ICT with taxan + CDDP + 5-FU (TPF-ICT) followed by RT showed superiority over ICT with CDDP + 5-FU (PF-ICT) followed by RT. Given that almost all randomized controlled trials investigating ICT include not only operable (endpoint, LP) but also inoperable (endpoint, OS) cases, physicians are faced with a dilemma regarding application in daily practice. In addition, increased treatment intensity causes augmentation of adverse events, which might reduce compliance. Thereafter, cetuximab, an effective drug with fewer adverse effects [bioradiotherapy (BRT)], emerged as another option. However, little evidence has confirmed its superiority over RT (or CCRT) in laryngeal cancer subpopulations. In spite of these developments, the OS of patients with laryngeal cancer has not improved for several decades. In fact, several studies indicated a decrease in OS during the 1990s, probably due to overuse of CCRT. Fortunately, the latter was not the case in most institutions. Currently, no other treatment has better OS than surgery. The eligibility criteria for LP and/or surgery largely depend upon the available expertise and experience, which differ from one institution to another. Therefore, a multidisciplinary team is required for the treatment of LP. PMID:29190391

Cement stabilization of unpaved roads.

DOT National Transportation Integrated Search

2017-05-01

In an effort to address the local citizens preference for preserving existing gravel roads, personnel of the Northern : Virginia District of the Virginia Department of Transportation (VDOT) have been exploring various options for improving the : e...

Contemporary management of patients with high-risk non-muscle-invasive bladder cancer who fail intravesical BCG therapy.

PubMed

Yates, D R; Rouprêt, M

2011-08-01

It is advocated that patients with high-risk non-muscle-invasive bladder cancer (NMIBC) receive an adjuvant course of intravesical Bacille Calmette-Guerin (BCG) as first-line treatment. However, a substantial proportion of patients will 'fail' BCG, either early with persistent (refractory) disease or recur late after a long disease-free interval (relapsing). Guideline recommendation in the 'refractory' setting is radical cystectomy, but there are situations when extirpative surgery is not feasible due to competing co-morbidity, a patient's desire for bladder preservation or reluctance to undergo surgery. In this review, we discuss the contemporary management of NMIBC in patients who have failed prior BCG and are not suitable for radical surgery and highlight the potential options available. These options can be categorised as immunotherapy, chemotherapy, device-assisted therapy and combination therapy. However, the current data are still inadequate to formulate definitive recommendations, and data from ongoing trials and maturing studies will give us an insight into whether there is a realistic efficacious second-line treatment for patients who fail intravesical BCG but are not candidates for definitive surgery.

Drug treatment of hypertensive crisis in children.

PubMed

Thomas, Christopher A

2011-10-01

Hypertensive crisis is a relatively rare event and is associated with significant morbidity and mortality in adults and pediatric patients alike. Rapid, safe, and effective treatment is imperative to alleviate immediate presenting clinical symptoms, prevent devastating morbidity, preserve long-term quality of life, and prevent mortality. Many medications in the hypertensive crisis arsenal have been used for nearly half a century. Nearly all treatment options have been utilized in children for decades, yet reliable data and sound clinical literature remain elusive. Every agent considered to be a first-line, second-line, or adjunctive option has yet to be evaluated in a randomized controlled trial in pediatric patients. With a paucity of clinical data to form evidence-based decisions, the clinician must rely entirely on the extrapolation from adult data and small retrospective studies, case series, and case reports of medication use in pediatric patients. Although more research in the treatment of pediatric hypertensive crisis is desperately needed, current practice demands a sharp knowledge of the pediatric clinical literature and pharmacology in this area as an essential tool to consistently improve patient outcomes with respect to morbidity and mortality.

Patient-Physician Communication and Knowledge Regarding Fertility Issues from German Oncologists' Perspective-a Quantitative Survey.

PubMed

Buske, Dorit; Sender, Annekathrin; Richter, Diana; Brähler, Elmar; Geue, Kristina

2016-03-01

Many people diagnosed with haematologic malignancies are of child-bearing age. Typical treatment courses pose a high risk of infertility, and a lot of people affected by this are in the midst of starting or growing their families. Thus, it is crucial that they are well informed about fertility preservation options and can discuss these with an oncologist early on in the development of their treatment plans. Unfortunately, however, this does not always happen. One hundred twenty oncologists from 37 German adult clinical facilities were surveyed regarding their discussions with young patients about fertility, family planning, and fertility preservation. Almost all of them said that they consider fertility preservation to be an important issue. They also reported several factors as having an influence on the likelihood and practicability of discussing these subjects. Most knew about the existence of cryoconservation of germ cells and the use of GnRH analogues (95 %), but only half of them claimed to have a thorough understanding of these options. Many said they would like to learn more about this and that informational brochures could be helpful. Even though many oncologists do have good working knowledge of the subject, patients of reproductive age are not yet consistently given comprehensive information about the options available to them. To improve oncologists' knowledge of reproductive medicine, cooperation with fertility specialists should be facilitated, and informational leaflets should be made available both to patients and their medical care providers.

Antifungal adjuvants: Preserving and extending the antifungal arsenal

PubMed Central

Butts, Arielle; Palmer, Glen E.; Rogers, P. David

2017-01-01

ABSTRACT As the rates of systemic fungal infections continue to rise and antifungal drug resistance becomes more prevalent, there is an urgent need for new therapeutic options. This issue is exacerbated by the limited number of systemic antifungal drug classes. However, the discovery, development, and approval of novel antifungals is an extensive process that often takes decades. For this reason, there is growing interest and research into the possibility of combining existing therapies with various adjuvants that either enhance activity or overcome existing mechanisms of resistance. Reports of antifungal adjuvants range from plant extracts to repurposed compounds, to synthetic peptides. This approach would potentially prolong the utility of currently approved antifungals and mitigate the ongoing development of resistance. PMID:27459018

Percutaneous Ultrasound-Guided TOPAZ Radiofrequency Coblation: A Novel Coaxial Technique for the Treatment of Recalcitrant Plantar Fasciitis-Our Experience.

PubMed

Shah, Amit; Best, Alistair J; Rennie, Winston J

2016-06-01

Various therapeutic options are available for treatment of recalcitrant plantar fasciitis. Studies using TOPAZ coblation (ArthroCare, Sunnyvale, CA) have had good early results. The current coblation technique involves a surgical incision or breach of the highly specialized plantar fat pad, which can be associated with risks. We describe a novel technique of ultrasound-guided percutaneous coblation with a lateral heel approach. Advantages include precise targeting of the plantar fascia by direct dynamic visualization of the coblation tip, a true percutaneous approach with a needle skin puncture (<5 mm), and preservation of the plantar fat pad by using a lateral heel approach. © 2016 by the American Institute of Ultrasound in Medicine.

Robotic spleen-preserving distal pancreatectomy. A case report.

PubMed

Vasilescu, C; Sgarbura, O; Tudor, S; Herlea, V; Popescu, I

2009-01-01

Distal pancreatectomy (DP) is the removal of the pancreatic tissue at the left side of the superior mesenteric vein and it is traditionally approached by an open or laparoscopic exposure. Preservation of the spleen is optional but appears to have a better immunological outcome. We present the case of a 53-year old patient with a 2.4/2.2 tumor located in the tail of the pancreas, with high tumour marker values for whom we decided to perform a robotic spleen-preserving distal pancreatectomy (RSPDP). The postoperative outcome was satisfactory. In conclusion, we recommend this type of approach for small pancreatic tail lesions.

Chemoselection: A Paradigm for Optimization of Organ Preservation in Locally Advanced Larynx Cancer

PubMed Central

Vainshtein, Jeffrey M.; Wu, Vivian F.; Spector, Matthew E.; Bradford, Carol R.; Wolf, Gregory T.; Worden, Francis P.

2014-01-01

Summary Definitive chemoradiation (CRT) and laryngectomy followed by postoperative radiotherapy (RT) are both considered standard of care options for the management of advanced laryngeal cancer. While organ preservation with chemoradiotherapy is often the preferred up-front approach for appropriately selected candidates, the functional benefits of organ preservation must be carefully balanced against the considerable morbidity of salvage laryngectomy in patients who fail primary chemoradiation. Up-front identification of patients who are likely to require surgical salvage, therefore, is an important aim of any organ preserving approach in order to minimize morbidity while maximizing organ preservation. To this end, a strategy of “chemoselection”, using the primary tumor's response after one cycle of induction chemotherapy as an in vivo method of selecting responders for definitive chemoradiation while reserving primary surgical management for non-responders, has been employed extensively at our institution. The rationale, treatment results, and future directions of this approach are discussed. PMID:24053204

An Interactive Procedure to Preserve the Desired Edges during the Image Processing of Noise Reduction

NASA Astrophysics Data System (ADS)

Hsu, Chih-Yu; Huang, Hsuan-Yu; Lee, Lin-Tsang

2010-12-01

The paper propose a new procedure including four stages in order to preserve the desired edges during the image processing of noise reduction. A denoised image can be obtained from a noisy image at the first stage of the procedure. At the second stage, an edge map can be obtained by the Canny edge detector to find the edges of the object contours. Manual modification of an edge map at the third stage is optional to capture all the desired edges of the object contours. At the final stage, a new method called Edge Preserved Inhomogeneous Diffusion Equation (EPIDE) is used to smooth the noisy images or the previously denoised image at the first stage for achieving the edge preservation. The Optical Character Recognition (OCR) results in the experiments show that the proposed procedure has the best recognition result because of the capability of edge preservation.

Effects of Cancer Treatment on Fertility (For Parents)

MedlinePlus

... reproductive organs to remove the cancer. Sperm and Egg Preservation Options If your child's treatment carries a ... vitro fertilization (sperm are used to fertilize an egg outside of the uterus, then the fertilized embryo ...

39 CFR 255.8 - Access to postal facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... with the National Historic Preservation Act of 1966, 16 U.S.C. 470 et seq.; (vii) The availability of other options to foster service accessibility; and (viii) Any other factor that is relevant and...

Fertility Preservation for Patients With Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update

PubMed Central

Loren, Alison W.; Mangu, Pamela B.; Beck, Lindsay Nohr; Brennan, Lawrence; Magdalinski, Anthony J.; Partridge, Ann H.; Quinn, Gwendolyn; Wallace, W. Hamish; Oktay, Kutluk

2013-01-01

Purpose To update guidance for health care providers about fertility preservation for adults and children with cancer. Methods A systematic review of the literature published from March 2006 through January 2013 was completed using MEDLINE and the Cochrane Collaboration Library. An Update Panel reviewed the evidence and updated the recommendation language. Results There were 222 new publications that met inclusion criteria. A majority were observational studies, cohort studies, and case series or reports, with few randomized clinical trials. After review of the new evidence, the Update Panel concluded that no major, substantive revisions to the 2006 American Society of Clinical Oncology recommendations were warranted, but clarifications were added. Recommendations As part of education and informed consent before cancer therapy, health care providers (including medical oncologists, radiation oncologists, gynecologic oncologists, urologists, hematologists, pediatric oncologists, and surgeons) should address the possibility of infertility with patients treated during their reproductive years (or with parents or guardians of children) and be prepared to discuss fertility preservation options and/or to refer all potential patients to appropriate reproductive specialists. Although patients may be focused initially on their cancer diagnosis, the Update Panel encourages providers to advise patients regarding potential threats to fertility as early as possible in the treatment process so as to allow for the widest array of options for fertility preservation. The discussion should be documented. Sperm and embryo cryopreservation as well as oocyte cryopreservation are considered standard practice and are widely available. Other fertility preservation methods should be considered investigational and should be performed by providers with the necessary expertise. PMID:23715580

Management of pediatric patients with DSD and ambiguous genitalia: Balancing the child's moral claims to self-determination with parental values and preferences.

PubMed

Diamond, David A; Swartz, Jonathan; Tishelman, Amy; Johnson, Judith; Chan, Yee-Ming

2018-06-01

A central ethical dilemma in management of the patient with a disorder of sex development (DSD) is the potential conflict between respect for the fundamental right of the child for physical and emotional integrity and self-determination, and the right of parents to serve as surrogate decision-makers and act in their child's best interest. Over the past 2 years we have encountered three complex DSD cases on the spectrum of mixed gonadal dysgenesis to ovotesticular DSD in which gender assignment and therefore optimal surgical management was uncertain. All patients had mosaic karyotypes with Y chromosome, dysgenetic ovary and dysgenetic testis, a urogenital sinus, and prominent phallus. In all three cases a team approach was taken to assess functional potential and risks along either gender pathway and to develop a spectrum of treatment options for parental consideration, including: 1. masculinization with removal of dysgenetic ovary; 2. initial vaginoplasty but with retention of the phallus (±bilateral gonadectomy); 3. initial vaginoplasty with "burial" of corporal bodies (Pippi Salle procedure) (±bilateral gonadectomy); 4. full feminization: vaginoplasty and clitoroplasty (with bilateral gonadectomy); 5. no surgical intervention. In all three cases, after consideration of risks and benefits of all options, parents selected option 2: gonadectomy to eliminate tumor risk and vaginoplasty, taking advantage of the child's young age to exteriorize urinary and reproductive tracts to avoid incontinence and infection and supporting parental bias toward female gender, but preservation of phallic structures to ensure a male option should the patient later declare a male gender identity. Parents of the three patients were contacted post-operatively (at 7, 17, and 22 months) for follow-up. All (3/3) regarded their child's development and wellbeing positively, and their own decisions regarding gender assignment and surgical plan favorably. All (3/3) regarded the team advisory process as balanced and supportive. In the setting of exposure of the neonatal brain to testosterone, vaginoplasty and phallic preservation afforded a balance between parental preferences and preservation of anatomic options, allowing potential reconstruction of male or female phenotype as gender identity is ascertained thereby respecting both parent and patient rights. Parents valued a spectrum of options, transparency, and the team decision-making process. Copyright © 2018 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Bladder stone management: an update.

PubMed

Cicione, Antonio; DE Nunzio, Cosimo; Manno, Stefano; Damiano, Rocco; Posti, Alessandro; Lima, Estevao; Tubaro, Andrea; Balloni, Filippo

2018-02-01

Bladder stone (BS) is a rare disease curable with several options. Herein, we reviewed the specific literature in order to update the current BS management. A comprehensive systematic MEDLINE search was performed for English language reports published before April 2017 using the BS related terms, i.e. bladder-vesical calculi, lithotripsy. Then manuscripts references were screened to identify unfounded studies. Studies regarding BS in children were excluded. Retrieved studies were classified according to their main item as: etiology, diagnosis, treatment, treatment in specific illnesses and advances in BS management. Treatment option was mainly related to stone size and number as well as concomitant causative disease. However, stone nature was not analyzed in all the retrieved studies. Both trans-urethral and percutaneous lithotripsy were efficacy for stone fragmentation although the last one was suggested to avoid urethral injuries. Holmiun:Yag laser lithotripsy has made stone fragmentation feasible by using local anesthesia however in selected patients only. The urological dogma to perform concomitant prostate surgery in men with BS has been recently questioned by some observational case-series studies however, the lack of randomization and long follow up preserve that knowledge. Bladder stone is a rare and ancient disease. Nowadays new technologies have been developed in the effort to make less invasive stone treatment. The retrieved studies show that stone fragmentation can be archived by using several surgical approaches and devices whereas comparative randomized studies are still unavailable to identify the best option.

Uterine fibroids: current perspectives

PubMed Central

Khan, Aamir T; Shehmar, Manjeet; Gupta, Janesh K

2014-01-01

Uterine fibroids are a major cause of morbidity in women of a reproductive age (and sometimes even after menopause). There are several factors that are attributed to underlie the development and incidence of these common tumors, but this further corroborates their relatively unknown etiology. The most likely presentation of fibroids is by their effect on the woman’s menstrual cycle or pelvic pressure symptoms. Leiomyosarcoma is a very rare entity that should be suspected in postmenopausal women with fibroid growth (and no concurrent hormone replacement therapy). The gold standard diagnostic modality for uterine fibroids appears to be gray-scale ultrasonography, with magnetic resonance imaging being a close second option in complex clinical circumstances. The management of uterine fibroids can be approached medically, surgically, and even by minimal access techniques. The recent introduction of selective progesterone receptor modulators (SPRMs) and aromatase inhibitors has added more armamentarium to the medical options of treatment. Uterine artery embolization (UAE) has now been well-recognized as a uterine-sparing (fertility-preserving) method of treating fibroids. More recently, the introduction of ultrasound waves (MRgFUS) or radiofrequency (VizAblate™ and Acessa™) for uterine fibroid ablation has added to the options of minimal access treatment. More definite surgery in the form of myomectomy or hysterectomy can be performed via the minimal access or open route methods. Our article seeks to review the already established information on uterine fibroids with added emphasis on contemporary knowledge. PMID:24511243

Options for managing hypoxic blackwater events in river systems: a review.

PubMed

Kerr, Janice L; Baldwin, Darren S; Whitworth, Kerry L

2013-01-15

Blackwater events are characterised by a high concentration of dissolved organic carbon in the water column. They occur naturally in lowland rivers with forested floodplains and bring a variety of benefits to both aquatic and floodplain biota. However, particularly when accompanied by high temperatures, respiration of the organic carbon may cause blackwater to become hypoxic. This may lead to a range of lethal and sub-lethal effects on the aquatic biota. We review the current scientific knowledge concerning the management of blackwater and hypoxia, and examine how this knowledge may be applied to the management of hypoxic blackwater events in lowland river systems. A range of management options, which aim to either prevent the development of hypoxic blackwater or to reintroduce oxygen into deoxygenated waters, are reported. Mitigation options that may be applicable to lowland river systems include manipulating the season and magnitude of floods in regulated rivers, increasing roughness in flow paths, establishing oxygenated refugia for aquatic biota and introducing hydraulic structures that promote turbulence and re-aeration. With climatic changes trending towards a scenario where extreme events leading to the development of hypoxic blackwater are more probable, it is now vital to validate and optimise management options on local and regional scales and work towards closing knowledge gaps. With judicious management of regulated rivers, it is possible to minimise the impacts of hypoxic flows while preserving the benefits brought to floodplain and river ecosystems by seasonal flooding and carbon exchange. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

Medical and Psychosocial Aspects of Fertility After Cancer

PubMed Central

Duffy, Christine; Allen, Susan

2009-01-01

Survival for cancer has improved significantly in the last 25 years with excellent overall 5-year and 10-year survival rates. Hence, the majority of young women diagnosed with cancer can expect to live for decades, making quality of life issues such as fertility increasingly important. Risks of infertility vary based on the chemotherapy and treatments employed, as well as a woman’s age. In general, younger women are less likely to experience permanent amenorrhea than older women, but even women who continue to menstruate have a greatly increased risk of premature menopause. Options for cancer patients entering chemotherapy treatment who wish to preserve fertility range from clinically well-established techniques such as embryo cryopreservation to more experimental techniques such as ovarian tissue cryopreservation. Pregnancy does not appear to increase the risk of cancer recurrence. Discussion of fertility issues in premenopausal women diagnosed with cancer present important challenges to the provider and to the patient. However, failure to discuss these options adequately can have lasting negative consequences on a woman’s quality of life. Physician education interventions should seek to improve the knowledge of fertility preservations options, and of locally and nationally available resources. PMID:19197170

Current strategies and future perspectives in fertility preservation for cancer patients.

PubMed

Micu, Romeo; Petrut, Bogdan; Zlatescu-Marton, Cristina; Traila, Alexandra; Harsa, Radu; Achimas-Cadariu, Patriciu

2017-01-01

Nowadays, cancer is being detected at younger ages. Health care providers should consider cancer patients' desire towards fertility preservation before the initiation of possibly sterilizing treatments. The aim of the current review was to register the current state of fertility preservation procedures available for male and female cancer patients.

Security and Correctness Analysis on Privacy-Preserving k-Means Clustering Schemes

NASA Astrophysics Data System (ADS)

Su, Chunhua; Bao, Feng; Zhou, Jianying; Takagi, Tsuyoshi; Sakurai, Kouichi

Due to the fast development of Internet and the related IT technologies, it becomes more and more easier to access a large amount of data. k-means clustering is a powerful and frequently used technique in data mining. Many research papers about privacy-preserving k-means clustering were published. In this paper, we analyze the existing privacy-preserving k-means clustering schemes based on the cryptographic techniques. We show those schemes will cause the privacy breach and cannot output the correct results due to the faults in the protocol construction. Furthermore, we analyze our proposal as an option to improve such problems but with intermediate information breach during the computation.

Radiotherapy for locally advanced resectable T3-T4 laryngeal cancer-does laryngeal preservation strategy compromise survival?

PubMed

Yamazaki, Hideya; Suzuki, Gen; Nakamura, Satoaki; Hirano, Shigeru; Yoshida, Ken; Konishi, Koji; Teshima, Teruki; Ogawa, Kazuhiko

2018-01-01

With the advancement of chemotherapy, a laryngeal preservation (LP) strategy was explored with the aim of improving maintenance of quality of life. Induction chemotherapy (ICT) following radiotherapy (RT) was considered a viable option because of its high initial response rate without hampering of overall survival (OS). Subsequently, concurrent chemoradiotherapy (CCRT) using CDDP became the standard of care for LP, showing the best LP ratio. For enhancing treatment intensity, ICT with taxan + CDDP + 5-FU (TPF-ICT) followed by RT showed superiority over ICT with CDDP + 5-FU (PF-ICT) followed by RT. Given that almost all randomized controlled trials investigating ICT include not only operable (endpoint, LP) but also inoperable (endpoint, OS) cases, physicians are faced with a dilemma regarding application in daily practice. In addition, increased treatment intensity causes augmentation of adverse events, which might reduce compliance. Thereafter, cetuximab, an effective drug with fewer adverse effects [bioradiotherapy (BRT)], emerged as another option. However, little evidence has confirmed its superiority over RT (or CCRT) in laryngeal cancer subpopulations. In spite of these developments, the OS of patients with laryngeal cancer has not improved for several decades. In fact, several studies indicated a decrease in OS during the 1990s, probably due to overuse of CCRT. Fortunately, the latter was not the case in most institutions. Currently, no other treatment has better OS than surgery. The eligibility criteria for LP and/or surgery largely depend upon the available expertise and experience, which differ from one institution to another. Therefore, a multidisciplinary team is required for the treatment of LP. © The Author 2017. Published by Oxford University Press on behalf of The Japan Radiation Research Society and Japanese Society for Radiation Oncology.

Left ventricular diastolic dysfunction in women with nonobstructive ischemic heart disease: insights from magnetic resonance imaging and spectroscopy.

PubMed

Nelson, Michael D

2017-10-01

Ischemic heart disease, in the absence of obstructive coronary artery disease, is prevalent in women and constitutes a major risk factor for developing major adverse cardiovascular events, including myocardial infarction, stroke, and heart failure. For decades, diagnosis was considered benign and often minimized; however, it is now known that this etiology carries much risk and is a significant burden to the health care system. This review summarizes the current state of knowledge on nonobstructive ischemic heart disease (NOIHD), the association between NOIHD and left ventricular diastolic dysfunction, potential links between NOIHD and the development of heart failure with preserved ejection fraction (HFpEF), and therapeutic options and knowledge gaps for patients living with NOIHD. Copyright © 2017 the American Physiological Society.

In vitro conservation of Dendrobium germplasm.

PubMed

Teixeira da Silva, Jaime A; Zeng, Songjun; Galdiano, Renato Fernandes; Dobránszki, Judit; Cardoso, Jean Carlos; Vendrame, Wagner A

2014-09-01

Dendrobium is a large genus in the family Orchidaceae that exhibits vast diversity in floral characteristics, which is of considerable importance to orchid breeders, biotechnologists and collectors. Native species have high value as a result of their medicinal properties, while their hybrids are important as ornamental commodities, either as cut flowers or potted plants and are thus veritable industrial crops. Thus, preservation of Dendrobium germplasm is valuable for species conservation, breeding programs and the floriculture industry. Cryopreservation represents the only safe, efficient and cost-effective long-term storage option to facilitate the conservation of genetic resources of plant species. This review highlights 16 years of literature related to the preservation of Dendrobium germplasm and comprises the most comprehensive assessment of thorough studies performed to date, which shows reliable and reproducible results. Air-drying, encapsulation-dehydration, encapsulation-vitrification, vitrification and droplet-vitrification are the current cryopreservation methodologies that have been used to cryopreserve Dendrobium germplasm. Mature seeds, pollen, protoplasts, shoot primordia, protocorms and somatic embryos or protocorm-like bodies (PLBs) have been cryopreserved with different levels of success. Encapsulation-vitrification and encapsulation-dehydration are the most used protocol, while PLBs represent the main explant explored.

Long-Term Information Management (LTIM) of Safeguards Data at Repositories: Phase II

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

Haddal, Risa N.

One of the challenges of implementing safeguards for geological repositories will be the long-term preservation of safeguards-related data for 100 years or more. While most countries considering the construction and operation of such facilities agree that safeguards information should be preserved, there are gaps with respect to standardized requirements, guidelines, timescales, and approaches. This study analyzes those gaps and explores research to clarify stakeholder needs, identify current policies, approaches, best practices and international standards, and explores existing safeguards information management infrastructure. The study also attempts to clarify what a safeguards data classification system might look like, how long data shouldmore » be retained, and how information should be exchanged between stakeholders at different phases of a repository’s life cycle. The analysis produced a variety of recommendations on what information to preserve, how to preserve it, where to store it, retention options and how to exchange information in the long term. Key findings include the use of the globally recognized international records management standard, ISO15489, for guidance on the development of information management systems, and the development of a Key Information File (KIF). The KIF could be used to identify only the most relevant, high-level safeguards information and the history of decision making about the repository. The study also suggests implementing on-site and off-site records storage in digital and physical form; developing a safeguards data classification system; long-term records retention with periodic reviews every 5 to 10 years during each phase of the repository life cycle; and establishing transition procedures well in advance so that data shepherds and records officers can transfer information with incoming facility managers effectively and efficiently. These and other recommendations are further analyzed in this study.« less

Challenges to Legitimacy: Dilemmas and Directions

ERIC Educational Resources Information Center

Yarmolinsky, Adam

1976-01-01

Three options are discussed for institutional responses to pressures from clients (students), competitors, taxpayers, citizen activists, and faculty: (1) to concentrate on the preservation of traditional values; (2) to maximize growth in new markets; or (3) to seek a new educational synthesis. (JT)

Managing fermentation with baled silage

USDA-ARS?s Scientific Manuscript database

Baled silage is an attractive management option for many forage and livestock producers. Many principles for making well-preserved baled silage are similar to those required for traditional precision-chopped silages. Generally, the overall goal is to quickly create an anaerobic environment in which ...

12 CFR 614.4170 - General.

Code of Federal Regulations, 2014 CFR

2014-01-01

... lender. Procedures shall require: (i) The procurement of periodic operating data essential for maintaining control, for the proper analysis of such data, and prompt action as needed; (ii) Inspections... insurance, margin requirements, warehousing, and the prompt exercise of legal options to preserve the lender...

12 CFR 614.4170 - General.

Code of Federal Regulations, 2011 CFR

2011-01-01

... lender. Procedures shall require: (i) The procurement of periodic operating data essential for maintaining control, for the proper analysis of such data, and prompt action as needed; (ii) Inspections... insurance, margin requirements, warehousing, and the prompt exercise of legal options to preserve the lender...

12 CFR 614.4170 - General.

Code of Federal Regulations, 2012 CFR

2012-01-01

... lender. Procedures shall require: (i) The procurement of periodic operating data essential for maintaining control, for the proper analysis of such data, and prompt action as needed; (ii) Inspections... insurance, margin requirements, warehousing, and the prompt exercise of legal options to preserve the lender...

12 CFR 614.4170 - General.

Code of Federal Regulations, 2013 CFR

2013-01-01

... lender. Procedures shall require: (i) The procurement of periodic operating data essential for maintaining control, for the proper analysis of such data, and prompt action as needed; (ii) Inspections... insurance, margin requirements, warehousing, and the prompt exercise of legal options to preserve the lender...

Soft palate preservation after tumor resection with transoral laser microsurgery

PubMed Central

Luna-Ortiz, Kuauhyama; Gómez-Pedraza, Antonio

2013-01-01

Background: Management and preservation of the soft palate is dependent on clinical stage and tumor histology. However, available literature is scarce regarding the palate preservation with the use of laser CO2. Objectives: We report the results obtained after management with laser surgery and soft palate preservation in three patients with salivary gland neoplasms. Method: Three patients with minor salivary gland tumors were treated by means of transoral laser microsurgery. All tumors were assessed using magnetic resonance imaging. All tumors were >3 cm. Soft palate function was preserved and reconstruction was performed with primary closure. Patients began oral feeding the same day and were discharged after 24 h. Conclusions: Transoral laser microsurgery is recommended for treatment of soft palate tumors. This treatment can be considered a better option when compared with other modalities such as radio- or chemoradiotherapy which require a longer time of treatment, are more expensive and tend to produce significant toxicity. Key words:Laser CO2, neoplasms, salivary gland. PMID:23229273

New pharmacotherapy for the treatment of glaucoma.

PubMed

Schehlein, Emily M; Novack, Gary; Robin, Alan L

2017-12-01

Glaucoma is the second leading cause of blindness in the world and current pharmacotherapies for glaucoma have remained relatively unchanged (with the exception of fixed combinations of previously available medications) since the mid-1990s with the development of prostaglandin analogues. Now, with both new formulations and new classes of medications with novel mechanisms of action, the medical therapy of glaucoma may be heralding a new dawn in medical management. Areas covered: This review outlines new topical therapies for intraocular pressure (IOP) lowering treatment, in addition to new formulations, preservative-free options, and advances in glaucoma medical therapy delivery. We performed a comprehensive search for published studies for glaucoma medical therapy using the electronic database PubMed. A manual search for each therapy or delivery system was also performed. Expert commentary: These advances in glaucoma therapy have the potential to overcome many barriers to glaucoma's medical care, particularly in terms of adherence. However, both time and research are needed to prove the relative efficacy and safety of these new pharmacotherapies and products, helping us decide their role in the treatment of elevated intraocular pressure. We are hopeful that these new developments in therapy may bring more options for glaucoma medical therapy.

Recent developments in the employment and retirement of older workers in Germany.

PubMed

Naegele, G; Krämer, K

2001-01-01

Against a background of an aging population, rising social security costs, and foreseeable labor and skill shortages, there have been public policy changes affecting older workers in Germany. Labor-market related initiatives aim at an increase of labor force participation among this group. Enterprise-related, active age-management strategies aim at improving occupational conditions of aging workers. In this context, prolonging the working life must be seen as one option of "active aging." Another view of the current retirement discussion is the question of how the unused potential of Germany's younger, early-retired seniors can be exploited. Active aging has become a social duty nowadays, with the intention that older persons contribute to society to avoid generational conflicts. In the future, active aging will preserve the competitiveness of enterprises and of the entire economy, despite an aging labor force. But gerontological research points out that different options to carry out individual life plans of active aging are also required. This article reviews the changes in public policies towards older workers and includes the findings of a project that illustrates good practice to combat age barriers in the labor world.

Factors that influence baled silage fermentation

USDA-ARS?s Scientific Manuscript database

Baled silage is an attractive management option for many forage and livestock producers. Most principles involved in making well-preserved, baled silage are similar to those required for precision-chopped silages. Generally, the overall goal is identical: create an anaerobic environment in which pla...

Clinical guide to fertility preservation in hematopoietic cell transplant recipients

PubMed Central

Joshi, S; Savani, BN; Chow, EJ; Gilleece, MH; Halter, J; Jacobsohn, DA; Pidala, J; Quinn, GP; Cahn, J-Y; Jakubowski, AA; Kamani, NR; Lazarus, HM; Rizzo, JD; Schouten, HC; Socie, G; Stratton, P; Sorror, ML; Warwick, AB; Wingard, JR; Loren, AW; Majhail, NS

2014-01-01

With broadening indications, more options for hematopoietic cell transplantation (HCT) and improvement in survival, the number of long-term HCT survivors is expected to increase steadily. Infertility is a frequent problem that long-term HCT survivors and their partners face and it can negatively impact on the quality of life. The most optimal time to address fertility issues is before the onset of therapy for the underlying disease; however, fertility preservation should also be addressed before HCT in all children and patients of reproductive age, with referral to a reproductive specialist for patients interested in fertility preservation. In vitro fertilization (IVF) and embryo cryopreservation, oocyte cryopreservation and ovarian tissue banking are acceptable methods for fertility preservation in adult women/pubertal females. Sperm banking is the preferred method for adult men/pubertal males. Frequent barriers to fertility preservation in HCT recipients may include the perception of lack of time to preserve fertility given an urgency to move ahead with transplant, lack of patient–physician discussion because of several factors (for example, time constraints, lack of knowledge), inadequate access to reproductive specialists, and costs and lack of insurance coverage for fertility preservation. There is a need to raise awareness in the medical community about fertility preservation in HCT recipients. PMID:24419521

Cryopreservation for preservation of potato genetic resources

PubMed Central

Niino, Takao; Arizaga, Miriam Valle

2015-01-01

Cryopreservation is becoming a very important tool for the long-term storage of plant genetic resources and efficient cryopreservation protocols have been developed for a large number of plant species. Practical procedures, developed using in vitro tissue culture, can be a simple and reliable preservation option of potato genetic resources rather than maintaining by vegetative propagation in genebanks due their allogamous nature. Cryopreserved materials insure a long-term backup of field collections against loss of plant germplasm. Occurrence of genetic variation, in tissue culture cells during prolonged subcultures, can be avoided with suitable cryopreservation protocols that provide high regrowth, leading and facilitating a systematic and strategic cryo-banking of plant genetic resources. Cryopreservation protocols for potato reviewed here, can efficiently complement field and in vitro conservation, providing for preservation of genotypes difficult to preserve by other methods, wild types and other species decided as priority collections. PMID:25931979

10 CFR 51.103 - Record of decision-general.

Code of Federal Regulations, 2011 CFR

2011-01-01

... were included in the range of alternatives discussed in the environmental impact statement, and specify... preferences among alternatives based on relevant factors, including economic and technical considerations... impacts of license renewal are so great that preserving the option of license renewal for energy planning...

MyOncofertility.org: a web-based patient education resource supporting decision making under severe emotional and cognitive overload.

PubMed

Jona, Kemi; Gerber, Adam

2010-01-01

Kristin, a 38-year-old female with breast cancer, was scheduled to begin treatment a week after receiving her diagnosis. Although she was in a four-year-long relationship, she had never thought about having kids. Kristin was told that embryo banking (IVF) was the best option for fertility preservation, and she had to decide immediately if she wanted biological children in order to start an egg-retrieval cycle. Because no other options were provided and she was uncertain about freezing embryos with her partner, she ended up foregoing fertility preservation prior to the treatments that ultimately left her infertile. Ethan, a 19-year-old male, was in the hospital for four days awaiting surgery to remove a pelvic sarcoma. The surgery required removal of his testes rendering him infertile. During those four days, no one talked to him or his family about sperm banking, even though it could hve been accomplished in a matter of minutes.

Treatment of prediabetes

PubMed Central

Kanat, Mustafa; DeFronzo, Ralph A; Abdul-Ghani, Muhammad A

2015-01-01

Progression of normal glucose tolerance (NGT) to overt diabetes is mediated by a transition state called impaired glucose tolerance (IGT). Beta cell dysfunction and insulin resistance are the main defects in type 2 diabetes mellitus (type 2 DM) and even normoglycemic IGT patients manifest these defects. Beta cell dysfunction and insulin resistance also contribute to the progression of IGT to type 2 DM. Improving insulin sensitivity and/or preserving functions of beta-cells can be a rational way to normalize the GT and to control transition of IGT to type 2 DM. Loosing weight, for example, improves whole body insulin sensitivity and preserves beta-cell function and its inhibitory effect on progression of IGT to type 2 DM had been proven. But interventions aiming weight loss usually not applicable in real life. Pharmacotherapy is another option to gain better insulin sensitivity and to maintain beta-cell function. In this review, two potential treatment options (lifestyle modification and pharmacologic agents) that limits the IGT-type 2 DM conversion in prediabetic subjects are discussed. PMID:26464759

Alternative therapies in management of leiomyomas.

PubMed

Patel, Amrita; Malik, Minnie; Britten, Joy; Cox, Jeris; Catherino, William H

2014-09-01

Leiomyomas are benign soft-tissue neoplasms that arise from smooth muscle. Relief of symptoms (abnormal uterine bleeding, pain, pressure) is the major goal in management of women with significant symptoms. For symptomatic myomas, hysterectomy is a definitive solution; however, there are emerging less-invasive options. Magnetic resonance imaging-guided focused ultrasound surgery, cryomyolysis, and temporary occlusion of the uterine arteries are treatment options that are minimally invasive interventions with the benefit of preserving the uterus. This review summarizes procedure techniques, eligibility, complications, and outcomes of these alternate therapies. Published by Elsevier Inc.

[Monotherapy in treatment-naïve patients].

PubMed

Arranz Caso, José Alberto

2008-12-01

The development of antiretroviral therapy (ART) with current triple drug combinations has dramatically reduced morbidity and mortality in HIV-infected patients. However, there is a need for less toxic treatments without sacrificing efficacy, as well as for less expensive drugs to facilitate universal access to this therapy. The protease inhibitors (PI) administered with ritonavir have a favorable pharmacokinetic profile and high genetic barrier and consequently are ideal candidates for use in monotherapy, thus avoiding the toxicity and cost associated with nucleoside analogs, as well as preserving drugs for future options. The promising results of studies performed with lopinavir/ritonavir (LPV/r) in induction-maintenance regimens in patients without prior failure to PIs encourage research into the cost-effectiveness of LPV/r in monotherapy from the beginning of ART. The few studies performed in this context seem to indicate the following: a) LPV/r monotherapy achieves undetectable viral loads in a large proportion of treatment-naïve patients, b) future treatment options are not compromised in patients not achieving undetectable viral loads since the likelihood of resistance mutations is low and treatment intensification achieves suppression of viral replication, and c) strategies for early detection can probably be considered in patients who will not achieve complete suppression with LPV/r monotherapy. Nevertheless, before LPV/r monotherapy can be considered a first-line option, new studies with larger samples and longer follow-up are required. These studies should pay particular attention to viral replication in areas where PI show less penetration.

Microtubules in Plant Cells: Strategies and Methods for Immunofluorescence, Transmission Electron Microscopy and Live Cell Imaging

PubMed Central

Celler, Katherine; Fujita, Miki; Kawamura, Eiko; Ambrose, Chris; Herburger, Klaus; Wasteneys, Geoffrey O.

2016-01-01

Microtubules are required throughout plant development for a wide variety of processes, and different strategies have evolved to visualize and analyze them. This chapter provides specific methods that can be used to analyze microtubule organization and dynamic properties in plant systems and summarizes the advantages and limitations for each technique. We outline basic methods for preparing samples for immunofluorescence labelling, including an enzyme-based permeabilization method, and a freeze-shattering method, which generates microfractures in the cell wall to provide antibodies access to cells in cuticle-laden aerial organs such as leaves. We discuss current options for live cell imaging of MTs with fluorescently tagged proteins (FPs), and provide chemical fixation, high pressure freezing/freeze substitution, and post-fixation staining protocols for preserving MTs for transmission electron microscopy and tomography. PMID:26498784

Endocrown with Leucite-Reinforced Ceramic: Case of Restoration of Endodontically Treated Teeth

PubMed Central

da Cunha, Leonardo Fernandes; Mondelli, José; Auersvald, Caroline Moreira; Gonzaga, Carla Castiglia; Mondelli, Rafael Francisco Lia; Correr, Gisele Maria; Furuse, Adilson Yoshio

2015-01-01

A common problem encountered by dentists is the restorative treatment of nonvital teeth. When the pulp chamber presents appropriate conditions for retention, the endocrown is indicated. This monolithic, ceramic adhesive restoration is singularly used yet warrants wider recognition and use. The endocrown allows preservation of the tooth structure and is minimally invasive. Currently, this treatment option, of a core buildup and full coverage restoration, reduces tooth structure excessively. This treatment presents not only functional limitations but also aesthetic concerns. Recently, the VITA-PM9 system, a leucite-reinforced glass ceramic, has been increasingly used in a variety of clinical situations due to its satisfactory physical-mechanical and aesthetic properties. Therefore, the present study describes a case of surgical restoration of a nonvital tooth using the endocrown technique and the VITA-PM9. PMID:26557391

32 CFR 105.12 - SAFE Kit collection and preservation.

Code of Federal Regulations, 2014 CFR

2014-07-01

... response, to include mental healthcare. The SAFE of a sexual assault victim should be conducted by a healthcare provider who has specialized education and clinical experience in the collection of forensic... under this reporting option. The healthcare provider shall encourage the victim to obtain referrals for...

Unilateral endonasal transcribriform approach with septal transposition for olfactory groove meningioma: can olfaction be preserved?

PubMed

Youssef, A Samy; Sampath, Raghuram; Freeman, Jacob L; Mattingly, Jameson K; Ramakrishnan, Vijay R

2016-10-01

Loss of olfaction has been considered inevitable in endoscopic endonasal resection of olfactory groove meningiomas. Olfaction preservation may be feasible through an endonasal unilateral transcribriform approach, with the option for expansion using septal transposition and contralateral preservation of the olfactory apparatus. An expanded unilateral endonasal transcribriform approach with septal transposition was performed in five cadaver heads. The approach was applied in a surgical case of a 24 × 26-mm olfactory groove meningioma originating from the right cribriform plate with partially intact olfaction. The surgical approach offered adequate exposure to the anterior skull base bilaterally. The nasal/septal mucosa was preserved on the contralateral side. Gross total resection of the meningioma was achieved with the successful preservation of the contralateral olfactory apparatus and preoperative olfaction. Six months later, the left nasal cavity showed no disruption of the mucosal lining and the right side was at the appropriate stage of healing for a harvested nasoseptal flap. One year later, the preoperative olfactory function was intact and favorably viewed by the patient. Objective testing of olfaction showed microsomia. Olfaction preservation may be feasible in the endoscopic endonasal resection of a unilateral olfactory groove meningioma through a unilateral transcribriform approach with septal transposition and preservation of the contralateral olfactory apparatus.

Reproductive technology and the life course: current debates and research in social egg freezing.

PubMed

Baldwin, Kylie; Culley, Lorraine; Hudson, Nicky; Mitchell, Helene

2014-09-01

While there are currently few confirmed births from previously frozen eggs in the UK, the improved outcomes of new technologies of vitrification and intra-cytoplasmic sperm injection (ICSI) have led to the marketing of egg freezing for non-medical reasons, whereby women are offered the possibility of preserving their eggs until such time as they wish to have a child. Non-academic commentary on this phenomenon has commonly constructed it within a neo-liberal discourse of 'choice', whereby women are positioned as choosing to 'delay motherhood,' often for reasons relating to their careers. However, there have been relatively few research studies which explore either women's awareness and understandings of social egg freezing or the reasons why women consider or undertake egg freezing. This paper summarises the current academic discussion surrounding social egg freezing and outlines the limited body of empirical literature identified from a systematic search of relevant databases. The potential benefits and harms of social egg freezing and the ethical issues it raises are well rehearsed in existing literature, but there is limited empirical evidence about who is accessing social egg freezing, why they are taking this option and what their experiences and future intentions are.

Stafford Technical Center: Designing a Future for Architects and Builders

ERIC Educational Resources Information Center

Lucci, William, Jr.

2005-01-01

In this article, the author describes Stafford Technical Center's Engineering Technology Academy (ETA), in which students pursue a variety of educational and career options for anything connected to construction technologies--including drafting and design, architecture, and even work in historic preservation. In addition to technical skills,…

A Comparative Analysis of Options for Preserving the Tank Industrial Base

DTIC Science & Technology

1993-03-01

4 G. LITERATURE REVIEW ........................... 5 II. BACKGROUND ..................................... 6 A. THE...INDUSTRIAL BASE .......................... 6 B. THE TANK INDUSTRIAL BASE, 1917-1945 ................ 7 C. THE TANK INDUSTRIAL BASE, 1945-1980...published studies on the subject. General Dynamics-Land Systems Division ( GDLS ), Congressional Budget Office (CBO) and the General Accounting Office

Nature Invented: An Ethical Critique of Preservation and Restoration Ecology.

ERIC Educational Resources Information Center

Hiers, Kevin

1995-01-01

The segregation of humanity from wilderness is presupposed by many of the goals for restoration ecology. Critiques the underlying assumption that human presence rather than human activity is the cause of environmental degradation and examines the application of sustainable development through education as a viable ethical option. (LZ)

Vegetation and other development options for mitigating urban air pollution impacts

Treesearch

Richard Baldauf; David J. Nowak

2014-01-01

While air pollution control devices and programs are the primary method of reducing emissions, urban air pollution can be further mitigated through planning and design strategies, including vegetation preservation and planting, building design and development, installing roadside and near-source structures, and modifying surrounding terrain features.

Options for Replacing and Reformatting Deteriorated Materials.

ERIC Educational Resources Information Center

Banks, Jennifer

This resource guide focuses on handling library materials that are too deteriorated to benefit from other preservation treatments. Hopeless case items, that would require an unreasonable amount of conservation work to fix, can be resolved through a process of reselecting items by replacing them or reformatting them. The reselection integrates…

Epidemiology, genetics, and subtyping of preserved ratio impaired spirometry (PRISm) in COPDGene.

PubMed

Wan, Emily S; Castaldi, Peter J; Cho, Michael H; Hokanson, John E; Regan, Elizabeth A; Make, Barry J; Beaty, Terri H; Han, MeiLan K; Curtis, Jeffrey L; Curran-Everett, Douglas; Lynch, David A; DeMeo, Dawn L; Crapo, James D; Silverman, Edwin K

2014-08-06

Preserved Ratio Impaired Spirometry (PRISm), defined as a reduced FEV1 in the setting of a preserved FEV1/FVC ratio, is highly prevalent and is associated with increased respiratory symptoms, systemic inflammation, and mortality. Studies investigating quantitative chest tomographic features, genetic associations, and subtypes in PRISm subjects have not been reported. Data from current and former smokers enrolled in COPDGene (n = 10,192), an observational, cross-sectional study which recruited subjects aged 45-80 with ≥10 pack years of smoking, were analyzed. To identify epidemiological and radiographic predictors of PRISm, we performed univariate and multivariate analyses comparing PRISm subjects both to control subjects with normal spirometry and to subjects with COPD. To investigate common genetic predictors of PRISm, we performed a genome-wide association study (GWAS). To explore potential subgroups within PRISm, we performed unsupervised k-means clustering. The prevalence of PRISm in COPDGene is 12.3%. Increased dyspnea, reduced 6-minute walk distance, increased percent emphysema and decreased total lung capacity, as well as increased segmental bronchial wall area percentage were significant predictors (p-value <0.05) of PRISm status when compared to control subjects in multivariate models. Although no common genetic variants were identified on GWAS testing, a significant association with Klinefelter's syndrome (47XXY) was observed (p-value < 0.001). Subgroups identified through k-means clustering include a putative "COPD-subtype", "Restrictive-subtype", and a highly symptomatic "Metabolic-subtype". PRISm subjects are clinically and genetically heterogeneous. Future investigations into the pathophysiological mechanisms behind and potential treatment options for subgroups within PRISm are warranted. Clinicaltrials.gov Identifier: NCT000608764.

Prevention of fungal spoilage in food products using natural compounds: A review.

PubMed

Ribes, Susana; Fuentes, Ana; Talens, Pau; Barat, Jose Manuel

2017-04-10

The kingdom Fungi is the most important group of microorganism contaminating food commodities, and chemical additives are commonly used in the food industry to prevent fungal spoilage. However, the increasing consumer concern about synthetic additives has led to their substitution by natural compounds in foods. The current review provides an overview of using natural agents isolated from different sources (plants, animals, and microorganisms) as promising antifungal compounds, including information about their mechanism of action and their use in foods to preserve and prolong shelf life. Compounds derived from plants, chitosan, lactoferrin, and biocontrol agents (lactic acid bacteria, antagonistic yeast, and their metabolites) are able to control the decay caused by fungi in a wide variety of foods. Several strategies are employed to reduce the drawbacks of some antifungal agents, like their incorporation into oil-in-water emulsions and nanoemulsions, edible films and active packaging, and their combination with other natural preservatives. These strategies facilitate the addition of volatile agents into food products and, improve their antifungal effectiveness. Moreover, biological agents have been investigated as one of the most promising options in the control of postharvest decay. Numerous mechanisms of action have been elucidated and different approaches have been studied to enhance their antifungal effectiveness.

Minimally-invasive surgery in the management of symptomatic parotid stones.

PubMed

Samani, Meera; Hills, Alexander James; Holden, Adam Matthew; Man, Chang-Bon; McGurk, Mark

2016-05-01

Traditionally, large, symptomatic, parotid stones that were refractory to conservative treatment were usually managed by parotidectomy, with the attendant risk to the facial nerve. Microendoscopes have transformed the management of such stones. For large stones that are not amenable to retrieval with a basket the endoscope provides a new dimension to operative surgery. It can guide the surgeon on to the duct and stone without the need to remove the parotid gland. In 2005-2014, 111 consecutive patients underwent endoscopically-assisted operations for the removal of 132 parotid stones at Guy's Hospital. Removal was successful in all but three cases. Long-term follow up (mean (SD) 44 (30) months) was obtained by postal or online survey and telephone, and 92 patients (83%) said that they had no symptoms. Further endoscope-assisted surgery was required in four cases, with preservation of the gland in all patients. Sialocoeles developed postoperatively in 15% (n=17). Transient facial nerve weakness occurred in 4 cases (4%), and there was no case of permanent deficit. Endoscopically-assisted retrieval of parotid stones is a technique to preserve the gland that adds to the current minimally-invasive options for management of parotid calculi. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Radiotherapy for Vestibular Schwannomas: A Critical Review

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

Murphy, Erin S., E-mail: murphye3@ccf.or; Suh, John H.

2011-03-15

Vestibular schwannomas are slow-growing tumors of the myelin-forming cells that cover cranial nerve VIII. The treatment options for patients with vestibular schwannoma include active observation, surgical management, and radiotherapy. However, the optimal treatment choice remains controversial. We have reviewed the available data and summarized the radiotherapeutic options, including single-session stereotactic radiosurgery, fractionated conventional radiotherapy, fractionated stereotactic radiotherapy, and proton beam therapy. The comparisons of the various radiotherapy modalities have been based on single-institution experiences, which have shown excellent tumor control rates of 91-100%. Both stereotactic radiosurgery and fractionated stereotactic radiotherapy have successfully improved cranial nerve V and VII preservation tomore » >95%. The mixed data regarding the ideal hearing preservation therapy, inherent biases in patient selection, and differences in outcome analysis have made the comparison across radiotherapeutic modalities difficult. Early experience using proton therapy for vestibular schwannoma treatment demonstrated local control rates of 84-100% but disappointing hearing preservation rates of 33-42%. Efforts to improve radiotherapy delivery will focus on refined dosimetry with the goal of reducing the dose to the critical structures. As future randomized trials are unlikely, we suggest regimented pre- and post-treatment assessments, including validated evaluations of cranial nerves V, VII, and VIII, and quality of life assessments with long-term prospective follow-up. The results from such trials will enhance the understanding of therapy outcomes and improve our ability to inform patients.« less

Progress in Rectal Cancer Treatment

PubMed Central

Ceelen, Wim P.

2012-01-01

The dramatic improvement in local control of rectal cancer observed during the last decades is to be attributed to attention to surgical technique and to the introduction of neoadjuvant therapy regimens. Nevertheless, systemic relapse remains frequent and is currently insufficiently addressed. Intensification of neoadjuvant therapy by incorporating chemotherapy with or without targeted agents before the start of (chemo)radiation or during the waiting period to surgery may present an opportunity to improve overall survival. An increasing number of patients can nowadays undergo sphincter preserving surgery. In selected patients, local excision or even a “wait and see” approach may be feasible following active neoadjuvant therapy. Molecular and genetic biomarkers as well as innovative imaging techniques may in the future allow better selection of patients for this treatment option. Controversy persists concerning the selection of patients for adjuvant chemotherapy and/or targeted therapy after neoadjuvant regimens. The currently available evidence suggests that in complete pathological responders long-term outcome is excellent and adjuvant therapy may be omitted. The results of ongoing trials will help to establish the ideal tailored approach in resectable rectal cancer. PMID:22970381

Assessment of follicle viability using fluorescence microscopy before and after ovarian thawing.

PubMed

Sofoudis, C; Zervomanolakis, I; Galani, I; Grigoriou, V; Botsis, D; Vlahos, N

2017-01-01

The incidence of young women diagnosed with cancer has been globally increasing. In many cases the surgical approach followed by chemotherapy, radiotherapy or hormonal therapy could lead to infertility or premature ovarian failure. Several options are available in order to preserve fertility and increase the future gestation rate. Among embryo cryopreservation and oocyte cryopreservation, ovarian tissue cryopreservation represents an ideal option, especially for premenopausal women and for those who cannot delay the start of chemotherapy. The purpose of this study was to examine the follicle viability using fluorescence microscope before and after ovarian thawing.

Option pricing from wavelet-filtered financial series

NASA Astrophysics Data System (ADS)

de Almeida, V. T. X.; Moriconi, L.

2012-10-01

We perform wavelet decomposition of high frequency financial time series into large and small time scale components. Taking the FTSE100 index as a case study, and working with the Haar basis, it turns out that the small scale component defined by most (≃99.6%) of the wavelet coefficients can be neglected for the purpose of option premium evaluation. The relevance of the hugely compressed information provided by low-pass wavelet-filtering is related to the fact that the non-gaussian statistical structure of the original financial time series is essentially preserved for expiration times which are larger than just one trading day.

Laminoplasty Techniques for the Treatment of Multilevel Cervical Stenosis

PubMed Central

Mitsunaga, Lance K.; Klineberg, Eric O.; Gupta, Munish C.

2012-01-01

Laminoplasty is one surgical option for cervical spondylotic myelopathy. It was developed to avoid the significant risk of complications associated with alternative surgical options such as anterior decompression and fusion and laminectomy with or without posterior fusion. Various laminoplasty techniques have been described. All of these variations are designed to reposition the laminae and expand the spinal canal while retaining the dorsal elements to protect the dura from scar formation and to preserve postoperative cervical stability and alignment. With the right surgical indications, reliable results can be expected with laminoplasty in treating patients with multilevel cervical myelopathy. PMID:22496982

Freeze-dried spermatozoa: An alternative biobanking option for endangered species.

PubMed

Anzalone, Debora Agata; Palazzese, Luca; Iuso, Domenico; Martino, Giuseppe; Loi, Pasqualino

2018-03-01

In addition to the iconic wild species, such as the pandas and Siberian tigers, an ever-increasing number of domestic species are also threatened with extinction. Biobanking of spermatozoa could preserve genetic heritages of extinct species, and maintain biodiversity of existing species. Because lyophilized spermatozoa retain fertilizing capacity, the aim was to assess whether freeze-dried spermatozoa are an alternative option to save endangered sheep breeds. To achieve this objective, semen was collected from an Italian endangered sheep breed (Pagliarola), and a biobank of cryopreserved and freeze-dried spermatozoa was established, and evaluated using IVF (for frozen spermatozoa) and ICSI procedures (for frozen and freeze-dried spermatozoa). As expected, the fertilizing capacity of cryopreserved Pagliarola's spermatozoa was comparable to commercial semen stocks. To evaluate the activating capability of freeze-dried spermatozoa, 108 MII sheep oocytes were subjected to ICSI, and allocated to two groups: 56 oocytes were activated by incubation with ionomycin (ICSI-FDSa) and 52 were not activated (ICSI-FDSna). Pronuclear formation (2PN) was investigated at 14-16 h after ICSI in fixed presumptive zygotes. Only artificially activated oocytes developed into blastocysts after ICSI. In the present study, freeze-dried ram spermatozoa induced blastocyst development following ICSI at a relatively high proportion, providing evidence that sperm lyophilization is an alternative, low cost storage option for biodiversity preservation of domestic species. Copyright © 2018 Elsevier B.V. All rights reserved.

76 FR 52901 - Airworthiness Directives; The Boeing Company Model 757-200, -200PF, and -200CB Series Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-24

... if necessary. This proposed AD would also add an option for the high frequency eddy current... also adds an optional ultrasonic inspection for the high frequency eddy current inspection to detect... proposed AD would also add an option for the high frequency eddy current inspection for cracking of the...

Climate change: Potential impacts and interactions in wetlands of the United States

USGS Publications Warehouse

Burkett, Virginia; Kusler, Jon

2000-01-01

Wetlands exist in a transition zone between aquatic and terrestrial environments which can be altered by subtle changes in hydrology. Twentieth century climate records show that the United States is generally experiencing a trend towards a wetter, warmer climate; some climate models suggest that his trend will continue and possibly intensify over the next 100 years. Wetlands that are most likely to be affected by these and other potential changes (e.g., sea-level rise) associated with atmospheric carbon enrichment include permafrost wetlands, coastal and estuarine wetlands, peatlands, alpine wetlands, and prairie pothote wetlands. Potential impacts range from changes in community structure to changes in ecological function, and from extirpation to enhancement. Wetlands (particularly boreal peatlands) play an important role in the global carbon cycle, generally sequestering carbon in the form of biomass, methane, dissolved organic material and organic sediment. Wetlands that are drained or partially dried can become a net source of methane and carbon dioxide to the atmosphere, serving as a positive biotic feedback to global warming. Policy options for minimizing the adverse impacts of climate change on wetland ecosystems include the reduction of current anthropogenic stresses, allowing for inland migration of coastal wetlands as sea-level rises, active management to preserve wetland hydrology, and a wide range of other management and restoration options.

Engineering the Follicle Microenvironment

PubMed Central

West, Erin R.; Shea, Lonnie D.; Woodruff, Teresa K.

2008-01-01

In vitro ovarian follicle culture provides a tool to investigate folliculogenesis, and may one day provide women with fertility-preservation options. The application of tissue engineering principles to ovarian follicle maturation may enable the creation of controllable microenvironments that will coordinate the growth of the multiple cellular compartments within the follicle. Three-dimensional culture systems can preserve follicle architecture, thereby maintaining critical cell–cell and cell–matrix signaling lost in traditional two-dimensional attached follicle culture systems. Maintaining the follicular structure while manipulating the biochemical and mechanical environment will enable the development of controllable systems to investigate the fundamental biological principles underlying follicle maturation. This review describes recent advances in ovarian follicle culture, and highlights the tissue engineering principles that may be applied to follicle culture, with the ultimate objective of germline preservation for females facing premature infertility. PMID:17594609

Ethical, moral, and theological insights into advances in male pediatric and adolescent fertility preservation.

PubMed

Ramstein, J J; Halpern, J; Gadzinski, A J; Brannigan, R E; Smith, J F

2017-07-01

The successful treatment of boys with cancer has led to increasing attention to preserving their quality of life after completing cancer therapy. One of the top priorities for living a full life is keeping open the opportunity to have children. While sperm banking for males facing sterilizing cancer treatment can be effective, this approach requires subsequent use of reproductive procedures such as in vitro fertilization (IVF) or intrauterine insemination (IUI) to achieve a pregnancy. Advances in fertility preservation techniques may allow pre-pubertal boys to conceive using advanced stem cell technologies and stem cell transplantation in the future. This review summarizes the ethical positions of leading medical societies and explores the religious and moral stances of major religious institutions regarding these options. © 2017 American Society of Andrology and European Academy of Andrology.

The role of interventional radiology in abdominopelvic trauma

PubMed Central

Ierardi, Anna Maria; Duka, Ejona; Lucchina, Natalie; Floridi, Chiara; De Martino, Alessandro; Donat, Daniela; Fontana, Federico

2016-01-01

The management of trauma patients has evolved in recent decades owing to increasing availability of advanced imaging modalities such as CT. Nowadays, CT has replaced the diagnostic function of angiography. The latter is considered when a therapeutic option is hypothesized. Arterial embolization is a life-saving procedure in abdominopelvic haemorrhagic patients, reducing relevant mortality rates and ensuring haemodynamic stabilization of the patient. Percutaneous transarterial embolization has been shown to be effective for controlling ongoing bleeding for patients with high-grade abdominopelvic injuries, thereby reducing the failure rate of non-operative management, preserving maximal organ function. Surgery is not always the optimal solution for stabilization of a patient with polytrauma. Mini-invasivity and repeatability may be considered as relevant advantages. We review technical considerations, efficacy and complication rates of hepatic, splenic, renal and pelvic embolization to extrapolate current evidence about transarterial embolization in traumatic patients. PMID:26642310

[Post-traumatic arthritis in the young patient : Treatment options before the endoprosthesis].

PubMed

Burkhart, K J; Hollinger, B

2016-10-01

In the young patient, treatment of post-traumatic elbow arthritis remains difficult. Total elbow arthroplasty must be delayed for as long as possible. Therapy starts with nonoperative treatment. If this fails, operative options can be discussed. The aim of surgery is to provide a functional range of motion with acceptable pain without obstructing future treatment options. Patients with pain at terminal extension and/or flexion may benefit from arthroscopic or open debridement. Patients with advanced osteoarthritis and pain throughout the complete range of motion, who are too young for total elbow arthroplasty, are offered interposition arthroplasty or arthrodesis. Arthrodesis of the elbow leads to significant restrictions in daily life due to the complete loss of extension/flexion. Therefore, arthrodesis is only offered as treatment in exceptional circumstances. Interposition arthroplasty is a reasonable option for the young patient without significant bony defects, which may provide a stable, functional flexion arc with an acceptable pain level. Interposition arthroplasty preserves the revision options of re-interposition arthroplasty as well as the withdrawal to total elbow arthroplasty. Partial and total elbow arthroplasty are treatment options of elbow arthritis but are not subjects of this article.

Valve sparing aortic replacement - root remodeling.

PubMed

Lausberg, Henning F; Schäfers, Hans-Joachim

2006-01-01

Aortic root remodeling restores aortic root geometry and improves valve competence. We have used this technique whenever aorto-ventricular diameter is preserved. The operative technique is detained in this presentation. As a result of our 10-year experience with root remodeling we propose this operation as a reproducible option for patients with dilatation of the aortic root.

Population viability as a measure of forest sustainability

Treesearch

Eric T. Linder; Nathan A. Klaus; David A. Buehler

2004-01-01

Many forest managers work to balance timber production with protection of ecological processes and other nontimber values. The preservation of biodiversity is an important nontimber value. When a suite of management options is being developed, it is difficult to estimate quantitatively the impact of the various scenarios on biodiversity. We suggest population viability...

Chemical yields from low-temperature pyrolysis of CCA-treated wood

Treesearch

Qirong Fu; Dimitris Argyropolous; Lucian Lucia; David Tilotta; Stan Lebow

2009-01-01

Low-temperature pyrolysis offers a feasible option for wood-waste management and the recovery of a variety of useful chemicals. The effect of chromated copper arsenate (CCA) wood preservative on the yield and composition of various pyrolysis products was investigated in the present research. A novel quantitative 31P nuclear magnetic resonance (...

Modern management of uterine fibroids.

PubMed

Levy, Barbara S

2008-01-01

Uterine fibroids are the most common tumor of the reproductive tract in women of reproductive age. Although they are benign tumors that are often asymptomatic, uterine fibroids may cause debilitating symptoms in many women, such as abnormal uterine bleeding, abdominal pain, increased abdominal girth, urinary frequency, constipation, pregnancy loss, dyspareunia, and in some cases infertility. Several approaches are available for the treatment of uterine fibroids. These include pharmacologic options, such as hormonal therapies and gonadotropin-releasing hormone agonists; surgical approaches, such as hysterectomy, myomectomy, myolysis, laparoscopic uterine artery occlusion, magnetic resonance imaging-guided focused ultrasound surgery, and uterine artery embolization. The choice of approach may be dictated by factors such as the patient's desire to become pregnant in the future, the importance of uterine preservation, symptom severity, and tumor characteristics. New treatment options for uterine fibroids would be minimally invasive, have long-term data demonstrating efficacy and safety, have minimal or no incidence of fibroid recurrence, be easy to perform, preserve fertility, and be cost effective. New treatment approaches are under investigation, with the goals of being effective, safe, and less invasive.

Germline stem cells: Towards the regeneration of spermatogenesis

PubMed Central

Valli, Hanna; Phillips, Bart T.; Shetty, Gunapala; Byrne, James A.; Clark, Amander T.; Meistrich, Marvin L.; Orwig, Kyle E.

2013-01-01

Improved therapies for cancer and other conditions have resulted in a growing population of long-term survivors. Infertility is an unfortunate side effect of some cancer therapies that impacts the quality of life of survivors who are in their reproductive or pre-reproductive years. Some of these patients have the opportunity to preserve their fertility using standard technologies that include sperm, egg or embryo banking, followed by in vitro fertilization and/or embryo transfer. However, these options are not available to all patients, especially the prepubertal patients who are not yet producing mature gametes. For these patients, there are several stem cell technologies in the research pipeline that may give rise to new fertility options and allow infertile patients to have their own biological children. We will review the role of stem cells in normal spermatogenesis as well as experimental stem cell based techniques that may have potential to generate or regenerate spermatogenesis and sperm. We will present these technologies in the context of the fertility preservation paradigm, but we anticipate that they will have broad implications for the assisted reproduction field. PMID:24314923

Ethics and Oncofertility: A Call for Religious Sensitivity.

PubMed

Hanselin, Michele R; Roybal, Deborah L; Leininger, Thomas B

2017-07-01

For patients of reproductive age, treating cancer may come at the price of infertility. Literature regarding fertility preservation recommendations in this population has increased significantly, but this literature too often overlooks or insufficiently considers the relevance of religious preferences. Similarly, practice guidelines do not address the role of religion in the oncofertility discussion. The acceptance of oncofertility practices varies significantly among Christianity, Judaism, and Islam. A patient's faith-based spirituality or secular morality may enhance his or her interpretation of the meaning of illness and should be incorporated into the informed-consent process. In this article, we describe the role of religious sensitivity in oncofertility care and argue for its importance in such care. We briefly summarize the views and moral reasoning about oncofertility in a few religions commonly encountered in many patient populations today. We recommend that clinicians discuss fertility options early in the decision process and, when relevant, incorporate the patient's moral and religious preferences into the treatment plan. We encourage providers to be prepared to offer resources to patients who desire moral and spiritual guidance about fertility preservation options. Hospital chaplains should be able to provide such resources.

Hearing preservation in management of epidermoids of the cerebellopontine angle: CPA epidermoids and hearing preservation.

PubMed

Miller, Mia E; Mastrodimos, Bill; Cueva, Roberto A

2012-12-01

Surgical approaches for epidermoid cysts of the cerebellopontine angle (CPA) are dictated by tumor location. Previous reports have advocated the sacrifice of usable hearing to achieve maximal tumor resection in a single operation. The aim of the current study is to demonstrate the applicability of hearing preservation approaches in the neurotologic management of epidermoids of the CPA. Retrospective chart review. A search of archived surgical cases at a single institution between January 1, 1997, and December 31, 2011, revealed 18 cases of epidermoid cysts involving the CPA. Eighteen patients with a mean age 40.9 years underwent surgery. Average tumor size was 4.47 cm, and presenting symptoms included headache, vertigo, cranial neuropathies, and seizures. Thirteen patients underwent a retrosigmoid approach, 2 translabyrinthine, 2 pterional, and 1 retrolabyrinthine/presigmoid. Complications included CSF leak, pseudomeningocele, meningitis, cranial nerve dysfunction, and persistent imbalance. All but 5 patients had long-term follow-up imaging to chronicle tumor residua/recurrence, varying from 6 to 149 months postoperatively. The average length of follow-up was 71.4 months, and residual tumor was common, with most patients demonstrating a focal or small area of residual tumor on follow-up imaging. Two patients had undergone previous surgery for epidermoid excision elsewhere. Two patients required reoperation for epidermoid regrowth, and the times between surgeries were 44 and 78 months. Of the patients who underwent a retrosigmoid approach, 9 had postoperative audiograms. All of these patients maintained hearing at or near their preoperative level except for 2 patients whose hearing declined and one whose hearing significantly improved. Hearing preservation approaches for epidermoids of the CPA is a feasible option for long-term control of these tumors. Resection from a retrosigmoid approach can provide years of useful hearing, and the majority of patients do not require reoperation.

Embryo yield after in vitro fertilization in women undergoing embryo banking for fertility preservation before chemotherapy.

PubMed

Robertson, Audra D; Missmer, Stacey A; Ginsburg, Elizabeth S

2011-02-01

To evaluate embryo yield after IVF in patients undergoing embryo banking before chemotherapy. A retrospective cohort study. Hospital-based academic medical center. Thirty-eight women diagnosed with cancer or autoimmune disease presenting for IVF cycles, with or without intracytoplasmic sperm injection (ICSI), for embryo cryopreservation before any therapy were compared with 921 presumably fertile women undergoing IVF for male factor infertility from January 2001 through October 2007. Standard IVF or ICSI protocol, embryo freezing, and ET. The number of 2 pronuclear (2PN) embryos created and suitable for cryopreservation or transfer. No statistically significant differences were observed between preservation and male factor groups for number of embryos, number of oocytes, or amount of gonadotropin needed to stimulate follicular development. Peak serum E(2) levels were significantly lower for women with disease-seeking fertility preservation. Women facing chemotherapy as treatment for cancer or systemic autoimmune disease infrequently undergo fertility preservation. If offered this potentially fertility-preserving option, these data suggest equivalent embryo yield compared with women with infertile male partners. Our data report no significant complications in subsequent births in those who sought fertility preservation, which is informative and encouraging for these women and their providers. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Arthroscopic Excision of Bipartite Patella With Preservation of Lateral Retinaculum in an Adolescent Ice Hockey Player.

PubMed

James, Evan W; LaPrade, Christopher M; Chahla, Jorge; Cinque, Mark E; Kennedy, Nicholas I; LaPrade, Robert F

Bipartite patella usually is an asymptomatic anatomical variant. However, in some adolescent athletes, it causes anterior knee pain, resulting in decreased participation and performance. We report the case of a high-level adolescent ice hockey player who underwent successful arthroscopic excision with preservation of the lateral retinaculum of a symptomatic bipartite patella after failed nonoperative treatment. The patient returned to play by 6 weeks, and 31-month subjective follow-up scores showed high satisfaction and good clinical outcomes. For patients with a symptomatic bipartite patella, arthroscopic surgery is a good option for reducing pain and returning the athlete to competition.

Develop guidelines for pavement preservation treatments and for building a pavement preservation program platform for Alaska.

DOT National Transportation Integrated Search

2012-11-01

This reports summarizes the project findings including the following: : An evaluation of the current pavement preservation program used in Alaska and a roadmap to grow the program : A summary of the best practices in terms of pavement preserv...

Failures in risk assessment and risk management for cosmetic preservatives in Europe and the impact on public health.

PubMed

Schwensen, Jakob F; White, Ian R; Thyssen, Jacob P; Menné, Torkil; Johansen, Jeanne D

2015-09-01

In view of the current and unprecedented increase in contact allergy to methylisothiazolinone (MI), we characterized and evaluated two recent epidemics of contact allergy to preservatives used in cosmetic products to address failures in risk assessment and risk management. To evaluate temporal trends of preservative contact allergy. The study population included consecutive patch tested eczema patients seen at a university hospital between 1985 and 2013. A total of 23 138 patients were investigated for a contact allergy. The overall prevalence of contact allergy to at least one preservative increased significantly over the study period, from 6.7% in 1985 to 11.8% in 2013 (p < 0.001). Importantly, the preservatives methyldibromo glutaronitrile and MI rapidly resulted in high sensitization prevalence rates, which reached epidemic proportions. Although the proportion of patients with current clinical disease attributable to methyldibromo glutaronitrile contact allergy decreased significantly following the ban on its use in cosmetic products (p < 0.001), the sudden and high proportion of current sensitization to MI requires immediate attention (p < 0.001). The introduction of new preservatives in Europe with inadequate pre-market risk assessment has rapidly increased the overall burden of cutaneous disease caused by preservatives. We suggest that the cosmetic industry has a responsibility to react faster and replace troublesome preservatives when a preservative contact allergy epidemic is recognized, but the European Commission has the ultimate responsibility for failures in risk management after new, major sensitizing preservatives are introduced onto the market. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The State of the Art and Practice in Digital Preservation

PubMed Central

Lee, Kyong-Ho; Slattery, Oliver; Lu, Richang; Tang, Xiao; McCrary, Victor

2002-01-01

The goal of digital preservation is to ensure long-term access to digitally stored information. In this paper, we present a survey of techniques used in digital preservation. We also introduce representative digital preservation projects and case studies that provide insight into the advantages and disadvantages of different preservation strategies. Finally, the pros and cons of current strategies, critical issues for digital preservation, and future directions are discussed. PMID:27446721

Do we know how to reconcile preservation of landscapes with adaptation of agriculture to climate change? A case-study in a hilly area in Southern Italy

NASA Astrophysics Data System (ADS)

Menenti, Massimo; Alfieri, Silvia; Basile, Angelo; Bonfante, Antonello; Monaco, Eugenia; Riccardi, Maria; De Lorenzi, Francesca

2013-04-01

Limited impacts of climate change on agricultural yields are unlikely to induce any significant changes in current landscapes. Larger impacts, unacceptable on economic or social ground, are likely to trigger interventions towards adaptation of agricultural production systems by reducing or removing vulnerabilities to climate variability and change. Such interventions may require a transition to a different production system, i.e. complete substitution of current crops, or displacement of current crops at their current location towards other locations, e.g. at higher elevations within the landscape. We have assessed the impacts of climate change and evaluated options for adaptation of a valley in Southern Italy, dominated by vine and olive orchards with a significant presence of wheat. We have first estimated the climatic requirements of several varieties for each dominant species. Next, to identify options for adaptation we have evaluated the compatibility of such requirements with indicators of a reference (current) climate and of future climate. This climate - compatibility assessment was done for each soil unit within the valley, leading to maps of locations where each crop is expected to be compatible with climate. This leads to identify both potential crop substitutions within the entire valley and crop displacements from one location to another within the valley. Two climate scenarios were considered: reference (1961-90) and future (2021-2050) climate, the former from climatic statistics, and the latter from statistical downscaling of general circulation models (AOGCM). Climatic data consists of daily time series of maximum and minimum temperature, and daily rainfall on a grid with a spatial resolution of 35 km. We evaluated the adaptive capacity of the "Valle Telesina" (Campania Region, Southern Italy). A mechanistic model of water flow in the soil-plant-atmosphere system (SWAP) was used to describe the hydrological conditions in response to climate for each soil unit. Crop-specific input data and model parameters were estimated on the basis of local experiments and of scientific literature and assumed to be generically representative of the species. Time series of MODIS TIR data were used to downscale gridded climate data on air temperature for both the reference and the future climate. The results indicate that no complete crop substitution will be required within this time frame, i.e. the Valle Telesina will preserve its typical landscape features of a vine - olive orchards dominated production system, typical of many regions in Mediterranean Europe. On the other hand very significant crop displacements will be necessary to grow each variety under optimal hydrothermal conditions, from the point of view of both quantity and quality of yield. The work was carried out within the Italian national project AGROSCENARI funded by the Ministry for Agricultural, Food and Forest Policies (MIPAAF, D.M. 8608/7303/2008)

Penile sparing surgical approaches for primary penile tumors: preserving function and appearance

PubMed Central

Baumgarten, Adam S.; Fisher, John S.; Lawindy, Samuel M.; Pavlinec, Jonathan G.; Carrion, Rafael E.

2017-01-01

Penile cancer is a rare and potentially disfiguring disease. There are multiple treatment options for primary penile lesions. Penile sparing approaches offer an attractive option as they can provide several quality of life benefits without detrimental oncologic outcomes. With appropriate diagnostic evaluation and staging, penile sparing techniques provide proper cancer control with improved cosmetic and functional results. Regardless of the chosen treatment modality, a commitment to close follow-up remains a critical component of all treatment considerations. The goal of this review is to provide an overview of the multiple treatment strategies for primary penile tumors with a focus on penile sparing surgical approaches. PMID:29184777

Parotitis and Sialendoscopy of the Parotid Gland.

PubMed

Hernandez, Stephen; Busso, Carlos; Walvekar, Rohan R

2016-04-01

Nonneoplastic disorders of the salivary glands involve inflammatory processes. These disorders have been managed conservatively with antibiotics, warm compresses, massage, sialogogues, and adequate hydration. Up to 40% of patients may have an inadequate response or persistent symptoms. When conservative techniques fail, the next step is operative intervention. Sialendoscopy offers a minimally invasive option for the diagnosis and management of chronic inflammatory disorders of the salivary glands and offers the option of gland and function preservation. In this article, we review some of the more common nonneoplastic disorders of the parotid gland, indications for diagnostic and interventional sialendoscopy, and operative techniques. Copyright © 2016 Elsevier Inc. All rights reserved.

Insulin-Like Growth Factor-1 Preserves Salivary Gland Function After Fractionated Radiation

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

Limesand, Kirsten H., E-mail: limesank@u.arizona.ed; Department of Nutritional Sciences, University of Arizona, Tucson, AZ; Avila, Jennifer L.

Purpose: Radiotherapy for head-and-neck cancer consists of fractionated radiation treatments that cause significant damage to salivary glands leading to chronic salivary gland dysfunction with only limited prevention and treatment options currently available. This study examines the feasibility of IGF-1 in preserving salivary gland function following a fractionated radiation treatment regimen in a pre-clinical model. Methods and Materials: Mice were exposed to fractionated radiation, and salivary gland function and histological analyses of structure, apoptosis, and proliferation were evaluated. Results: In this study, we report that treatment with fractionated doses of radiation results in a significant level of apoptotic cells in FVBmore » mice after each fraction, which is significantly decreased in transgenic mice expressing a constitutively active mutant of Akt1 (myr-Akt1). Salivary gland function is significantly reduced in FVB mice exposed to fractionated radiation; however, myr-Akt1 transgenic mice maintain salivary function under the same treatment conditions. Injection into FVB mice of recombinant insulin-like growth factor-1 (IGF-1), which activates endogenous Akt, suppressed acute apoptosis and preserved salivary gland function after fractionated doses of radiation 30 to 90 days after treatment. FVB mice exposed to fractionated radiation had significantly lower levels of proliferating cell nuclear antigen-positive salivary acinar cells 90 days after treatment, which correlated with a chronic loss of function. In contrast, FVB mice injected with IGF-1 before each radiation treatment exhibited acinar cell proliferation rates similar to those of untreated controls. Conclusion: These studies suggest that activation of IGF-1-mediated pathways before head-and-neck radiation could modulate radiation-induced salivary gland dysfunction and maintain glandular homeostasis.« less

Mechanical properties and release rates of cinnamon oil infused into PLA and Waxy Starch for single-serving cups

USDA-ARS?s Scientific Manuscript database

Consumers demand a safe food supply and are increasingly demanding natural options. Packaging is one of the most important technologies for preserving the quality of food and food products and for ensuring their safety. Food packaging, either rigid or flexible, functions as a barrier to light, humid...

Conservation of ectomycorrhizal fungi: green-tree retention preserves species diversity

Treesearch

Joyce L. Eberhart; Daniel L. Luoma

2013-01-01

Th e Demonstration of Ecosystem Management Options (DEMO) project is a large, interdisciplinary study designed to test the biological and silvicultural eff ects of green-tree retention in Douglas-fi r (Pseudotsuga menziesii) forests. Six treatments were replicated on six blocks in Washington and Oregon, USA: no harvest, 75 percent aggregated, 40 percent (dispersed and...

21 CFR 150.161 - Artificially sweetened fruit preserves and jams.

Code of Federal Regulations, 2010 CFR

2010-04-01

.... Such food may also contain one or more of the following optional ingredients: (1) Spice, spice oil, spice extract. (2) A vinegar, lemon juice, lime juice, citric acid, lactic acid, malic acid, tartaric..., “___ added” or “with added ___”, the blank being filled in with the words “spice”, “spice oil”, or “spice...

Castration-resistant Prostate Cancer: Preservation of Quality of Life and Well-being.

PubMed

Rosario, Derek J; Greasley, Rosa; Bourke, Liam

2016-12-01

Managing optimal health in castrate-resistant prostate cancer is a complex clinical challenge. Quality of life should be assessed with disease-specific validated tools and can be used in clinical practice to assist in considering management options. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Rural Development Issues in the Northeast: 2000-2005. Working Paper.

ERIC Educational Resources Information Center

Goetz, Stephan J.

This paper examines social and economic forces affecting rural areas at the beginning of the 21st century and lists potential strategies to cope with those concerns. Rural development is necessary to place rural and urban areas on a more equal footing, compensate for the youth "brain drain," preserve the retirement-option value, relieve…

Reduced-impact logging and temporal activity of understorey bats in lowland Amazonia

Treesearch

Ivan Castro Arellano; Steven J. Presley; Michael R. Willig; Joseph M. Wunderle; Luiz N. Saldanha

2009-01-01

Because global timber demands continue to threaten tropical rain forests, identification of sustainable use forest management protocols that meet human needs while preserving biodiversity is critical. Reduced-impact logging (RIL) protocols are increasingly common in the tropics and may be a viable option for sustainable forest use; however, few studies have documented...

New directions in the rational design of electrical and magnetic seizure therapies: individualized Low Amplitude Seizure Therapy (iLAST) and Magnetic Seizure Therapy (MST).

PubMed

Radman, Thomas; Lisanby, Sarah H

2017-04-01

Electroconvulsive therapy remains a key treatment option for severe cases of depression, but undesirable side-effects continue to limit its use. Innovations in the design of novel seizure therapies seek to improve its risk benefit ratio through enhanced control of the focality of stimulation. The design of seizure therapies with increased spatial precision is motivated by avoiding stimulation of deep brain structures implicated in memory retention, including the hippocampus. The development of two innovations in seizure therapy-individualized low-amplitude seizure therapy (iLAST) and magnetic seizure therapy (MST), are detailed. iLAST is a method of seizure titration involving reducing current spread in the brain by titrating current amplitude from the traditional fixed amplitudes. MST, which can be used in conjunction with iLAST dosing methods, involves the use of magnetic stimulation to reduce shunting and spreading of current by the scalp occurring during electrical stimulation. Evidence is presented on the rationale for increasing the focality of ECT in hopes of preserving its effectiveness, while reducing cognitive side-effects. Finally, the value of electric field and neural modelling is illustrated to explain observed clinical effects of modifications to ECT technique, and their utility in the rational design of the next generation of seizure therapies.

An Onyx tunnel: reconstructive transvenous balloon-assisted Onyx embolization for dural arteriovenous fistula of the transverse-sigmoid sinus.

PubMed

Kerolus, Mena G; Chung, Joonho; Munich, Stephen A; Matsuda, Yoshikazu; Okada, Hideo; Lopes, Demetrius K

2017-11-17

Transvenous embolization is an effective method for treating dural arteriovenous fistulas (DAVFs) of the transverse-sigmoid sinus (TSS). However, in cases of complicated DAVFs, it is difficult to preserve the patency of the dural sinus. The authors describe the technical details of a new reconstructive technique using transvenous balloon-assisted Onyx embolization as another treatment option in a patient with an extensive and complex DAVF of the left TSS. A microcatheter and compliant balloon catheter were navigated into the left internal jugular vein and placed at the distal end of the DAVF in the transverse sinus. The microcatheter was placed between the vessel wall of the TSS and the balloon. After the balloon was fully inflated, Onyx-18 was injected at the periphery of the balloon in a slow, controlled, progressive, stepwise manner; the balloon and microcatheter were simultaneously withdrawn toward the sigmoid sinus, with Onyx encompassing the entirety of the complex DAVF. The Onyx refluxed into multiple arterial feeders in a distal-to-proximal step-by-step manner, ultimately resulting in an Onyx tunnel. The final angiography study revealed complete obliteration of the DAVF and patency of the TSS. The Onyx tunnel, or reconstructive transvenous balloon-assisted Onyx embolization technique, may be an effective treatment option for large, complex DAVFs of the TSS. This technique may provide another option to facilitate the complete obliteration of the DAVF while preserving the functional sinus.

Surgical management of vestibular schwannoma: attempted preservation of hearing and facial function.

PubMed

Youssef, T F; Matter, A; Ahmed, M R

2013-05-01

Vestibular schwannomas are benign tumours which usually originate from the vestibular portion of the VIIIth cranial nerve. Treatment options include observation with serial imaging, stereotactic radiation and microsurgical removal. The goal of surgery was complete eradication of tumour with preservation of hearing and facial nerve function. A retrospective review was undertaken of 24 cases of vestibular schwannoma jointly operated upon by a team of neurosurgeons and otologists at the Suez Canal University Hospital, with assessment of VIIth and VIIIth cranial nerve function, tumour size, and extent of growth. All surgery utilised a retromastoid, suboccipital approach. Complete tumour removal was achieved in 19 patients. Anatomical preservation of the facial nerve was possible in 66.6 per cent of patients. Pre-operative, useful hearing was present in four patients, and preserved in 80 per cent. Cerebrospinal fluid leakage was diagnosed in two (8.3 per cent) patients, who responded to conservative therapy. The retromastoid, suboccipital surgical approach to the skull base can be safely and successfully achieved using a microsurgical technique, with minimal or no damage to neurovascular structures, even for large tumours.

Meniscus tear surgery and meniscus replacement

PubMed Central

Vaquero, Javier; Forriol, Francisco

2016-01-01

Summary Objective the menisci are easily injured and difficult to repair. The aim of this study was to analyze the current state of meniscal surgery aimed at preserving morphology and conserving the biomechanics of the knee to prevent joint degeneration. Methodology a search of the electronic medical literature database Medline was conducted, from http://www.ncbi.nlm.nih.gov/pubmed. The search was not limited by language. Candidate articles were identified by searching for those that included the keywords meniscus, surgery, suture, implant, allograft. The limits were included for clinical research and clinical trials. Basic research was not included. The studies selected were evaluated and classified in three different categories: basic science, reconstruction (suture and meniscectomy) and implants (scaffolds and allograft). Results the consequences of meniscectomy performed at a young age can lead to a joint cartilage degeneration twenty years later. There are few surgical options for the repair of meniscal injuries in order both to preserve the meniscus and to ensure the long term survival of the knee joint, meniscectomy, repair, suturing the tear, or reconstruction, when a meniscal allograft or synthetic substitute is used to replace the meniscus, but the biomechanical properties of the native meniscus are not reproduced entirely by the scaffolds that exist today. Conclusion therapies that successfully repair or replace the meniscus are therefore likely to prevent or delay osteoarthritis progression. PMID:27331034

Fertility preservation in pediatric and adolescent cancer patients in Switzerland: A qualitative cross-sectional survey.

PubMed

Diesch, Tamara; von der Weid, Nicolas Xavier; Szinnai, Gabor; Schaedelin, Sabine; De Geyter, Christian; Rovó, Alicia

2016-10-01

Fertility preservation (FP) is an important topic of discussion in the field of oncology, particularly in pediatric oncology. Despite the awareness of severe impact of infertility on quality of life and different guidelines available in this area, the options in FP are not routinely discussed with the pediatric cancer patients and their parents. To the best of our knowledge, this is the first survey report concerned to FP counseling and procedures in pediatric and adolescent cancer patients in Switzerland. This survey was conducted from June 2014 to October 2014 on the counseling and procedures performed between 2009 and 2013; the questionnaire was completed by one of the professional from hematology/oncology centers in Switzerland. Currently, only four out of nine centers have a program for FP. In 2013, 45/301 (15%) patients received FP counseling and 36/301 (12%) underwent an FP procedure. The most commonly performed procedures from 2009 to 2013 were administration of gonadotropin releasing hormone agonist (3%) and cryopreservation of ovarian tissue in females (3%) and cryopreservation of sperms in males (6%); the most frequently cited reason for the absence of FP counseling was lack of time (55%). Therefore, this survey should help to develop and harmonize practices with respect to FP counseling and procedures in Switzerland, and to establish FP as a standard of care during cancer treatment. Copyright © 2016. Published by Elsevier Ltd.

48 CFR 570.401 - Renewal options.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Renewal options. 570.401... Requirements 570.401 Renewal options. (a) Exercise of options. Before exercising an option to renew, follow the... survey. Before exercising an option to renew a lease, review current market information to ensure the...

26 CFR 1.401(a)(4)-4 - Nondiscriminatory availability of benefits, rights, and features.

Code of Federal Regulations, 2014 CFR

2014-04-01

... with respect to an optional form of benefit or a social security supplement is disregarded in determining whether the optional form of benefit or the social security supplement is currently available to... determining the current availability of an optional form of benefit or social security supplement if the...

26 CFR 1.401(a)(4)-4 - Nondiscriminatory availability of benefits, rights, and features.

Code of Federal Regulations, 2013 CFR

2013-04-01

... with respect to an optional form of benefit or a social security supplement is disregarded in determining whether the optional form of benefit or the social security supplement is currently available to... determining the current availability of an optional form of benefit or social security supplement if the...

26 CFR 1.401(a)(4)-4 - Nondiscriminatory availability of benefits, rights, and features.

Code of Federal Regulations, 2012 CFR

2012-04-01

... with respect to an optional form of benefit or a social security supplement is disregarded in determining whether the optional form of benefit or the social security supplement is currently available to... determining the current availability of an optional form of benefit or social security supplement if the...

Current Trends in Preservation Research and Development.

ERIC Educational Resources Information Center

Cunha, George Martin

1990-01-01

Overview of current trends in the preservation of library materials discusses collections conservation and management; climate control; insect and mold control; fire control; the effects of compact shelving; freezing and freeze-drying; space drying; alkaline paper; recycled paper; mass deacidification; and paper strengthening. (27 notes and…

What Women Want from Their Health Care Providers about Pregnancy Options Counseling: A Qualitative Study.

PubMed

French, Valerie A; Steinauer, Jody E; Kimport, Katrina

Unintended pregnancy is common in the United States, yet scant research has evaluated women's preferences on pregnancy options counseling. This study explores pregnant women's preferences for pregnancy options counseling from health care providers. We conducted semistructured interviews with pregnant women at a prenatal clinic and an abortion clinic. We asked women about recent discussions-or lack thereof-about pregnancy options (parenting, adoption, and abortion) with a clinician, and what they would want their provider to discuss about pregnancy options. We analyzed transcripts using modified grounded theory. We interviewed 10 women in prenatal care and 18 women seeking abortion. In both settings, most said clinicians should discuss pregnancy options with pregnant women and 1) respect patient autonomy, 2) avoid assumptions about a woman's desired pregnancy outcome, and 3) consider the patient-including her health and fertility intentions-beyond her pregnancy. Participants wanted their doctors to assess a pregnancy's individual circumstances to determine the appropriateness of options counseling. A few participants, including women who did and did not receive options counseling, reported they personally preferred not to receive such counseling. Explaining this preference, they cited preservation of privacy, having already made a decision for the pregnancy, or just not wanting to discuss abortion. Regarding best practices for providing options counseling, participants said it should be done in a routine manner, with discretion, and early in pregnancy. Pregnant women seeking both prenatal and abortion care broadly support options counseling. Discussion of pregnancy options, including abortion, provides patient-centered care and supports women's preferences. Copyright © 2017 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

A feasibility study of municipal solid waste incineration fly ash utilisation in Estonia.

PubMed

Berber, Hakan; Frey, Ruedi; Voronova, Viktoria; Koroljova, Arina

2017-09-01

The purpose of this paper is to discuss the alternative environmental management options for the utilisation of municipal solid waste (MSW) incineration fly ash (FA), which is generated at Iru Power Plant where MSW is incinerated in Estonia. To determine sustainable and economically feasible environmental management options for MSW incineration FA in Estonia, CO 2 sequestration with a further carbonation process was examined. A partial Cost & Benefit Analysis has been conducted to compare the carbonation process to the current situation. Two carbonation options were developed. Option 1 is to use carbonated FA in any other processes based on the waste-to-product principle. Option 2 is to send carbonated FA to the non-hazardous landfill in Tallinn, Estonia. Important parameters, such as Net Present Value (NPV), Internal Rate of Return (IRR), Benefit-Cost Ratio (BCR) and Break Even Point (BEP), have been calculated for carbonation options and the current case. In addition, a sensitivity analysis has been conducted to examine its robustness. The results showed that the best option is carbonation Option 1 with NPV of 9,209,662 EUR, IRR of 43%, BCR of 2.63 and BEP between 2018 and 2019. Both Options 1 and 2 constitute more sustainable and environmentally friendly management options compared to the current situation. It can be concluded that this preliminary feasibility study showed that running a carbonation plant may be profitable and sustainable for Estonia. Currently, there is no treatment technology for MSW incineration FA in Estonia and FA is sent to a neighbouring country for further utilisation. This is the first study to demonstrate FA management options with economic and environmental benefits.

Pathways: patient-centred decision counselling for women at risk of cancer-related infertility: a protocol for a comparative effectiveness cluster randomised trial.

PubMed

Woodard, Terri Lynn; Hoffman, Aubri S; Crocker, Laura C; Holman, Deborah A; Hoffman, Derek B; Ma, Jusheng; Bassett, Roland L; Leal, Viola B; Volk, Robert J

2018-02-21

National guidelines recommend that all reproductive-age women with cancer be informed of their fertility risks and offered referral to fertility specialists to discuss fertility preservation options. However, reports indicate that only 5% of patients have consultations, and rates of long-term infertility-related distress remain high. Previous studies report several barriers to fertility preservation; however, initial success has been reported using provider education, patient decision aids and navigation support. This protocol will test effects of a multicomponent intervention compared with usual care on women's fertility preservation knowledge and decision-making outcomes. This cluster-randomised trial will compare the multicomponent intervention (provider education, patient decision aid and navigation support) with usual care (consultation and referral, if requested). One hundred newly diagnosed English-speaking women of reproductive age who are at risk of cancer-related infertility will be recruited from four regional oncology clinics.The Pathways patient decision aid website provides (1) up-to-date evidence and descriptions of fertility preservation and other family-building options, tailored to cancer type; (2) structured guidance to support personalising the information and informed decision-making; and (3) a printable summary to help women prepare for discussions with their oncologist and/or fertility specialist. Four sites will be randomly assigned to intervention or control groups. Participants will be recruited after their oncology consultation and asked to complete online questionnaires at baseline, 1 week and 2 months to assess their demographics, fertility preservation knowledge, and decision-making process and quality. The primary outcome (decisional conflict) will be tested using Fisher's exact test. Secondary outcomes will be assessed using generalised linear mixed models, and sensitivity analyses will be conducted, as appropriate. The University of Texas MD Anderson Cancer Center provided approval and ongoing review of this protocol. Results will be presented at relevant scientific meetings and submitted for publication in a peer-reviewed journal. NCT03141437; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

[Preservation of ability to work and securing vocational participation : non-pharmaceutical support options for rheumatologists].

PubMed

Drambyan, Y; Parthier, K

2014-02-01

For patients of working age with chronic rheumatic diseases preservation of the ability to work and therefore for equal participation in professional life is of particular importance. Significant supporting actions by rheumatologists include non-pharmaceutical and non-medical interventions in addition to drug therapy. Measures aiming at sustained working capacity such as physiotherapy, occupational therapy, medical rehabilitation and stepwise return to work have to be utilized. This support can include referral to a counseling service and assistance with the application for medical or vocational rehabilitation programs. In order to ensure sustainable success of the initiated measures it is essential that follow-up care and function-related interventions are supervised by a rheumatologist.

The direct assignment option as a modular design component: an example for the setting of two predefined subgroups.

PubMed

An, Ming-Wen; Lu, Xin; Sargent, Daniel J; Mandrekar, Sumithra J

2015-01-01

A phase II design with an option for direct assignment (stop randomization and assign all patients to experimental treatment based on interim analysis, IA) for a predefined subgroup was previously proposed. Here, we illustrate the modularity of the direct assignment option by applying it to the setting of two predefined subgroups and testing for separate subgroup main effects. We power the 2-subgroup direct assignment option design with 1 IA (DAD-1) to test for separate subgroup main effects, with assessment of power to detect an interaction in a post-hoc test. Simulations assessed the statistical properties of this design compared to the 2-subgroup balanced randomized design with 1 IA, BRD-1. Different response rates for treatment/control in subgroup 1 (0.4/0.2) and in subgroup 2 (0.1/0.2, 0.4/0.2) were considered. The 2-subgroup DAD-1 preserves power and type I error rate compared to the 2-subgroup BRD-1, while exhibiting reasonable power in a post-hoc test for interaction. The direct assignment option is a flexible design component that can be incorporated into broader design frameworks, while maintaining desirable statistical properties, clinical appeal, and logistical simplicity.

Management options of varicoceles

PubMed Central

Chan, Peter

2011-01-01

Varicocele is one of the most common causes of male infertility. Treatment options for varicoceles includes open varicocelectomy performed at various anatomical levels. Laparoscopic varicocelectomy has been established to be a safe and effective treatment for varicoceles. Robotic surgery has been introduced recently as an alternative surgical option for varicocelectomy. Microsurgical varicocelectomy has gained increasing popularity among experts in male reproductive medicine as the treatment of choice for varicocele because of its superior surgical outcomes. There is a growing volume of literature in the recent years on minimal invasive varicocele treatment with percutaneous retrograde and anterograde venous embolization/sclerotherapy. In this review, we will discuss the advantages and limitations associated with each treatment modality for varicoceles. Employment of these advanced techniques of varicocelectomy can provide a safe and effective approach aiming to eliminate varicocele, preserve testicular function and, in a substantial number of men, increase semen quality and the likelihood of pregnancy. PMID:21716892

Conservation, Preservation, and Digitization.

ERIC Educational Resources Information Center

Lynch, Clifford A.; Brownrigg, Edwin B.

1986-01-01

Digital technologies should be considered a method of preservation for library materials. Current conservation strategies of restoration, deacidification, and microfilming are expensive, and they limit access. Digitization offers improved access while preserving materials and reflects a change in the library role from depository of printed…

Whale Preservation. Grades Five to Nine.

ERIC Educational Resources Information Center

Racicot, Darlene

Dedicated to the conservation and preservation of whales, dolphins, and porpoises through public education, this instructional unit for grades 5-9 provides current (1993) facts, lesson plans, activities, and conservation and preservation techniques. Interdisciplinary activities involve students in debates, critical thinking, research, and…

The Guaranteed Student Loan Program: Options for Controlling Federal Costs While Preserving Needed Credit for College. A Discussion Paper.

ERIC Educational Resources Information Center

College Entrance Examination Board, Washington, DC.

The Reagan Administration's proposals concerning the Guaranteed Student Loan (GSL) Program and possible alternatives are examined. A variety of proposals are analyzed in terms of the estimated cost savings and potential effects on the supply of and demand for student loans. Background is also included on the history of legislative changes and…

Women: Tapping a New Resource for Energy.

ERIC Educational Resources Information Center

Consumer Action Now, New York, NY.

In 1973 the Arab oil embargo triggered what has come to be known as the "energy crisis." In 1974, Consumer Action Now (CAN) decided to devote its full efforts to the grave issues of energy and to look for options that would preserve our choices as a new energy era is entered. Any transition to a more energy-efficient society depends on a…

Moisture Sorption, Biological Durability, and Mechanical Performance of WPC Containing Modified Wood and Polylactates

Treesearch

B. Kristoffer Segerholm; Rebecca E. Ibach; Mats Westin

2012-01-01

Biological durability is an important feature for wood-plastic composites (WPC) intended for outdoor applications. One route to achieving WPC products with increased biological durability is to use wood preservative agents in the formulation of the WPC. Another option could be to use a chemically modified wood component that already exhibits increased resistance to...

78 FR 59394 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing of Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-26

.... exchange-traded covered call options on the Index in order to seek additional cash flow in the form of... more closely approximate those of the markets in which it invests), to manage cash flows or to preserve... Creation Units for cash, the Fund may incur additional costs associated with the acquisition of Deposit...

78 FR 78437 - Self-Regulatory Organizations; BOX Options Exchange LLC; Notice of Filing of Amendment Nos. 1 and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-26

... distinctions between non-Complex Orders on the BOX Book \\8\\ and Complex Orders. COPIP also would preserve the already established execution priority of interest on the BOX Book over Complex Orders \\9\\ by providing that the bids and offers on the BOX Book for the individual legs of a Strategy (``BOX Book Interest...

Natural Tooth Pontic: An Instant Esthetic Option for Periodontally Compromised Teeth—A Case Series

PubMed Central

Raj, Rishi; Narayan, Ipshita; Gowda, Triveni Mavinakote; Mehta, D. S.

2016-01-01

Sudden tooth loss in the esthetic zone of the maxillary or mandibular anterior region can be due to trauma, periodontal disease, or endodontic failure. The treatment options for replacing the missing tooth can vary between removable prosthesis, tooth-supported prosthesis, and implant-supported prosthesis. Irrespective of the final treatment, the first line of management would be to provisionally restore the patient's esthetic appearance at the earliest, while functionally stabilizing the compromised arch. Using the patient's own natural tooth as a pontic offers the benefits of being the right size, shape, and color and provides exact repositioning in its original intraoral three-dimensional position. Additionally, using the patient's platelet concentrate (platelet rich fibrin) facilitates early wound healing and preservation of alveolar ridge shape following tooth extraction. The abutment teeth can also be preserved with minimal or no preparation, thus keeping the technique reversible, and can be completed at the chair side thereby avoiding laboratory costs. This helps the patient better tolerate the effect of tooth loss psychologically. The article describes a successful, immediate, and viable technique for rehabilitation of three different patients requiring replacement of a single periodontally compromised tooth in an esthetic region. PMID:27994892

State of the art on oocyte cryopreservation in female cancer patients: A critical review of the literature.

PubMed

Massarotti, Claudia; Scaruffi, Paola; Lambertini, Matteo; Remorgida, Valentino; Del Mastro, Lucia; Anserini, Paola

2017-06-01

During the last decades, important advances in therapeutic options have led to increased survival rates in cancer patients; however, cancer treatments are associated with several potential adverse effects including infertility in those diagnosed during their reproductive years. A proper discussion about fertility preservation options before the use of therapies with potential gonadotoxicity (i.e. oncofertility counseling) is standard of care and should be offered to all patients of childbearing age. Temporary ovarian suppression with LH-RH analogs, oocyte and embryo cryopreservation are standard strategies for fertility preservation in female cancer patients. Oocyte cryopreservation should be preferred to embryo cryopreservation when this latter is prohibited by law, avoided for ethical or religious issues and in single women refusing sperm donation. Despite the increasing use of this strategy, data are still lacking about the efficacy and safety of the procedure in female cancer patients, with most of the evidence on this regard deriving from infertile non-oncologic women. This article aims at critically review the available evidence about the success of oocyte cryopreservation in female cancer patients with the final goal to further improve the oncofertility counseling of these women. Copyright © 2017 Elsevier Ltd. All rights reserved.

Algorithm for Simulating Atmospheric Turbulence and Aeroelastic Effects on Simulator Motion Systems

NASA Technical Reports Server (NTRS)

Ercole, Anthony V.; Cardullo, Frank M.; Kelly, Lon C.; Houck, Jacob A.

2012-01-01

Atmospheric turbulence produces high frequency accelerations in aircraft, typically greater than the response to pilot input. Motion system equipped flight simulators must present cues representative of the aircraft response to turbulence in order to maintain the integrity of the simulation. Currently, turbulence motion cueing produced by flight simulator motion systems has been less than satisfactory because the turbulence profiles have been attenuated by the motion cueing algorithms. This report presents a new turbulence motion cueing algorithm, referred to as the augmented turbulence channel. Like the previous turbulence algorithms, the output of the channel only augments the vertical degree of freedom of motion. This algorithm employs a parallel aircraft model and an optional high bandwidth cueing filter. Simulation of aeroelastic effects is also an area where frequency content must be preserved by the cueing algorithm. The current aeroelastic implementation uses a similar secondary channel that supplements the primary motion cue. Two studies were conducted using the NASA Langley Visual Motion Simulator and Cockpit Motion Facility to evaluate the effect of the turbulence channel and aeroelastic model on pilot control input. Results indicate that the pilot is better correlated with the aircraft response, when the augmented channel is in place.

Idiopathic membranous nephropathy: outline and rationale of a treatment strategy.

PubMed

du Buf-Vereijken, Peggy W G; Branten, Amanda J W; Wetzels, Jack F M

2005-12-01

Idiopathic membranous nephropathy is a common cause of nephrotic syndrome. The treatment of patients with idiopathic membranous nephropathy is heavily debated. Based on literature data and our own experience, we propose a rational treatment strategy. Patients with renal insufficiency (serum creatinine level > 1.5 mg/dL [> 135 micromol/L]) are at greatest risk for the development of end-stage renal disease and should receive immunosuppressive therapy. In patients with normal renal function (serum creatinine level < 1.5 mg/dL [< 135 micromol/L]), risk for developing end-stage renal disease can be estimated by measuring urinary excretion of beta2-microglobulin or alpha1-microglobulin and immunoglobulin G. For low-risk patients, a wait-and-see policy is advised. High-risk patients likely benefit from immunosuppressive therapy. Currently, combinations of steroids with chlorambucil or cyclophosphamide are the best studied. We prefer cyclophosphamide in view of its fewer side effects. Cyclosporine may be an alternative option in patients with well-preserved renal function, although long-term data are lacking. Other immunosuppressive agents, such as mycophenolate mofetil or rituximab, currently are under study; however, data are insufficient to support their routine use.

Valve-sparing options in tetralogy of Fallot surgery.

PubMed

Bacha, Emile

2012-01-01

Given late outcomes of patients with tetralogy of Fallot repaired in the 1970s and 1980s, as well as a better understanding of the late deleterious effects of pulmonary regurgitation, there is a tendency toward preservation of the pulmonary valve function during primary repair of tetralogy of Fallot. The bar keeps moving downward, to include smaller and more dysmorphic pulmonary valves. This article reviews some useful indications and techniques for valve-sparing options, including intraoperative balloon dilation and cusp reconstruction using a patch. Just like other valve repair techniques, no one technique can be applied uniformly, and surgeons must master a wide armamentarium of techniques. Copyright © 2012 Elsevier Inc. All rights reserved.

Preserved, deteriorated, and premorbidly impaired patterns of intellectual ability in schizophrenia.

PubMed

Ammari, Narmeen; Heinrichs, R Walter; Pinnock, Farena; Miles, Ashley A; Muharib, Eva; McDermid Vaz, Stephanie

2014-05-01

The main purpose of this investigation was to identify patterns of intellectual performance in schizophrenia patients suggesting preserved, deteriorated, and premorbidly impaired ability, and to determine clinical, cognitive, and functional correlates of these patterns. We assessed 101 patients with schizophrenia or schizoaffective disorder and 80 non-psychiatric control participants. The "preserved" performance pattern was defined by average-range estimated premorbid and current IQ with no evidence of decline (premorbid-current IQ difference <10 points). The "deteriorated" pattern was defined by a difference between estimated premorbid and current IQ estimates of 10 points or more. The premorbidly "impaired" pattern was defined by below average estimated premorbid and current IQ and no evidence of decline greater than 10 points. Preserved and deteriorated patterns in healthy controls were also identified and studied in comparison to patient findings. The groups were compared on demographic, neurocognitive, clinical and functionality variables. Patients with the preserved pattern outperformed those meeting criteria for deteriorated and compromised intellectual ability on a composite measure of neurocognitive ability as well as in terms of functional competence. Patients demonstrating the deteriorated and compromised patterns were equivalent across all measures. However, "preserved" patients failed to show any advantage in terms of community functioning and demonstrated cognitive impairments relative to control participants. Our results suggest that proposed patterns of intellectual decline and stability exist in both the schizophrenia and general populations, but may not hold true across other cognitive abilities and do not translate into differential functional outcome.

Portable power supply options for positive airway pressure devices.

PubMed

Riaz, Muhammad; Certal, Victor; Camacho, Macario

2015-01-01

Patients with obstructive sleep apnea (OSA) often face the challenge of how to power their positive airway pressure (PAP) devices when alternating current power supplies are not available in remote areas with lack of electricity or frequent power outages. This article elucidates portable power supply options for PAP devices with the aim to increase alternative power source awareness among medical providers. A search of scientific databases (Medline, Scopus, Web of Science, Google Scholar, and the Cochrane Library) was carried out on the topic of alternative portable power supply options for treatment of OSA. Scientific databases listed above yielded only limited results. Most articles were found via Google search. These articles were reviewed for alternative power supply options for OSA patients when alternating current is not available. The power supply options in this article include lead-acid batteries (starter, marine and deep-cycle batteries), lithium ion batteries, solar kits, battery packs, backup power systems, portable generators, and travel-size PAP devices. There are several options to power PAP devices with direct current when alternating current is not available. Knowledgeable primary care physicians especially in rural and remote areas can help OSA patients improve PAP compliance in order to mitigate morbidity and long-term complications of OSA.

Reasons Why Young Women Accept or Decline Fertility Preservation After Cancer Diagnosis.

PubMed

Hershberger, Patricia E; Sipsma, Heather; Finnegan, Lorna; Hirshfeld-Cytron, Jennifer

2016-01-01

To understand young women's reasons for accepting or declining fertility preservation after cancer diagnosis to aid in the development of theory regarding decision making in this context. Qualitative descriptive. Participants' homes or other private location. Twenty-seven young women (mean age, 29 years) diagnosed with cancer and eligible for fertility preservation. Recruitment was conducted via the Internet and in fertility centers. Participants completed demographic questionnaires and in-depth semi-structured interviews. Tenets of grounded theory guided an inductive and deductive analysis. Young women's reasons for deciding whether to undergo fertility preservation were linked to four theoretical dimensions: Cognitive Appraisals, Emotional Responses, Moral Judgments, and Decision Partners. Women who declined fertility preservation described more reasons in the Cognitive Appraisals dimension, including financial cost and human risks, than women who accepted. In the Emotional Responses dimension, most women who accepted fertility preservation reported a strong desire for biological motherhood, whereas women who declined tended to report a strong desire for surviving cancer. Three participants who declined reported reasons linked to the Moral Judgments dimension, and most participants were influenced by Decision Partners, including husbands, boyfriends, parents, and clinicians. The primary reason on which many but not all participants based decisions related to fertility preservation was whether the immediate emphasis of care should be placed on surviving cancer or securing options for future biological motherhood. Nurses and other clinicians should base education and counseling on the four theoretical dimensions to effectively support young women with cancer. Copyright © 2016 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

Reasons Why Young Women Accept or Decline Fertility Preservation Following Cancer Diagnosis

PubMed Central

Hershberger, Patricia E.; Sipsma, Heather; Finnegan, Lorna; Hirshfeld-Cytron, Jennifer

2015-01-01

Objective To understand young women’s reasons for accepting or declining fertility preservation following cancer diagnosis to aid in the development of theory regarding decision making in this context. Design Qualitative descriptive. Setting Participants’ homes or other private location. Participants Twenty-seven young women (mean age = 29 years) diagnosed with cancer and eligible for fertility preservation. Methods Recruitment was conducted via the Internet and in fertility centers. Participants completed demographic questionnaires and in-depth semi-structured interviews. Tenets of grounded theory guided an inductive and deductive analysis. Results Young women’s reasons for deciding whether to undergo fertility preservation were linked to four theoretical dimensions: Cognitive Appraisals, Emotional Responses, Moral Judgments, and Decision Partners. Women who declined fertility preservation described more reasons in the Cognitive Appraisals dimension, including financial cost and human risks, than women who accepted. In the Emotional Responses dimension, most women who accepted fertility preservation reported a strong desire for biological motherhood, whereas women who declined tended to report a strong desire for surviving cancer. Three participants who declined reported reasons linked to the Moral Judgments dimension, and the majority were influenced by Decision Partners, including husbands, boyfriends, parents, and clinicians. Conclusion The primary reason upon which many but not all participants based decisions related to fertility preservation was whether the immediate emphasis of care should be placed on surviving cancer or securing options for future biological motherhood. Nurses and other clinicians should base education and counseling on the four theoretical dimensions to effectively support young women with cancer. PMID:26815806

Chronic orchialgia: Review of treatments old and new

PubMed Central

Tojuola, Bayo; Layman, Jeffrey; Kartal, Ibrahim; Gudelogul, Ahmet; Brahmbhatt, Jamin; Parekattil, Sijo

2016-01-01

Introduction: Chronic orchialgia is historically and currently a challenging disease to treat. It is a diagnostic and therapeutic challenge for physicians. Conservative therapy has served as the first line of treatment. For those who fail conservative therapy, surgical intervention may be required. We aim to provide a review of currently available surgical options and novel surgical treatment options. Methods: A review of current literature was performed using PubMed. Literature discussing treatment options for chronic orchialgia were identified. The following search terms were used to identify literature that was relevant to this review: Chronic orchialgia, testicular pain, scrotal content pain, and microsurgical denervation of the spermatic cord (MDSC). Results: The incidence of chronic orchialgia has been increasing over time. In the USA, it affects up to 100,000 men per year due to varying etiologies. The etiology of chronic orchialgia can be a confounding problem. Conservative therapy should be viewed as the first line therapy. Studies have reported poor success rates. Current surgical options for those who fail conservative options include varicocelectomy, MDSC, epididymectomy, and orchiectomy. Novel treatment options include microcryoablation of the peri-spermatic cord, botox injection, and amniofix injection. Conclusion: Chronic orchialgia has been and will continue to be a challenging disease to treat due to its multiple etiologies and variable treatment outcomes. Further studies are needed to better understand the problem. Treatment options for patients with chronic orchialgia are improving. Additional studies are warranted to better understand the long-term durability of this treatment options. PMID:26941490

The Farm Credit Situation: Implications for Agricultural Policy.

ERIC Educational Resources Information Center

Bullock, J. Bruce

1986-01-01

Examines issues regarding current farm finance situation from a public policy perspective: origins and causes of current situation, available policy options for dealing with the problems, and impacts of policy options. (NEC)

Surgical and endoscopic treatment of pain in chronic pancreatitis: a multidisciplinary update.

PubMed

Issa, Y; van Santvoort, H C; van Goor, H; Cahen, D L; Bruno, M J; Boermeester, M A

2013-01-01

Chronic pancreatitis is an inflammatory disease of the pancreas with abdominal pain as the most prominent symptom. Adequate treatment of patients with chronic pancreatitis remains a major challenge, mainly because of the lack of evidence-based treatment protocols. The primary goal of treatment is to achieve long-term pain relief, control of the complications associated with the disease, and to restore the quality of life. Currently, a conservative step-up approach is often used for the treatment of pain; progression to severe and intractable pain is considered necessary before invasive treatment is considered. Recent studies, however, suggest that surgical intervention should not be considered only as last-resort treatment, since it can mitigate disease progression, achieve excellent pain control, and preserve pancreatic function. In this review, we present a state-of-the art overview of endoscopic and surgical treatment options for patients with painful chronic pancreatitis, and elaborate on the timing of surgery. Copyright © 2013 S. Karger AG, Basel.

Myotonic Dystrophy Type 1 Management and Therapeutics.

PubMed

Smith, Cheryl A; Gutmann, Laurie

2016-12-01

Myotonic dystrophy (DM1) is the most common form of adult muscular dystrophy. It is a multisystem disorder with a complex pathophysiology. Although inheritance is autosomal dominant, disease variability is attributed to anticipation, a maternal expansion bias, variable penetrance, somatic mosaicism, and a multitude of aberrant pre-mRNA splicing events. Patient presentations range from asymptomatic or mild late onset adult to severe congenital forms. Multiple organ systems may be affected. Patients may experience early cataracts, myotonia, muscle weakness/atrophy, fatigue, excessive daytime sleepiness, central/obstructive apnea, respiratory failure, cardiac arrhythmia, insulin resistance, dysphagia, GI dysmotility, cognitive impairment, Cluster C personality traits, and/or mood disorders. At present, there is no curative or disease-modifying treatment, although clinical treatment trials have become more promising. Management focuses on genetic counseling, preserving function and independence, preventing cardiopulmonary complications, and symptomatic treatment (e.g., pain, myotonia, hypersomnolence, etc.). Currently, there is an increasing international consensus on monitoring and treatment options for these patients which necessitates a multidisciplinary team to provide comprehensive, coordinated clinical care.

Land use change around protected areas: management to balance human needs and ecological function.

PubMed

DeFries, Ruth; Hansen, Andrew; Turner, B L; Reid, Robin; Liu, Jianguo

2007-06-01

Protected areas throughout the world are key for conserving biodiversity, and land use is key for providing food, fiber, and other ecosystem services essential for human sustenance. As land use change isolates protected areas from their surrounding landscapes, the challenge is to identify management opportunities that maintain ecological function while minimizing restrictions on human land use. Building on the case studies in this Invited Feature and on ecological principles, we identify opportunities for regional land management that maintain both ecological function in protected areas and human land use options, including preserving crucial habitats and migration corridors, and reducing dependence of local human populations on protected area resources. Identification of appropriate and effective management opportunities depends on clear definitions of: (1) the biodiversity attributes of concern; (2) landscape connections to delineate particular locations with strong ecological interactions between the protected area and its surrounding landscape; and (3) socioeconomic dynamics that determine current and future use of land resources in and around the protected area.

CosmosDG: An hp -adaptive Discontinuous Galerkin Code for Hyper-resolved Relativistic MHD

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

Anninos, Peter; Lau, Cheuk; Bryant, Colton

We have extended Cosmos++, a multidimensional unstructured adaptive mesh code for solving the covariant Newtonian and general relativistic radiation magnetohydrodynamic (MHD) equations, to accommodate both discrete finite volume and arbitrarily high-order finite element structures. The new finite element implementation, called CosmosDG, is based on a discontinuous Galerkin (DG) formulation, using both entropy-based artificial viscosity and slope limiting procedures for the regularization of shocks. High-order multistage forward Euler and strong-stability preserving Runge–Kutta time integration options complement high-order spatial discretization. We have also added flexibility in the code infrastructure allowing for both adaptive mesh and adaptive basis order refinement to be performedmore » separately or simultaneously in a local (cell-by-cell) manner. We discuss in this report the DG formulation and present tests demonstrating the robustness, accuracy, and convergence of our numerical methods applied to special and general relativistic MHD, although we note that an equivalent capability currently also exists in CosmosDG for Newtonian systems.« less

CosmosDG: An hp-adaptive Discontinuous Galerkin Code for Hyper-resolved Relativistic MHD

NASA Astrophysics Data System (ADS)

Anninos, Peter; Bryant, Colton; Fragile, P. Chris; Holgado, A. Miguel; Lau, Cheuk; Nemergut, Daniel

2017-08-01

We have extended Cosmos++, a multidimensional unstructured adaptive mesh code for solving the covariant Newtonian and general relativistic radiation magnetohydrodynamic (MHD) equations, to accommodate both discrete finite volume and arbitrarily high-order finite element structures. The new finite element implementation, called CosmosDG, is based on a discontinuous Galerkin (DG) formulation, using both entropy-based artificial viscosity and slope limiting procedures for the regularization of shocks. High-order multistage forward Euler and strong-stability preserving Runge-Kutta time integration options complement high-order spatial discretization. We have also added flexibility in the code infrastructure allowing for both adaptive mesh and adaptive basis order refinement to be performed separately or simultaneously in a local (cell-by-cell) manner. We discuss in this report the DG formulation and present tests demonstrating the robustness, accuracy, and convergence of our numerical methods applied to special and general relativistic MHD, although we note that an equivalent capability currently also exists in CosmosDG for Newtonian systems.

Cardiac Cachexia: Perspectives for Prevention and Treatment.

PubMed

Okoshi, Marina Politi; Capalbo, Rafael Verardino; Romeiro, Fernando G; Okoshi, Katashi

2017-01-01

Cachexia is a prevalent pathological condition associated with chronic heart failure. Its occurrence predicts increased morbidity and mortality independent of important clinical variables such as age, ventricular function, or heart failure functional class. The clinical consequences of cachexia are dependent on both weight loss and systemic inflammation, which accompany cachexia development. Skeletal muscle wasting is an important component of cachexia; it often precedes cachexia development and predicts poor outcome in heart failure. Cachexia clinically affects several organs and systems. It is a multifactorial condition where underlying pathophysiological mechanisms are not completely understood making it difficult to develop specific prevention and treatment therapies. Preventive strategies have largely focused on muscle mass preservation. Different treatment options have been described, mostly in small clinical studies or experimental settings. These include nutritional support, neurohormonal blockade, reducing intestinal bacterial translocation, anemia and iron deficiency treatment, appetite stimulants, immunomodulatory agents, anabolic hormones, and physical exercise regimens. Currently, nonpharmacological therapy such as nutritional support and physical exercise are considered central to cachexia prevention and treatment.

The role of interventional radiology in the treatment of intrahepatic cholangiocarcinoma.

PubMed

Ierardi, Anna Maria; Angileri, Salvatore Alessio; Patella, Francesca; Panella, Silvia; Lucchina, Natalie; Petre, Elena N; Pinto, Antonio; Franceschelli, Giuseppe; Carrafiello, Gianpaolo; Cornalba, Gianpaolo; Sofocleous, Constantinos T

2017-01-01

Intrahepatic cholangiocarcinoma (ICC) is the second most common primary hepatic malignancy after hepatocellular carcinoma. Complete surgical resection remains the only potentially curative option for patients with ICC. However, until now, early diagnosis with potential surgical intervention has been the exception rather than the rule with only 30% of patients qualifying for attempted surgical cure. Many patients are unresectable because of disease stage, anatomic conditions, medical comorbidities, and small future remnant liver. Interventional radiology procedures are available for these types of patients with intra-arterial therapies and/or ablative treatments both for curative and for palliative treatment. The goals of interventional therapy are to control local tumor growth, to relieve symptoms, and to improve and preserve quality of life. The choice of treatment depends largely on tumor extent and patient performance. No randomized studies exist to compare treatments. The present review describes the current evidence of the interventional treatments in the management of the ICC. Moreover, interventional procedures available to increase the future liver reserve before surgery were analyzed.

Preserving the tree of life.

PubMed

Mace, Georgina M; Gittleman, John L; Purvis, Andy

2003-06-13

Phylogenies provide new ways to measure biodiversity, to assess conservation priorities, and to quantify the evolutionary history in any set of species. Methodological problems and a lack of knowledge about most species have so far hampered their use. In the future, as techniques improve and more data become accessible, we will have an expanded set of conservation options, including ways to prioritize outcomes from evolutionary and ecological processes.

Interventions for Hip Pain in the Maturing Athlete

PubMed Central

Gomberawalla, M. Mustafa; Kelly, Bryan T.; Bedi, Asheesh

2014-01-01

Context: Femoroacetabular impingement (FAI) alters hip mechanics, results in hip pain, and may lead to secondary osteoarthritis (OA) in the maturing athlete. Hip impingement can be caused by osseous abnormalities in the proximal femur or acetabulum. These impingement lesions may cause altered loads within the hip joint, which result in repetitive collision damage or sheer forces to the chondral surfaces and acetabular labrum. These anatomic lesions and resultant abnormal mechanics may lead to early osteoarthritic changes. Evidence Acquisition: Relevant articles from the years 1995 to 2013 were identified using MEDLINE, EMBASE, and the bibliographies of reviewed publications. Level of Evidence: Level 4. Results: Improvements in hip arthroscopy have allowed FAI to be addressed utilizing the arthroscope. Adequately resecting the underlying osseous abnormalities is essential to improving hip symptomatology and preventing further chondral damage. Additionally, preserving the labrum by repairing the damaged tissue and restoring the suction seal may theoretically help normalize hip mechanics and prevent further arthritic changes. The outcomes of joint-preserving treatment options may be varied in the maturing athlete due to the degree of underlying OA. Irreversible damage to the hip joint may have already occurred in patients with moderate to advanced OA. In the presence of preexisting arthritis, these patients may only experience fair or even poor results after hip arthroscopy, with early conversion to hip replacement. For patients with advanced hip arthritis, total hip arthroplasty remains a treatment option to reliably improve symptoms with good to excellent outcomes and return to low-impact activities. Conclusion: Advances in the knowledge base and treatment techniques of intra-articular hip pain have allowed surgeons to address this complex clinical problem with promising outcomes. Traditionally, open surgical dislocations for hip preservation surgery have shown good long-term results. Improvements in hip arthroscopy have led to outcomes equivalent to open surgery while utilizing significantly less invasive techniques. However, outcomes may ultimately depend on the degree of underlying OA. When counseling the mature athlete with hip pain, an understanding of the underlying anatomy, degree of arthritis, and expectations will help guide the treating surgeon in offering appropriate treatment options. PMID:24427445

Early invasive cervical cancer during pregnancy: different therapeutic options to preserve fertility.

PubMed

Ferraioli, Domenico; Ferriaoli, Domenico; Buenerd, Annie; Marchiolè, Pierangelo; Constantini, Sergio; Venturini, Pier Luigi; Mathevet, Patrice

2012-06-01

Cervical cancer is the second most common cancer diagnosed during pregnancy. Conservative management is possible, and different options should be discussed with patients. The main decision parameters are stage of disease, lymph node status, trimester of pregnancy and wishes of the patient. We reviewed our experience on cases of early-stage cervical cancer discovered during pregnancy and treated with different options of fertility-sparing management. Between 1990 and 2010, 5 patients with early-stage cervical cancer diagnosed during pregnancy were referred to our department for fertility-sparing treatment. The mean age at diagnosis was 28.6 years (range, 26-30 years). The stages of the tumors according to the International Federation of Gynecology and Obstetrics were IA2 in 2 women and IB1 in 3 women. The histological type was squamous carcinoma in 3 cases and adenocarcinoma in 2 cases. All patients willing to preserve their fertility were treated with vaginal radical trachelectomy (VRT) and pelvic lymph nodes dissection (PLN-D). Three procedures were performed in the first trimester: 1 patient was treated with medical abortion and then VRT and PLN-D, 2 patients were submitted to VRT and PLN-D during the first trimester, and 1 patient's case was complicated by spontaneous abortion. One patient was observed during the second trimester (20 weeks of gestation) and treated with VRT and PLN-D during pregnancy. Because this patient had pelvic lymph nodes positive for cancer, a cesarean delivery (CD) with radical hysterectomy and para-aortic lymph nodes dissection was performed followed by chemoradiotherapy. The last patient was evaluated during the third trimester of her pregnancy. Treatment included CD followed by VRT and PLN-D, which was delayed, to allow fetal maturity. Diagnosis of cervical cancer can occur during pregnancy. Different options of fertility-sparing treatment can be discussed on the basis of several factors: tumor stage, gestational age, and the patient's desire regarding fertility and pregnancy sparing.

Evaluation of Policy Options for Increasing the Availability of Primary Care Services in Rural Washington State.

PubMed

Friedberg, Mark W; Martsolf, Grant R; White, Chapin; Auerbach, David I; Kandrack, Ryan; Reid, Rachel O; Butcher, Emily; Yu, Hao; Hollands, Simon; Nie, Xiaoyu

2017-01-01

The Washington State legislature has recently considered several policy options to address a perceived shortage of primary care physicians in rural Washington. These policy options include opening the new Elson S. Floyd College of Medicine at Washington State University in 2017; increasing the number of primary care residency positions in the state; expanding educational loan-repayment incentives to encourage primary care physicians to practice in rural Washington; increasing Medicaid payment rates for primary care physicians in rural Washington; and encouraging the adoption of alternative models of primary care, such as medical homes and nurse-managed health centers, that reallocate work from physicians to nurse practitioners (NPs) and physician assistants (PAs). RAND Corporation researchers projected the effects that these and other policy options could have on the state's rural primary care workforce through 2025. They project a 7-percent decrease in the number of rural primary care physicians and a 5-percent decrease in the number of urban ones. None of the policy options modeled in this study, on its own, will offset this expected decrease by relying on physicians alone. However, combinations of these strategies or partial reallocation of rural primary care services to NPs and PAs via such new practice models as medical homes and nurse-managed health centers are plausible options for preserving the overall availability of primary care services in rural Washington through 2025.

Proximity Operations for the Robotic Boulder Capture Option for the Asteroid Redirect Mission

NASA Technical Reports Server (NTRS)

Reeves, David M.; Naasz, Bo J.; Wright, Cinnamon A.; Pini, Alex J.

2014-01-01

In September of 2013, the Asteroid Robotic Redirect Mission (ARRM) Option B team was formed to expand on NASA's previous work on the robotic boulder capture option. While the original Option A concept focuses on capturing an entire smaller Near-Earth Asteroid (NEA) using an inflatable bag capture mechanism, this design seeks to land on a larger NEA and retrieve a boulder off of its surface. The Option B team has developed a detailed and feasible mission concept that preserves many aspects of Option A's vehicle design while employing a fundamentally different technique for returning a significant quantity of asteroidal material to the Earth-Moon system. As part of this effort, a point of departure proximity operations concept was developed complete with a detailed timeline, as well as DeltaV and propellant allocations. Special attention was paid to the development of the approach strategy, terminal descent to the surface, controlled ascent with the captured boulder, and control during the Enhanced Gravity Tractor planetary defense demonstration. The concept of retrieving a boulder from the surface of an asteroid and demonstrating the Enhanced Gravity Tractor planetary defense technique is found to be feasible and within the proposed capabilities of the Asteroid Redirect Vehicle (ARV). While this point of departure concept initially focuses on a mission to Itokawa, the proximity operations design is also shown to be extensible to wide range of asteroids.

Ovarian preservation in a young patient with Gorlin syndrome and multiple bilateral ovarian masses.

PubMed

Morse, Christopher B; McLaren, Janet F; Roy, Darshan; Siegelman, Evan S; Livolsi, Virginia A; Gracia, Clarisa R

2011-07-01

To report a case of bilateral ovarian fibromas and ovarian leiomyomas in a young patient with Gorlin syndrome and to highlight issues of fertility preservation, ovarian conservation, and preimplantation genetic diagnosis in this population. Case report. University hospital. A 15-year-old female patient with Gorlin syndrome and bilateral ovarian masses. Ultrasound, magnetic resonance imaging, hormone analysis, and laparotomy with resection of ovarian fibromas. Preservation of ovarian function, pathologic diagnosis. Our patient represented an adolescent case of bilateral ovarian fibromas and leiomyomas in Gorlin syndrome presenting with menstrual irregularities. She was managed surgically with resection of the lesions and conservation of normal ovarian tissue. In Gorlin syndrome, ovarian fibromas are a common clinical manifestation. Patients with ovarian involvement may present with complex gynecologic needs and may have decreased fertility potential. Careful surgical management, follow-up, and counseling on options for future fertility should be offered to all patients. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Preservation of fertility in women affected by cancer. An audit of the cryopreservation services provided for women at Human Assisted Reproduction Ireland.

PubMed

O'Donovan, M; Harrison, R F

2005-10-01

There has been a remarkable improvement in survival rates for adult and childhood cancers, due to progress in cancer treatments. However multiagent chemotherapy and radiotherapy are associated with gonadal failure. Whereas sperm banking is commonly performed, female gametes are not so amenable to cryopreservation. Options available to women for fertility preservation include, embryo and oocyte cryopreservation. Our unit established an oocyte/embryo cryopreservation service for women affected by cancer in October 2003. Ninteen women have been referred and five (26%) women have had oocytes cryopreserved. The mean age of women in the group cryopreserved was 34 years (range 21-41). Their mean day 3 FSH was 6.2 IU (range 5.5-6.8). The mean dose of rFSH used was 1870 units (range 1500-2600). The mean number of oocytes cryopreserved was 8 (range 3-16). Preservation of fertility is of major concern to women affected by cancer. This service offers them hope for their future fertility.

Sulphates for skin preservation--a novel approach to reduce tannery effluent salinity hazards.

PubMed

Vankar, Padma S; Dwivedi, Ashish Kr

2009-04-15

In tanneries microorganisms are able to find environment suitable for their growth. Raw hide of buffalo and other animals like goat that are economically important, are an ideal source of nutrients for bacterial and fungal growth. In the past, preservatives like sodium chloride provided effective protection to fresh hides however the ill effect of their excessive use was not evaluated. But recently concern over potential ecological hazards has become more deliberate and sodium chloride features lot of disadvantages in agriculture as most of the tannery effluent is flown in agricultural fields in India. After rigorous laboratory experimentation on moisture content, SEM of hide, pure sodium sulphate as well as sodium sulphate in addition with sodium chloride (i.e. 10% w/w and 20% w/w) proved as most preferable option for curing of buffalo hide which gives effective preservation. Pollution load studies put forward sodium sulphate as an effective curing agent for buffalo hide to apply at industrial scale also.

Totally laparoscopic gallbladder-preserving surgery: A minimally invasive and favorable approach for cholelithiasis.

PubMed

Gao, DE-Kang; Wei, Shao-Hua; Li, Wei; Ren, Jie; Ma, Xiao-Ming; Gu, Chun-Wei; Wu, Hao-Rong

2015-02-01

The aim of the present study was to investigate the effectiveness of laparoscopic gallbladder-preserving surgery (L-GPS) for cholelithiasis and the feasibility and value of totally laparoscopic GPS (TL-GPS). A total of 517 patients underwent L-GPS, including 365 cases of laparoscopy-assisted GPS (LA-GPS), 143 cases of TL-GPS (preservation rate, 98.3%) and nine conversions to laparoscopic cholecystectomy. The surgeries were all performed by one medical team and the mean operating time was 72 min. All macroscopic calculi were removed through endoscopy. The number of calculi observed in the patients was between one and several dozen; diameters ranged between 0.1 and 2.5 cm. Only three cases of incisional infection were noted in the LA-GPS group and long-term follow-up showed a low recurrence rate of 1.2%. L-GPS is, therefore, an excellent approach to cure cholelithiasis and TL-GPS is a feasible and effective option that could avoid incisional complications.

Oocyte cryopreservation: a feasible fertility preservation option for reproductive age cancer survivors

PubMed Central

Labella, Patty Ann; Grifo, James; Knopman, Jaime M.

2010-01-01

Purpose To compare oocyte cryopreservation cycles performed in cancer patients to those of infertile women. Methods Cancer patients referred for fertility preservation underwent counseling in compliance with the ASRM; those electing oocyte cryopreservation were included. Ovarian stimulation was achieved with injectable gonadotropins and freezing was performed using slow-cooling and vitrification methods. Results Fifty cancer patients (mean age 31 y) underwent oocyte cryopreservation; adequate ovarian stimulation was achieved in 10 ± 0.3 days. The outcome from these cycles included a mean peak estradiol of 2,376 pg/ml and an average of 19 oocytes retrieved (15 mature oocytes were cryopreserved/cycle). All patients tolerated ovarian hyperstimulation. There were no significant differences noted between cryopreservation cycles performed in cancer patients and in women without malignancy. Conclusions Oocyte cryopreservation appears to be a feasible fertility preservation method for reproductive-age women diagnosed with cancer. This modality is not only effective but also, providing a multidiscipline effort, can be completed in timely fashion. PMID:20480389

Preservation of lower extremity amputation length using muscle perforator free flaps.

PubMed

Hallock, G G

2008-06-01

Coverage of any lower extremity amputation stump must be durable to resist external forces, well contoured, and thin enough for proper shoewear or prothesis fitting. Preservation of bone length to maximise the ability to ambulate is also of paramount importance. If local soft tissues are inadequate to fulfil these prerequisites, consideration of a microsurgical tissue transfer is a reasonable option, especially to cover bone or save a major joint. Muscle perforator free flaps, as shown in this series of eight patients using four different donor sites, are a versatile alternative for the necessary soft tissue augmentation. Multiple choices are available and often even from the involved lower extremity to minimise further morbidity. The vascular pedicles of this genré of flaps are relatively exceedingly long and of respectable calibre to facilitate reaching an appropriate recipient site. They can be sensate if desired. Of course, muscle function is by definition preserved. Complications are minimal and usually related to the reason for the amputation in the first place.

Fertility preservation in the transgender patient: expanding oncofertility care beyond cancer.

PubMed

Wallace, Sumer Allensworth; Blough, Kiara L; Kondapalli, Laxmi A

2014-01-01

While the field of oncofertility raised awareness about fertility concerns in oncology patients, new applications for fertility preservation are emerging, such as transgender medicine. As transgender medicine evolves, the number of individuals seeking gender reassignment hormone therapy is drastically increasing, generating a population of patients with unmet fertility needs and unknown reproductive potential. We present the first case report of a female-to-male (FtM) transgender patient to undergo oocyte cryopreservation before initiating androgen therapy. Our patient is a 17-year-old FtM transgender person undergoing gender transition throughout adolescence with an endocrinologist. The patient wished to complete androgen therapy before starting his first year of college to avoid gender ambiguity. After extensive consultation and psychological assessment, the patient was considered an appropriate candidate and proceeded with oocyte cryopreservation. He underwent baseline fertility testing followed by successful ovarian stimulation and surgical retrieval. We recommend that a discussion of reproductive health concerns and fertility preservation options be incorporated into the comprehensive care of transgender patients.

Opinion and Special Articles: Loan forgiveness options for young neurologists: Current landscape and practice implications.

PubMed

George, Benjamin P; Dorsey, E Ray; Grischkan, Justin A

2017-04-11

Increasing education debt has led to the availability of a variety of loan forgiveness options including the Department of Education's Public Service Loan Forgiveness (PSLF) program. This article discusses the current landscape of loan forgiveness options including trends in PSLF for rising neurology trainees, and implications for choices in specialization, employment, practice location, and the pursuit of an academic career. We further provide guidance on how to navigate the various loan forgiveness options that neurology residents and fellows may consider. © 2017 American Academy of Neurology.

Infertility in reproductive-age female cancer survivors.

PubMed

Levine, Jennifer M; Kelvin, Joanne Frankel; Quinn, Gwendolyn P; Gracia, Clarisa R

2015-05-15

Improved survival rates among reproductive-age females diagnosed with cancer have increased the focus on long-term quality of life, including maintenance of the ability to conceive biological children. Cancer-directed therapies such as high-dose alkylating agents and radiation to the pelvis, which deplete ovarian reserve, radiation to the brain, which affects the hypothalamic-pituitary-gonadal axis, and surgical resection of reproductive structures can decrease the likelihood of having biological children. Standard fertility preservation strategies such as embryo and oocyte cryopreservation before the onset of therapy offer the opportunity to conserve fertility, but they may not be feasible because of the urgency to start cancer therapy, financial limitations, and a lack of access to reproductive endocrinologists. Ovarian tissue freezing is considered experimental, with limited data related to pregnancies, but it minimizes treatment delay. Studies evaluating gonadotropin-releasing hormone analogues have had mixed results, although a recent randomized, prospective study in women with breast cancer demonstrated a protective effect. Fertility preservation programs are increasingly being developed within cancer programs. In this article, we describe risks to infertility and options for preservation, raise psychosocial and ethical issues, and propose elements for establishing an effective fertility preservation program. © 2015 American Cancer Society.

A questionnaire survey on attitude toward sperm cryopreservation among hematologists in Japan.

PubMed

Kobayashi, Tomohiro; Shin, Takeshi; Nishio, Kojiro; Shimomura, Yukihito; Iwahata, Toshiyuki; Suzuki, Keisuke; Miyata, Akane; Kobori, Yoshitomo; Arai, Gaku; Okada, Hiroshi

2017-03-01

Advances in multimodal treatment have led to dramatic improvement in cancer treatment outcomes. It is now necessary to consider cancer patients' holistic quality of life. Fertility preservation is the top concern for cancer survivors of reproductive age. Sperm cryopreservation before treatment is recommended for postpubescent men, but many patients lose fertility without having been informed about options for fertility preservation. To determine how sperm cryopreservation is perceived and practiced in Japan, we surveyed hematologists who often treat young males. A questionnaire about sperm cryopreservation was sent to 45 major hematology institutions. A total of 22 institutions responded before the deadline. All institutions but one responded that they felt sperm cryopreservation is necessary. Only 15 institutions responded that they inform patients about sperm cryopreservation, and 12 institutions responded that they perform sperm cryopreservation before chemotherapy. A total of 213 young males started their first course of chemotherapy during the survey period, of whom 61 (28.6%) had their sperm cryopreserved. Although almost all hematologists stated that sperm cryopreservation is necessary for fertility preservation, not all institutions informed patients about it. Our findings indicate that, to promote fertility preservation in Japan, it will be necessary to systematize sperm cryopreservation and build inter-hospital networks.

New Promising Strategies in Oncofertility

PubMed Central

Hudson, Janella N.; Stanley, Nathanael B.; Nahata, Leena; Bowman-Curci, Meghan; Quinn, Gwendolyn P.

2017-01-01

Introduction Approximately 70,000 adolescent and young adults (AYA) are diagnosed with cancer each year. While advancements in treatment have led to improved prognosis and survival for patients, these same treatments can adversely affect AYA reproductive capacity. Localized treatments such as surgery and radiation therapy may affect fertility by removing or damaging reproductive organs, and systemic therapies such as chemotherapy can be toxic to gonads, (ovaries and testicles), thus affecting fertility and/or endocrine function. This can be traumatic for AYA with cancer as survivors often express desire to have genetic children and report feelings of regret or depression as a result of infertility caused by cancer treatments. Areas Covered Emerging technologies in the field of assisted reproductive technology offer new promise for preserving the reproductive capacity of AYA cancer patients prior to treatment as well as providing alternatives for survivors. The following review revisits contemporary approaches to fertility preservation as well newly developing technologies. Expert Commentary There are several advances in ART that hold promise for patients and survivors. However there are challenges that inhibit uptake including poor communication between providers and patients about risks and fertility preservation options; high costs; and lack of insurance coverage for fertility preservation services. PMID:28959743

[Modification of the retrolabyrinthine approach with hearing preservation in CPA tumors].

PubMed

Schipper, J; Lohnstein, P; Stummer, W; Knapp, F; Turowski, B; Klenzner, T

2010-02-01

In an anatomical study including a CT scan of the cadaver sections by means of a virtual model analysis the option of a modified retrolabyrinthine passage to the cerebellopontine angle (CPA) preserving the Saccus endolymphaticus and the upper petrosus sinus was analysed. Due to the individual anatomical variations of the petrosus bone the results showed several limitations with regard to the retrolabyrintine passage to the CPA. The smallest distance between the dura of the posterior fossa and the posterior semicircular canal measured in a high resolution CT was of particular importance as to how much room was available for the surgical manipulation in the retrolabyrinthine space. As the back side angle to the petrosus bone is much flatter in a translabyrinthine approach than in a retrosigmoidal approach the internal auditory canal needed to be controlled by using a 30 degree endoscope. In five patients the translabyrinthine approach was modified by temporarily preserving the labyrinth in an effort to remove the CPA tumors. Based on our clinical experience and on the findings of the anatomical and radiological studies we eventually removed the CPA tumors type B2 or C3 in three patients preserving hearing by using a modified retrolabyrinthine approach.

[Laparoscopic radical trachelectomy for preservation of fertility in early cervical cancer. A case report].

PubMed

Isla Ortiz, David; Montalvo-Esquivel, Gonzalo; Chanona-Vilchis, José Gregorio; Herrera Gómez, Ángel; Ñamendys Silva, Silvio Antonio; Pareja Franco, Luis René

2016-01-01

Radical hysterectomy is the standard treatment for patients with early-stage cervical cancer. However, for women who wish to preserve fertility, radical trachelectomy is a safe and viable option. To present the first case of laparoscopic radical trachelectomy performed in the National Cancer Institute, and published in Mexico. Patient, 34 years old, gravid 1, caesarean 1, stage IB1 cervical cancer, squamous, wishing to preserve fertility. She underwent a laparoscopic radical trachelectomy and bilateral dissection of the pelvic lymph nodes. Operation time was 330minutes, and the estimated blood loss was 100ml. There were no intraoperative or postoperative complications. The final pathology reported a tumour of 15mm with infiltration of 7mm, surgical margins without injury, and pelvic nodes without tumour. After a 12 month follow-up, the patient is having regular periods, but has not yet tried to get pregnant. No evidence of recurrence. Laparoscopic radical trachelectomy and bilateral pelvic lymphadenectomy is a safe alternative in young patients who wish to preserve fertility with early stage cervical cancer. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

Home Food Preservation Training for Extension Educators

ERIC Educational Resources Information Center

Goard, Linnette Mizer; Hill, Melinda; Shumaker, Katharine; Warrix, Marisa

2013-01-01

During times of economic downturn, there has been an increased interest in home food preservation. As the primary resource for current research-based recommendations, a team of Extension Family and Consumer Sciences educators with specialization in food safety and food preservation responded to this demand by developing a standardized food…

Beyond Preservation: New Directions for Technological Innovation through Intangible Cultural Heritage

ERIC Educational Resources Information Center

Robbins, Christopher

2010-01-01

While many digitization projects are currently underway, to help preserve Indigenous traditions, few explore the full potential of the development of digital media and networked technology through Indigenous cultures. This paper outlines the three phases necessary for a robust digital preservation, promotion and growth project: 1) Straightforward…

Salmonid Gamete Preservation in the Snake River Basin, Annual Report 2002.

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

Young, William; Kucera, Paul

2003-07-01

In spite of an intensive management effort, chinook salmon (Oncorhynchus tshawytscha) and steelhead (Oncorhynchus mykiss) populations in the Northwest have not recovered and are currently listed as threatened species under the Endangered Species Act. In addition to the loss of diversity from stocks that have already gone extinct, decreased genetic diversity resulting from genetic drift and inbreeding is a major concern. Reduced population and genetic variability diminishes the environmental adaptability of individual species and entire ecological communities. The Nez Perce Tribe (NPT), in cooperation with Washington State University and the University of Idaho, established a germplasm repository in 1992 inmore » order to preserve the remaining salmonid diversity in the region. The germplasm repository provides long-term storage for cryopreserved gametes. Although only male gametes can be cryopreserved, conserving the male component of genetic diversity will maintain future management options for species recovery. NPT efforts have focused on preserving salmon and steelhead gametes from the major river subbasins in the Snake River basin. However, the repository is available for all management agencies to contribute gamete samples from other regions and species. In 2002 a total of 570 viable semen samples were added to the germplasm repository. This included the gametes of 287 chinook salmon from the Lostine River, Catherine Creek, upper Grande Ronde River, Imnaha River (Lookingglass Hatchery), Lake Creek, South Fork Salmon River, Johnson Creek, Big Creek, Capehorn Creek, Marsh Creek, Pahsimeroi River (Pahsimeroi Hatchery), and upper Salmon River (Sawtooth Hatchery) and the gametes of 280 steelhead from the North Fork Clearwater River (Dworshak Hatchery), Fish Creek, Little Sheep Creek, Pahsimeroi River (Pahsimeroi Hatchery) and Snake River (Oxbow Hatchery). In addition, gametes from 60 Yakima River spring chinook and 34 Wenatchee River coho salmon were added to the repository by Washington Department of Fish and Wildlife and Columbia River Intertribal Fish Commission, respectively. To date, a total of 3,928 Columbia River salmon and steelhead gamete samples and three Kootenai River white sturgeon are preserved in the repository. Samples are stored in independent locations at the University of Idaho (UI) and Washington State University (WSU).« less

77 FR 21402 - Airworthiness Directives; Sikorsky Aircraft Corporation Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-10

... option is to conduct an eddy current inspection and the other option is to conduct a visual inspection... blade sanding inspection rather than the eddy current inspection, at an average labor rate of $85 per.... (1) Inspect by using either an eddy current inspection in accordance with paragraphs B.(1)(a) through...

Decision analysis and risk models for land development affecting infrastructure systems.

PubMed

Thekdi, Shital A; Lambert, James H

2012-07-01

Coordination and layering of models to identify risks in complex systems such as large-scale infrastructure of energy, water, and transportation is of current interest across application domains. Such infrastructures are increasingly vulnerable to adjacent commercial and residential land development. Land development can compromise the performance of essential infrastructure systems and increase the costs of maintaining or increasing performance. A risk-informed approach to this topic would be useful to avoid surprise, regret, and the need for costly remedies. This article develops a layering and coordination of models for risk management of land development affecting infrastructure systems. The layers are: system identification, expert elicitation, predictive modeling, comparison of investment alternatives, and implications of current decisions for future options. The modeling layers share a focus on observable factors that most contribute to volatility of land development and land use. The relevant data and expert evidence include current and forecasted growth in population and employment, conservation and preservation rules, land topography and geometries, real estate assessments, market and economic conditions, and other factors. The approach integrates to a decision framework of strategic considerations based on assessing risk, cost, and opportunity in order to prioritize needs and potential remedies that mitigate impacts of land development to the infrastructure systems. The approach is demonstrated for a 5,700-mile multimodal transportation system adjacent to 60,000 tracts of potential land development. © 2011 Society for Risk Analysis.

Preeradication vaccine policy options for poliovirus infection and disease control.

PubMed

Thompson, Kimberly M; Pallansch, Mark A; Duintjer Tebbens, Radboud J; Wassilak, Steve G; Kim, Jong-Hoon; Cochi, Stephen L

2013-04-01

With the circulation of wild poliovirus (WPV) types 1 and 3 continuing more than a decade after the original goal of eradicating all three types of WPVs by 2000, policymakers consider many immunization options as they strive to stop transmission in the remaining endemic and outbreak areas and prevent reintroductions of live polioviruses into nonendemic areas. While polio vaccination choices may appear simple, our analysis of current options shows remarkable complexity. We offer important context for current and future polio vaccine decisions and policy analyses by developing decision trees that clearly identify potential options currently used by countries as they evaluate national polio vaccine choices. Based on a comprehensive review of the literature we (1) identify the current vaccination options that national health leaders consider for polio vaccination, (2) characterize current practices and factors that appear to influence national and international choices, and (3) assess the evidence of vaccine effectiveness considering sources of variability between countries and uncertainties associated with limitations of the data. With low numbers of cases occurring globally, the management of polio risks might seem like a relatively low priority, but stopping live poliovirus circulation requires making proactive and intentional choices to manage population immunity in the remaining endemic areas and to prevent reestablishment in nonendemic areas. Our analysis shows remarkable variability in the current national polio vaccine product choices and schedules, with combination vaccine options containing inactivated poliovirus vaccine and different formulations of oral poliovirus vaccine making choices increasingly difficult for national health leaders. © 2013 Society for Risk Analysis.

Formulation considerations of intranasal corticosteroids for the treatment of allergic rhinitis.

PubMed

Meltzer, Eli O

2007-01-01

To examine how various aspects of an intranasal corticosteroid (INS) formulation may influence the efficacy, tolerability, and patient preference and adherence to INS therapy. A PubMed search of the literature was conducted for studies on allergic rhinitis published between January 1977 and January 2006 using the keywords intranasal corticosteroid, preservatives, benzalkonium chloride, and tonicity. Prospective studies, retrospective studies, and case reports were selected for inclusion in this review. Currently available INSs are effective first-line treatments for allergic rhinitis. Differences in patient preference for a particular INS are largely attributable to sensory attributes of the nasal spray, which arise from characteristics of the formulation. Additives and preservatives can cause tolerability issues by irritating the mucosal membranes and causing nasal drying, or they can confer an unpleasant odor or taste to an INS formulation. The relative osmotic pressure, or tonicity, of an INS can modulate nasal absorption and retention, thereby potentially influencing the clinical efficacy. Characteristics such as delivery device and spray volume can affect a patient's perception and experience with a particular INS. Newer INSs, such as ciclesonide, are in development for the treatment of allergic rhinitis, and consideration of the formulation characteristics of these agents is an important part of the development process. INSs are an effective treatment option for patients with allergic rhinitis; however, there is room for formulation improvement. Optimization of formulation may increase the efficacy, tolerability, and patient preference and adherence to INSs.

Neoadjuvant chemoradiation therapy and pathological complete response in rectal cancer

PubMed Central

Ferrari, Linda; Fichera, Alessandro

2015-01-01

The management of rectal cancer has evolved significantly in the last few decades. Significant improvements in local disease control were achieved in the 1990s, with the introduction of total mesorectal excision and neoadjuvant radiotherapy. Level 1 evidence has shown that, with neoadjuvant chemoradiation therapy (CRT) the rates of local recurrence can be lower than 6% and, as a result, neoadjuvant CRT currently represents the accepted standard of care. This approach has led to reliable tumor down-staging, with 15–27% patients with a pathological complete response (pCR)—defined as no residual cancer found on histological examination of the specimen. Patients who achieve pCR after CRT have better long-term outcomes, less risk of developing local or distal recurrence and improved survival. For all these reasons, sphincter-preserving procedures or organ-preserving options have been suggested, such as local excision of residual tumor or the omission of surgery altogether. Although local recurrence rate has been stable at 5–6% with this multidisciplinary management method, distal recurrence rates for locally-advanced rectal cancers remain in excess of 25% and represent the main cause of death in these patients. For this reason, more recent trials have been looking at the administration of full-dose systemic chemotherapy in the neoadjuvant setting (in order to offer early treatment of disseminated micrometastases, thus improving control of systemic disease) and selective use of radiotherapy only in non-responders or for low rectal tumors smaller than 5 cm. PMID:26290512

Osteotomy and fracture fixation in children and teenagers.

PubMed

de Billy, B; Gindraux, F; Langlais, J

2014-02-01

Significant changes have occurred recently in fixation methods following fracture or osteotomy in children and teenagers. Children have benefited the most from these advances. A child's growth is anatomically and physiologically ensured by the growth plate and periosteum. The need to keep the periosteum intact during trauma cases has led to the introduction of flexible intramedullary nailing. We will review the basic principles of this safe, universally adopted technique, and also describe available material, length and diameter options. The problems and the limitations of this method will be discussed extensively. In orthopedics, the desire to preserve the periosteum has led to the use of locking compression plates. Because of their low profile and high stability, they allow the micromovements essential for bone union. These new methods reduce the immobilization period and allow autonomy to be regained more quickly, which is especially important in children with neurological impairment. The need to preserve the growth plate, which is well known in pediatric surgery, is reviewed with the goal of summarizing current experimental data on standard fracture and osteotomy fixation methods. Adjustable block stop wires provide better control over compression. These provide an alternate means of fixation between K-wires and screws (now cannulated) and have contributed to the development of minimally invasive surgical techniques. The aim of this lecture is to provide a rationale for the distinct technical features of pediatric surgery, while emphasizing the close relationship between the physiology of growth, bone healing and technical advances. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Ovarian preservation in locally advanced cervical cancer undergoing neoadjuvant chemotherapy and radical surgery: our experience and analysis of the literature.

PubMed

Signorelli, Mauro; Bogani, Giorgio; Chiappa, Valentina; Ditto, Antonino; Scaffa, Cono; Martinelli, Fabio; Lorusso, Domenica; Raspagliesi, Francesco

2018-03-30

The aim of this study was to estimate the rate of ovarian metastases and recurrences among patients affected by locally advanced stage cancer patients (LACC), undergoing neoadjuvant chemotherapy (NACT) and radical surgery with conservation of ovaries. Retrospective evaluation of consecutive patients affected by LACC (stage IB2- IIB), treated by NACT followed by radical surgery at National Cancer Institute, Milan, Italy, between 1990-2015. Overall, 331 patients were included. Stage at presentation included stage IB2, IIA and IIB in 120 (36.3%), 63 (19%) and 148 (44.7%) patients, respectively. Main histotype was squamous cell carcinoma (n=265, 80.1%) followed by adenocarcinoma/adenosquamous (n=51, 15.4%), and more than half of patients had a grade 3 carcinoma . Overall, 102 (30.8%) women had at least one ovary preserved during surgery, while 229 (69.2%) had bilateral salpingo-oophorectomy. Comparing patients who had ovarian preservation with patients who had not, we observed that the two groups were comparable in terms of baseline characteristics. Survival outcomes were not influenced by ovarian preservation (disease-free (p=0.93) and overall (p=0.65) survivals). One (1%) woman had a localized ovarian recurrence. Our data suggest that ovarian preservation at the time of surgery is a safe option among women with LACC after NACT with no detrimental impact on oncologic outcome. Further prospective studies are warranted.

A review of the surgical management of breast cancer: plastic reconstructive techniques and timing implications.

PubMed

Rosson, Gedge D; Magarakis, Michael; Shridharani, Sachin M; Stapleton, Sahael M; Jacobs, Lisa K; Manahan, Michele A; Flores, Jaime I

2010-07-01

The oncologic management of breast cancer has evolved over the past several decades from radical mastectomy to modern-day preservation of chest and breast structures. The increased rate of mastectomies over recent years made breast reconstruction an integral part of the breast cancer management. Plastic surgery now offers patients a wide variety of reconstruction options from primary closure of the skin flaps to performance of microvascular and autologous tissue transplantation. Well-coordinated partnerships between surgical oncologists, plastic surgeons, and patients address concerns of tumor control, cosmesis, and patients' wishes. The gamut of breast reconstruction options is reviewed, particularly noting state-of-the-art techniques, as well as the advantages and disadvantages of various timing modalities.

Analysis of Alternative (Low Impact) Development on a Theoretical Residential Development in North Central Florida

NASA Astrophysics Data System (ADS)

Wise, W. R.

2001-05-01

Research currently in progress will evaluate land development options on a 161 +/- HA site in North Central Florida lying within a 292+/- HA watershed that contributes to Bullfrog Creek in the Camp Blanding Wildlife Management Area. The research analyzes aspects of an emerging storm-water management philosophy, called low-impact development (LID) by Prince Georges County, Maryland. LID seeks to preserve site hydrology by reducing the area of disturbance on the site, preserving natural drainage features on the site and by utilizing BMPs that promote infiltration and slower transport of runoff. This research investigates the benefits and problems associated with this design philosophy, particularly in Florida. Two scenarios will be investigated: Low density residential and Medium density residential. Within each scenario the hydrologic response of the site under conventional and LID will be explored. Furthermore, the impact of using cluster developments in LIDs will be investigated. Parameters to be measured include: peak flow, runoff volume, pollutant load generated/removed by BMPs, peak-flow timing and base flow. HEC-HMS will be used for hydrologic modeling (soil moisture accounting module). Pollutant loads generated and removed will be based on published data for land use and BMPs. An economic analysis, based on the estimated construction costs of conventional and LID, will also be done. Further sensitivity analyses will be conducted on the effect that various watershed conditions have on the hydrologic response of the site developed as a LID. This research will provide insight to several questions. In the most general sense it will indicate whether this emerging design philosophy, much of which was developed in other regions of the country, is beneficial to Florida watersheds "as it is" and what, if any, alterations should be considered. Secondly, this research will show the impact of development with different site-planning options, for example cluster development versus deed restrictions on lots. Thirdly, the research will give insight to the applicability of this land-development approach under different allowable residential densities. Lastly, the effect of different physical characteristics on the watershed can be explored.

A Tool for Estimating Variability in Wood Preservative Treatment Retention

Treesearch

Patricia K. Lebow; Adam M. Taylor; Timothy M. Young

2015-01-01

Composite sampling is standard practice for evaluation of preservative retention levels in preservative-treated wood. Current protocols provide an average retention value but no estimate of uncertainty. Here we describe a statistical method for calculating uncertainty estimates using the standard sampling regime with minimal additional chemical analysis. This tool can...

Assessment of the potential quality of preservative-treated pilings removed from service : [abstract

Treesearch

Xiping Wang; John W. Forsman; John R. Erickson; Robert J. Ross; Douglas J. Gardner; Gary D. McGinnis; Rodney C. DeGroot

1999-01-01

Preservative-treated wood products are important construction materials. Preservative-treated wood pilings, after removal from service, constitute a major disposal problem for managers of waterfront facilities. For example, approximately 7,000 to 8,000 tons of mechanically or biologically deteriorated wood pilings are currently removed from U.S. naval facilities...

Involving Corporations in Dispensing During Mass Prophylaxis

DTIC Science & Technology

2007-03-01

BLANK xi LIST OF TABLES Table 3.1 SWOT for Current Public Health Response Option............................ 34 Table 3.2 SWOT for the Postal...Service Option .................................................. 36 Table 3.3 SWOT for the Corporate Support Option...39 Table 3.4 SWOT for the Composite Support Option .......................................... 41 xii

Generation and preservation of the slow underlying membrane potential oscillation in model bursting neurons.

PubMed

Franklin, Clarence C; Ball, John M; Schulz, David J; Nair, Satish S

2010-09-01

The underlying membrane potential oscillation of both forced and endogenous slow-wave bursting cells affects the number of spikes per burst, which in turn affects outputs downstream. We use a biophysical model of a class of slow-wave bursting cells with six active currents to investigate and generalize correlations among maximal current conductances that might generate and preserve its underlying oscillation. We propose three phases for the underlying oscillation for this class of cells: generation, maintenance, and termination and suggest that different current modules coregulate to preserve the characteristics of each phase. Coregulation of I(Burst) and I(A) currents within distinct boundaries maintains the dynamics during the generation phase. Similarly, coregulation of I(CaT) and I(Kd) maintains the peak and duration of the underlying oscillation, whereas the calcium-activated I(KCa) ensures appropriate termination of the oscillation and adjusts the duration independent of peak.

What is new in 2017? Update on fertility preservation in cancer patients.

PubMed

Winkler-Crepaz, Katharina; Böttcher, Bettina; Toth, Bettina; Wildt, Ludwig; Hofer-Tollinger, Susanne

2017-12-01

The prevention of fertility loss due to cancer treatment as well as non-malignant causes has been gaining importance over the last few decades. Clinically applied modalities for fertility preservation in cancer patients include cryopreservation of oocytes and embryos, the application of GnRH agonists, ovarian tissue banking, and cryopreservation of ejaculated or surgically extracted sperm. In addition, several new possibilities to restore fertility are currently being investigated, such as the establishment of in-vitro culture systems for gonadal tissue, the development of artificial gonads, and the application of germline stem cells. This review aims to provide an update on the methods currently applied in clinical practice for fertility preservation, as well as to summarize the progress made in the development of novel strategies for fertility preservation.

Navy Perspective on Joint Force Interdependence

DTIC Science & Technology

2015-01-01

commanders, or produce unaffordable options for the Nation. Rather than expending our finite energy on rehashing roles and missions, or com- mitting...unclassified c. THIS PAGE unclassified Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 JFQ 76, 1st Quarter 2015 Greenert 11 preserve our...avoiding unaf- fordable duplicative efforts by teaming on the promising capabilities of the electromagnetic railgun, a game-changer in defeating cruise

Pilot study of radical hysterectomy versus radical trachelectomy on sexual distress.

PubMed

Brotto, Lori A; Smith, Kelly B; Breckon, Erin; Plante, Marie

2013-01-01

Radical trachelectomy, which leaves the uterus intact, has emerged as a desirable surgical option for eligible women with early-stage cervical cancer who wish to preserve fertility. The available data suggest excellent obstetrical outcomes with radical trachelectomy, and no differences in sexual responding between radical trachelectomy and radical hysterectomy. There is a need to examine the effect of radical hysterectomy on sexual distress given that it is distinct from sexual function. Participants were 34 women diagnosed with early-stage cervical cancer. The authors report 1-month postsurgery data for 29 women (radical hysterectomy group: n = 17, M age = 41.8 years; radical trachelectomy group: n = 12, M age = 31.8 years), and 6-month follow-up data on 26 women. Whereas both groups experienced an increase in sex-related distress immediately after surgery, distress continued to increase 6 months after surgery for the radical hysterectomy group but decreased in the radical trachelectomy group. There were no between-group differences in mood, anxiety, or general measures of health. The decrease in sex-related distress in the radical trachelectomy but not in the radical hysterectomy group suggests that the preservation of fertility may have attenuated sex-related distress. Care providers should counsel women exploring surgical options for cervical cancer about potential sex distress-related sequelae.

Progress in understanding human ovarian folliculogenesis and its implications in assisted reproduction.

PubMed

Yang, Dong Zi; Yang, Wan; Li, Yu; He, Zuanyu

2013-02-01

To highlight recent progress in understanding the pattern of follicular wave emergence of human menstrual cycle, providing a brief overview of the new options for human ovarian stimulation and oocyte retrieval by making full use of follicular physiological waves of the patients either with normal or abnormal ovarian reserve. Literature review and editorial commentary. There has been increasing evidence to suggest that multiple (two or three) antral follicular waves are recruited during human menstrual cycle. The treatment regimens designed based on the theory of follicular waves, to promote increased success with assisted reproduction technology (ART) and fertility preservation have been reported. These new options for human ovarian stimulation and oocyte retrieval by making full use of follicular waves of the patients either with normal or abnormal ovarian reserve lead to new thinking about the standard protocols in ART and challenge the traditional theory that a single wave of antral follicles grows only during the follicular phase of the menstrual cycle. The understanding of human ovarian folliculogenesis may have profound implications in ART and fertility preservation. Further studies are needed to evaluate the optimal regimens in ART based on the theory of follicular waves and to identify non-invasive markers for predicting the outcome and the potential utilities of follicles obtained from anovulatory follicular waves in ART.

Status of exotic woody species in big cypress national preserve. Technical report

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

Gunderson, L.H.

The current status of exotic woody plants in Big Cypress National Preserve is documented. A map of the distribution of principal pest species, Melaleuca quinquenervia, Schinus terebinthifolius, and Casuarina sp., is presented. Prognoses of population increases of these problem species are determined utilizing the current distributions and assessing environmental conditions. Some potential problem species are also identified.

Techniques for Enhancing Implosion Performance on High-Foot Ignition Capsules on NIF

NASA Astrophysics Data System (ADS)

Dittrich, T. R.; Hurricane, O.; Berzak Hopkins, L. F.; Callahan, D. A.; Clark, D.; Haan, S. W.; Hinkel, D. E.; Ma, T.; Nikroo, A.; Pak, A. E.; Park, H. S.; Salmonson, J. D.; Weber, C. R.

2016-10-01

Two options that have the potential to improve implosion performance in the High-Foot series of ignition capsules on NIF will be presented. The first option explores changing the shape of the x-ray drive to include a 4th and even a 5th shock in the implosion. According to simulations, these extra shocks improve the configuration of the assembled fuel and lead to improved confinement and performance. A ``ramp compression'' between the foot of the drive and the main pulse is also investigated. The second option studies the effect of increasing the Si dopant in a thin-shell capsule. NIF shot N150211 produced relatively high fusion yield (7.6E15 neutrons) but may have suffered from shell burn through. Increasing the Si dopant may delay this burn through yet preserve high implosion velocity. This work was performed under the auspices of the Department of Energy by Lawrence Livermore National Laboratory under contract DE-AC52-07NA27344.

75 FR 27611 - Self-Regulatory Organizations; NASDAQ OMX PHLX, Inc.; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-17

...) are registered trademarks of The NASDAQ OMX Group, Inc. (which with its affiliates are the... Registered Options Traders (on-floor) and Specialists; (ii) amending the current options transaction charge for Registered Options Traders (on-floor) and Specialists and applying that charge and the options...

78 FR 49563 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Proposed...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-14

... futures on all of the volatility indexes that underlie volatility index options trading on CBOE. Currently, volatility index (security) futures expirations correspond to each volatility index options expiration months...-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Proposed Rule To Amend Rule...

Clinical Significance of Symptoms in Smokers with Preserved Pulmonary Function.

PubMed

Woodruff, Prescott G; Barr, R Graham; Bleecker, Eugene; Christenson, Stephanie A; Couper, David; Curtis, Jeffrey L; Gouskova, Natalia A; Hansel, Nadia N; Hoffman, Eric A; Kanner, Richard E; Kleerup, Eric; Lazarus, Stephen C; Martinez, Fernando J; Paine, Robert; Rennard, Stephen; Tashkin, Donald P; Han, MeiLan K

2016-05-12

Currently, the diagnosis of chronic obstructive pulmonary disease (COPD) requires a ratio of forced expiratory volume in 1 second (FEV1) to forced vital capacity (FVC) of less than 0.70 as assessed by spirometry after bronchodilator use. However, many smokers who do not meet this definition have respiratory symptoms. We conducted an observational study involving 2736 current or former smokers and controls who had never smoked and measured their respiratory symptoms using the COPD Assessment Test (CAT; scores range from 0 to 40, with higher scores indicating greater severity of symptoms). We examined whether current or former smokers who had preserved pulmonary function as assessed by spirometry (FEV1:FVC ≥0.70 and an FVC above the lower limit of the normal range after bronchodilator use) and had symptoms (CAT score, ≥10) had a higher risk of respiratory exacerbations than current or former smokers with preserved pulmonary function who were asymptomatic (CAT score, <10) and whether those with symptoms had different findings from the asymptomatic group with respect to the 6-minute walk distance, lung function, or high-resolution computed tomographic (HRCT) scan of the chest. Respiratory symptoms were present in 50% of current or former smokers with preserved pulmonary function. The mean (±SD) rate of respiratory exacerbations among symptomatic current or former smokers was significantly higher than the rates among asymptomatic current or former smokers and among controls who never smoked (0.27±0.67 vs. 0.08±0.31 and 0.03±0.21 events, respectively, per year; P<0.001 for both comparisons). Symptomatic current or former smokers, regardless of history of asthma, also had greater limitation of activity, slightly lower FEV1, FVC, and inspiratory capacity, and greater airway-wall thickening without emphysema according to HRCT than did asymptomatic current or former smokers. Among symptomatic current or former smokers, 42% used bronchodilators and 23% used inhaled glucocorticoids. Although they do not meet the current criteria for COPD, symptomatic current or former smokers with preserved pulmonary function have exacerbations, activity limitation, and evidence of airway disease. They currently use a range of respiratory medications without any evidence base. (Funded by the National Heart, Lung, and Blood Institute and the Foundation for the National Institutes of Health; SPIROMICS ClinicalTrials.gov number, NCT01969344.).

Dyadic OPTION: Measuring perceptions of shared decision-making in practice.

PubMed

Melbourne, Emma; Roberts, Stephen; Durand, Marie-Anne; Newcombe, Robert; Légaré, France; Elwyn, Glyn

2011-04-01

Current models of the medical consultation emphasize shared decision-making (SDM), whereby the expertise of both the doctor and the patient are recognised and seen to equally contribute to the consultation. The evidence regarding the desirability and effectiveness of the SDM approach is often conflicting. It is proposed that the conflicts are due to the nature of assessment, with current assessments from the perspective of an outside observer. To empirically assess perceived involvement in the medical consultation using the dyadic OPTION instrument. 36 simulated medical consultations were organised between general practitioners and standardized- patients, using the observer OPTION and the newly developed dyadic OPTION instruments. SDM behaviours observed in the consultations were seen to depend on both members of the doctor and patient dyad, rather than each in isolation. Thus a dyadic approach to measurement is supported. This current study highlights the necessity for a dyadic approach to assessment and introduces a novel research instrument: the dyadic OPTION instrument. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

14 CFR 21.293 - Current records.

Code of Federal Regulations, 2010 CFR

2010-01-01

... option authorization— (i) A technical data file that includes the type design drawings, specifications, reports on tests prescribed by this part, and the original type inspection report and amendments to that... his factory, for each product type certificated under a delegation option authorization, current...

Prospects and challenges of CRISPR/Cas genome editing for the study and control of neglected vector-borne nematode diseases.

PubMed

Zamanian, Mostafa; Andersen, Erik C

2016-09-01

Neglected tropical diseases caused by parasitic nematodes inflict an immense health and socioeconomic burden throughout much of the developing world. Current estimates indicate that more than two billion people are infected with nematodes, resulting in the loss of 14 million disability-adjusted life years per annum. Although these parasites cause significant mortality, they primarily cause chronic morbidity through a wide range of severe clinical ailments. Treatment options for nematode infections are restricted to a small number of anthelmintic drugs, and the rapid expansion of anthelmintic mass drug administration raises concerns of drug resistance. Preservation of existing drugs is necessary, as well as the development of new treatment options and methods of control. We focus this review on how the democratization of CRISPR/Cas9 genome editing technology can be enlisted to improve our understanding of the biology of nematode parasites and our ability to treat the infections they cause. We will first explore how this robust method of genome manipulation can be used to newly exploit the powerful model nematode Caenorhabditis elegans for parasitology research. We will then discuss potential avenues to develop CRISPR/Cas9 editing protocols in filarial nematodes. Lastly, we will propose potential ways in which CRISPR/Cas9 can be used to engineer gene drives that target the transmission of mosquito-borne filarial nematodes. © 2016 The Authors. The FEBS Journal published by John Wiley & Sons Ltd on behalf of Federation of European Biochemical Societies.

Management of low-risk early-stage cervical cancer: Should conization, simple trachelectomy, or simple hysterectomy replace radical surgery as the new standard of care?

PubMed Central

Ramirez, Pedro T.; Pareja, Rene; Rendón, Gabriel J.; Millan, Carlos; Frumovitz, Michael; Schmeler, Kathleen M.

2014-01-01

The standard treatment for women with early-stage cervical cancer (IA2-IB1) remains radical hysterectomy with pelvic lymphadenectomy. In select patients interested in future fertility, the option of radical trachelectomy with pelvic lymphadenectomy is also considered a viable option. The possibility of less radical surgery may be appropriate not only for patients desiring to preserve fertility but also for all patients with low-risk early-stage cervical cancer. Recently, a number of studies have explored less radical surgical options for early-stage cervical cancer, including simple hysterectomy, simple trachelectomy, and cervical conization with or without sentinel lymph node biopsy and pelvic lymph node dissection. Such options may be available for patients with low-risk early-stage cervical cancer. Criteria that define this low-risk group include: squamous carcinoma, adenocarcinoma, or adenosquamous carcinoma, tumor size <2 cm, stromal invasion <10mm, and no lymph-vascular space invasion. In this report, we provide a review of the existing literature on the conservative management of cervical cancer and describe ongoing multi-institutional trials evaluating the role of conservative surgery in selected patients with early-stage cervical cancer. PMID:24041877

Building esprit de corps: learning to better navigate between "my" patient and "our" patient.

PubMed

DeRenzo, Evan G; Schwartz, Jack

2010-01-01

Excellence in the care of hospital patients, particularly those in an intensive care unit, reflects esprit de corps among the care team. Esprit de corps depends on a delicate balance; each clinician must preserve a sense of personal responsibility for "my" patient and yet participate in the collaborative work essential to the care of "our" patient. A harmful imbalance occurs when a physician demands total control of the decision-making process, especially concerning end-of-life treatment options. Although emotional factors may push a physician to claim decision-making exclusivity, compounded by a legal framework that overemphasizes individual responsibility, esprit de corps can be preserved through timely communication among clinicians and a recognition that optimal care for "my" patient requires effective team practice.

A case of traumatic pancreaticoduodenal injury: a simple and an organ-preserving approach as damage control surgery.

PubMed

Choi, Sae Byeol; You, Jiyoung; Choi, Sang Yong

2012-01-10

Traumatic pancreaticoduodenal injury still remains challenging with high morbidity and mortality. Optimal management by performing simple and fast damage control surgery ensures better outcomes. A 36-year-old man was admitted with a combined pancreaticoduodenal injury after being assaulted. More than 80% of duodenal circumference (first portion) was disrupted and the neck of the pancreas was transected. Primary repair of the duodenum and pancreaticogastrostomy were performed. The stump of the proximal pancreatic duct was also sutured. The patient developed an intra-abdominal abscess with pancreatic fistula that eventually recovered by conservative treatment. Pancreaticogastrostomy can be a treatment option for pancreatic transection. Rapid and simple damage control surgery with functional preservation of the organ will be beneficial for trauma patients.

The Pathways fertility preservation decision aid website for women with cancer: development and field testing.

PubMed

Woodard, Terri L; Hoffman, Aubri S; Covarrubias, Laura A; Holman, Deborah; Schover, Leslie; Bradford, Andrea; Hoffman, Derek B; Mathur, Aakrati; Thomas, Jerah; Volk, Robert J

2018-02-01

To improve survivors' awareness and knowledge of fertility preservation counseling and treatment options, this study engaged survivors and providers to design, develop, and field-test Pathways: a fertility preservation patient decision aid website for young women with cancer©. Using an adapted user-centered design process, our stakeholder advisory group and research team designed and optimized the Pathways patient decision aid website through four iterative cycles of review and revision with clinicians (n = 21) and survivors (n = 14). Field-testing (n = 20 survivors) assessed post-decision aid scores on the Fertility Preservation Knowledge Scale, feasibility of assessing women's decision-making values while using the website, and website usability/acceptability ratings. Iterative stakeholder engagement optimized the Pathways decision aid website to meet survivors' and providers' needs, including providing patient-friendly information and novel features such as interactive value clarification exercises, testimonials that model shared decision making, financial/referral resources, and a printable personal summary. Survivors scored an average of 8.2 out of 13 (SD 1.6) on the Fertility Preservation Knowledge Scale. They rated genetic screening and having a biological child as strong factors in their decision-making, and 71% indicated a preference for egg freezing. Most women (> 85%) rated Pathways favorably, and all women (100%) said they would recommend it to other women. The Pathways decision aid is a usable and acceptable tool to help women learn about fertility preservation. The Pathways decision aid may help women make well-informed values-based decisions and prevent future infertility-related distress.

Frontal Lobe Decortication (Frontal Lobectomy with Ventricular Preservation) in Epilepsy-Part 1: Anatomic Landmarks and Surgical Technique.

PubMed

Wen, Hung Tzu; Da Róz, Leila Maria; Rhoton, Albert L; Castro, Luiz Henrique Martins; Teixeira, Manoel Jacobsen

2017-02-01

An extensive frontal resection is a frequently performed neurosurgical procedure, especially for treating brain tumor and refractory epilepsy. However, there is a paucity of reports available regarding its surgical anatomy and technique. We sought to present the anatomic landmarks and surgical technique of the frontal lobe decortication (FLD) in epilepsy. The goals were to maximize the gray matter removal, spare primary and supplementary motor areas, and preserve the frontal horn. The anatomic study was based on dissections performed in 15 formalin-fixed adult cadaveric heads. The clinical experience with 15 patients is summarized. FLD consists of 5 steps: 1) coagulation and section of arterial branches of lateral surface; 2) paramedian subpial resection 3 cm ahead of the precentral sulcus to reach the genu of corpus callosum; 3) resection of gray matter of lateral surface, preserving the frontal horn; 4) removal of gray matter of basal surface preserving olfactory tract; 5) removal of gray matter of the medial surface under the rostrum of corpus callosum. The frontal horn was preserved in all 15 patients; 12 patients (80%) had no complications; 2 patients presented temporary hemiparesis; and 1 Rasmussen syndrome patient developed postoperative fever. The best seizure control was in cases with focal magnetic resonance imaging abnormalities limited to the frontal lobe. FLD is an anatomy-based surgical technique for extensive frontal lobe resection. It presents reliable anatomic landmarks, selective gray matter removal, preservation of frontal horn, and low complication rate in our series. It can be an alternative option to the classical frontal lobectomy. Copyright © 2016 Elsevier Inc. All rights reserved.

Minimally invasive esthetic ridge preservation with growth-factor enhanced bone matrix.

PubMed

Nevins, Marc L; Said, Sherif

2017-12-28

Extraction socket preservation procedures are critical to successful esthetic implant therapy. Conventional surgical approaches are technique sensitive and often result in alteration of the soft tissue architecture, which then requires additional corrective surgical procedures. This case series report presents the ability of flapless surgical techniques combined with a growth factor-enhanced bone matrix to provide esthetic ridge preservation at the time of extraction for compromised sockets. When considering esthetic dental implant therapy, preservation, or further enhancement of the available tissue support at the time of tooth extraction may provide an improved esthetic outcome with reduced postoperative sequelae and decreased treatment duration. Advances in minimally invasive surgical techniques combined with recombinant growth factor technology offer an alternative for bone reconstruction while maintaining the gingival architecture for enhanced esthetic outcome. The combination of freeze-dried bone allograft (FDBA) and rhPDGF-BB (platelet-derived growth factor-BB) provides a growth-factor enhanced matrix to induce bone and soft tissue healing. The use of a growth-factor enhanced matrix is an option for minimally invasive ridge preservation procedures for sites with advanced bone loss. Further studies including randomized clinical trials are needed to better understand the extent and limits of these procedures. The use of minimally invasive techniques with growth factors for esthetic ridge preservation reduces patient morbidity associated with more invasive approaches and increases the predictability for enhanced patient outcomes. By reducing the need for autogenous bone grafts the use of this technology is favorable for patient acceptance and ease of treatment process for esthetic dental implant therapy. © 2017 Wiley Periodicals, Inc.

Distraction arthroplasty compared to other cartilage preservation procedures in patients with post-traumatic arthritis: a systematic review.

PubMed

Rivera, Jessica C; Beachler, Jason A

2018-01-23

Post-traumatic arthritis (PTA) is characterized by the deterioration of articular cartilage temporally associated with an articular injury. With a paucity of literature comparing joint preservation techniques, we performed a systematic review of the literature intending to describe and summarize the results of ankle distraction arthroplasty as it compares with studies on tibio-talar microfracture, allograft, and autograft for ankle joint preservation in the post-traumatic population under 50 years of age. Research databases were searched and abstracts screened for relevance on our topic of interest. Abstracts meeting screening criteria with high interobserver reliability underwent full-manuscript review and coding for pertinent citation, study level, treatment, and outcome variables. Outcome variables for patient-reported pain scales, validated outcome measurement tools, radiographic progression, reoperation/re-treatment rates, and complication rates were recorded. Out of 105 unique citations, 10 publications were included. The distraction arthroplasty studies had 36 out of 181 patients requiring reoperation for complications (19.9%), while other joint-preserving procedures studies had 40 out of 177 patients requiring reoperations for complications (22.6%). Clinical outcome scores at mean follow-up time ranging from 2 to 10 years between studies were similar. Reported results for a variety of cartilage preservation procedures, including distraction arthroplasty, are satisfactory and reoperation rates for complication are similar. Limitations in available data and underlying study quality affect synthesis of the results therein. While distraction arthroplasty is an option for cartilage preservation in patients with PTA of the ankle, the technique is highly specialized which may affect the external validity. III.

Induction chemotherapy in head and neck squamous cell carcinoma of the paranasal sinus and nasal cavity: a role in organ preservation

PubMed Central

Ock, Chan-Young; Keam, Bhumsuk; Kim, Tae Min; Han, Doo Hee; Won, Tae-Bin; Lee, Se-Hoon; Hah, J. Hun; Kwon, Tack-Kyun; Kim, Dong-Wan; Kim, Dong-Young; Rhee, Chae-Seo; Wu, Hong-Gyun; Sung, Myung-Whun; Heo, Dae Seog

2016-01-01

Background/Aims: The role of induction chemotherapy (IC) for eyeball preservation has not been established in head and neck squamous cell carcinoma (HNSCC) of the paranasal sinus and nasal cavity (PNSNC). Periorbital involvement frequently leads to eyeball exenteration with a margin of safety. We evaluated the treatment outcomes, including survival and eyeball preservation, of patients who received IC for HNSCC of the PNSNC. Methods: We reviewed 21 patients diagnosed with HNSCC of the PNSNC who were treated with IC. We analyzed response, eyeball preservation rate, and overall survival. Results: Tumors were located in the paranasal sinus (n = 14) or nasal cavity (n = 7). Most patients had stage T4a (n = 10) or T4b (n = 7) disease. More than half of the patients received a chemotherapy regimen of docetaxel, fluorouracil, and cisplatin (n = 11). Thirteen patients (61.9%) achieved a partial response after IC and 15 patients (71.4%) achieved T down-staging. Among 17 patients with stage T4 disease, which confers a high risk of orbital exenteration, 14 (82.4%) achieved preservation of the involved eye. The 3-year overall survival (OS) rate of patients who achieved a partial response to IC was 84.6%. The 3-year OS rate of patients with stable disease or disease progression after IC was 25.0% (p = 0.038). Conclusions: IC could be considered for down-staging patients with advanced T-stage disease. It could also be a reasonable option for eyeball preservation in locally advanced HNSCC of the PNSNC. PMID:26976150

Direct current testing to measure corrosiveness of wood preservatives

Treesearch

Samuel L. Zelinka; Douglas R. Rammer; Donald S. Stone; James T. Gilbertson

2007-01-01

A qualitative test that mimics the corrosion behaviour of metals in contact with treated wood without using wood specimens would be of great value in rapidly evaluating the corrosiveness of new wood preservatives. The objective of this study was to determine whether the linear polarisation resistance of metals immersed in a solution of preservative chemicals is related...

Technical Note: Comparison of accelerated methods for evaluating leaching from preservative-treated wood

Treesearch

Stan T. Lebow; Patricia K. Lebow; Kolby C. Hirth

2017-01-01

Current standardized methods are not well-suited for estimating in-service preservative leaching from treated wood products. This study compared several alternative leaching methods to a commonly used standard method, and to leaching under natural exposure conditions. Small blocks or lumber specimens were pressure treated with a wood preservative containing borax and...

Chronic and Acute Stress Promote Overexploitation in Serial Decision Making

PubMed Central

Lenow, Jennifer K.; Constantino, Sara M.

2017-01-01

Many decisions that humans make resemble foraging problems in which a currently available, known option must be weighed against an unknown alternative option. In such foraging decisions, the quality of the overall environment can be used as a proxy for estimating the value of future unknown options against which current prospects are compared. We hypothesized that such foraging-like decisions would be characteristically sensitive to stress, a physiological response that tracks biologically relevant changes in environmental context. Specifically, we hypothesized that stress would lead to more exploitative foraging behavior. To test this, we investigated how acute and chronic stress, as measured by changes in cortisol in response to an acute stress manipulation and subjective scores on a questionnaire assessing recent chronic stress, relate to performance in a virtual sequential foraging task. We found that both types of stress bias human decision makers toward overexploiting current options relative to an optimal policy. These findings suggest a possible computational role of stress in decision making in which stress biases judgments of environmental quality. SIGNIFICANCE STATEMENT Many of the most biologically relevant decisions that we make are foraging-like decisions about whether to stay with a current option or search the environment for a potentially better one. In the current study, we found that both acute physiological and chronic subjective stress are associated with greater overexploitation or staying at current options for longer than is optimal. These results suggest a domain-general way in which stress might bias foraging decisions through changing one's appraisal of the overall quality of the environment. These novel findings not only have implications for understanding how this important class of foraging decisions might be biologically implemented, but also for understanding the computational role of stress in behavior and cognition more broadly. PMID:28483979

76 FR 66209 - Airworthiness Directives; Sikorsky Aircraft Corporation (Sikorsky) Model S-92A Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-26

... option is to conduct an eddy current inspection and the other option is to conduct a visual inspection... eddy current inspection, at an average labor rate of $85 per work hour. Required parts would cost about... using either an eddy current inspection in accordance with paragraphs B.(1)(a) through B.(1)(o) or using...

Toxic Overload: The Waste Disposal Dilemma.

ERIC Educational Resources Information Center

Knox, Robert J.

1991-01-01

The role of the Environmental Protection Agency as ombudsman concerning waste disposal is examined with respect to both the current options of source reduction and recycling as pollution prevention, and alternative approaches that expand upon these current options, particularly with respect to toxic and medical waste. (JJK)

The LHCb software and computing upgrade for Run 3: opportunities and challenges

NASA Astrophysics Data System (ADS)

Bozzi, C.; Roiser, S.; LHCb Collaboration

2017-10-01

The LHCb detector will be upgraded for the LHC Run 3 and will be readout at 30 MHz, corresponding to the full inelastic collision rate, with major implications on the full software trigger and offline computing. If the current computing model and software framework are kept, the data storage capacity and computing power required to process data at this rate, and to generate and reconstruct equivalent samples of simulated events, will exceed the current capacity by at least one order of magnitude. A redesign of the software framework, including scheduling, the event model, the detector description and the conditions database, is needed to fully exploit the computing power of multi-, many-core architectures, and coprocessors. Data processing and the analysis model will also change towards an early streaming of different data types, in order to limit storage resources, with further implications for the data analysis workflows. Fast simulation options will allow to obtain a reasonable parameterization of the detector response in considerably less computing time. Finally, the upgrade of LHCb will be a good opportunity to review and implement changes in the domains of software design, test and review, and analysis workflow and preservation. In this contribution, activities and recent results in all the above areas are presented.

Topical hexaminolevulinate photodynamic therapy for the treatment of persistent human papilloma virus infections and cervical intraepithelial neoplasia.

PubMed

Hillemanns, Peter; Einstein, Mark H; Iversen, Ole Erik

2015-02-01

Current treatments for high-grade cervical intraepithelial neoplasia (CIN2/3) are mainly excisional procedures, which are associated with significant side effects and pose risks for future pregnancies. An effective and safe therapy is needed to reduce the requirement for surgical interventions in women of reproductive age. This review looks at the pharmacokinetic and clinical data for topical hexaminolevulinate (HAL) photodynamic therapy (PDT), which is currently entering late phase clinical trials for high-grade CIN. The authors include published studies in patients and volunteers but laboratory and animal studies have been excluded as have studies on other porphyrins such as Photofrin, 5-aminolevulinic acid, methyl aminolevulinate and studies reporting other clinical applications for HAL. Topical HAL PDT has potential as a non-surgical tissue-preserving treatment for CIN and persistent oncogenic human papilloma virus infections. HAL PDT selectively treats the entire epithelial sheet, without the tissue destruction seen in excisional procedures. The authors believe that this treatment could replace surgery in a large proportion of patients. It would be of particular value to the high percentage of women who are interested in future child-bearing. If the treatment is approved, it is very likely that physicians will want to use this treatment, as many patients will be keen to consider a non-surgical option.

Novel drug delivery systems for glaucoma

PubMed Central

Lavik, E; Kuehn, M H; Kwon, Y H

2011-01-01

Reduction of intraocular pressure (IOP) by pharmaceutical or surgical means has long been the standard treatment for glaucoma. A number of excellent drugs are available that are effective in reducing IOP. These drugs are typically applied as eye drops. However, patient adherence can be poor, thus reducing the clinical efficacy of the drugs. Several novel delivery systems designed to address the issue of adherence and to ensure consistent reduction of IOP are currently under development. These delivery systems include contact lenses-releasing glaucoma medications, injectables such as biodegradable micro- and nanoparticles, and surgically implanted systems. These new technologies are aimed at increasing clinical efficacy by offering multiple delivery options and are capable of managing IOP for several months. There is also a desire to have complementary neuroprotective approaches for those who continue to show progression, despite IOP reduction. Many potential neuroprotective agents are not suitable for traditional oral or drop formulations. Their potential is dependent on developing suitable delivery systems that can provide the drugs in a sustained, local manner to the retina and optic nerve. Drug delivery systems have the potential to improve patient adherence, reduce side effects, increase efficacy, and ultimately, preserve sight for glaucoma patients. In this review, we discuss benefits and limitations of the current systems of delivery and application, as well as those on the horizon. PMID:21475311

Future water supply management adaptation measures - case study of Ljubljana field aquifer

NASA Astrophysics Data System (ADS)

Čenčur Curk, B.; Zajc Benda, T.; Souvent, P.; Bračič Železnik, B.; Bogardi, I.

2012-04-01

The main drinking water supply problems are related to the significant change of groundwater quantity and quality observed in the last decades as an effect of land use practices and very likely also climate change. The latter may affect the ability of drinking water suppliers to provide enough water of sufficient quality to the consumers. These topics were studied in the frame of SEE project CC-WaterS (Climate Change and Impact on Water Supply) with the main goal to develop a water supply management system regarding optimisation of water extraction and land use restrictions under climate change scenarios for water suppliers, since existing management practices are mostly inadequate to reduce impacts of CC on water supply reliability. The main goal was a designation of appropriate measures and risk assessment to adapt water supply to changing climate and land use activities considering socio-economic aspects. This was accomplished by using 'Fuzzy Decimaker', which is a tool for selecting and ranking risk reduction measures or management actions for local waterworks or water authorities under the pressure of climate change. Firstly, management options were selected and ranked. For public water supply of Ljubljana, the capital of Slovenia, several management options were selected. For improvement of water supply and preservation of water resource quantities there is a need for engineering interventions, such as reducing water losses on pipelines. For improving drinking water safety and preserving water resource quality farmers are not allowed to use fertilisers in the first safeguarding zone and they get compensations for income reduction because of lower farming production. Compensations for farming restrictions in the second safeguarding zone were applied as additional management option. On the other hand, drinking water treatment is another management option to be considered. Trends in groundwater level are decreasing, above all recharge areas of waterworks; therefore there is a threat of reduction of water resource availability. For this following management options were proposed: artificial recharge with infiltration wells, setting up new and additional waterworks (one with river bank filtration, one with exploitation of local porous aquifer and one with deep groundwater exploitation from dolomite aquifer). Management actions can be evaluated according to several criteria, such as water supply risk reduction for the various users (drinking, agricultural, industrial and ecological), realization of the actions (cost, flexibility and leg time). Ranking criteria are characterized by different units (e.g. units of water supply (quantity) risk may involve number of unsupplied people, monetary terms, agricultural area or habitat loss). Decision making process is followed by defining relative weights, balancing factors and best and worst values for the indicators; calculating base risk and risk elements for each management option and sensitivity analysis. The result of this decision making process is evaluation of preferred management option(s) according to the ranking results.

The selective preservation of colour naming in semantic dementia.

PubMed

Robinson, G; Cipolotti, L

2001-01-01

This paper documents a series of seven patients with semantic dementia who showed a selective preservation in colour naming. This was in the context of a pervasive impairment in naming nouns across a wide range of other semantic categories. To our knowledge, this is the first series of patients with semantic dementia documenting a selective preservation of colour naming. These findings are discussed in the light of current theoretical accounts of category-specific effects and the possible contribution of imageability to this selective preservation of colours.

National Conference on the Development of Statewide Preservation Programs. Report of a Conference on the Current Status and Future Directions of Statewide Programs for the Preservation of Our Intellectual Heritage (Washington, D.C., March 1-3, 1989).

ERIC Educational Resources Information Center

Morrow, Carolyn Clark, Ed.

This report presents some of the prominent features of a national invitational conference whose goal was to provide a national forum to discuss ongoing preservation efforts in individual states; describe the preservation challenge faced by all states in common; review the kinds of materials at risk; and alert administrators to the opportunities…

Knowledge Preservation Techniques That Can Facilitate Intergroup Communications

NASA Technical Reports Server (NTRS)

Moreman, Douglas; Dyer, John; Coffee, John; Noga, Donald F. (Technical Monitor)

2000-01-01

We have developed tools, social methods and software, for (1) acquiring technical knowledge from engineers and scientists, (2) preserving that knowledge, (3) making the totality of our stored knowledge rapidly searchable. Our motivation has been, mainly, to preserve rare knowledge of senior engineers who are near retirement. Historical value of such knowledge, and also of our tools, has been pointed out to us by historians. We now propose the application these tools to enhancing communication among groups that are working jointly on a project. Of most value will be projects having groups among whom communication is rare and incomplete. We propose that discussions among members of a group be recorded in audio and that both the actual audio and transcriptions of that audio, and optional other pieces be combined into electronic, webpage-like "books". These books can then be searched rapidly by interested people in other groups. At points of particular interest, a searcher can zoom in on the text and even on the original recordings to pick up nuances (e.g. to distinguish a utterance said in seriousness from one in sarcasm). In this matter, not only can potentially valuable technical details be preserved for the future, but communication be enhanced during the life of a joint undertaking.

Industry-Related Day Care: Trends and Options.

ERIC Educational Resources Information Center

Verzaro-Lawrence, Marce; And Others

1982-01-01

Examines current needs and trends of child care options in the United States, and discusses industrial responses to providing day care services. The advantages and disadvantages of industry-related day care and options available are also discussed. (Author/DB)

Public Sector Readiness for Digital Preservation in New Zealand: The Rate of Adoption of an Innovation in Records Management Practices

ERIC Educational Resources Information Center

Dorner, Daniel G.

2009-01-01

Recent legislation in New Zealand has placed statutory obligations on its government organizations to introduce sound records management practices and to ensure long-term access to their digital records. To obtain a base level of knowledge on current digital preservation practices and on awareness of digital preservation issues, an online survey…

Fertility Preservation in Klinefelter Syndrome Patients during the Transition Period.

PubMed

Rives, Nathalie; Rives, Aurélie; Rondanino, Christine; Castanet, Mireille; Cuny, Ariane; Sibert, Louis

2018-01-01

Spermatozoa have occasionally been identified in ejaculate of adult Klinefelter syndrome (KS) patients but very exceptionally in KS adolescents. Spermatozoa can also be retrieved in testicular tissue of KS adolescents. The testis may also harbor spermatogonia and noncompletely differentiated germ cells. Neither clinical features nor hormonal parameters could predict germ cell recovery in KS adults or adolescents. No predictive factors can actually demonstrate that early diagnosis of KS would allow increasing the chance of sperm retrieval even if it has been suggested that semen quality may decline with age in KS patients. Leydig cell dysfunction may also be another factor that might affect the spermatogenesis process in XXY adolescents. Fertility preservation might be preferentially proposed in KS adolescents when semen sampling is possible, when the patient is able to consider alternative options to become a father, and to accept germ cell retrieval failure. However, precocious diagnosis of KS has also to be considered because it might not solely improve the possibility of fertility preservation after the onset of puberty, but also the medical care and the quality of life of these patients. © 2018 S. Karger AG, Basel.

Surviving global risks through the preservation of humanity's data on the Moon

NASA Astrophysics Data System (ADS)

Turchin, Alexey; Denkenberger, David

2018-05-01

Many global catastrophic risks are threatening human civilization, and a number of ideas have been suggested for preventing or surviving them. However, if these interventions fail, society could preserve information about the human race and human DNA samples in the hopes that the next civilization on Earth will be able to reconstruct Homo sapiens and our culture. This requires information preservation of an order of magnitude of 100 million years, a little-explored topic thus far. It is important that a potential future civilization discovers this information as early as possible, thus a beacon should accompany the message in order to increase visibility. The message should ideally contain information about how humanity was destroyed, perhaps including a continuous recording until the end. This could help the potential future civilization to survive. The best place for long-term data storage is under the surface of the Moon, with the beacon constructed as a complex geometric figure drawn by small craters or trenches around a central point. There are several cost-effective options for sending the message as opportunistic payloads on different planned landers.

76 FR 77046 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-09

... Change Relating to the Firm Related Equity Option Cap December 5, 2011. Pursuant to Section 19(b)(1) of... ``Equity Options Fees'' to apply the Firm Related Equity Option Cap to certain proprietary orders of... Equity Option Cap to proprietary orders of certain affiliates of member organizations. Currently, Firms...

76 FR 16646 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-24

...-Settled Foreign Currency Option Fees, in Section III of the Fee Schedule, with Singly Listed Options \\3...\\. The Exchange currently assesses fees for sector index options and U.S. Dollar-Settled foreign currency... U.S. Dollar-Settled Foreign Currency Option Fees.'' \\4\\ BKX represents the KBW Bank Index. \\5\\ RUT...

Long-term Outcomes Favor Duodenum-preserving Pancreatic Head Resection over Pylorus-preserving Pancreaticoduodenectomy for Chronic Pancreatitis: A Meta-analysis and Systematic Review.

PubMed

Sukharamwala, Prashant B; Patel, Krishen D; Teta, Anthony F; Parikh, Shailraj; Ross, Sharona B; Ryan, Carrie E; Rosemurgy, Alexander S

2015-09-01

Pylorus-preserving pancreaticoduodenectomy (PPPD) and duodenum-preserving pancreatic head resection (DPPHR) are important treatment options for patients with chronic pancreatitis. This meta-analysis was undertaken to compare the long-term outcomes of DPPHR versus PPPD in patients with chronic pancreatitis. A systematic literature search was conducted using Embase, MEDLINE, Cochrane, and PubMed databases on all studies published between January 1991 and January 2013 reporting intermediate and long-term outcomes after DPPHR and PPPD for chronic pancreatitis. Long-term outcomes of interest were complete pain relief, quality of life, professional rehabilitation, exocrine insufficiency, and endocrine insufficiency. Other outcomes of interest included perioperative morbidity and length of stay (LOS). Ten studies were included comprising of 569 patients. There was no significant difference in complete pain relief (P = 0.24), endocrine insufficiency (P = 0.15), and perioperative morbidity (P = 0.13) between DPPHR and PPPD. However, quality of life (P < 0.00001), professional rehabilitation (P = 0.004), exocrine insufficiency (P = 0.005), and LOS (P = 0.00001) were significantly better for patients undergoing DPPHR compared with PPPD. In conclusion, there is no significant difference in endocrine insufficiency, postoperative pain relief, and perioperative morbidity for patients undergoing DPPHR versus PPPD. Improved intermediate and long-term outcomes including LOS, quality of life, professional rehabilitation, and preservation of exocrine function make DPPHR a more favorable approach than PPPD for patients with chronic pancreatitis.

Biobanking efforts and new advances in male fertility preservation for rare and endangered species.

PubMed

Comizzoli, Pierre

2015-01-01

Understanding and sustaining biodiversity is a multi-disciplinary science that benefits highly from the creation of organized and accessible collections of biomaterials (Genome Resource Banks). Large cryo-collections are invaluable tools for understanding, cataloging, and protecting the genetic diversity of the world's unique animals and plants. Specifically, the systematic collection and preservation of semen from rare species has been developed significantly in recent decades with some biobanks now being actively used for endangered species management and propagation (including the introduction of species such as the black-footed ferret and the giant panda). Innovations emerging from the growing field of male fertility preservation for humans, livestock species, and laboratory animals are also becoming relevant to the protection and the propagation of valuable domestic and wild species. These new approaches extend beyond the "classical" methods associated with sperm freezing to include testicular tissue preservation combined with xenografting or in vitro culture, all of which have potential for rescuing vast amounts of unused germplasm. There also are other options under development that are predicted to have a high impact within the next decade (stem cell technologies, bio-stabilization of sperm cells at ambient temperatures, and the use of genomics tools). However, biobanking efforts and new fertility preservation strategies have to expand the way beyond mammalian species, which will offer knowledge and tools to better manage species that serve as valuable biomedical models or require assistance to reverse endangerment.

Biobanking efforts and new advances in male fertility preservation for rare and endangered species

PubMed Central

Comizzoli, Pierre

2015-01-01

Understanding and sustaining biodiversity is a multi-disciplinary science that benefits highly from the creation of organized and accessible collections of biomaterials (Genome Resource Banks). Large cryo-collections are invaluable tools for understanding, cataloging, and protecting the genetic diversity of the world's unique animals and plants. Specifically, the systematic collection and preservation of semen from rare species has been developed significantly in recent decades with some biobanks now being actively used for endangered species management and propagation (including the introduction of species such as the black-footed ferret and the giant panda). Innovations emerging from the growing field of male fertility preservation for humans, livestock species, and laboratory animals are also becoming relevant to the protection and the propagation of valuable domestic and wild species. These new approaches extend beyond the “classical” methods associated with sperm freezing to include testicular tissue preservation combined with xenografting or in vitro culture, all of which have potential for rescuing vast amounts of unused germplasm. There also are other options under development that are predicted to have a high impact within the next decade (stem cell technologies, bio-stabilization of sperm cells at ambient temperatures, and the use of genomics tools). However, biobanking efforts and new fertility preservation strategies have to expand the way beyond mammalian species, which will offer knowledge and tools to better manage species that serve as valuable biomedical models or require assistance to reverse endangerment. PMID:25966625

[Fertility preservation, contraception and menopause hormone therapy in women treated for rare ovarian tumors: Guidelines from the French national network dedicated to rare gynaecological cancer].

PubMed

Rousset-Jablonski, Christine; Selle, Fréderic; Adda-Herzog, Elodie; Planchamp, François; Selleret, Lise; Pomel, Christophe; Chabbert-Buffet, Nathalie; Daraï, Emile; Pautier, Patricia; Trémollières, Florence; Guyon, Frederic; Rouzier, Roman; Laurence, Valérie; Chopin, Nicolas; Faure-Conter, Cécile; Bentivegna, Enrica; Vacher-Lavenu, Marie-Cécile; Lhomme, Catherine; Floquet, Anne; Treilleux, Isabelle; Lecuru, Fabrice; Gouy, Sébastien; Kalbacher, Elsa; Genestie, Catherine; de la Motte Rouge, Thibault; Ferron, Gwenael; Devouassoux-Shisheboran, Mojgan; Kurtz, Jean-Emmanuel; Namer, Moise; Joly, Florence; Pujade-Lauraine, Eric; Grynberg, Michael; Querleu, Denis; Morice, Philippe; Gompel, Anne; Ray-Coquard, Isabelle

2018-03-01

Rare ovarian tumors include complex borderline ovarian tumors, sex-cord tumors, germ cell tumors, and rare epithelial tumors. Indications and modalities of fertility preservation, infertility management and contraindications for hormonal contraception or menopause hormone therapy are frequent issues in clinical practice. A panel of experts from the French national network dedicated to rare gynaecological cancers, and of experts in reproductive medicine and gynaecology have worked on guidelines about fertility preservation, contraception and menopause hormone therapy in women treated for ovarian rare tumors. A panel of 39 experts from different specialties contributed to the preparation of the guidelines, following the DELPHI method (formal consensus method). Statements were drafted after a systematic literature review, and then rated through two successive rounds. Thirty-five recommendations were selected, and concerned indications for fertility preservation, contraindications for ovarian stimulation (in the context of fertility preservation or for infertility management), contraceptive options (especially hormonal ones), and menopause hormone therapy for each tumor type. Overall, prudence has been recommended in the case of potentially hormone-sensitive tumors such as sex cord tumors, serous and endometrioid low-grade adenocarcinomas, as well as for high-risk serous borderline ovarian tumors. In the context of a scarce literature, a formal consensus method allowed the elaboration of guidelines, which will help clinicians in the management of these patients. Copyright © 2017 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

Nerve Agents: What They Are, How They Work, How to Counter Them.

PubMed

Costanzi, Stefano; Machado, John-Hanson; Mitchell, Moriah

2018-05-16

Nerve agents are organophosphorus chemical warfare agents that exert their action through the irreversible inhibition of acetylcholinesterase, with a consequent overstimulation of cholinergic transmission followed by its shutdown. Beyond warfare, they have notoriously been employed in acts of terrorism as well as high profile assassinations. After a brief historical introduction on the development and deployment of nerve agents, this review provides a survey of their chemistry, the way they affect cholinergic transmission, the available treatment options, and the current directions for their improvement. As the review illustrates, despite their merits, the currently available treatment options present several shortcomings. Current research directions involve the search for improved antidotes, antagonists of the nicotinic receptors, small-molecule pretreatment options, as well as bioscavengers as macromolecular pretreatment options. These efforts are making good progress in many different directions and, hopefully, will lead to a lower target susceptibility, thus reducing the appeal of nerve agents as chemical weapons.

Access and preservation of digital research content: Linked open data services - A research library perspective

NASA Astrophysics Data System (ADS)

Kraft, Angelina; Sens, Irina; Löwe, Peter; Dreyer, Britta

2016-04-01

Globally resolvable, persistent digital identifiers have become an essential tool to enable unambiguous links between published research results and their underlying digital resources. In addition, this unambiguous identification allows citation. In an ideal research world, any scientific content should be citable and the coherent content, as well as the citation itself, should be persistent. However, today's scientists do not just produce traditional research papers - they produce comprehensive digital collections of objects which, alongside digital texts, include digital resources such as research data, audiovisual media, digital lab journals, images, statistics and software code. Researchers start to look for services which allow management of these digital resources with minimum time investment. In light of this, we show how the German National Library of Science and Technology (TIB) develops supportive frameworks to accompany the life cycle of scientific knowledge generation and transfer. This includes technical infrastructures for • indexing, cataloguing, digital preservation, DOI names and licencing for text and digital objects (the TIB DOI registration, active since 2004) and • a digital repository for the deposition and provision of accessible, traceable and citeable research data (RADAR). One particular problem for the management of data originating from (collaborating) research infrastructures is their dynamic nature in terms of growth, access rights and quality. On a global scale, systems for access and preservation are in place for the big data domains (e.g. environmental sciences, space, climate). However, the stewardship for disciplines without a tradition of data sharing, including the fields of the so-called long tail, remains uncertain. The RADAR - Research Data Repository - project establishes a generic end-point data repository, which can be used in a collaborative way. RADAR enables clients to upload, edit, structure and describe their (collaborative) data in an organizational workspace. In such a workspace, administrators and curators can manage access and editorial rights before the data enters the preservation and optional publication phase. RADAR applies different PID strategies for closed vs. open data. For closed datasets, RADAR uses handles as identifiers and offers format-independent data preservation between 5 and 15 years, which can also be prolonged. By default, preserved data are only available to the respective data curators, which may selectively grant other researches access to preserved data. For open datasets, RADAR provides a Digital Object Identifier (DOI) to enable researchers to clearly reference and reuse data and to guarantee data accessibility. RADAR offers the publication service of research data together with format-independent data preservation for an unlimited time period. Each published dataset can be enriched with discipline-specific metadata and an optional embargo period can be specified. With these two services, RADAR aims to meet demands from a broad range of specialized research disciplines: To provide a secure, citable data storage and citability for researchers which need to retain restricted access to data on one hand, and an e-infrastructure which allows for research data to be stored, found, managed, annotated, cited, curated and published in a digital platform available 24/7, on the other.

Review of Systemic Treatment Options for Adult Atopic Dermatitis.

PubMed

Gooderham, Melinda; Lynde, Charles W; Papp, Kim; Bourcier, Marc; Guenther, Lyn; Gulliver, Wayne; Hong, Chih-Ho; Poulin, Yves; Sussman, Gordon; Vender, Ronald

Atopic dermatitis (AD) is a chronic, pruritic inflammatory skin disease resulting from defects in skin barrier and aberrant immune responses. AD significantly affects the quality of life. Not all patients respond to topical therapies, and often systemic therapy is required to control the disease. To review the treatment options for adult AD patients including those options for patients who do not respond adequately or have contraindications to oral systemic therapy. A working group of clinicians with experience managing AD was convened to review the current literature on treatment options for adult AD patients. This review is based on the best available evidence from a published systematic review and an additional literature search. Current treatments for AD are reviewed, including options for adult AD patients who do not respond or have contraindications to current systemic therapies. A new approach with targeted therapies is reviewed based on best available evidence. Many AD patients respond satisfactorily to topical or systemic treatments, but for those patients who do not respond or have contraindications, new biologic agents appear to be promising therapies.

Medical management of heavy menstrual bleeding

PubMed Central

Maybin, Jacqueline A; Critchley, Hilary OD

2016-01-01

Women with benign heavy menstrual bleeding have the choice of a number of medical treatment options to reduce their blood loss and improve quality of life. The role of the clinician is to provide information to facilitate women in making an appropriate choice. Unfortunately, many options can be associated with hormonal side effects, prevention of fertility and lack of efficacy, leading to discontinuation and progression to surgical interventions. Herein, we discuss the various options currently available to women, including antifibrinolytics, nonsteroidal anti-inflammatory preparations, oral contraceptive pills and oral, injectable and intrauterine progestogens. In addition, we describe the more novel option of selective progesterone receptor modulators and their current benefits and limitations. PMID:26695687

Privacy-preserving data aggregation protocols for wireless sensor networks: a survey.

PubMed

Bista, Rabindra; Chang, Jae-Woo

2010-01-01

Many wireless sensor network (WSN) applications require privacy-preserving aggregation of sensor data during transmission from the source nodes to the sink node. In this paper, we explore several existing privacy-preserving data aggregation (PPDA) protocols for WSNs in order to provide some insights on their current status. For this, we evaluate the PPDA protocols on the basis of such metrics as communication and computation costs in order to demonstrate their potential for supporting privacy-preserving data aggregation in WSNs. In addition, based on the existing research, we enumerate some important future research directions in the field of privacy-preserving data aggregation for WSNs.

Targeting a portion of central European spider diversity for permanent preservation.

PubMed

Candek, Klemen; Gregorič, Matjaž; Kostanjšek, Rok; Frick, Holger; Kropf, Christian; Kuntner, Matjaž

2013-01-01

Given the limited success of past and current conservation efforts, an alternative approach is to preserve tissues and genomes of targeted organisms in cryobanks to make them accessible for future generations. Our pilot preservation project aimed to obtain, expertly identify, and permanently preserve a quarter of the known spider species diversity shared between Slovenia and Switzerland, estimated at 275 species. We here report on the faunistic part of this project, which resulted in 324 species (227 in Slovenia, 143 in Switzerland) for which identification was reasonably established. This material is now preserved in cryobanks, is being processed for DNA barcoding, and is available for genomic studies.

Dual-fibular reconstruction of a massive tibial defect after Ewing's sarcoma resection in a pediatric patient with a vascular variation.

PubMed

Saridis, Alkis G; Megas, Panagiotis D; Georgiou, Christos S; Diamantakis, Georgios M; Tyllianakis, Minos E

2011-01-01

In the management of malignancies of the extremities, limb salvage procedures have recently taken on greater significance. For those patients under intense adjuvant chemotherapy and with massive bone loss, free vascularized fibular grafting is currently advocated as a reliable reconstructive option, maybe because of the controversial results of bone transport in similar situations. However, when there is a vascular abnormality of either the recipient or donor extremity, microsurgical procedures are not feasible, further limiting potential reconstructive alternatives. We present the case of a 13-year-old female patient with Ewing's sarcoma of the right tibia. Preoperative angiography showed that vascularity of the affected side depended totally on a single peroneal artery. The patient was treated initially with multiagent chemotherapy, followed by an excision of 23 cm. The defect was bridged by a gradual medial transportation of the ipsilateral fibula with the Ilizarov technique and strengthened by nonvascularized transfer of the contralateral fibula. Total external fixation time was 162 days. After the removal of the Ilizarov frame a walking cast was applied for another month. At 5 years postoperatively there was no recurrence of the malignancy. The patient had full weight-bearing ability on the affected limb, with preservation of the ankle and knee joints motion and without any limb length discrepancy or axial deformity. The functional outcome that was visible was graded excellent. Transverse distraction osteogenesis of the ipsilateral fibula performed well under chemotherapy, showing unproblematic callus formation. Supplemented with nonvascularized transfer of the contralateral fibula, provided a reconstructive option with biological affinity, sufficient biomechanical strength and durability, and with a decreased complication rate. This case report presents a viable option, especially in cases in which vascular abnormalities of either the donor or the recipient limb, combined with multiagent chemotherapy, restrict potential reconstructive alternatives. It also highlights why vascularized bone graft should not be regarded as a panacea for all situations in which a fibular graft is required. Level IV, case report.

76 FR 63976 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-14

... proposed change is intended to attract more customer volume to the Exchange in the SPY option class and to allow CBOE market-makers to better compete for order flow. CBOE noted that the SPY option class is... class. CBOE believes that the current demographics of electronic SPY option order flow is more driven by...

75 FR 33374 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-11

... proposes to amend its Fees Schedule to establish fees for transactions in all S&P 500 Dividend Index... transactions in DVS options to all options on the S&P 500 Dividend Index, regardless of the specified accrual period.\\6\\ Currently the established transaction fees for DVS options are as follows: \\6\\ See Securities...

Organ Preservation: Current Concepts and New Strategies for the Next Decade

PubMed Central

Guibert, Edgardo E.; Petrenko, Alexander Y.; Balaban, Cecilia L.; Somov, Alexander Y.; Rodriguez, Joaquín V.; Fuller, Barry J.

2011-01-01

Summary Organ transplantation has developed over the past 50 years to reach the sophisticated and integrated clinical service of today through several advances in science. One of the most important of these has been the ability to apply organ preservation protocols to deliver donor organs of high quality, via a network of organ exchange to match the most suitable recipient patient to the best available organ, capable of rapid resumption of life-sustaining function in the recipient patient. This has only been possible by amassing a good understanding of the potential effects of hypoxic injury on donated organs, and how to prevent these by applying organ preservation. This review sets out the history of organ preservation, how applications of hypothermia have become central to the process, and what the current status is for the range of solid organs commonly transplanted. The science of organ preservation is constantly being updated with new knowledge and ideas, and the review also discusses what innovations are coming close to clinical reality to meet the growing demands for high quality organs in transplantation over the next few years. PMID:21566713

Evaluation of a Microbial Sensor as a Tool for Antimicrobial Activity Test of Cosmetic Preservatives.

PubMed

Gomyo, Hideyuki; Ookawa, Masaki; Oshibuchi, Kota; Sugamura, Yuriko; Hosokawa, Masahito; Shionoiri, Nozomi; Maeda, Yoshiaki; Matsunaga, Tadashi; Tanaka, Tsuyoshi

2015-01-01

For high-throughput screening of novel cosmetic preservatives, a rapid and simple assay to evaluate the antimicrobial activities should be developed because the conventional agar dilution method is time-consuming and labor-intensive. To address this issue, we evaluated a microbial sensor as a tool for rapid antimicrobial activity testing. The sensor consists of an oxygen electrode and a filter membrane that holds the test microorganisms, Staphylococcus aureus and Candida albicans. The antimicrobial activity of the tested cosmetic preservative was evaluated by measuring the current increases corresponding to the decreases in oxygen consumption in the microbial respiration. The current increases detected by the sensor showed positive correlation to the concentrations of two commercially used preservatives, chlorphenesin and 2-phenoxyethanol. The same tendency was also observed when a model cosmetic product was used as a preservative solvent, indicating the feasibility in practical use. Furthermore, the microbial sensor and microfluidic flow-cell was assembled to achieve sequential measurements. The sensor system presented in this study could be useful in large-scale screening experiments.

Current treatment for vitreous floaters.

PubMed

Sendrowski, David P; Bronstein, Mark A

2010-03-01

Vitreous floaters are a common complaint in the ophthalmic care setting. Patients seek explanation and advice regarding possible treatment options. Because the condition is considered benign, ophthalmic care practitioners have little to offer regarding treatment options. The majority of cases encountered are managed with patient education and reassurance. Although almost all patients accept the conservative management option, there is a small subset of patients who may desire a more aggressive treatment intervention for resolution of their visual symptoms. Information with regard to treatment options is readily available to patients through Internet searches and non-peer reviewed educational Web sites. The risks and benefits for these treatment options are not fully covered. Management of floaters should include education regarding "off-label" procedures as well as discussion about benefits and risks associated with such treatment options. It is vital that eye care practitioners advise and counsel patients with symptomatic floaters for optimum ocular health care. This article reviews the current conventional and "off-label" treatment options for symptomatic patients with vitreous floaters. Copyright (c) 2010 American Optometric Association. Published by Elsevier Inc. All rights reserved.

Sexual dysfunction and infertility as late effects of cancer treatment

PubMed Central

Schover, Leslie R.; van der Kaaij, Marleen; van Dorst, Eleonora; Creutzberg, Carien; Huyghe, Eric; Kiserud, Cecilie E.

2014-01-01

Sexual dysfunction is a common consequence of cancer treatment, affecting at least half of men and women treated for pelvic malignancies and over a quarter of people with other types of cancer. Problems are usually linked to damage to nerves, blood vessels, and hormones that underlie normal sexual function. Sexual dysfunction also may be associated with depression, anxiety, relationship conflict, and loss of self-esteem. Innovations in cancer treatment such as robotic surgery or more targeted radiation therapy have not had the anticipated result of reducing sexual dysfunction. Some new and effective cancer treatments, including aromatase inhibitors for breast cancer or chemoradiation for anal cancer also have very severe sexual morbidity. Cancer-related infertility is an issue for younger patients, who comprise a much smaller percentage of total cancer survivors. However, the long-term emotional impact of being unable to have a child after cancer can be extremely distressing. Advances in knowledge about how cancer treatments may damage fertility, as well as newer techniques to preserve fertility, offer hope to patients who have not completed their childbearing at cancer diagnosis. Unfortunately, surveys in industrialised nations confirm that many cancer patients are still not informed about potential changes to their sexual function or fertility, and all modalities of fertility preservation remain underutilised. After cancer treatment, many patients continue to have unmet needs for information about restoring sexual function or becoming a parent. Although more research is needed on optimal clinical practice, current studies suggest a multidisciplinary approach, including both medical and psychosocial treatment options. PMID:26217165

Dual Inhibition of MEK and PI3K/Akt Rescues Cancer Cachexia through Both Tumor Extrinsic and Intrinsic Activities

PubMed Central

Mace, Thomas A.; Farren, Matthew R.; Farris, Alton B.; Young, Gregory S.; Elnaggar, Omar; Che, Zheng; Timmers, Cynthia D.; Rajasekera, Priyani; Maskarinec, Jennifer M.; Bloomston, Mark; Bekaii-Saab, Tanios; Guttridge, Denis C.; Lesinski, Gregory B.

2016-01-01

Involuntary weight loss, a part of the cachexia syndrome, is a debilitating co-morbidity of cancer and currently has no treatment options. Results from a recent clinical trial at our institution showed that biliary tract cancer patients treated with a MEK inhibitor exhibited poor tumor responses, but surprisingly gained weight and increased their skeletal muscle mass. This implied that MEK inhibition might be anti-cachectic. To test this potential effect of MEK inhibition, we utilized the established Colon-26 model of cancer cachexia and the MEK1/2 inhibitor MEK162. Results showed that MEK inhibition effectively prevented muscle wasting. Importantly, MEK162 retained its ability to spare muscle loss even in mice bearing a Colon-26 clone resistant to the MEK inhibitor, demonstrating that the effects of blocking MEK is at least in part independent of the tumor. Because single agent MEK inhibitors have been limited as a front-line targeted therapy due to compensatory activation of other oncogenic signaling pathways, we combined MEK162 with the PI3K/Akt inhibitor buparlisib. Results showed that this combinatorial treatment significantly reduced tumor growth due to a direct activity on Colon-26 tumor cells in vitro and in vivo, while also preserving skeletal muscle mass. Together, our results suggest that as a monotherapy MEK inhibition preserves muscle mass, but when combined with a PI3K/Akt inhibitor exhibits potent anti-tumor activity. Thus, combinatorial therapy might serve as a new approach for the treatment of cancer cachexia. PMID:27811010

Pediatric genetic macular and choroidal diseases

PubMed Central

Bergman, Mica Y.; Nallasamy, Sudha

2014-01-01

Genetic diseases of the macula and choroid have various inheritance patterns and varying degrees of impact on vision. Herein, we review the literature including most recent advances in the understanding of the genetics of these diseases. Although many of these disorders have limited treatment options, knowledge of inheritance patterns can aid in early detection and with close monitoring can help the ophthalmologist preserve as much vision as possible (for example with early treatment of choroidal neovascularization). PMID:27625881

Redo thoracic endovascular aortic repair due to endoleak with celiac artery snorkeling.

PubMed

Planer, David; Bliagos, Dimitrios; Gray, William A

2011-10-01

Reintervention due to endoleak of aortic endograft repair is often challenging. Herein, we report endovascular endoleak repair in a patient with previous thoracic and abdominal endovascular grafts with extensive coverage of the aorta. The present technique included snorkeling of the celiac trunk to preserve antegrade flow in the celiac artery and to maintain future options for reintervention. Copyright © 2011 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.

Upper Extremity Amputations and Prosthetics

PubMed Central

Ovadia, Steven A.; Askari, Morad

2015-01-01

Upper extremity amputations are most frequently indicated by severe traumatic injuries. The location of the injury will determine the level of amputation. Preservation of extremity length is often a goal. The amputation site will have important implications on the functional status of the patient and options for prosthetic reconstruction. Advances in amputation techniques and prosthetic reconstructions promote improved quality of life. In this article, the authors review the principles of upper extremity amputation, including techniques, amputation sites, and prosthetic reconstructions. PMID:25685104

[Surgical treatment of chronic pancreatitis, 2010].

PubMed

Farkas, Gyula

2011-04-01

Chronic pancreatitis (CP) is a benign inflammatory process, which can cause enlargement of the pancreatic head accompanied by severe pain and weight loss, and often leads to a significant reduction in quality of life (QoL). Basically, the disease is characterised by pain and functional disorders which are initially treated with conservative therapy, but in case of complications (uncontrollable pain or obstruction) surgical treatment is required. This article reviews the relevant literature of CP treatment, in particular randomized controlled trials and meta-analyses were involved with a comparison of different surgical treatment options for the management of CP complications. Recent studies have demonstrated that surgical procedures are superior to endoscopic therapy as regards long-term results of QoL and pain control. There was no significant difference found in postoperative pain relief and overall mortality when duodenum-preserving pancreatic head resection (DPPHR) of Beger and its modification (duodenum and organ-preserving pancreatic head resection [DOPPHR]) were compared with pancreatoduodenectomy (PD), but hospital stay, weight gain, exocrine and endocrine insufficiency, and QoL were significantly better in the DPPHR and DOPPHR groups. DPPHR and PD seem to be equally effective in terms of postoperative pain relief and overall mortality. However, recent data suggest that DOPPHR is superior in the treatment of CP with regard to several peri- and postoperative outcome parameters and QoL. Therefore, this should be the preferable treatment option for CP complications.

Adolescents and Young Adults With Cancer: Oncology Nurses Report Attitudes and Barriers to Discussing Fertility Preservation.

PubMed

Nobel Murray, Alexandra; Chrisler, Joan C; Robbins, Mark L

2016-08-01

Fertility issues have been found to be an important topic for adolescents and young adults (AYAs) with cancer. Medical technology has made fertility preservation (FP) increasingly effective for postpubertal patients whose treatment course may inhibit their future ability to achieve biologic parenthood. Oncology providers' recommendations have been shown to vary, potentially affecting patients' decision-making processes regarding FP. This study was designed to assess oncology nurses' recommendations for patients to consider FP options and to explore what patient-related factors may influence discussion of FP with AYAs with cancer. 116 oncology nurses participated in this study and were randomized to read one of four vignettes about a patient whose proposed treatment course could affect his or her fertility. Participants' recommendations to partake in FP were analyzed to test for differences by patient age and gender. Open-ended responses to questions about their experiences as oncology nurses were analyzed descriptively. Nurses strongly recommended that all patients explore FP options before the start of treatment. Oncology nurses endorsed stronger opinions that young adult female patients should be given independent decision-making power to delay treatment for FP, compared to male and female adolescent patients and young adult male patients. Participants mentioned barriers to discussions that included concerns about exacerbating negative emotions and the decision-making capacity of young patients.

Hip resurfacing in patients under thirty years old: an attractive option for young and active patients.

PubMed

Krantz, Nicolas; Miletic, Bruno; Migaud, Henri; Girard, Julien

2012-09-01

Metal-on-metal hip resurfacing is offered as an alternative to traditional hip arthroplasty for young, active adults with advanced osteoarthritis. The concept of hip resurfacing is considered very attractive for this specific population (hard-on-hard bearing component with a large femoral head limiting the risk of dislocation, and allowing femoral bone stock preservation). A prospective clinical trial was designed to investigate the outcome of hip resurfacing in young patients (under 30 years old). We studied 24 hips in 22 patients. Mean age at operation was 24.9 years (range 17.1-29.9). No patient was lost to follow-up. There was no revision at average follow-up of 50.6 months (44-59). Mean UCLA activity score improved from 5.5 (1-9) pre-operatively to 7.6 (1-10) postoperatively (p < 0.001). Mean Harris hip score increased from 43.9 (19-67) to 89.3 (55-100) (p < 0.001). Radiological analysis discerned no osteolysis and no implant migration. The absence of short-term complications, such as mechanical failure or dislocation, is encouraging and leads us to think that mid-term results will be satisfactory. Moreover, the specific advantages of hip resurfacing (bone stock preservation, excellent stability, low risk of dislocation, large-diameter head) make the procedure a very attractive option for young subjects.

77 FR 67040 - Self-Regulatory Organizations; BOX Options Exchange LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-08

... Proposal Regarding Quote Mitigation November 2, 2012. Pursuant to Section 19(b)(1) under the Securities... (Quote Mitigation) and refine the current quote mitigation strategy for its options trading facility, BOX Market LLC (``BOX'') by replacing the current quote mitigation rule with a ``holdback timer'' mechanism...

Novel delivery methods bypassing the blood-brain and blood-tumor barriers.

PubMed

Hendricks, Benjamin K; Cohen-Gadol, Aaron A; Miller, James C

2015-03-01

Glioblastoma (GBM) is the most common primary brain tumor and carries a grave prognosis. Despite years of research investigating potentially new therapies for GBM, the median survival rate of individuals with this disease has remained fairly stagnant. Delivery of drugs to the tumor site is hampered by various barriers posed by the GBM pathological process and by the complex physiology of the blood-brain and blood-cerebrospinal fluid barriers. These anatomical and physiological barriers serve as a natural protection for the brain and preserve brain homeostasis, but they also have significantly limited the reach of intraparenchymal treatments in patients with GBM. In this article, the authors review the functional capabilities of the physical and physiological barriers that impede chemotherapy for GBM, with a specific focus on the pathological alterations of the blood-brain barrier (BBB) in this disease. They also provide an overview of current and future methods for circumventing these barriers in therapeutic interventions. Although ongoing research has yielded some potential options for future GBM therapies, delivery of chemotherapy medications across the BBB remains elusive and has limited the efficacy of these medications.

Overview of the [corrected] travoprost /timolol BAK-free fixed combination.

PubMed

Konstas, Anastasios G P; Quaranta, Luciano; Realini, Tony

2012-04-01

Glaucoma is the second leading cause of blindness globally, representing a significant public health concern. More than 60 million people are affected by glaucoma worldwide; as this population ages, the number is expected to increase. Glaucoma is a collection of heterogeneous diseases sharing common clinical characteristics. The goal of treatment is to prevent significant visual dysfunction through reduction of intraocular pressure (IOP). This is a review of the current literature about combination therapeutic regimens for the reduction of IOP, focusing on the risk : benefit profile of a fixed-combination therapy using travoprost and timolol. Since the debut of prostaglandin analogues in the 1990s, only modest innovation has occurred in glaucoma pharmacology. A growing body of research has established that the preservative benzalkonium chloride (BAK) might not be the benign contributor expected of excipient ingredients. Thus, BAK-free treatments were developed, with the goal of IOP reduction without furthering ocular surface disease symptoms. The BAK-free travoprost/timolol combination represents an important addition to glaucoma medication options and may fill an unmet need in this therapeutic arena.

Variation in Protein Origin and Utilization: Research and Clinical Application.

PubMed

Paddon-Jones, Douglas; Coss-Bu, Jorge A; Morris, Claudia R; Phillips, Stuart M; Wernerman, Jan

2017-04-01

Muscle health can be rapidly compromised in clinical environments. Modifiable strategies to preserve metabolic homeostasis in adult patient populations include physical activity and pharmacologic support; however, optimizing dietary practices, or more specifically protein intake, is a necessary prerequisite for any other treatment strategy to be fully effective. Simply increasing protein intake is a well-intentioned but often unfocused strategy to protect muscle health in an intensive care setting. Protein quality is a frequently overlooked factor with the potential to differentially influence health outcomes. Quality can be assessed by a variety of techniques, with digestible indispensable amino acid score being the current and most comprehensive technique endorsed by the Food and Agriculture Organization. In practical terms, animal-based proteins are consistently scored higher in quality compared with incomplete proteins, regardless of the assessment method. Consequently, choosing parenteral and/or enteral feeding options that contain high-quality proteins, rich in the branched-chain amino acid leucine, may help establish a dietary framework with the potential to support clinical practice and improve health outcomes in critically ill patients.

Chronic and Acute Stress Promote Overexploitation in Serial Decision Making.

PubMed

Lenow, Jennifer K; Constantino, Sara M; Daw, Nathaniel D; Phelps, Elizabeth A

2017-06-07

Many decisions that humans make resemble foraging problems in which a currently available, known option must be weighed against an unknown alternative option. In such foraging decisions, the quality of the overall environment can be used as a proxy for estimating the value of future unknown options against which current prospects are compared. We hypothesized that such foraging-like decisions would be characteristically sensitive to stress, a physiological response that tracks biologically relevant changes in environmental context. Specifically, we hypothesized that stress would lead to more exploitative foraging behavior. To test this, we investigated how acute and chronic stress, as measured by changes in cortisol in response to an acute stress manipulation and subjective scores on a questionnaire assessing recent chronic stress, relate to performance in a virtual sequential foraging task. We found that both types of stress bias human decision makers toward overexploiting current options relative to an optimal policy. These findings suggest a possible computational role of stress in decision making in which stress biases judgments of environmental quality. SIGNIFICANCE STATEMENT Many of the most biologically relevant decisions that we make are foraging-like decisions about whether to stay with a current option or search the environment for a potentially better one. In the current study, we found that both acute physiological and chronic subjective stress are associated with greater overexploitation or staying at current options for longer than is optimal. These results suggest a domain-general way in which stress might bias foraging decisions through changing one's appraisal of the overall quality of the environment. These novel findings not only have implications for understanding how this important class of foraging decisions might be biologically implemented, but also for understanding the computational role of stress in behavior and cognition more broadly. Copyright © 2017 the authors 0270-6474/17/375681-09$15.00/0.

[S3 Guideline. Part 3: Non-Traumatic Avascular Necrosis in Adults - Surgical Treatment of Atraumatic Avascular Femoral Head Necrosis in Adults].

PubMed

Maus, U; Roth, A; Tingart, M; Rader, C; Jäger, M; Nöth, U; Reppenhagen, S; Heiss, C; Beckmann, J

2015-10-01

The present article describes the guidelines for the surgical treatment of atraumatic avascular necrosis (aFKN). These include joint preserving and joint replacement procedures. As part of the targeted literature, 43 publications were included and evaluated to assess the surgical treatment. According to the GRADE and SIGN criteria level of evidence (LoE), grade of recommendation (EC) and expert consensus (EK) were listed for each statement and question. The analysed studies have shown that up to ARCO stage III, joint-preserving surgery can be performed. A particular joint-preserving surgery currently cannot be recommended as preferred method. The selection of the method depends on the extent of necrosis. Core decompression performed in stage ARCO I (reversible early stage) or stage ARCO II (irreversible early stage) with medial or central necrosis with an area of less than 30 % of the femoral head shows better results than conservative therapy. In ARCO stage III with infraction of the femoral head, the core decompression can be used for a short-term pain relief. For ARCO stage IIIC or stage IV core decompression should not be performed. In these cases, the indication for implantation of a total hip replacement should be checked. Additional therapeutic procedures (e.g., osteotomies) and innovative treatment options (advanced core decompression, autologous bone marrow, bone grafting, etc.) can be discussed in the individual case. In elective hip replacement complications and revision rates have been clearly declining for decades. In the case of an underlying aFKN, however, previous joint-preserving surgery (osteotomies and grafts in particular) can complicate the implantation of a THA significantly. However, the implant life seems to be dependent on the aetiology. Higher revision rates for avascular necrosis are particularly expected in sickle cell disease, Gaucher disease, or kidney transplantation patients. Furthermore, the relatively young age of the patient with avascular necrosis should be seen as the main risk factor for higher revision rate. The results after resurfacing (today with known restricted indications) and cemented as well as cementless THA in aFKN are comparable for the appropriate indication to those in coxarthrosis or other diagnoses. Regardless of the underlying disease endoprosthetic treatment in aFKN leads to good results. Both cemented and cementless fixation techniques can be recommended. Georg Thieme Verlag KG Stuttgart · New York.

Preserving Plutonium-244 as a National Asset

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

Patton, Bradley D; Alexander, Charles W; Benker, Dennis

Plutonium-244 (244 Pu) is an extremely rare and long-lived isotope of plutonium with a half-life of 80 million years. Measureable amounts of 244 Pu are found in neither reactor-grade nor weapons-grade plutonium. Production of this isotope requires a very high thermal flux to permit the two successive neutron captures that convert 242 Pu to 243 Pu to 244 Pu, particularly given the short (about 5 hour) half-life of 243 Pu. Such conditions simply do not exist in plutonium production processes. Therefore, 244 Pu is ideal for precise radiochemical analyses measuring plutonium material properties and isotopic concentrations in items containing plutonium.more » Isotope dilution mass spectrometry is about ten times more sensitive when using 244 Pu rather than 242 Pu for determining plutonium isotopic content. The isotope can also be irradiated in small quantities to produce superheavy elements. The majority of the existing global inventory of 244 Pu is contained in the outer housing of Mark-18A targets at the Savannah River Site (SRS). The total inventory is about 20 grams of 244 Pu in about 400 grams of plutonium distributed among the 65 targets. Currently, there are no specific plans to preserve these targets. Although the cost of separating and preserving this material would be considerable, it is trivial in comparison to new production costs. For all practical purposes, the material is irreplaceable, because new production would cost billions of dollars and require a series of irradiation and chemical separation cycles spanning up to 50 years. This paper will discuss a set of options for overcoming the significant challenges to preserve the 244 Pu as a National Asset: (1) the need to relocate the material from SRS in a timely manner, (2) the need to reduce the volume of material to the extent possible for storage, and (3) the need to establish an operational capability to enrich the 244 Pu in significant quantities. This paper suggests that if all the Mark-18A plutonium is separated, it would occupy a small volume and would be inexpensive to store while an enrichment capability is developed. Very small quantities could be enriched in existing mass separators to support critical needs.« less

The analysis and resolution of ethical dilemmas.

PubMed

Macauley, Robert C

2013-01-01

Perhaps no other field of medicine illustrates the ethical dilemmas occasioned by the explosion of technology more than neurology. Many dilemmas which at first appear to be ethical, however, are actually biotechnical, informational, or interpersonal in nature. For those which are, indeed, ethical, a review of existing information and acquisition of additional data can often serve to identify the proper response. When the optimal course of action remains unclear, the comprehensive, structured approach described in this chapter is both philosophically rigorous and clinically relevant. It takes into account a variety of critical considerations - including rights, duties, consequences, virtues, and similar cases - while utilizing both inductive and deductive methods. The end result is the "least bad" of available options, or, at the very least, a practical response which preserves future options and avoids crucial mistakes. © 2013 Elsevier B.V. All rights reserved.

Targeting a portion of central European spider diversity for permanent preservation

PubMed Central

2013-01-01

Abstract Given the limited success of past and current conservation efforts, an alternative approach is to preserve tissues and genomes of targeted organisms in cryobanks to make them accessible for future generations. Our pilot preservation project aimed to obtain, expertly identify, and permanently preserve a quarter of the known spider species diversity shared between Slovenia and Switzerland, estimated at 275 species. We here report on the faunistic part of this project, which resulted in 324 species (227 in Slovenia, 143 in Switzerland) for which identification was reasonably established. This material is now preserved in cryobanks, is being processed for DNA barcoding, and is available for genomic studies. PMID:24723774

Fertility preservation in young cancer patients--too little, too late?

PubMed

Robbins, Helen Louise; Zahoor, Arooba; Jones, Kevin

2015-12-01

Fertility is an important concern for many younger women with cancer; however, evidence suggests that these matters are often inadequately addressed, potentially with long-term implications for quality of life. Increased confidence in discussing fertility-related matters and an emphasis on early discussion and referral are needed to improve current practice. Further work is needed to better assess current practice and to explore how barriers to discussion about fertility preservation may be best overcome.

Preservation of Near-Earth Space for Future Generations

NASA Astrophysics Data System (ADS)

Simpson, John A.

2007-05-01

List of contributors; Preface; Part I. Introduction: 1. Introduction J. A. Simpson; Part II. Defining the Problem: 2. The Earth satellite population: official growth and constituents Nicholas L. Johnson; 3. The current and future environment: an overall assessment Donald J. Kessler; 4. The current and future space debris environment as assessed in Europe Dietrich Rex; 5. Human survivability issues in the low Earth orbit space debris environment Bernard Bloom; 6. Protecting the space environment for astronomy Joel R. Primack; 7. Effects of space debris on commercial spacecraft - the RADARSAT example H. Robert Warren and M. J. Yelle; 8. Potential effects of the space debris environment on military space systems Albert E. Reinhardt; Part III. Mitigation of and Adaptation to the Space Environment: Techniques and Practices: 9. Precluding post-launch fragmentation of delta stages Irvin J. Webster and T. Y. Kawamura; 10. US international and interagency cooperation in orbital debris Daniel V. Jacobs; 11. ESA concepts for space debris mitigation and risk reduction Heiner Klinkrad; 12. Space debris: how France handles mitigation and adaptation Jean-Louis Marcé; 13. Facing seriously the issue of protection of the outer space environment Qi Yong Liang; 14. Space debris - mitigation and adaptation U. R. Rao; 15. Near Earth space contamination and counteractions Vladimir F. Utkin and S. V. Chekalin; 16. The current and future space debris environment as assessed in Japan Susumu Toda; 17. Orbital debris minimization and mitigation techniques Joseph P. Loftus Jr, Philip D. Anz-Meador and Robert Reynolds; Part IV. Economic Issues: 18. In pursuit of a sustainable space environment: economic issues in regulating space debris Molly K. Macauley; 19. The economics of space operations: insurance aspects Christopher T. W. Kunstadter; Part V. Legal Issues: 20. Environmental treatymaking: lessons learned for controlling pollution of outer space Winfried Lang; 21. Regulation of orbital debris - current status Howard A. Baker; 22. Who should regulate the space environment: the laissez-faire, national and multinational options Diane P. Wood; Part VI. A Multilateral Treaty: 23. Orbital debris: prospects for international cooperation Jeffrey Maclure and William C. Bartley; 24. Preservation of near Earth space for future generations: current initiatives on space debris in the United Nations Stephen Gorove; 25. A legal regime for orbital debris: elements of a multilateral treaty Pamela L. Meredith; Part VII. Panel Discussions: 26. Panel discussion led by Diane Wood; 27. Panel discussion led by Paul Uhlir; 28. Suggested further reading on orbital debris.

75 FR 30451 - Self-Regulatory Organizations; The Options Clearing Corporation; Order Granting Approval of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-01

... May 14, 2010. The ODD currently contains general disclosures on the characteristics and risks of...-linked securities. Accordingly, the ODD disclosure only covers the characteristics and risks of options...; Order Granting Approval of Accelerated Delivery of Supplement to the Options Disclosure Document...

The Implications of Real Options on ERP-Enabled Adoption

ERIC Educational Resources Information Center

Nwankpa, Joseph K.

2012-01-01

Current research on Enterprise Resource Planning (ERP) systems and real options focuses on valuation and justification issues that manager's face prior to project approval with existing literature attempting to demonstrate that ERP systems as technology positioning investments have option-like characteristics thus making such ERP systems…

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

Jensen, R.M.

Although use of reverse-air filters dominates in operating US utility power stations, pulse-jet designs seem to be getting the lion`s share of attention for new and retrofit plants. This article examines key technical advantages of reverse-air designs that are becoming lost in the current debate. Control of particulate emissions continues to be an area of growing concern for operators of coal-fired powerplants, especially as it relates to air toxics and fine particulates. That concern has led to greater scrutiny of the devices used to control those emissions. Regarding the fabric-filter option, reverse-air (RA) designs have operated reliably at large utilitymore » units, but now face a strong challenge from pulse-jet (PJ) designs--which are more popular with operators of independent-power-producer, waste-to-energy, and other small solid-fuel-fired units. Both RA and PJ designs can adequately meet the particulate emissions requirements for large coal-fired units when properly applied. The wholesale shift by electric utilities from RA to PJ fabric filters--at least in discussion if not actual projects--is apparent but may be short-sighted. The oft-stated reason--that RA fabric filters can only handle a face velocity one-half that of PJ, resulting in higher cost for the RA option--is too simplistic. The many design and operating characteristics that distinguish the two should be thoroughly reviewed before blanket acceptance of PJ technology. Some of the technical areas reviewed here are level of commercial design experience, bag life, pressure drop, bag replacement procedure, cleaning cycles, particle elutriation, submicron-particle floaters, residual-cake preservation, and particle re-entrainment.« less

The Utility of Decision Trees in Oncofertility Care in Japan.

PubMed

Ito, Yuki; Shiraishi, Eriko; Kato, Atsuko; Haino, Takayuki; Sugimoto, Kouhei; Okamoto, Aikou; Suzuki, Nao

2017-03-01

To identify the utility and issues associated with the use of decision trees in oncofertility patient care in Japan. A total of 35 women who had been diagnosed with cancer, but had not begun anticancer treatment, were enrolled. We applied the oncofertility decision tree for women published by Gardino et al. to counsel a consecutive series of women on fertility preservation (FP) options following cancer diagnosis. Percentage of women who decided to undergo oocyte retrieval for embryo cryopreservation and the expected live-birth rate for these patients were calculated using the following equation: expected live-birth rate = pregnancy rate at each age per embryo transfer × (1 - miscarriage rate) × No. of cryopreserved embryos. Oocyte retrieval was performed for 17 patients (48.6%; mean ± standard deviation [SD] age, 36.35 ± 3.82 years). The mean ± SD number of cryopreserved embryos was 5.29 ± 4.63. The expected live-birth rate was 0.66. The expected live-birth rate with FP indicated that one in three oncofertility patients would not expect to have a live birth following oocyte retrieval and embryo cryopreservation. While the decision trees were useful as decision-making tools for women contemplating FP, in the context of the current restrictions on oocyte donation and the extremely small number of adoptions in Japan, the remaining options for fertility after cancer are limited. In order for cancer survivors to feel secure in their decisions, the decision tree may need to be adapted simultaneously with improvements to the social environment, such as greater support for adoption.

Donning times and flotation characteristics of infant life preservers : four representative types.

DOT National Transportation Integrated Search

1991-04-01

Four currently available representative types of infant life preservers were tested to assess the donning times and flotation characteristics for infant subjects(6 months to 2 years old). Two of the four devices tested were fixed-foam recreational de...

Current options for the treatment of pathological scarring.

PubMed

Poetschke, Julian; Gauglitz, Gerd G

2016-05-01

Scarring is the consequence of surgery, trauma or different skin diseases. Apart from fresh, immature scars,that transform into mature scars over the course of would healing and that do not require further treatment,linear hypertrophic scars, widespread hypertrophic scars, keloids and atrophic scars exist. Symptoms like pruritusand pain, stigmatization as well as functional and aesthetic impairments that are very disturbing for the affected patients can bethe basis for the desire for treatment. Today, a multitude of options for the treatment and prevention of scars exists. Topical agents based on silicone or onion extract, intralesional injections of cristalline glucocorticoids (oftentimes in combinationwith cryotherapy) or 5-Fluorouracil as well as ablative and nonablative laser treatment are used. Current guidelines summarize the multitude of available treatment options and the currently available datafor the treating physicians, allowing them to make clear therapy recommendations for every single scar type. Relieving patients of their discomfort and doing their aesthetic demands justice is thus possible. Apart from scar prevention becoming more and more important, the increased use of modernlaser treatment options constitutes a key point in clinical scar treatment. At the same time the attention is turned to evaluating current therapeutic options with the help of contemporary study designs so as to graduallyimprove the level of evidence in scar treatment. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

Ventromedial prefrontal and anterior cingulate cortex adopt choice and default reference frames during sequential multialternative choice

PubMed Central

Boorman, Erie D; Rushworth, Matthew F; Behrens, Tim E

2013-01-01

Although damage to medial frontal cortex causes profound decision-making impairments, it has been difficult to pinpoint the relative contributions of key anatomical subdivisions. Here we use fMRI to examine the contributions of human ventromedial prefrontal cortex (vmPFC) and dorsal anterior cingulate cortex (dACC) during sequential choices between multiple alternatives – two key features of choices made in ecological settings. By carefully constructing options whose current value at any given decision was dissociable from their longer-term value, we were able to examine choices in current and long-term frames of reference. We present evidence showing that activity at choice and feedback in vmPFC and dACC was tied to the current choice and the best long-term option, respectively. vmPFC, mid-cingulate, and PCC encoded the relative value between the chosen and next-best option at each sequential decision, whereas dACC encoded the relative value of adapting choices from the option with the highest value in the longer-term. Furthermore, at feedback we identify temporally dissociable effects that predict repetition of the current choice and adaptation away from the long-term best option in vmPFC and dACC, respectively. These functional dissociations at choice and feedback suggest that sequential choices are subject to competing cortical mechanisms. PMID:23392656

Long-term follow-up after transoral laser microsurgery and adjuvant radiotherapy for advanced recurrent squamous cell carcinoma of the head and neck

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

Christiansen, Hans; Hermann, Robert Michael; Martin, Alexios

Purpose: The aim of this study was to evaluate the efficacy of adjuvant radiotherapy after transoral laser microsurgery for advanced recurrent head-and-neck squamous cell carcinoma (HNSCC). Patients and Methods: Between 1988 and 2000, 37 patients with advanced local recurrences (23 local and 14 locoregional recurrences) of HNSCC without distant metastases were treated in curative intent with organ-preserving transoral laser microsurgery and adjuvant radiotherapy (before 1994 split-course radiotherapy with carboplatinum, after 1994 conventional radiotherapy). Initial therapy of the primary (8.1% oral cavity, 35.1% oropharynx, 13.5% hypopharynx, and 43.3% larynx) before relapse was organ-preserving transoral laser microsurgery without any adjuvant therapy. Results:more » After a median follow-up of 124 months, the 5-year overall survival rate was 21.3%, the loco-regional control rate 48.3%, respectively. In multivariate analysis, stage of original primary tumor (Stage I/II vs. Stage III/IV), and patient age (<58 years vs. {>=}58 years) showed statistically significant impact on prognosis. In laryngeal cancer, larynx preservation rate after treatment for recurrent tumor was 50% during follow-up. Conclusion: Our data show that organ-preserving transoral laser microsurgery followed by adjuvant radiotherapy is a curative option for patients who have advanced recurrence after transoral laser surgery and is an alternative to radical treatment.« less

Onco-testicular sperm extraction: birth of a healthy baby after fertility preservation in synchronous bilateral testicular cancer and azoospermia.

PubMed

Roque, M; Sampaio, M; Salles, P G de Oliveira; Geber, S

2015-05-01

Testicular germ cell tumours (TGCT) represent 1%-1.5% of all male neoplasms, and they have the highest prevalence among men between 15 and 35 years old. Synchronous bilateral disease is a rare presentation, and the ratio of metachronous to synchronous bilateral disease is about 4 : 1. Several studies have suggested a correlation between male infertility and testicular cancer, with a 20-fold increase in the incidence of testicular cancer in infertile patients compared with the general population. At the time of diagnosis, 50%-75% of patients with unilateral TGCT present with subfertility; almost 13% of the patients are azoospermic before treatment, and up to two-thirds of patients become azoospermic following adjuvant cancer therapies. Therefore, fertility preservation should be considered in all oncological treatments. The only available option to preserve the reproductive potential in azoospermic patients with testicular cancer is to perform an onco-testicular sperm extraction (onco-TESE) before cancer treatment. In this paper, we describe a rare case of a patient with synchronous bilateral testicular cancer and azoospermia who was submitted to onco-TESE, sperm cryopreservation, and which was followed by the delivery of a healthy baby after intracytoplasmic sperm injection (ICSI), emphasising the importance of fertility preservation in oncology patients. © 2014 Blackwell Verlag GmbH.

Prosthodontic Treatment Using Vital and Non Vital Submerged Roots-Two Case Reports

PubMed Central

Shankar, Y. Ravi; Srinivas, K.; Surapaneni, Hemchand; Reddy, S.V. Sudhakar

2013-01-01

Residual ridge resorption has been considered as an inevitable consequence after extraction of the teeth. There is a gradual loss of the alveolar bone due to the pattern of bone remodeling. In spite of the availability of newer treatment modalities like endodontic restoration and periodontic procedures for preservation of the remaining teeth they are not feasible for the patients in severe stages where restoration might not be possible. The only reliable method of preserving the remaining bone is by maintaining the functional health of the teeth. Over the years, many studies showed that roots which are fractured and left behind during extractions are retained into the alveolar bone with no evidence of pathosis. Over denture as a treatment option was developed in an effort to preserve the remaining alveolar bone by retaining the natural teeth or roots. In over denture treatment, the teeth selected as abutments are prone to caries and periodontal disease over a period of time, hence evolved the vital or non vital root submergence concept. After a thorough radiographic and clinical examination, few teeth without pathosis are retained that eventually are surgically submerged in the alveolar ridge. After healing, the over denture with reaining vital or non vital teeth preserve the integrity of the bone, making the treatment an effective and successfull preventive prosthodontic treatment. PMID:24298542

Hearing preservation and facial nerve function after microsurgery for intracanalicular vestibular schwannomas: comparison of middle fossa and retrosigmoid approaches.

PubMed

Noudel, R; Gomis, P; Duntze, J; Marnet, D; Bazin, A; Roche, P H

2009-08-01

Therapeutic options for vestibular schwannomas (VS) include microsurgery, stereotactic radiosurgery and conservative management. Early treatment of intracanalicular vestibular schwannomas (IVS) may be advisable because their spontaneous course will show hearing loss in most cases. Advanced microsurgical techniques and continuous intraoperative monitoring of cranial nerves may allow hearing preservation (HP) without facial nerve damage. However, there are still controversies about the definition of hearing preservation, and the best surgical approach that should be used. In this study, we reviewed the main data from the recent literature on IVS surgery and compared hearing, facial function and complication rates after the retrosigmoid (RS) and middle fossa (MF) approaches, respectively. The results showed that the average HP rate after IVS surgery ranged from 58% (RS) to 62% (MF). HP varied widely depending on the audiometric criteria that were used for definition of serviceable hearing. There was a trend to show that the MF approach offered a better quality of postoperative hearing (not statistically significant), whereas the RS approach offered a better facial nerve preservation and fewer complications (not statistically significant). We believe that the timing of treatment in the course of the disease and selection between radiosurgical versus microsurgical procedure are key issues in the management of IVS. Preservation of hearing and good facial nerve function in surgery for VS is a reasonable goal for many patients with intracanalicular tumors and serviceable hearing. Once open surgery has been decided, selection of the approach mainly depends on individual anatomical considerations and experience of the surgeon.

Long-term preservation of Leptospira spp.: challenges and prospects.

PubMed

Philip, Noraini; Garba, Bashiru; Neela, Vasantha Kumari

2018-05-08

Preservation of leptospiral cultures is tantamount to success in leptospiral diagnostics, research, and development of preventive strategies. Each Leptospira isolate has imperative value not only in disease diagnosis but also in epidemiology, virulence, pathogenesis, and drug development studies. As the number of circulating leptospires is continuously increasing and congruent with the importance to retain their original characteristics and properties, an efficient long-term preservation is critically needed to be well-established. However, the preservation of Leptospira is currently characterized by difficulties and conflicting results mainly due to the biological nature of this organism. Hence, this review seeks to describe the efforts in developing efficient preservation methods, to discover the challenges in preserving this organism and to identify the factors that can contribute to an effective long-term preservation of Leptospira. Through the enlightenment of the previous studies, a potentially effective method has been suggested. The article also attempts to evaluate novel strategies used in other industrial and biotechnological preservation efforts and consider their potential application to the conservation of Leptospira spp.

Crude oil options market found to be efficient

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

Not Available

1992-08-17

This paper reports that the U.S. crude oil options market operates efficiently and does not overreact. The authors, with the JFK School of Government, studied the crude oil options market under a Department of Energy grant. The current market was created in November 1986 when the New York Mercantile Exchange introduced an options contract for delivery of West Texas intermediate crude futures. it has grown greatly since then.

Option pricing: Stock price, stock velocity and the acceleration Lagrangian

NASA Astrophysics Data System (ADS)

Baaquie, Belal E.; Du, Xin; Bhanap, Jitendra

2014-12-01

The industry standard Black-Scholes option pricing formula is based on the current value of the underlying security and other fixed parameters of the model. The Black-Scholes formula, with a fixed volatility, cannot match the market's option price; instead, it has come to be used as a formula for generating the option price, once the so called implied volatility of the option is provided as additional input. The implied volatility not only is an entire surface, depending on the strike price and maturity of the option, but also depends on calendar time, changing from day to day. The point of view adopted in this paper is that the instantaneous rate of return of the security carries part of the information that is provided by implied volatility, and with a few (time-independent) parameters required for a complete pricing formula. An option pricing formula is developed that is based on knowing the value of both the current price and rate of return of the underlying security which in physics is called velocity. Using an acceleration Lagrangian model based on the formalism of quantum mathematics, we derive the pricing formula for European call options. The implied volatility of the market can be generated by our pricing formula. Our option price is applied to foreign exchange rates and equities and the accuracy is compared with Black-Scholes pricing formula and with the market price.

Research of cost aspects of cement pavements construction

NASA Astrophysics Data System (ADS)

Bezuglyi, Artem; Illiash, Sergii; Tymoshchuk, Oleksandr

2017-09-01

The tendency to increasing traffic volume on public roads and to increased axle loads of vehicles makes the road scientists to develop scientifically justified methods for preserving the existing and developing the new transport network of Ukraine. One of the options for solving such issues is the construction of roads with rigid (cement concrete) pavement. However, any solution must be justified considering technical and economic components. This paper presents the results of the research of cost aspects of cement pavements construction.

An Unconditionally Stable, Positivity-Preserving Splitting Scheme for Nonlinear Black-Scholes Equation with Transaction Costs

PubMed Central

Guo, Jianqiang; Wang, Wansheng

2014-01-01

This paper deals with the numerical analysis of nonlinear Black-Scholes equation with transaction costs. An unconditionally stable and monotone splitting method, ensuring positive numerical solution and avoiding unstable oscillations, is proposed. This numerical method is based on the LOD-Backward Euler method which allows us to solve the discrete equation explicitly. The numerical results for vanilla call option and for European butterfly spread are provided. It turns out that the proposed scheme is efficient and reliable. PMID:24895653

An unconditionally stable, positivity-preserving splitting scheme for nonlinear Black-Scholes equation with transaction costs.

PubMed

Guo, Jianqiang; Wang, Wansheng

2014-01-01

This paper deals with the numerical analysis of nonlinear Black-Scholes equation with transaction costs. An unconditionally stable and monotone splitting method, ensuring positive numerical solution and avoiding unstable oscillations, is proposed. This numerical method is based on the LOD-Backward Euler method which allows us to solve the discrete equation explicitly. The numerical results for vanilla call option and for European butterfly spread are provided. It turns out that the proposed scheme is efficient and reliable.

Climate change, deforestation, and the fate of the Amazon.

PubMed

Malhi, Yadvinder; Roberts, J Timmons; Betts, Richard A; Killeen, Timothy J; Li, Wenhong; Nobre, Carlos A

2008-01-11

The forest biome of Amazonia is one of Earth's greatest biological treasures and a major component of the Earth system. This century, it faces the dual threats of deforestation and stress from climate change. Here, we summarize some of the latest findings and thinking on these threats, explore the consequences for the forest ecosystem and its human residents, and outline options for the future of Amazonia. We also discuss the implications of new proposals to finance preservation of Amazonian forests.

Arms control and The President's Strategic Defense Initiative

NASA Astrophysics Data System (ADS)

Bon, J. J.

1985-04-01

The President's Strategic Defense Initiative (SDI) provides the hope for eliminating the threat from ballistic missiles. This study evaluates the impact of SDI on existing and future arms control agreements. Because new or modified space-related treaties are a probable result of the SDI, this study concludes that the best single strategy for arms control negotiations is to preserve overall US interests and maintain open technological options vice severely limiting any space technology that might some day become part of a space-based defensive system.

Supercooling Preservation Of The Rat Liver For Transplantation

PubMed Central

Bruinsma, Bote G.; Berendsen, Tim A.; Izamis, Maria-Louisa; Yeh, Heidi; Yarmush, Martin L.; Uygun, Korkut

2015-01-01

The current standard for liver preservation is limited in duration. Employing a novel subzero preservation technique that includes supercooling and machine perfusion can significantly improve preservation and prolong storage times. By loading rat livers with cryoprotectants to prevent both intra- and extracellular ice formation and protect against hypothermic injury, livers can be cooled to −6 °C without freezing and kept viable for up to 96 hours. Here, we describe the procedures of loading cryoprotectants by means of subnormothermic machine perfusion (SNMP), controlled cooling to a supercooled state, followed by SNMP recovery and orthotopic liver transplantation. PMID:25692985

Achalasia: current therapeutic options

PubMed Central

Arora, Zubin; Thota, Prashanthi N.; Sanaka, Madhusudhan R.

2017-01-01

Achalasia is a chronic incurable esophageal motility disorder characterized by impaired lower esophageal sphincter (LES) relaxation and loss of esophageal peristalsis. Although rare, it is currently the most common primary esophageal motility disorder, with an annual incidence of around 1.6 per 100,000 persons and prevalence of around 10.8/100,000 persons. Symptoms of achalasia include dysphagia to both solids and liquids, regurgitation, aspiration, chest pain and weight loss. As the underlying etiology of achalasia remains unclear, there is currently no curative treatment for achalasia. Management of achalasia mainly involves improving the esophageal outflow in order to provide symptomatic relief to patients. The most effective treatment options for achalasia include pneumatic dilation, Heller myotomy and peroral endoscopic myotomy (POEM), with the latter increasingly emerging as the treatment of choice for many patients. This review focusses on evidence for current and emerging treatment options for achalasia with a particular emphasis on POEM. PMID:28717439

Propellant Depots: The Future of Space Exploration

NASA Astrophysics Data System (ADS)

Crenwelge, Drew

NASA is currently exploring several options for mankind's return to the lunar surface and beyond. The selected option must stimulate both commercial and international involvement, support future missions to the Moon and other destinations, and above all, fit within the current budget profile. Contrary to the current Constellation approach, this paper describes the option of using an in-space propellant depot architecture that can refuel or top-off visiting vehicles at EML1, and how it fits within NASA's new space exploration criteria. In addition to receiving and transferring fuel, the propellant depot will also provide cryogenic propellant storage and management that utilizes flight proven technologies in conjunction with technologies currently under development. The propellant depot system, propellant management and acquisition devices, thermodynamic analysis, and key enabling technologies are also discussed. Depot design concepts along with an overview of a future lunar mission sequence are also presented.

The Association For Preservation Technology International (APT)

Science.gov Websites

Heritage Library Introduction to Early American Masonry Conferences & Training Current Annual Conference Future Past Future/Past Conferences Other Conferences & Training APT Training & Education from the National Center for Preservation Technology and Training (NCPTT). Registration fee is $35 for

Policy reform as creative destruction: political and administrative challenges in preserving the public-private mix.

PubMed

Brown, L D

1992-01-01

As political pressure for affordable universal coverage intensifies, various proposals have been crafted to improve the system without sacrificing the role of the private sector. Some analysts view the preservation of a mixed public-private system as an exercise in incrementalism, avoiding disquieting departures from familiar arrangements. A review of the political and administrative challenges of several main options--market innovation, tax credits, play or pay, and Medicaid expansion--suggests that the path to true reform is a slippery slope. Over time, changes in particular sectors, such as insurance, employers, government, and providers, will very likely implicate the others too. Although redefining the public-private mix may be more incremental than (say) adoption of a Canadian model, it will also entail considerable "creative destruction" of existing patterns and cannot fail to disturb the institutional status quo substantially.

Fertility sparing treatment in borderline ovarian tumours

PubMed Central

Alvarez, Rosa Maria; Vazquez-Vicente, Daniel

2015-01-01

Borderline ovarian tumours are low malignant potential tumours. They represent 10–15% of all epithelial ovarian malignancies. Patients with this type of tumour are younger at the time of diagnosis than patients with invasive ovarian cancer. Most of them are diagnosed in the early stages and have an excellent prognosis. It has been quite clearly established that the majority of borderline ovarian tumours should be managed with surgery alone. Because a high proportion of women with this malignancy are young and the prognosis is excellent, the preservation of fertility is an important issue in the management of these tumours. In this systemic review of the literature, we have evaluated in-depth oncological safety and reproductive outcomes in women with borderline ovarian tumours treated with fertility-sparing surgery, reviewing the indications, benefits, and disadvantages of each type of conservative surgery, as well as new alternative options to surgery to preserve fertility. PMID:25729420

Pregnancy after breast cancer: a case study resolving the reproductive challenge with a gestational surrogate.

PubMed

Krychman, Michael L; King, Tari

2006-01-01

Pregnancy and fertility issues are substantial concerns for the young breast cancer survivor, yet the available literature is hampered by a lack of prospective clinical studies and meaningful long-term outcome data. A lack of reliable information often leads to physician discomfort and patients may be left to navigate the world of fertility preservation and reproductive technology on their own. This case exemplifies some of the many issues that breast cancer survivors may face and adds another dimension to the survivor's dilemma; once fertility options have been preserved, what is the best method to sustain the pregnancy--self or surrogate? For many, the goal of balancing optimal treatment and long-term survival with restoration of a complete quality of life, including childbearing, may be attainable. This discussion highlights the importance of offering young breast cancer patients an opportunity to discuss these issues with their health care providers prior to initiating therapy.

Moisture concentration variation of silages produced on commercial farms in the South-central USA.

PubMed

Han, K J; Pitman, W D; Chapple, A

2014-10-01

Preservation of forage crops as silage offers opportunity to avoid the high risk of rain-damaged hay in the humid south-central USA. Recent developments with baled silage or baleage make silage a less expensive option than typical chopped silage. Silage has been important in the region primarily for dairy production, but baleage has become an option for the more extensive beef cattle industry in the region. Silage samples submitted to the Louisiana State University Agricultural Center Forage Quality Lab from 2006 through 2013 were assessed for dry matter (DM) and forage nutritive characteristics of chopped silage and baleage of the different forage types from commercial farms primarily in Louisiana and Mississippi. Of the 1,308 silage samples submitted, 1,065 were annual ryegrass (AR) with small grains (SG), the warm-season annual (WA) grasses, sorghums and pearl millet, and the warm-season perennial (WP) grasses, bermudagrass and bahiagrass, providing the remaining samples. Concentration of DM was used to indicate an effective ensiling opportunity, and AR silage was more frequently within the target DM range than was the WA forage group. The AR samples also indicated a high-quality forage with average crude protein (CP) of 130 g/kg and total digestible nutrient (TDN) near 600 g/kg. The cooler winter weather at harvest apparently complicated harvest of SG silage with chopped SG silage lower in both CP and TDN (104 and 553 g/kg, respectively) than either AR silage or baleage of SG (137 and 624 g/kg for CP and TDN, respectively). The hot, humid summer weather along with large stems and large forage quantities of the WA grasses and the inherently higher fiber concentration of WP grasses at harvest stage indicate that preservation of these forage types as silage will be challenging, although successful commercial silage samples of each forage type and preservation approach were included among samples of silages produced in the region.

Moisture Concentration Variation of Silages Produced on Commercial Farms in the South-Central USA

PubMed Central

Han, K. J.; Pitman, W. D.; Chapple, A.

2014-01-01

Preservation of forage crops as silage offers opportunity to avoid the high risk of rain-damaged hay in the humid south-central USA. Recent developments with baled silage or baleage make silage a less expensive option than typical chopped silage. Silage has been important in the region primarily for dairy production, but baleage has become an option for the more extensive beef cattle industry in the region. Silage samples submitted to the Louisiana State University Agricultural Center Forage Quality Lab from 2006 through 2013 were assessed for dry matter (DM) and forage nutritive characteristics of chopped silage and baleage of the different forage types from commercial farms primarily in Louisiana and Mississippi. Of the 1,308 silage samples submitted, 1,065 were annual ryegrass (AR) with small grains (SG), the warm-season annual (WA) grasses, sorghums and pearl millet, and the warm-season perennial (WP) grasses, bermudagrass and bahiagrass, providing the remaining samples. Concentration of DM was used to indicate an effective ensiling opportunity, and AR silage was more frequently within the target DM range than was the WA forage group. The AR samples also indicated a high-quality forage with average crude protein (CP) of 130 g/kg and total digestible nutrient (TDN) near 600 g/kg. The cooler winter weather at harvest apparently complicated harvest of SG silage with chopped SG silage lower in both CP and TDN (104 and 553 g/kg, respectively) than either AR silage or baleage of SG (137 and 624 g/kg for CP and TDN, respectively). The hot, humid summer weather along with large stems and large forage quantities of the WA grasses and the inherently higher fiber concentration of WP grasses at harvest stage indicate that preservation of these forage types as silage will be challenging, although successful commercial silage samples of each forage type and preservation approach were included among samples of silages produced in the region. PMID:25178295

Female pattern alopecia: current perspectives

PubMed Central

Levy, Lauren L; Emer, Jason J

2013-01-01

Hair loss is a commonly encountered problem in clinical practice, with men presenting with a distinctive pattern involving hairline recession and vertex balding (Norwood-Hamilton classification) and women exhibiting diffuse hair thinning over the crown (increased part width) and sparing of the frontal hairline (Ludwig classification). Female pattern hair loss has a strikingly overwhelming psychological effect; thus, successful treatments are necessary. Difficulty lies in successful treatment interventions, as only two medications – minoxidil and finasteride – are approved for the treatment of androgenetic alopecia, and these medications offer mediocre results, lack of a permanent cure, and potential complications. Hair transplantation is the only current successful permanent option, and it requires surgical procedures. Several other medical options, such as antiandrogens (eg, spironolactone, oral contraceptives, cyproterone, flutamide, dutasteride), prostaglandin analogs (eg, bimatoprost, latanoprost), and ketoconazole are reported to be beneficial. Laser and light therapies have also become popular despite the lack of a profound benefit. Management of expectations is crucial, and the aim of therapy, given the current therapeutic options, is to slow or stop disease progression with contentment despite patient expectations of permanent hair regrowth. This article reviews current perspectives on therapeutic options for female pattern hair loss. PMID:24039457

Effects of Problem Frame and Gender on Principals' Decision Making

ERIC Educational Resources Information Center

Miller, Paul M.; Fagley, Nancy S.; Casella, Nancy E.

2009-01-01

Research indicates people's decisions can sometimes be influenced by seemingly trivial differences in the "framing" (i.e., wording) of alternative options. The tendency to prefer risk averse options when framed positively and risky options when framed negatively is known as the framing effect. The current study examined the susceptibility of…

78 FR 10228 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-13

... transaction fee for XSP index options. Currently, the Exchange has a $0.18 customer transaction fee per... customer transaction fees for transactions in XSP index options. Eliminating the customer transaction fee... opportunity to pay lower fees for such transactions and provide greater incentives for customers to trade XSP...

78 FR 11243 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-15

.... Specifically, the Exchange is proposing to increase the threshold in which it waives customer transaction fees, implement a $0.25 marketing fee for trading in SPY and QQQ options, and eliminate the complex order... customer transaction fee in ``ETF, ETN and HOLDRs Options.'' Currently, the Exchange waives transaction...

77 FR 67044 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-08

... report also contained information and analysis of FLEX Index Options trading patterns. The Exchange also... Effectiveness of Proposed Rule Change Related to Extending the FLEX Exercise Settlement Values Pilot November 2... regarding permissible exercise settlement values for FLEX Index Options, which pilot program is currently...

Expertise-Based Differences in Search and Option-Generation Strategies

ERIC Educational Resources Information Center

Raab, Markus; Johnson, Joseph G.

2007-01-01

The current work builds on option-generation research using experts of various skill levels in a realistic task. We extend previous findings that relate an athlete's performance strategy to generated options and subsequent choices in handball. In a 2-year longitudinal study, we present eye-tracking data to independently verify decision strategies…

Aerospace engineering educational program

NASA Technical Reports Server (NTRS)

Craft, William; Klett, David; Lai, Steven

1992-01-01

The principle goal of the educational component of NASA CORE is the creation of aerospace engineering options in the mechanical engineering program at both the undergraduate and graduate levels. To accomplish this goal, a concerted effort during the past year has resulted in detailed plans for the initiation of aerospace options in both the BSME and MSME programs in the fall of 1993. All proposed new courses and the BSME aerospace option curriculum must undergo a lengthy approval process involving two cirriculum oversight committees (School of Engineering and University level) and three levels of general faculty approval. Assuming approval is obtained from all levels, the options will officially take effect in Fall '93. In anticipation of this, certain courses in the proposed curriculum are being offered during the current academic year under special topics headings so that current junior level students may graduate in May '94 under the BSME aerospace option. The proposed undergraduate aerospace option curriculum (along with the regular mechanical engineering curriculum for reference) is attached at the end of this report, and course outlines for the new courses are included in the appendix.

Advances and challenges in laparoscopic surgery in the management of hepatocellular carcinoma.

PubMed

Ziogas, Ioannis A; Tsoulfas, Georgios

2017-12-27

Hepatocellular carcinoma is the fifth most common malignancy and the third most common cause of cancer-related mortality worldwide. From the wide variety of treatment options, surgical resection and liver transplantation are the only therapeutic ones. However, due to shortage of liver grafts, surgical resection is the most common therapeutic modality implemented. Owing to rapid technological development, minimally invasive approaches have been incorporated in liver surgery. Liver laparoscopic resection has been evaluated in comparison to the open technique and has been shown to be superior because of the reported decrease in surgical incision length and trauma, blood loss, operating theatre time, postsurgical pain and complications, R0 resection, length of stay, time to recovery and oral intake. It has been reported that laparoscopic excision is a safe and feasible approach with near zero mortality and oncologic outcomes similar to open resection. Nevertheless, current indications include solid tumors in the periphery < 5 cm, especially in segments II through VI, while according to the consensus laparoscopic major hepatectomy should only be performed by surgeons with high expertise in laparoscopic and hepatobiliary surgery in tertiary centers. It is necessary for a surgeon to surpass the 60-cases learning curve observed in order to accomplish the desirable outcomes and preserve patient safety. In this review, our aim is to thoroughly describe the general principles and current status of laparoscopic liver resection for hepatocellular carcinoma, as well as future prospects.

Temperature and oxygenation during organ preservation: friends or foes?

PubMed

Gilbo, Nicholas; Monbaliu, Diethard

2017-06-01

The liberalization of donor selection criteria in organ transplantation, with the increased use of suboptimal grafts, has stimulated interest in ischemia-reperfusion injury prevention and graft reconditioning. Organ preservation technologies are changing considerably, mostly through the reintroduction of dynamic machine preservation. Here, we review the current evidence on the role of temperature and oxygenation during dynamic machine preservation. A large but complex body of evidence exists and comparative studies are few. Oxygenation seems to support an advantageous effect in hypothermic machine preservation and is mandatory in normothermic machine preservation, although in the latter, supraphysiological oxygen tensions should be avoided. High-risk grafts, such as suboptimal organs, may optimally benefit from oxygenated perfusion conditions that support metabolism and activate mechanisms of repair such as subnormothermic machine preservation, controlled oxygenated rewarming, and normothermic machine preservation. For lower risk grafts, oxygenation during hypothermic machine preservation may sufficiently reduce injuries and recharge the cellular energy to secure functional recovery after transplantation. The relationship between temperature and oxygenation in organ preservation is more complex than physiological laws would suggest. Rather than one default perfusion temperature/oxygenation standard, perfusion protocols should be tailored for specific needs of grafts of different quality.

Preservation of the biomedical literature: an overview.

PubMed Central

Byrnes, M M

1989-01-01

The National Library of Medicine began to preserve its collection many years ago. This article presents a brief review of NLM's early conservation and microfilming programs, and describes the current activities of the library's new Preservation Section. Also mentioned are the complementary efforts of NLM staff who are involved in research into electronic imaging and the campaign to increase the use of alkaline paper in medical and scientific publishing. Goals of the National Preservation Plan for the Biomedical Literature are summarized and a report on progress in implementing the plan is provided. Results of the preservation needs assessment described in the accompanying article by Kirkpatrick are briefly analyzed. Recent efforts of the Commission on Preservation and Access, the National Endowment for the Humanities, the Research Libraries Group, and several international associations are described in terms of their potential benefit to preservation of the biomedical literature. The need to monitor new preservation technologies and preserve materials in audiovisual and electronic formats is emphasized. It is argued that with enough coordination, cooperation, and willingness among health sciences libraries to share the costs, the goal of preserving all of the important biomedical literature can be accomplished. PMID:2758180

Cosmetic preservative labelling on the Thai market.

PubMed

Bunyavaree, Monthathip; Kasemsarn, Pranee; Boonchai, Waranya

2016-04-01

Preservatives are added to cosmetics and other consumer products to prevent microbial growth and product degradation. Many cosmetic preservatives are skin sensitizers and frequent causes of contact dermatitis. The use of preservatives may vary by country and/or region, according to legislation, and may be reflected in differences in the prevalence rates of preservative allergy worldwide. To examine the type and frequency of preservative use in cosmetics sold in Thai markets in metropolitan Bangkok, Thailand. Preservatives contained in 1000 different cosmetics sold in Thai markets were documented and analysed, based on the labelling of ingredients. Most of the cosmetic and skincare products sold in Thai markets were international brands, with only a small proportion of cosmetic products being produced in Thailand. International brand cosmetics were more likely to contain non-formaldehyde-releasing preservatives than domestically produced brands. Isothiazolinone-based preservatives, which are responsible for the current increase in the prevalence of contact allergy, were found at a significant frequency in domestically produced, leave-on cosmetic products. Preservatives in cosmetics were significantly different according to source of production and type of cosmetics. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Preserving residual renal function in dialysis patients: an update on evidence to assist clinical decision making

PubMed Central

Jensen, Jens Dam; Peters, Christian Daugaard; Jespersen, Bente

2011-01-01

It has been documented that preservation of residual renal function in dialysis patients improves quality of life as well as survival. Clinical trials on strategies to preserve residual renal function are clearly lacking. While waiting for more results from clinical trials, patients will benefit from clinicians being aware of available knowledge. The aim of this review was to offer an update on current evidence assisting doctors in clinical practice. PMID:25949486

75 FR 11621 - Agency Information Collection Activities: Notice of Request for Extension of Currently Approved...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-11

... Awards (TPEA) Program is a biennial awards program developed by the FHWA and the Federal Transit... System Preservation Program Grant Application. Delta Region Transportation Development Program Grant...: Transportation, Community, and System Preservation Program Grant Application: Section 1117 of the Safe...

Planning for Preservation during Mass Digitization Projects

ERIC Educational Resources Information Center

Teper, Jennifer Hain; Shaw, Emily F.

2011-01-01

In anticipation of current and future mass digitization projects in which the University of Illinois at Urbana-Champaign's Library will participate, the Library's Conservation Unit began to gather data on the "scannability" of our general book collections to anticipate potential effects on conservation and preservation work flows. The…

78 FR 30810 - Paleontological Resources Preservation

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-23

... fossil resource management on public lands (see S. Rep. 105- 227, at 60 (1998)). The request directed the... of fossils; (2) the need for standards that would maximize the availability of fossils for scientific study; and (3) the effectiveness of current methods for storing and preserving fossils collected from...

Roadwaste : issues and options.

DOT National Transportation Integrated Search

1998-06-01

The Oregon Department of Transportation (ODOT) is conducting a study to determine roadwaste management options. Phase 1 consisted of a thorough review of regulations and standards, roadwaste characterization, current management practices, and new tec...

Retrieval analysis of motion preserving spinal devices and periprosthetic tissues

PubMed Central

Kurtz, Steven M.; Steinbeck, Marla; Ianuzzi, Allyson; van Ooij, André; Punt, Ilona M.; Isaza, Jorge; Ross, E.R.S.

2009-01-01

This article reviews certain practical aspects of retrieval analysis for motion preserving spinal implants and periprosthetic tissues as an essential component of the overall revision strategy for these implants. At our institution, we established an international repository for motion-preserving spine implants in 2004. Our repository is currently open to all spine surgeons, and is intended to be inclusive of all cervical and lumbar implant designs such as artificial discs and posterior dynamic stabilization devices. Although a wide range of alternative materials is being investigated for nonfusion spine implants, many of the examples in this review are drawn from our existing repository of metal-on-polyethylene, metal-on-metal lumbar total disc replacements (TDRs), and polyurethane-based dynamic motion preservation devices. These devices are already approved or nearing approval for use in the United States, and hence are the most clinically relevant at the present time. This article summarizes the current literature on the retrieval analysis of these implants and concludes with recommendations for the development of new test methods that are based on the current state of knowledge of in vivo wear and damage mechanisms. Furthermore, the relevance and need to evaluate the surrounding tissue to obtain a complete understanding of the biological reaction to implant component corrosion and wear is reviewed. PMID:25802641

Status, Antimicrobial Mechanism, and Regulation of Natural Preservatives in Livestock Food Systems.

PubMed

Lee, Na-Kyoung; Paik, Hyun-Dong

2016-01-01

This review discusses the status, antimicrobial mechanisms, application, and regulation of natural preservatives in livestock food systems. Conventional preservatives are synthetic chemical substances including nitrates/nitrites, sulfites, sodium benzoate, propyl gallate, and potassium sorbate. The use of artificial preservatives is being reconsidered because of concerns relating to headache, allergies, and cancer. As the demand for biopreservation in food systems has increased, new natural antimicrobial compounds of various origins are being developed, including plant-derived products (polyphenolics, essential oils, plant antimicrobial peptides (pAMPs)), animal-derived products (lysozymes, lactoperoxidase, lactoferrin, ovotransferrin, antimicrobial peptide (AMP), chitosan and others), and microbial metabolites (nisin, natamycin, pullulan, ε-polylysine, organic acid, and others). These natural preservatives act by inhibiting microbial cell walls/membranes, DNA/RNA replication and transcription, protein synthesis, and metabolism. Natural preservatives have been recognized for their safety; however, these substances can influence color, smell, and toxicity in large amounts while being effective as a food preservative. Therefore, to evaluate the safety and toxicity of natural preservatives, various trials including combinations of other substances or different food preservation systems, and capsulation have been performed. Natamycin and nisin are currently the only natural preservatives being regulated, and other natural preservatives will have to be legally regulated before their widespread use.

Status, Antimicrobial Mechanism, and Regulation of Natural Preservatives in Livestock Food Systems

PubMed Central

Lee, Na-Kyoung; Paik, Hyun-Dong

2016-01-01

This review discusses the status, antimicrobial mechanisms, application, and regulation of natural preservatives in livestock food systems. Conventional preservatives are synthetic chemical substances including nitrates/nitrites, sulfites, sodium benzoate, propyl gallate, and potassium sorbate. The use of artificial preservatives is being reconsidered because of concerns relating to headache, allergies, and cancer. As the demand for biopreservation in food systems has increased, new natural antimicrobial compounds of various origins are being developed, including plant-derived products (polyphenolics, essential oils, plant antimicrobial peptides (pAMPs)), animal-derived products (lysozymes, lactoperoxidase, lactoferrin, ovotransferrin, antimicrobial peptide (AMP), chitosan and others), and microbial metabolites (nisin, natamycin, pullulan, ε-polylysine, organic acid, and others). These natural preservatives act by inhibiting microbial cell walls/membranes, DNA/RNA replication and transcription, protein synthesis, and metabolism. Natural preservatives have been recognized for their safety; however, these substances can influence color, smell, and toxicity in large amounts while being effective as a food preservative. Therefore, to evaluate the safety and toxicity of natural preservatives, various trials including combinations of other substances or different food preservation systems, and capsulation have been performed. Natamycin and nisin are currently the only natural preservatives being regulated, and other natural preservatives will have to be legally regulated before their widespread use. PMID:27621697

Use of stereotactic intensity-modulated radiotherapy in thyroid-related ophthalmopathy. Case report.

PubMed

Espinoza, Salvador; Saboori, Mehran; Forman, Scott; Moorthy, Chitti R; Benzil, Deborah L

2004-11-01

Thyroid-related ophthalmopathy (TRO), a debilitating condition involving a range of visual and orbital symptoms, occurs in up to 40% of patients with Graves disease. The goals of treatment include correcting thyroid dysfunction, relieving ocular pain, preserving vision, and improving cosmetic appearance. Options for therapy include symptomatic treatment, glucocorticoid medication, radiation therapy, and surgery. Traditional radiation treatment uses small opposed bilateral fields consisting of retrobulbar volumes and customized blocks to shield periorbital structures. The combination of intensity-modulated radiotherapy (IMRT) and stereotactic technology facilitates the administration of radiation to patients suffering from TRO and provides greater safety and efficacy than traditional treatment. The authors present the case of a patient with severe TRO whose symptoms resolved rapidly after treatment with stereotactic IMRT. The outcome in this case supports stereotactic IMRT as an effective treatment option for patients with TRO who also undergo radiation therapy.

Surgical options for lumbosacral fusion: biomechanical stability, advantage, disadvantage and affecting factors in selecting options.

PubMed

Yoshihara, Hiroyuki

2014-07-01

Numerous surgical procedures and instrumentation techniques for lumbosacral fusion (LSF) have been developed. This is probably because of its high mechanical demand and unique anatomy. Surgical options include anterior column support (ACS) and posterior stabilization procedures. Biomechanical studies have been performed to verify the stability of those options. The options have their own advantage but also disadvantage aspects. This review article reports the surgical options for lumbosacral fusion, their biomechanical stability, advantages/disadvantages, and affecting factors in option selection. Review of literature. LSF has lots of options both for ACS and posterior stabilization procedures. Combination of posterior stabilization procedures is an option. Furthermore, combinations of ACS and posterior stabilization procedures are other options. It is difficult to make a recommendation or treatment algorithm of LSF from the current literature. However, it is important to know all aspects of the options and decision-making of surgical options for LSF needs to be tailored for each patient, considering factors such as biomechanical stress and osteoporosis.

17 CFR 240.15c3-1a - Options (Appendix A to 17 CFR 240.15c3-1).

Code of Federal Regulations, 2013 CFR

2013-04-01

... Regulations Under the Securities Exchange Act of 1934 Rules Relating to Over-The-Counter Markets § 240.15c3-1a... and down) in the current market value of the underlying instrument equal to the percentage... life of the option; and (6) The current term structure of interest rates. (C) The term major market...

17 CFR 240.15c3-1a - Options (Appendix A to 17 CFR 240.15c3-1).

Code of Federal Regulations, 2010 CFR

2010-04-01

... Regulations Under the Securities Exchange Act of 1934 Rules Relating to Over-The-Counter Markets § 240.15c3-1a... and down) in the current market value of the underlying instrument equal to the percentage... life of the option; and (6) The current term structure of interest rates. (C) The term major market...

17 CFR 240.15c3-1a - Options (Appendix A to 17 CFR 240.15c3-1).

Code of Federal Regulations, 2011 CFR

2011-04-01

... Regulations Under the Securities Exchange Act of 1934 Rules Relating to Over-The-Counter Markets § 240.15c3-1a... and down) in the current market value of the underlying instrument equal to the percentage... life of the option; and (6) The current term structure of interest rates. (C) The term major market...

[Endometriosis Update 2016].

PubMed

Imesch, Patrick; Fink, Daniel

2016-03-02

Endometriosis is a common gynecologic benign disease, affecting 6–10% of women of reproductive age. The disease is often associated with dysmenorrhea, dyspareunia, chronic pelvic pain and infertility. The exact mechanism of the pathogenesis of endometriosis has not yet been fully elucidated, therefore, current medical therapeutic options are more symptom-oriented than causal. The aim of the present work is to summarize the current diagnostic and therapeutic options.

Recreating Family: Parents Identify Worker-Client Relationships as Paramount in Family Preservation Programs

ERIC Educational Resources Information Center

Gockel, Annemarie; Russell, Mary; Harris, Barbara

2008-01-01

Although existing family preservation program research has focused on identifying the components of effective treatment, we remain far from fully developing empirically supported interventions (Barth, Chamberlain, Reid, Rolls, Hurlburt, Farmer, James, McCabe, & Kohl, 2005; Dufour, Chamberland, & Trocme, 2003). The current longitudinal study…

Evaluation of twig pre-harvest temperature for effective cryopreservation of Vaccinium dormant buds

USDA-ARS?s Scientific Manuscript database

Cryopreservation of plant material by dormant buds is less expensive than using shoot tips; however currently, dormant buds are used only for preservation of selected temperate tree and shrub species. Using dormant buds could be an efficient strategy for long-term preservation of blueberry (Vacciniu...

Current biotechnologies and future possibilities in preservation of animal germplasm

USDA-ARS?s Scientific Manuscript database

Animal germplasm (semen, eggs, embryos, DNA, tissue) can be preserved from all agricultural species and result in the regeneration of animal lines or breeds. However, there are limitations to successful utilization of the material that are attributed to the type, post-thaw quality, and available as...

Reuse and Disposal

Treesearch

Carol A. Clausen; Stan T. Lebow

2011-01-01

Although preservative-treated wood is a durable construction material, it is eventually removed from service. The typical fate of treated wood removed from service varies depending on the original application and the type of preservative used. Currently, most treated wood removed from service in the United States is placed in landfills (Clausen 2003). Treated wood is...

Digital Preservation and Access of Natural Resources Documents

ERIC Educational Resources Information Center

Kulhavy, David L.; Reynolds, R. Philip; Unger, Daniel R.; Bullard, Steven H.; McBroom, Matthew W.

2017-01-01

Digitization and preservation of natural resource documents were reviewed and the current status of digitization presented for a North American university. It is important to present the status of the digitation process for natural resources and to advocate for increased collections of digital material for ease of reference and exchange of…

Preserving History in a Digital World

ERIC Educational Resources Information Center

Baumann, Jim

2012-01-01

Stanford University's (California) Julie Sweetkind-Singer is a recognized authority on digital preservation, and has been honored by the Library of Congress for her work in the field. She currently serves as both the assistant director of Stanford's Geospatial, Cartographic and Scientific Data and Services and as head of the Branner Earth Sciences…

Virtual surgical planning and three-dimensional printing in multidisciplinary oncologic chest wall resection and reconstruction: A case report.

PubMed

Sharaf, Basel; Sabbagh, M Diya; Vijayasekaran, Aparna; Allen, Mark; Matsumoto, Jane

2018-04-30

Primary sarcomas of the sternum are extremely rare and present the surgical teams involved with unique challenges. Historically, local muscle flaps have been utilized to reconstruct the resulting defect. However, when the resulting oncologic defect is larger than anticipated, local tissues have been radiated, or when preservation of chest wall muscles is necessary to optimize function, local reconstructive options are unsuitable. Virtual surgical planning (VSP) and in house three-dimensional (3D) printing provides the platform for improved understanding of the anatomy of complex tumours, communication amongst surgeons, and meticulous pre-operative planning. We present the novel use of this technology in the multidisciplinary surgical care of a 35 year old male with primary sarcoma of the sternum. Emphasis on minimizing morbidity, maintaining function of chest wall muscles, and preservation of the internal mammary vessels for microvascular anastomosis are discussed. While the majority of patients at our institution receive local or regional flaps for reconstruction of thoracic defects, advances in microvascular surgery allow the reconstructive surgeon the latitude to choose other flap options if necessary. VSP and 3D printing allowed the surgical team involved to utilize free tissue transfer to reconstruct the defect with free tissue transfer from the thigh. Perseveration of the internal mammary vessels was paramount during tumor extirpation. Virtual surgical planning and rapid prototyping is a useful adjunct to standard imaging in complex chest wall resection and reconstruction. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Monitoring population status of sea otters (Enhydra lutris) in Glacier Bay National Park and Preserve, Alaska: options and considerations

USGS Publications Warehouse

Esslinger, George G.; Esler, Daniel N.; Howlin, S.; Starcevich, L.A.

2015-06-25

After many decades of absence from southeast Alaska, sea otters (Enhydra lutris) are recolonizing parts of their former range, including Glacier Bay, Alaska. Sea otters are well known for structuring nearshore ecosystems and causing community-level changes such as increases in kelp abundance and changes in the size and number of other consumers. Monitoring population status of sea otters in Glacier Bay will help park researchers and managers understand and interpret sea otter-induced ecosystem changes relative to other sources of variation, including potential human-induced impacts such as ocean acidification, vessel disturbance, and oil spills. This report was prepared for the National Park Service (NPS), Southeast Alaska Inventory and Monitoring Network following a request for evaluation of options for monitoring sea otter population status in Glacier Bay National Park and Preserve. To meet this request, we provide a detailed consideration of the primary method of assessment of abundance and distribution, aerial surveys, including analyses of power to detect interannual trends and designs to reduce variation around annual abundance estimates. We also describe two alternate techniques for evaluating sea otter population status—(1) quantifying sea otter diets and energy intake rates, and (2) detecting change in ages at death. In addition, we provide a brief section on directed research to identify studies that would further our understanding of sea otter population dynamics and effects on the Glacier Bay ecosystem, and provide context for interpreting results of monitoring activities.

Expanding the Paradigm: Postsecondary Education Options for Individuals with Autism Spectrum Disorder and Intellectual Disabilities

ERIC Educational Resources Information Center

Hart, Debra; Grigal, Meg; Weir, Cate

2010-01-01

This article will provide an overview of postsecondary education (PSE) options for students with Autism Spectrum Disorder (ASD) and other Intellectual Disabilities (ID). Topics include a historical and philosophical discussion outlining how students with ASD and ID can benefit from postsecondary opportunities, a description of current PSE options,…

78 FR 66796 - Self-Regulatory Organizations: Miami International Securities Exchange LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-06

... transaction fee for executions in standard option contracts and $0.008 transaction fee for Mini Option... Exchange for purposes of the transaction fee and Section 1(a)(i) of the Fee Schedule include: (i... (``DPLMM''). See MIAX Options Fee Schedule, Section 1(a)(i)--Market Maker Transaction Fees. The current...

Behavioral and Neural Signatures of Reduced Updating of Alternative Options in Alcohol-Dependent Patients during Flexible Decision-Making.

PubMed

Reiter, Andrea M F; Deserno, Lorenz; Kallert, Thomas; Heinze, Hans-Jochen; Heinz, Andreas; Schlagenhauf, Florian

2016-10-26

Addicted individuals continue substance use despite the knowledge of harmful consequences and often report having no choice but to consume. Computational psychiatry accounts have linked this clinical observation to difficulties in making flexible and goal-directed decisions in dynamic environments via consideration of potential alternative choices. To probe this in alcohol-dependent patients (n = 43) versus healthy volunteers (n = 35), human participants performed an anticorrelated decision-making task during functional neuroimaging. Via computational modeling, we investigated behavioral and neural signatures of inference regarding the alternative option. While healthy control subjects exploited the anticorrelated structure of the task to guide decision-making, alcohol-dependent patients were relatively better explained by a model-free strategy due to reduced inference on the alternative option after punishment. Whereas model-free prediction error signals were preserved, alcohol-dependent patients exhibited blunted medial prefrontal signatures of inference on the alternative option. This reduction was associated with patients' behavioral deficit in updating the alternative choice option and their obsessive-compulsive drinking habits. All results remained significant when adjusting for potential confounders (e.g., neuropsychological measures and gray matter density). A disturbed integration of alternative choice options implemented by the medial prefrontal cortex appears to be one important explanation for the puzzling question of why addicted individuals continue drug consumption despite negative consequences. In addiction, patients maintain substance use despite devastating consequences and often report having no choice but to consume. These clinical observations have been theoretically linked to disturbed mechanisms of inference, for example, to difficulties when learning statistical regularities of the environmental structure to guide decisions. Using computational modeling, we demonstrate disturbed inference on alternative choice options in alcohol addiction. Patients neglecting "what might have happened" was accompanied by blunted coding of inference regarding alternative choice options in the medial prefrontal cortex. An impaired integration of alternative choice options implemented by the medial prefrontal cortex might contribute to ongoing drug consumption in the face of evident negative consequences. Copyright © 2016 the authors 0270-6474/16/3610935-14$15.00/0.

The role of preservatives in the conjunctival toxicity of subconjunctival gentamicin injection.

PubMed Central

Pande, M.; Ghanchi, F.

1992-01-01

Subconjunctival gentamicin was identified as the cause of conjunctival chemosis and capillary closure in a recent study conducted in this department. The gentamicin preparation used in the study contained preservatives. The current prospective study was set up to investigate the role of preservatives in the conjunctival toxicity of subconjunctival gentamicin. Seventy five patients undergoing cataract surgery were enrolled in the study. They were split into three groups of 25 each. Group A patients were given a subconjunctival injection of a preservative-free aqueous solution of gentamicin at the end of the cataract procedure. Group B patients were given a subconjunctival injection of gentamicin containing sodium metabisulphite and disodium edetate as preservatives at the end of the cataract procedure. Group C was the control group where patients were not given any subconjunctival injection. The incidence of severity of conjunctival chemosis were observed in the three groups. The difference between groups A and B patients who received preservative-free gentamicin and gentamicin with preservatives respectively was significant (p < 0.02). PMID:1390493

Image contrast enhancement with brightness preservation using an optimal gamma correction and weighted sum approach

NASA Astrophysics Data System (ADS)

Jiang, G.; Wong, C. Y.; Lin, S. C. F.; Rahman, M. A.; Ren, T. R.; Kwok, Ngaiming; Shi, Haiyan; Yu, Ying-Hao; Wu, Tonghai

2015-04-01

The enhancement of image contrast and preservation of image brightness are two important but conflicting objectives in image restoration. Previous attempts based on linear histogram equalization had achieved contrast enhancement, but exact preservation of brightness was not accomplished. A new perspective is taken here to provide balanced performance of contrast enhancement and brightness preservation simultaneously by casting the quest of such solution to an optimization problem. Specifically, the non-linear gamma correction method is adopted to enhance the contrast, while a weighted sum approach is employed for brightness preservation. In addition, the efficient golden search algorithm is exploited to determine the required optimal parameters to produce the enhanced images. Experiments are conducted on natural colour images captured under various indoor, outdoor and illumination conditions. Results have shown that the proposed method outperforms currently available methods in contrast to enhancement and brightness preservation.

Analyses related to the development of DSM-5 criteria for substance use related disorders: 3. An assessment of Pathological Gambling criteria.

PubMed

Denis, Cécile; Fatséas, Mélina; Auriacombe, Marc

2012-04-01

The DSM-5 Substance-Related Disorders Work Group proposed to include Pathological Gambling within the current Substance-Related Disorders section. The objective of the current report was to assess four possible sets of diagnostic criteria for Pathological Gambling. Gamblers (N=161) were defined as either Pathological or Non-Pathological according to four classification methods. (a) Option 1: the current DSM-IV criteria for Pathological Gambling; (b) Option 2: dropping the "Illegal Acts" criterion, while keeping the threshold at 5 required criteria endorsed; (c) Option 3: the proposed DSM-5 approach, i.e., deleting "Illegal Acts" and lowering the threshold of required criteria from 5 to 4; (d) Option 4: to use a set of Pathological Gambling criteria modeled on the DSM-IV Substance Dependence criteria. Cronbach's alpha and eigenvalues were calculated for reliability, Phi, discriminant function analyses, correlations and multivariate regression models were performed for validity and kappa coefficients were calculated for diagnostic consistency of each option. All criteria sets were reliable and valid. Some criteria had higher discriminant properties than others. The proposed DSM-5 criteria in Options 2 and 3 performed well and did not appear to alter the meanings of the diagnoses of Pathological Gambling from DSM-IV. Future work should further explore if Pathological Gambling might be assessed using the same criteria as those used for Substance Use Disorders. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Early Phase Contingency Trajectory Design for the Failure of the First Lunar Orbit Insertion Maneuver: Direct Recovery Options

NASA Astrophysics Data System (ADS)

Song, Young-Joo; Bae, Jonghee; Kim, Young-Rok; Kim, Bang-Yeop

2017-12-01

To ensure the successful launch of the Korea pathfinder lunar orbiter (KPLO) mission, the Korea Aerospace Research Institute (KARI) is now performing extensive trajectory design and analysis studies. From the trajectory design perspective, it is crucial to prepare contingency trajectory options for the failure of the first lunar brake or the failure of the first lunar orbit insertion (LOI) maneuver. As part of the early phase trajectory design and analysis activities, the required time of flight (TOF) and associated delta-V magnitudes for each recovery maneuver (RM) to recover the KPLO mission trajectory are analyzed. There are two typical trajectory recovery options, direct recovery and low energy recovery. The current work is focused on the direct recovery option. Results indicate that a quicker execution of the first RM after the failure of the first LOI plays a significant role in saving the magnitudes of the RMs. Under the conditions of the extremely tight delta-V budget that is currently allocated for the KPLO mission, it is found that the recovery of the KPLO without altering the originally planned mission orbit (a 100 km circular orbit) cannot be achieved via direct recovery options. However, feasible recovery options are suggested within the boundaries of the currently planned delta-V budget. By changing the shape and orientation of the recovered final mission orbit, it is expected that the KPLO mission may partially pursue its scientific mission after successful recovery, though it will be limited.

Optimising concentrations of antimicrobial agents in pharmaceutical preparations: Case of an oral solution of glycerol and an ophthalmic solution containing cysteamine.

PubMed

Chan Hew Wai, A; Becasse, P; Tworski, S; Pradeau, D; Planas, V

2014-11-01

In the context of current distrust of antimicrobial preservatives, the quantities of these substances in two pharmaceutical formulas were studied: an ophthalmic solution of cysteamine preserved benzalkonium chloride at 1mg/5mL and Glycerotone(®) preserved with sorbic acid at 0.1g/100g. The purpose of this work was to verify that a reduction of the quantities of preservative continues to fulfil the requirements for antimicrobial preservation. The Test of efficacy of antimicrobial preservation, section 5.1.3 of the 8th edition of the European Pharmacopoeia, was carried out on each formulation prepared with decreasing quantities of preservative. The results show that formulations whose preservative concentration was reduced by a factor of four remained compliant with standards. It is to be noted that in formulas without preservative, fungal growth was observed in both the solution of Glycerotone(®) and the ophthalmic solution containing cysteamine. Although there is no question that an antimicrobial preservative is necessary, the quantity of preservative can be reduced without deteriorating the quality of the pharmaceutical product but the minimal effective concentration remains to be determined. The formulations of many pharmaceutical products should therefore be examined in order to limit the quantities of preservative while continuing to guarantee patient's safety. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Generation and characterisation of decellularised human corneal limbus.

PubMed

Spaniol, Kristina; Witt, Joana; Mertsch, Sonja; Borrelli, Maria; Geerling, Gerd; Schrader, Stefan

2018-03-01

Limbal epithelial stem cells (LESC) reside in a niche in the corneo-scleral transition zone. Deficiency leads to pain, corneal opacity, and eventually blindness. LESC transplantation of ex-vivo expanded human LESC on a carrier such as human amniotic membrane is a current treatment option. We evaluated decellularised human limbus (DHL) as a potential carrier matrix for the transplantation of LESC. Human corneas were obtained from the local eye bank. The limbal tissue was decellularised by sodium desoxychelate and DNase solution and sterilised by γ-irradiation. Native limbus- and DHL-surface structures were assessed by scanning electron microscopy and collagen ultrastructure using transmission electron microscopy. Presence and preservation of limbal basement membrane proteins in native limbus and DHL were analysed immunohistochemically. Absence of DNA after decellularisation was assessed by Feulgen staining and DNA quantification. Presence of immune cells was explored by CD45 staining, and potential cytotoxicity was tested using a cell viability assay. In the DHL, the DNA content was reduced from 1.5 ± 0.3 μg/mg to 0.15 ± 0.01 μg/mg; the three-dimensional structure and the arrangement of the collagen fibrils were preserved. Main basement membrane proteins such as collagen IV, laminin, and fibronectin were still present after decellularisation and γ-irradiation. CD45-expressing cells were evident neither in the native limbus nor in the DHL. DHL did not convey cytotoxicity. The extracellular matrix (ECM) of the limbus provides a tissue specific morphology and three-dimensionality consisting of particular ECM proteins. It therefore represents a substantial component of the stem cell niche. The DHL provides a specific limbal niche surrounding, and might serve as an easily producible carrier matrix for LESC transplantation.

Dual Inhibition of MEK and PI3K/Akt Rescues Cancer Cachexia through both Tumor-Extrinsic and -Intrinsic Activities.

PubMed

Talbert, Erin E; Yang, Jennifer; Mace, Thomas A; Farren, Matthew R; Farris, Alton B; Young, Gregory S; Elnaggar, Omar; Che, Zheng; Timmers, Cynthia D; Rajasekera, Priyani; Maskarinec, Jennifer M; Bloomston, Mark; Bekaii-Saab, Tanios; Guttridge, Denis C; Lesinski, Gregory B

2017-02-01

Involuntary weight loss, a part of the cachexia syndrome, is a debilitating comorbidity of cancer and currently has no treatment options. Results from a recent clinical trial at our institution showed that biliary tract cancer patients treated with a MEK inhibitor exhibited poor tumor responses but surprisingly gained weight and increased their skeletal muscle mass. This implied that MEK inhibition might be anticachectic. To test this potential effect of MEK inhibition, we utilized the established Colon-26 model of cancer cachexia and the MEK1/2 inhibitor MEK162. Results showed that MEK inhibition effectively prevented muscle wasting. Importantly, MEK162 retained its ability to spare muscle loss even in mice bearing a Colon-26 clone resistant to the MEK inhibitor, demonstrating that the effects of blocking MEK are at least in part independent of the tumor. Because single-agent MEK inhibitors have been limited as a first-line targeted therapy due to compensatory activation of other oncogenic signaling pathways, we combined MEK162 with the PI3K/Akt inhibitor buparlisib. Results showed that this combinatorial treatment significantly reduced tumor growth due to a direct activity on Colon-26 tumor cells in vitro and in vivo, while also preserving skeletal muscle mass. Together, our results suggest that as a monotherapy, MEK inhibition preserves muscle mass, but when combined with a PI3K/Akt inhibitor exhibits potent antitumor activity. Thus, combinatorial therapy might serve as a new approach for the treatment of cancer cachexia. Mol Cancer Ther; 16(2); 344-56. ©2016 AACRSee related article by Kobayashi et al., p. 357. ©2016 American Association for Cancer Research.

Uterine fibroid management: from the present to the future

PubMed Central

Donnez, Jacques; Dolmans, Marie-Madeleine

2016-01-01

Abstract Uterine fibroids (also known as leiomyomas or myomas) are the most common form of benign uterine tumors. Clinical presentations include abnormal bleeding, pelvic masses, pelvic pain, infertility, bulk symptoms and obstetric complications. Almost a third of women with leiomyomas will request treatment due to symptoms. Current management strategies mainly involve surgical interventions, but the choice of treatment is guided by patient's age and desire to preserve fertility or avoid ‘radical’ surgery such as hysterectomy. The management of uterine fibroids also depends on the number, size and location of the fibroids. Other surgical and non-surgical approaches include myomectomy by hysteroscopy, myomectomy by laparotomy or laparoscopy, uterine artery embolization and interventions performed under radiologic or ultrasound guidance to induce thermal ablation of the uterine fibroids. There are only a few randomized trials comparing various therapies for fibroids. Further investigations are required as there is a lack of concrete evidence of effectiveness and areas of uncertainty surrounding correct management according to symptoms. The economic impact of uterine fibroid management is significant and it is imperative that new treatments be developed to provide alternatives to surgical intervention. There is growing evidence of the crucial role of progesterone pathways in the pathophysiology of uterine fibroids due to the use of selective progesterone receptor modulators (SPRMs) such as ulipristal acetate (UPA). The efficacy of long-term intermittent use of UPA was recently demonstrated by randomized controlled studies. The need for alternatives to surgical intervention is very real, especially for women seeking to preserve their fertility. These options now exist, with SPRMs which are proven to treat fibroid symptoms effectively. Gynecologists now have new tools in their armamentarium, opening up novel strategies for the management of uterine fibroids. PMID:27466209

Use of the Generating Options for Active Risk Control (GO-ARC) Technique can lead to more robust risk control options.

PubMed

Card, Alan J; Simsekler, Mecit Can Emre; Clark, Michael; Ward, James R; Clarkson, P John

2014-01-01

Risk assessment is widely used to improve patient safety, but healthcare workers are not trained to design robust solutions to the risks they uncover. This leads to an overreliance on the weakest category of risk control recommendations: administrative controls. Increasing the proportion of non-administrative risk control options (NARCOs) generated would enable (though not ensure) the adoption of more robust solutions. Experimentally assess a method for generating stronger risk controls: The Generating Options for Active Risk Control (GO-ARC) Technique. Participants generated risk control options in response to two patient safety scenarios. Scenario 1 (baseline): All participants used current practice (unstructured brainstorming). Scenario 2: Control group used current practice; intervention group used the GO-ARC Technique. To control for individual differences between participants, analysis focused on the change in the proportion of NARCOs for each group. Proportion of NARCOs decreased from 0.18 at baseline to 0.12. Intervention group: Proportion increased from 0.10 at baseline to 0.29 using the GO-ARC Technique. Results were statistically significant. There was no decrease in the number of administrative controls generated by the intervention group. The Generating Options for Active Risk Control (GO-ARC) Technique appears to lead to more robust risk control options.

Current options and future possibilities for the treatment of dyskinesia and motor fluctuations in Parkinson's disease.

PubMed

Cenci, M A; Ohlin, K E; Odin, P

2011-09-01

Dyskinesia and motor fluctuations affect up to 90% of patients with Parkinson's disease (PD) within ten years of L-DOPA pharmacotherapy, and represent a major challenge to a successful clinical management of this disorder. There are currently two main treatment options for these complications, namely, deep brain electrical stimulation or continuous infusion of dopaminergic agents. The latter is achieved using either subcutaneous apomorphine infusion or enteric L-DOPA delivery. Some patients also benefit from the antidyskinetic effect of amantadine as an adjunct to L-DOPA treatment. Ongoing research in animal models of PD aims at discovering additional, novel treatment options that can either prevent or reverse dyskinesia and motor fluctuations. Alternative methods of continuous L-DOPA delivery (including gene therapy), and pharmacological agents that target nondopaminergic receptor systems are currently under intense experimental scrutiny. Because clinical response profiles show large individual variation in PD, an increased number of treatment options for dyskinesia and motor fluctuations will eventually allow for antiparkinsonian and antidyskinetic therapies to be tailor-made to the needs of different patients and/or PD subtypes.

Non-pharmacological treatment options for refractory epilepsy: an overview of human treatment modalities and their potential utility in dogs.

PubMed

Martlé, Valentine; Van Ham, Luc; Raedt, Robrecht; Vonck, Kristl; Boon, Paul; Bhatti, Sofie

2014-03-01

Refractory epilepsy is a common disorder both in humans and dogs and treatment protocols are difficult to optimise. In humans, different non-pharmacological treatment modalities currently available include surgery, the ketogenic diet and neurostimulation. Surgery leads to freedom from seizures in 50-75% of patients, but requires strict patient selection. The ketogenic diet is indicated in severe childhood epilepsies, but efficacy is limited and long-term compliance can be problematic. In the past decade, various types of neurostimulation have emerged as promising treatment modalities for humans with refractory epilepsy. Currently, none of these treatment options are used in routine daily clinical practice to treat dogs with the condition. Since many dogs with poorly controlled seizures do not survive, the search for alternative treatment options for canine refractory epilepsy should be prioritised. This review provides an overview of non-pharmacological treatment options for human refractory epilepsy. The current knowledge and limitations of these treatments in canine refractory epilepsy is also discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.

A cell transportation solution that preserves live circulating tumor cells in patient blood samples.

PubMed

Stefansson, Steingrimur; Adams, Daniel L; Ershler, William B; Le, Huyen; Ho, David H

2016-05-06

Circulating tumor cells (CTCs) are typically collected into CellSave fixative tubes, which kills the cells, but preserves their morphology. Currently, the clinical utility of CTCs is mostly limited to their enumeration. More detailed investigation of CTC biology can be performed on live cells, but obtaining live CTCs is technically challenging, requiring blood collection into biocompatible solutions and rapid isolation which limits transportation options. To overcome the instability of CTCs, we formulated a sugar based cell transportation solution (SBTS) that stabilizes cell viability at ambient temperature. In this study we examined the long term viability of human cancer cell lines, primary cells and CTCs in human blood samples in the SBTS for transportation purposes. Four cell lines, 5 primary human cells and purified human PBMCs were tested to determine the viability of cells stored in the transportation solution at ambient temperature for up to 7 days. We then demonstrated viability of MCF-7 cells spiked into normal blood with SBTS and stored for up to 7 days. A pilot study was then run on blood samples from 3 patients with metastatic malignancies stored with or without SBTS for 6 days. CTCs were then purified by Ficoll separation/microfilter isolation and identified using CTC markers. Cell viability was assessed using trypan blue or CellTracker™ live cell stain. Our results suggest that primary/immortalized cell lines stored in SBTS remain ~90% viable for > 72 h. Further, MCF-7 cells spiked into whole blood remain viable when stored with SBTS for up to 7 days. Finally, live CTCs were isolated from cancer patient blood samples kept in SBTS at ambient temperature for 6 days. No CTCs were isolated from blood samples stored without SBTS. In this proof of principle pilot study we show that viability of cell lines is preserved for days using SBTS. Further, this solution can be used to store patient derived blood samples for eventual isolation of viable CTCs after days of storage. Therefore, we suggest an effective and economical transportation of cancer patient blood samples containing live CTCs can be achieved.

Cost-effectiveness analysis of Option B+ for HIV prevention and treatment of mothers and children in Malawi.

PubMed

Fasawe, Olufunke; Avila, Carlos; Shaffer, Nathan; Schouten, Erik; Chimbwandira, Frank; Hoos, David; Nakakeeto, Olive; De Lay, Paul

2013-01-01

The Ministry of Health in Malawi is implementing a pragmatic and innovative approach for the management of all HIV-infected pregnant women, termed Option B+, which consists of providing life-long antiretroviral treatment, regardless of their CD4 count or clinical stage. Our objective was to determine if Option B+ represents a cost-effective option. A decision model simulates the disease progression of a cohort of HIV-infected pregnant women receiving prophylaxis and antiretroviral therapy, and estimates the number of paediatric infections averted and maternal life years gained over a ten-year time horizon. We assess the cost-effectiveness from the Ministry of Health perspective while taking into account the practical realities of implementing ART services in Malawi. If implemented as recommended by the World Health Organization, options A, B and B+ are equivalent in preventing new infant infections, yielding cost effectiveness ratios between US$ 37 and US$ 69 per disability adjusted life year averted in children. However, when the three options are compared to the current practice, the provision of antiretroviral therapy to all mothers (Option B+) not only prevents infant infections, but also improves the ten-year survival in mothers more than four-fold. This translates into saving more than 250,000 maternal life years, as compared to mothers receiving only Option A or B, with savings of 153,000 and 172,000 life years respectively. Option B+ also yields favourable incremental cost effectiveness ratios (ICER) of US$ 455 per life year gained over the current practice. In Malawi, Option B+ represents a favorable policy option from a cost-effectiveness perspective to prevent future infant infections, save mothers' lives and reduce orphanhood. Although Option B+ would require more financial resources initially, it would save societal resources in the long-term and represents a strategic option to simplify and integrate HIV services into maternal, newborn and child health programmes.

Therapeutic options for management of endometrial hyperplasia

PubMed Central

2016-01-01

Endometrial hyperplasia (EH) comprises a spectrum of changes in the endometrium ranging from a slightly disordered pattern that exaggerates the alterations seen in the late proliferative phase of the menstrual cycle to irregular, hyperchromatic lesions that are similar to endometrioid adenocarcinoma. Generally, EH is caused by continuous exposure of estrogen unopposed by progesterone, polycystic ovary syndrome, tamoxifen, or hormone replacement therapy. Since it can progress, or often occur coincidentally with endometrial carcinoma, EH is of clinical importance, and the reversion of hyperplasia to normal endometrium represents the key conservative treatment for prevention of the development of adenocarcinoma. Presently, cyclic progestin or hysterectomy constitutes the major treatment option for EH without or with atypia, respectively. However, clinical trials of hormonal therapies and definitive standard treatments remain to be established for the management of EH. Moreover, therapeutic options for EH patients who wish to preserve fertility are challenging and require nonsurgical management. Therefore, future studies should focus on evaluation of new treatment strategies and novel compounds that could simultaneously target pathways involved in the pathogenesis of estradiol-induced EH. Novel therapeutic agents precisely targeting the inhibition of estrogen receptor, growth factor receptors, and signal transduction pathways are likely to constitute an optimal approach for treatment of EH. PMID:26463434

Therapeutic options for management of endometrial hyperplasia.

PubMed

Chandra, Vishal; Kim, Jong Joo; Benbrook, Doris Mangiaracina; Dwivedi, Anila; Rai, Rajani

2016-01-01

Endometrial hyperplasia (EH) comprises a spectrum of changes in the endometrium ranging from a slightly disordered pattern that exaggerates the alterations seen in the late proliferative phase of the menstrual cycle to irregular, hyperchromatic lesions that are similar to endometrioid adenocarcinoma. Generally, EH is caused by continuous exposure of estrogen unopposed by progesterone, polycystic ovary syndrome, tamoxifen, or hormone replacement therapy. Since it can progress, or often occur coincidentally with endometrial carcinoma, EH is of clinical importance, and the reversion of hyperplasia to normal endometrium represents the key conservative treatment for prevention of the development of adenocarcinoma. Presently, cyclic progestin or hysterectomy constitutes the major treatment option for EH without or with atypia, respectively. However, clinical trials of hormonal therapies and definitive standard treatments remain to be established for the management of EH. Moreover, therapeutic options for EH patients who wish to preserve fertility are challenging and require nonsurgical management. Therefore, future studies should focus on evaluation of new treatment strategies and novel compounds that could simultaneously target pathways involved in the pathogenesis of estradiol-induced EH. Novel therapeutic agents precisely targeting the inhibition of estrogen receptor, growth factor receptors, and signal transduction pathways are likely to constitute an optimal approach for treatment of EH.

Glottic and supraglottic pT3 squamous cell carcinoma: outcomes with transoral laser microsurgery.

PubMed

Pantazis, Dimitrios; Liapi, Georgia; Kostarelos, Dimitrios; Kyriazis, Georgios; Pantazis, Theodoros-Leonidas; Riga, Maria

2015-08-01

Patients diagnosed with T3 squamous cell laryngeal carcinomas are nowadays offered either organ-preserving surgical or non-surgical treatment, with the optimum approach remaining undefined. No direct comparison of organ-preserving therapeutical options, stratified by anatomical subsites is available in the literature. The aim of this study is to present institutional treatment outcomes for laser-assisted microsurgery (TLM) of laryngeal T3 squamous cell carcinomas and review the relevant literature. Sixty-four consecutive, previously untreated patients were evaluated. Twenty-four supraglottic and 19 glottic patients were treated with TLM and neck dissection, tumor exposure and postoperative upstaging of the tumors through pathology evaluation of the specimens being the only exclusion criteria. Five-year disease-specific survival and organ preservation rates for supraglottic carcinomas were both 91.7 %. The respective values for glottic carcinomas were 63.2 and 73.3 %. TLM-treated T3 supraglottic tumors seem to attribute better outcomes than T3 glottic tumors in terms of recurrence-free survival, organ preservation and local control (p = 0.01, <0.0001 and 0.01, respectively). The results of this study suggest that TLM-treated T3 supraglottic tumors have a good prognosis, substantially better than that of glottic tumors. A literature review, on the other hand, attributes to chemo-radiation-treated T3 supraglottic tumors a considerably poorer prognosis. Further studies of homogenous populations in terms of anatomical subsites are needed in order to reach a consensus regarding treatment of T3 laryngeal tumors.

Iris reconstruction using autologous iris preserved in cold balanced salt solution for 8 hours in iatrogenic total iridodialysis during cataract surgery: a case report.

PubMed

Bang, Seung Pil; Jun, Jong Hwa

2017-04-04

A large iris defect or extensive iridodialysis can be an intractable cause of visual disturbance, photophobia, glare, monocular diplopia, or cosmetic deformity. The implantation of an artificial iris substitute could be an effective option, but this can cause a reduction in endothelial cell density. We succeeded in the anatomical restoration of iris tissue that was totally dialyzed out of the eye, and was preserved in cold balanced salt solution for 8 h. Engrafted iris tissue was maintained within the aqueous humor. A 71-year-old man was referred to our clinic for management of an iatrogenic total iridodialysis. The totally dialyzed iris tissue was immediately preserved in sterile cold balanced salt solution and packed in a sterile biopsy bottle that was surrounded with ice cubes. Under general anesthesia, a pars plana vitrectomy was performed to remove the remaining lens cortex and vitreous fiber anterior to the equator. A sulcus-positioned intraocular lens (IOL) was repositioned and fixed by ab externo scleral sutures. Preserved iris tissue was inserted and ironed using both iris spatula and ocular viscoelastic devices. Five-point ab interno scleral sutures were made 1.0 mm posterior to the limbus. The engrafted iris was successfully maintained for 6 months and did not undergo any atrophic change or depigmentation, which may be caused by primary implantation failure due to a blocked blood supply.

Surgical treatment of hemorrhoids: a critical appraisal of the current options.

PubMed

Cerato, Marlise Mello; Cerato, Nilo Luiz; Passos, Patrícia; Treigue, Alberto; Damin, Daniel C

2014-01-01

Surgical treatment of hemorrhoids is still a dilemma. New techniques have been developed leading to a lower rate of postoperative pain; however, they are associated with a greater likelihood of recurrence. To review current indications as well as the results and complications of the main techniques currently used in the surgical treatment of hemorrhoidal disease. A systematic search of the published data on the options for treatment of hemorrhoids up to December 2012 was conducted using Medline/PubMed, Cochrane, and UpToDate. Currently available surgical treatment options include procedure for prolapse and hemorrhoids (PPH), transanal hemorrhoidal dearterialization (THD), and conventional hemorrhoidectomy techniques. Excisional techniques showed similar results regarding pain, time to return to normal activities, and complication rates. PPH and THD were associated with less postoperative pain and lower complication rates; however, both had higher postoperative recurrence rates. Conventional surgical techniques yield better long-term results. Despite good results in the immediate postoperative period, PPH and THD have not shown consistent long-term favorable results.

Endometriosis: Survey of Current Diagnostic and Therapeutic Options and Latest Research Work

PubMed Central

Juhasz-Böss, I.; Laschke, M. W.; Müller, F.; Rosenbaum, P.; Baum, S.; Solomayer, E. F.; Ulrich, U.

2014-01-01

Endometriosis is one of the most frequent benign diseases in women of child-bearing age. The main symptoms are chronic upper abdominal pain and infertility. However, the aetiology and pathogenesis of endometriosis are as yet insufficiently clarified. Thus, therapy is mainly symptomatic with laparoscopic surgery being the gold standard. The aim of drug therapy is to achieve a hypo-oestrogenic condition. In cases of severe endometriosis and a desire to have children there is often an indication for assisted reproduction. The present article illustrates almost all current aspects on the diagnosis of and therapy of endometriosis. From the clinical viewpoint, emphasis is placed on the rare cases of deeply infiltrating endometriosis that are, however, accompanied with a high morbidity. Current therapeutic options in cases of infertility are also presented in more detail. Furthermore, special attention is paid to the latest research results from both clinical and basic research fields in order to demonstrate our current knowledge on the pathogenesis and, where possible, potentially related therapeutic options. PMID:25221341

Solar pumped laser technology options for space power transmission

NASA Technical Reports Server (NTRS)

Conway, E. J.

1986-01-01

An overview of long-range options for in-space laser power transmission is presented. The focus is on the new technology and research status of solar-pumped lasers and their solar concentration needs. The laser options include gas photodissociation lasers, optically-pumped solid-state lasers, and blackbody-pumped transfer lasers. The paper concludes with a summary of current research thrusts.

Current approach to fertility preservation by embryo cryopreservation

PubMed Central

Bedoschi, Giuliano; Oktay, Kutluk

2013-01-01

The ovaries are susceptible to damage following treatment with gonadotoxic chemotherapy, pelvic radiotherapy, and/or ovarian surgery. Gonadotoxic treatments have also been used in patients with various nonmalignant systemic diseases. Any women of reproductive age with a sufficiently high risk of developing future ovarian failure due to those medical interventions may benefit from embryo cryopreservation though the tools of assessment of such a risk are still not very precise. Furthermore, the risk assessment can be influenced by many other factors such as the delay expected after chemotherapy and the number of children desired in the future. Embryo cryopreservation is an established and most successful method of fertility preservation when there is sufficient time available to perform ovarian stimulation. This publication will review the current state, approach, and indications of embryo cryopreservation for fertility preservation. PMID:23535505

DNA preservation in silk.

PubMed

Liu, Yawen; Zheng, Zhaozhu; Gong, He; Liu, Meng; Guo, Shaozhe; Li, Gang; Wang, Xiaoqin; Kaplan, David L

2017-06-27

The structure of DNA is susceptible to alterations at high temperature and on changing pH, irradiation and exposure to DNase. Options to protect and preserve DNA during storage are important for applications in genetic diagnosis, identity authentication, drug development and bioresearch. In the present study, the stability of total DNA purified from human dermal fibroblast cells, as well as that of plasmid DNA, was studied in silk protein materials. The DNA/silk mixtures were stabilized on filter paper (silk/DNA + filter) or filter paper pre-coated with silk and treated with methanol (silk/DNA + PT-filter) as a route to practical utility. After air-drying and water extraction, 50-70% of the DNA and silk could be retrieved and showed a single band on electrophoretic gels. 6% silk/DNA + PT-filter samples provided improved stability in comparison with 3% silk/DNA + filter samples and DNA + filter samples for DNA preservation, with ∼40% of the band intensity remaining at 37 °C after 40 days and ∼10% after exposure to UV light for 10 hours. Quantitative analysis using the PicoGreen assay confirmed the results. The use of Tris/borate/EDTA (TBE) buffer enhanced the preservation and/or extraction of the DNA. The DNA extracted after storage maintained integrity and function based on serving as a functional template for PCR amplification of the gene for zinc finger protein 750 (ZNF750) and for transgene expression of red fluorescence protein (dsRed) in HEK293 cells. The high molecular weight and high content of a crystalline beta-sheet structure formed on the coated surfaces likely accounted for the preservation effects observed for the silk/DNA + PT-filter samples. Although similar preservation effects were also obtained for lyophilized silk/DNA samples, the rapid and simple processing available with the silk-DNA-filter membrane system makes it appealing for future applications.

Liver graft preservation using perfluorocarbon improves the outcomes of simulated donation after cardiac death liver transplantation in rats.

PubMed

Okumura, Shinya; Uemura, Tadahiro; Zhao, Xiangdong; Masano, Yuki; Tsuruyama, Tatsuaki; Fujimoto, Yasuhiro; Iida, Taku; Yagi, Shintaro; Bezinover, Dmitri; Spiess, Bruce; Kaido, Toshimi; Uemoto, Shinji

2017-09-01

The outcomes of liver transplantation (LT) from donation after cardiac death (DCD) donors remain poor due to severe warm ischemia injury. Perfluorocarbon (PFC) is a novel compound with high oxygen carrying capacity. In the present study, a rat model simulating DCD LT was used, and the impact of improved graft oxygenation provided by PFC addition on liver ischemia/reperfusion injury (IRI) and survival after DCD LT was investigated. Orthotopic liver transplants were performed in male Lewis rats, using DCD liver grafts preserved with cold University of Wisconsin (UW) solution in the control group and preserved with cold oxygenated UW solution with addition of 20% PFC in the PFC group. For experiment I, in a 30-minute donor warm ischemia model, postoperative graft injury was analyzed at 3 and 6 hours after transplantation. For experiment II, in a 50-minute donor warm ischemia model, the postoperative survival was assessed. For experiment I, the levels of serum aspartate aminotransferase, alanine aminotransferase, hyaluronic acid, malondialdehyde, and several inflammatory cytokines were significantly lower in the PFC group. The hepatic expression levels of tumor necrosis factor α and interleukin 6 were significantly lower, and the expression level of heme oxygenase 1 was significantly higher in the PFC group. Histological analysis showed significantly less necrosis and apoptosis in the PFC group. Sinusoidal endothelial cells and microvilli of the bile canaliculi were well preserved in the PFC group. For experiment II, the postoperative survival rate was significantly improved in the PFC group. In conclusion, graft preservation with PFC attenuated liver IRI and improved postoperative survival. This graft preservation protocol might be a new therapeutic option to improve the outcomes of DCD LT. Liver Transplantation 23 1171-1185 2017 AASLD. © 2017 by the American Association for the Study of Liver Diseases.

Current Trends and Future Directions in Data Curation Research and Education

ERIC Educational Resources Information Center

Weber, Nicholas M.; Palmer, Carole L.; Chao, Tiffany C.

2012-01-01

Digital research data have introduced a new set of collection, preservation, and service demands into the tradition of digital librarianship. Consequently, the role of an information professional has evolved to include the activities of data curation. This new field more specifically addresses the needs of stewarding and preserving digital…

Saving Ohio's Historic Neighborhood Schools: A Primer for School Preservation Advocates.

ERIC Educational Resources Information Center

National Trust for Historic Preservation, Washington, DC.

This publication was developed to assist concerned citizens faced with the loss of their neighborhood schools. It recounts a brief history of school reform in Ohio, leading to the current crisis, and suggests strategies advocates for the preservation of their neighborhood schools can use to save their neighborhood assets. Broad issues addressed…

75 FR 66729 - Certain Preserved Mushrooms From the People's Republic of China: Preliminary Results of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-29

... From the People's Republic of China: Preliminary Results of Antidumping Duty New Shipper Reviews AGENCY...: October 29, 2010. SUMMARY: The Department of Commerce (the Department) is currently conducting two new... Preserved Mushrooms from the People's Republic of China: Notice of Initiation of Antidumping Duty New...

41 CFR 102-78.65 - What are Federal agencies' historic preservation responsibilities when disposing of real property...

Code of Federal Regulations, 2012 CFR

2012-01-01

... agencies' historic preservation responsibilities when disposing of real property under their control? 102... real property under their control? Federal agencies must— (a) To the extent practicable, establish and implement alternatives for historic properties, including adaptive use, that are not needed for current or...

41 CFR 102-78.65 - What are Federal agencies' historic preservation responsibilities when disposing of real property...

Code of Federal Regulations, 2013 CFR

2013-07-01

... agencies' historic preservation responsibilities when disposing of real property under their control? 102... real property under their control? Federal agencies must— (a) To the extent practicable, establish and implement alternatives for historic properties, including adaptive use, that are not needed for current or...

41 CFR 102-78.65 - What are Federal agencies' historic preservation responsibilities when disposing of real property...

Code of Federal Regulations, 2014 CFR

2014-01-01

... agencies' historic preservation responsibilities when disposing of real property under their control? 102... real property under their control? Federal agencies must— (a) To the extent practicable, establish and implement alternatives for historic properties, including adaptive use, that are not needed for current or...

41 CFR 102-78.65 - What are Federal agencies' historic preservation responsibilities when disposing of real property...

Code of Federal Regulations, 2011 CFR

2011-01-01

... agencies' historic preservation responsibilities when disposing of real property under their control? 102... real property under their control? Federal agencies must— (a) To the extent practicable, establish and implement alternatives for historic properties, including adaptive use, that are not needed for current or...

41 CFR 102-78.65 - What are Federal agencies' historic preservation responsibilities when disposing of real property...

Code of Federal Regulations, 2010 CFR

2010-07-01

... agencies' historic preservation responsibilities when disposing of real property under their control? 102... real property under their control? Federal agencies must— (a) To the extent practicable, establish and implement alternatives for historic properties, including adaptive use, that are not needed for current or...

[Lesser toe deformities. Definition, pathogenesis, and options for surgical correction].

PubMed

Arnold, H

2005-08-01

Whereas in the past resection arthroplasty was - in analogy to hallux valgus surgery - the preferred therapy to correct lesser toe deformities, the point of view has undergone a change. Much interest is directed toward functional aspects that require reconstructive management. Whenever possible the integrity of joint play should be saved. Above all the metatarsophalangeal joint of the lesser toes is worth being preserved to prevent a severe disturbance of the biomechanics of the foot. Tendon transfers and subtle corrective osteotomies such as the Weil procedure allow restricting resection procedures to contraction deformities.

An infrared modular panoramic imaging objective

NASA Astrophysics Data System (ADS)

Palmer, Troy A.; Alexay, Christopher C.

2004-08-01

We describe the optical and mechanical design of an athermal infrared objective lens with an afocal anamorphic adapter. The lens presented consists of two modules: an athermal 25mm F/2.3 mid-wave IR objective lens and an optional panoramic adapter. The adapter utilizes anamorphic lenses to create unique image control. The result of which enables an independent horizontal wide field of view, while preserving the original narrow vertical field. We have designed, fabricated and tested two such lenses. A summary of the assembly and testing process is also presented.

Options in Extraterrestrial Sample Handling and Study

NASA Technical Reports Server (NTRS)

Papanastassiou, Dimitri A.

2000-01-01

This presentation mentions important service functions such as: sample preservation, hazard assessment, and handling. It also discuss how preliminary examination of samples is necessary for sample hazard assessment and for sample allocations. Clean facilities and clean sample handling are required. Conflicts, cross contamination issues will be present and need to be resolved. Extensive experience is available for extraterrestrial samples and must be sought and applied. Extensive experience is available in studies of pathogenicity and must be sought and applied as necessary. Advisory and oversight structures must also be in place

Expensing options solves nothing.

PubMed

Sahlman, William A

2002-12-01

The use of stock options for executive compensation has become a lightning rod for public anger, and it's easy to see why. Many top executives grew hugely rich on the back of the gains they made on their options, profits they've been able to keep even as the value they were supposed to create disappeared. The supposed scam works like this: Current accounting regulations let companies ignore the cost of option grants on their income statements, so they can award valuable option packages without affecting reported earnings. Not charging the cost of the grants supposedly leads to overstated earnings, which purportedly translate into unrealistically high share prices, permitting top executives to realize big gains when they exercise their options. If an accounting anomaly is the problem, then the solution seems obvious: Write off executive share options against the current year's revenues. The trouble is, Sahlman writes, expensing option grants won't give us a more accurate view of earnings, won't add any information not already included in the financial statements, and won't even lead to equal treatment of different forms of executive pay. Far worse, expensing evades the real issue, which is whether compensation (options and other-wise) does what it's supposed to do--namely, help a company recruit, retain, and provide the right people with appropriate performance incentives. Any performance-based compensation system has the potential to encourage cheating. Only ethical management, sensible governance, adequate internal control systems, and comprehensive disclosure will save the investor from disaster. If, Sahlman warns, we pass laws that require the expensing of options, thinking that's fixed the fundamental flaws in corporate America's accounting, we will have missed a golden opportunity to focus on the much more extensive defects in the present system.

Contamination of organic nutrient sources with potentially toxic elements, antibiotics and pathogen microorganisms in relation to P fertilizer potential and treatment options for the production of sustainable fertilizers: A review.

PubMed

Bloem, E; Albihn, A; Elving, J; Hermann, L; Lehmann, L; Sarvi, M; Schaaf, T; Schick, J; Turtola, E; Ylivainio, K

2017-12-31

Organic nutrient sources such as farmyard manure, sewage sludge, their biogas digestates or other animal by-products can be valuable fertilizers delivering organic matter to the soil. Currently, especially phosphorus (P) is in the focus of research since it is an essential plant nutrient with finite resources, estimated to last only for some more decades. Efficient utilization of organic P sources in agriculture will help to preserve P resources and thereby has the potential to close nutrient cycles and prevent unwanted P-losses to the environment, one of the major causes for eutrophication of water bodies. Unfortunately, organic P sources usually contain also various detrimental substances, such as potentially toxic elements or organic contaminants like pharmaceuticals as well as pathogenic microorganisms. Additionally, the utilization of some of these substrates such as sewage sludge or animal by-products is legally limited in agriculture because of the potential risk to contaminate sites with potentially toxic elements and organic contaminants. Thus, to close nutrient cycles it is important to develop solutions for the responsible use of organic nutrient sources. The aim of this review is to give an overview of the contamination of the most important organic nutrient sources with potentially toxic elements, antibiotics (as one important organic contaminant) and pathogenic microorganisms. Changes in manure and sewage sludge management as well as the increasing trend to use such substrates in biogas plants will be discussed with respect to potential risks posed to soils and water bodies. Some examples for abatement options by which contamination can be reduced to produce P fertilizers with high amounts of plant available P forms are presented. Copyright © 2017 Elsevier B.V. All rights reserved.

Sharing data for public health research by members of an international online diabetes social network.

PubMed

Weitzman, Elissa R; Adida, Ben; Kelemen, Skyler; Mandl, Kenneth D

2011-04-27

Surveillance and response to diabetes may be accelerated through engaging online diabetes social networks (SNs) in consented research. We tested the willingness of an online diabetes community to share data for public health research by providing members with a privacy-preserving social networking software application for rapid temporal-geographic surveillance of glycemic control. SN-mediated collection of cross-sectional, member-reported data from an international online diabetes SN entered into a software application we made available in a "Facebook-like" environment to enable reporting, charting and optional sharing of recent hemoglobin A1c values through a geographic display. Self-enrollment by 17% (n = 1,136) of n = 6,500 active members representing 32 countries and 50 US states. Data were current with 83.1% of most recent A1c values reported obtained within the past 90 days. Sharing was high with 81.4% of users permitting data donation to the community display. 34.1% of users also displayed their A1cs on their SN profile page. Users selecting the most permissive sharing options had a lower average A1c (6.8%) than users not sharing with the community (7.1%, p = .038). 95% of users permitted re-contact. Unadjusted aggregate A1c reported by US users closely resembled aggregate 2007-2008 NHANES estimates (respectively, 6.9% and 6.9%, p = 0.85). Success within an early adopter community demonstrates that online SNs may comprise efficient platforms for bidirectional communication with and data acquisition from disease populations. Advancing this model for cohort and translational science and for use as a complementary surveillance approach will require understanding of inherent selection and publication (sharing) biases in the data and a technology model that supports autonomy, anonymity and privacy.

Low acid producing solid propellants

NASA Technical Reports Server (NTRS)

Bennett, Robert R.

1995-01-01

The potential environmental effects of the exhaust products of conventional rocket propellants have been assessed by various groups. Areas of concern have included stratospheric ozone, acid rain, toxicity, air quality and global warming. Some of the studies which have been performed on this subject have concluded that while the impacts of rocket use are extremely small, there are propellant development options which have the potential to reduce those impacts even further. This paper discusses the various solid propellant options which have been proposed as being more environmentally benign than current systems by reducing HCI emissions. These options include acid neutralized, acid scavenged, and nonchlorine propellants. An assessment of the acid reducing potential and the viability of each of these options is made, based on current information. Such an assessment is needed in order to judge whether the potential improvements justify the expenditures of developing the new propellant systems.

DNA vaccines in veterinary use

PubMed Central

Redding, Laurel; Werner, David B

2015-01-01

DNA vaccines represent a new frontier in vaccine technology. One important application of this technology is in the veterinary arena. DNA vaccines have already gained a foothold in certain fields of veterinary medicine. However, several important questions must be addressed when developing DNA vaccines for animals, including whether or not the vaccine is efficacious and cost effective compared with currently available options. Another important question to consider is how to apply this developing technology in a wide range of different situations, from the domestic pet to individual fish in fisheries with several thousand animals, to wildlife programs for disease control. In some cases, DNA vaccines represent an interesting option for vaccination, while in others, currently available options are sufficient. This review will examine a number of diseases of veterinary importance and the progress being made in DNA vaccine technology relevant to these diseases, and we compare these with the conventional treatment options available. PMID:19722897

Antimicrobial peptides as natural bio-preservative to enhance the shelf-life of food.

PubMed

Rai, Mahendra; Pandit, Raksha; Gaikwad, Swapnil; Kövics, György

2016-09-01

Antimicrobial peptides (AMPs) are diverse group of natural proteins present in animals, plants, insects and bacteria. These peptides are responsible for defense of host from pathogenic organisms. Chemical, enzymatic and recombinant techniques are used for the synthesis of antimicrobial peptides. These peptides have been found to be an alternative to the chemical preservatives. Currently, nisin is the only antimicrobial peptide, which is widely utilized in the preservation of food. Antimicrobial peptides can be used alone or in combination with other antimicrobial, essential oils and polymeric nanoparticles to enhance the shelf-life of food. This review presents an overview on different types of antimicrobial peptides, purification techniques, mode of action and application in food preservation.

Effect of Edge-Preserving Adaptive Image Filter on Low-Contrast Detectability in CT Systems: Application of ROC Analysis

PubMed Central

Okumura, Miwa; Ota, Takamasa; Kainuma, Kazuhisa; Sayre, James W.; McNitt-Gray, Michael; Katada, Kazuhiro

2008-01-01

Objective. For the multislice CT (MSCT) systems with a larger number of detector rows, it is essential to employ dose-reduction techniques. As reported in previous studies, edge-preserving adaptive image filters, which selectively eliminate only the noise elements that are increased when the radiation dose is reduced without affecting the sharpness of images, have been developed. In the present study, we employed receiver operating characteristic (ROC) analysis to assess the effects of the quantum denoising system (QDS), which is an edge-preserving adaptive filter that we have developed, on low-contrast resolution, and to evaluate to what degree the radiation dose can be reduced while maintaining acceptable low-contrast resolution. Materials and Methods. The low-contrast phantoms (Catphan 412) were scanned at various tube current settings, and ROC analysis was then performed for the groups of images obtained with/without the use of QDS at each tube current to determine whether or not a target could be identified. The tube current settings for which the area under the ROC curve (Az value) was approximately 0.7 were determined for both groups of images with/without the use of QDS. Then, the radiation dose reduction ratio when QDS was used was calculated by converting the determined tube current to the radiation dose. Results. The use of the QDS edge-preserving adaptive image filter allowed the radiation dose to be reduced by up to 38%. Conclusion. The QDS was found to be useful for reducing the radiation dose without affecting the low-contrast resolution in MSCT studies. PMID:19043565

Quality of Life and Functional Outcome After Transanal Abdominal Transanal Proctectomy for Low Rectal Cancer

PubMed Central

Marks, John H.; Salem, Jean F.; Valsdottir, Elsa B.; Yarandi, Shadi S.; Marks, Gerald J.

2018-01-01

BACKGROUND Transanal abdominal transanal proctectomy is a sphincter-preserving procedure designed to avoid colostomy in patients with cancer in the distal third of the rectum. Oncologic outcomes of this procedure have been established. However, data regarding patient satisfaction and quality of life are scant. OBJECTIVE The purpose of this study was to evaluate the quality of life and functional outcomes of patients after transanal abdominal transanal proctectomy. DESIGN This is a cross-sectional study. SETTINGS The study was conducted at a tertiary referral colorectal center. PATIENTS Patients who underwent transanal abdominal transanal proctectomy were included and surveyed using the Fecal Incontinence Quality of Life Scale, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30, the Quality of Life Questionnaire CR38 module, and a questionnaire designed by the authors to assess satisfaction with quality of life. MAIN OUTCOME MEASURES Quality of life, functional outcomes, and patient satisfaction were measured and compared by age, tumor level, and stage of the disease. RESULTS A total of 133 surveys were mailed, and 90 patients responded and were included in the study. Patient quality of life was not significantly different after surgery. Patients with more proximal tumors had better lifestyle, physical, and emotional scores. Older patients performed better on multiple levels, including coping, emotional, body image, future perspective, and digestive. Stage of disease had no impact on quality of life. Compared with reference values, patients who underwent transanal abdominal transanal proctectomy performed better on most of the components. All of patients preferred transanal abdominal transanal proctectomy over having a stoma based on their current anal sphincter function, and >97% of patients preferred transanal abdominal transanal proctectomy based on their current quality of life, sexual function, and level of activities. LIMITATIONS This study is limited by the lack of a comparison group and a potential selection bias. CONCLUSIONS Satisfaction with quality of life and functional outcomes is high after transanal abdominal transanal proctectomy. Older patients and those with more proximal tumors performed better. This patient population clearly preferred a sphincter-preserving option for treatment of their rectal cancer. PMID:28177987

Can providing a morning healthy snack help to reduce hunger during school time? Experimental evidence from an elementary school in Connecticut.

PubMed

Castellari, Elena; Berning, Joshua P

2016-11-01

While children may be naturally inclined to regulate their hunger, they are also guided by adults and influenced by environmental constraints regarding when and how much to eat. As such, the timing and availability of meals could alter a child's natural eating habits. This could impact the nutritional quality of what they eat as well. We conducted a field experiment with three fourth grade classes at a public elementary school in Eastern Connecticut to analyze if providing a nutritious snack one hour prior to lunch effects a child's level of hunger and consequently their lunch-time consumption. We found students shift their caloric and nutrient intake from lunch to snack time. In addition, we found a significant reduction in student hunger. Our results highlight the importance in considering the timing and quality of meals provided during school time. In our sample, current snack and lunch schedule may not be optimal and changing it can have an impact on the wellbeing of students. Providing healthful options for snack could be an effective way to improve student diets while preserving their ability to make their own choices. Copyright © 2016 Elsevier Ltd. All rights reserved.

A Survey of Modulation of Gut Microbiota by Dietary Polyphenols

PubMed Central

Dueñas, Montserrat; Muñoz-González, Irene; Cueva, Carolina; Jiménez-Girón, Ana; Sánchez-Patán, Fernando; Santos-Buelga, Celestino; Moreno-Arribas, M. Victoria; Bartolomé, Begoña

2015-01-01

Dietary polyphenols present in a broad range of plant foods have been related to beneficial health effects. This review aims to update the current information about the modulation of the gut microbiota by dietary phenolic compounds, from a perspective based on the experimental approaches used. After referring to general aspects of gut microbiota and dietary polyphenols, studies related to this topic are presented according to their experimental design: batch culture fermentations, gastrointestinal simulators, animal model studies, and human intervention studies. In general, studies evidence that dietary polyphenols may contribute to the maintenance of intestinal health by preserving the gut microbial balance through the stimulation of the growth of beneficial bacteria (i.e., lactobacilli and bifidobacteria) and the inhibition of pathogenic bacteria, exerting prebiotic-like effects. Combination of in vitro and in vivo models could help to understand the underlying mechanisms in the polyphenols-microbiota-host triangle and elucidate the implications of polyphenols on human health. From a technological point of view, supplementation with rich-polyphenolic stuffs (phenolic extracts, phenolic-enriched fractions, etc.) could be an effective option to improve health benefits of functional foods such as the case of dairy fermented foods. PMID:25793210

Treatments for achalasia in 2017: how to choose among them.

PubMed

Kahrilas, Peter J; Pandolfino, John E

2017-07-01

To review recent advances in achalasia diagnostics and therapeutics. The cardinal feature of achalasia, impaired lower esophageal sphincter (LES) relaxation, can occur in association with varied patterns of esophageal contractility. The Chicago Classification distinguishes among these as follows: without contractility (type I), with panesophageal pressurization (type II), with premature (spastic) distal esophageal contractions (type III), or even with preserved peristalsis [esophagogastric junction (EGJ) outlet obstruction]. Physiological testing also reveals achalasia-like syndromes that also benefit from achalasia therapies. Coincident with this has been the development of peroral endoscopic myotomy (POEM), an endoscopic technique for performing an esophageal myotomy. Hence, the option now exists to either selectively ablate the LES (pneumatic dilation, laparoscopic Heller myotomy, or POEM) or to ablate the sphincter and create a myotomy along some or the entire adjacent smooth muscle esophagus (POEM). Each achalasia syndrome has unique treatment considerations; type II achalasia responds well to all therapies, whereas type III responds best to POEM. Emerging data support the concept that optimal management of achalasia is phenotype-specific, guided by high-resolution manometry, and, in some instance, functional luminal imaging probe studies. This opinion article reviews the varied characteristic and treatment considerations of achalasia syndromes as currently understood.

Premature ovarian insufficiency: Pathogenesis and management

PubMed Central

Fenton, Anna J.

2015-01-01

The term premature ovarian insufficiency (POI) describes a continuum of declining ovarian function in a young woman, resulting in an earlier than average menopause. It is a term that reflects the variable nature of the condition and is substantially less emotive than the formerly used “premature ovarian failure” which signaled a single event in time. Contrary to the decline in the age of menarche seen over the last 3-4 decades there has been no similar change in the age of menopause. In developed nations, the average age for cessation of menstrual cycles is 50-52 years. The age is younger among women from developing nations. Much has been written about POI despite a lack of good data on the incidence of this condition. It is believed that 1% of women under the age of 40 years and 0.1% under the age of 30 years will develop POI. Research is increasingly providing information about the pathogenesis and treatments are being developed to better preserve ovarian function during cancer treatment and to improve fertility options. This narrative review summarizes the current literature to provide an approach to best practice management of POI. PMID:26903753

Xenotransplantation as a model for human testicular development.

PubMed

Hutka, Marsida; Smith, Lee B; Mitchell, Rod T

The developing male reproductive system may be sensitive to disruption by a wide range of exogenous 'endocrine disruptors'. In-utero exposure to environmental chemicals and pharmaceuticals have been hypothesized to have an impact in the increasing incidence of male reproductive disorders. The vulnerability to adverse effects as a consequence of such exposures is elevated during a specific 'window of susceptibility' in fetal life referred to as the masculinisation programing window (MPW). Exposures that occur during prepuberty, such as chemotherapy treatment for cancer during childhood, may also affect future fertility. Much of our current knowledge about fetal and early postnatal human testicular development derives from studies conducted in animal models predictive for humans. Therefore, over recent years, testicular transplantation has been employed as a 'direct' approach to understand the development of human fetal and prepubertal testis in health and disease. In this review we describe the potential use of human testis xenotransplantation to study testicular development and its application for (i) assessing the effects of environmental exposures in humans, and (ii) establishing fertility preservation options for prepubertal boys with cancer. Copyright © 2017 International Society of Differentiation. Published by Elsevier B.V. All rights reserved.

Testicular cancer and male infertility.

PubMed

Paduch, Darius A

2006-11-01

Testicular cancer and infertility affect a similar age group of patients and have common biologic, epidemiologic, and environmental backgrounds. In this review, we provide current literature on links between infertility and testicular cancer, and new developments in the management of testicular cancer aimed at improving quality of life in men with testicular cancer. In-utero environmental exposure to endocrine disruptors modulates the genetically determined fate of primitive gonad and results in testicular dysgenesis syndrome, which may result in infertility and testicular cancer. Excellent response of testicular cancer to radiation and chemotherapy results in over 90% of survival and quality of life--fertility and sexual function--is of significant concern to patients and clinicians. The testicular-sparing management of testicular masses emerges as a sound alternative to radical orchiectomy and allows for preservation of spermatogenesis and hormonal function, and at the same time achieving similar survival rates. Secondary malignancies, pulmonary, and cardiovascular complications are recognized as late complications of treatment for testicular cancer. Better understanding of common mechanisms involved in infertility and testicular cancer, and scientifically driven evidence-based treatment options should improve quality of life in young men faced with this potentially life-threatening disease.

CLIPS: The C language integrated production system

NASA Technical Reports Server (NTRS)

Riley, Gary

1994-01-01

Expert systems are computer programs which emulate human expertise in well defined problem domains. The potential payoff from expert systems is high: valuable expertise can be captured and preserved, repetitive and/or mundane tasks requiring human expertise can be automated, and uniformity can be applied in decision making processes. The C Language Integrated Production System (CLIPS) is an expert system building tool, developed at the Johnson Space Center, which provides a complete environment for the development and delivery of rule and/or object based expert systems. CLIPS was specifically designed to provide a low cost option for developing and deploying expert system applications across a wide range of hardware platforms. The commercial potential of CLIPS is vast. Currently, CLIPS is being used by over 5,000 individuals throughout the public and private sector. Because the CLIPS source code is readily available, numerous groups have used CLIPS as the basis for their own expert system tools. To date, three commercially available tools have been derived from CLIPS. In general, the development of CLIPS has helped to improve the ability to deliver expert system technology throughout the public and private sectors for a wide range of applications and diverse computing environments.

A Surgical Perspective on Targeted Therapy of Hepatocellular Carcinoma

PubMed Central

Faltermeier, Claire; Busuttil, Ronald W.; Zarrinpar, Ali

2015-01-01

Hepatocellular carcinoma (HCC), the second leading cause of cancer deaths worldwide, is difficult to treat and highly lethal. Since HCC is predominantly diagnosed in patients with cirrhosis, treatment planning must consider both the severity of liver disease and tumor burden. To minimize the impact to the patient while treating the tumor, techniques have been developed to target HCC. Anatomical targeting by surgical resection or locoregional therapies is generally reserved for patients with preserved liver function and minimal to moderate tumor burden. Patients with decompensated cirrhosis and small tumors are optimal candidates for liver transplantation, which offers the best chance of long-term survival. Yet, only 20%–30% of patients have disease amenable to anatomical targeting. For the majority of patients with advanced HCC, chemotherapy is used to target the tumor biology. Despite these treatment options, the five-year survival of patients in the United States with HCC is only 16%. In this review we provide a comprehensive overview of current approaches to target HCC. We also discuss emerging diagnostic and prognostic biomarkers, novel therapeutic targets identified by recent genomic profiling studies, and potential applications of immunotherapy in the treatment of HCC. PMID:28943622

Angina pectoris: current therapy and future treatment options.

PubMed

Parikh, Raj; Kadowitz, Philip J

2014-02-01

Angina pectoris is the consequence of an inequality between the demand and supply of blood to the heart. Angina manifests itself as chest pain or discomfort and is a common complaint of patients in the hospital and in the clinic. There are, in fact, roughly half a million new cases of angina per year. Chest pain, while having many etiologies, is generally considered to be most lethal when related to a cardiac cause. In this review, the authors outline the current medical and surgical therapies that are used in the management of angina. Highlights of the various clinical trials that have assisted in the investigation of these therapies are summarized also. Then, the authors provide a focused review of the novel therapy options for angina that are currently being explored. From new medical treatments to revised surgical techniques to the discovery of stem cell therapy, many innovative options are being investigated for the treatment of angina.

Transportation: Destination Mars

NASA Technical Reports Server (NTRS)

Eoff, Bill

1998-01-01

As the agency space transportation lead center, Marshall Space Flight Center has been conducting transportation assessments for future robotic and human Mars missions to identify critical technologies. Five human Mars options are currently under assessment with each option including all transportation requirements from Earth to Mars and return. The primary difference for each option is the propulsion source from Earth to Mars. In case any of the options require heavy launch capability that is not currently projected as available, an in-house study has been initiated to determine the most cost effective means of providing such launch capability. This assessment is only considering launch architectures that support the overall human Mars mission cost goal of $25B. The guidelines for the launch capability study included delivery of 80 metric ton (176 KLB) payloads, 25 feet diameter x 92 feet long, to 220 nmi orbits at 28.5 degrees. The launch vehicle concept of the study was designated "Magnum" to differentiate from prior heavy launch vehicle assessments. This assessment along with the assessment of options for all transportation phases of a Mars mission are on-going.

Using the Personal Health Train for Automated and Privacy-Preserving Analytics on Vertically Partitioned Data.

PubMed

van Soest, Johan; Sun, Chang; Mussmann, Ole; Puts, Marco; van den Berg, Bob; Malic, Alexander; van Oppen, Claudia; Towend, David; Dekker, Andre; Dumontier, Michel

2018-01-01

Conventional data mining algorithms are unable to satisfy the current requirements on analyzing big data in some fields such as medicine, policy making, judicial, and tax records. However, applying diverse datasets from different institutes (both healthcare and non-healthcare related) can enrich information and insights. So far, analyzing this data in an automated, privacy-preserving manner does not exist to our knowledge. In this work, we propose an infrastructure, and proof-of-concept for privacy-preserving analytics on vertically partitioned data.

National Intelligent Transportation Systems Program Plan: Five-Year Horizon

DOT National Transportation Integrated Search

2013-06-01

This white paper is a follow-up to the Volpe Center report for FHWA, Ridesharing Options Analysis and Practitioners Toolkit. The white paper provides an update to current ridesharing options and further explores technology and policy develop...

Toxin-Based Drug May Be New Option for Rare Leukemia

Cancer.gov

In patients with hairy cell leukemia, the toxin-based treatment moxetumomab pasudotox may be an effective new treatment option. As this Cancer Currents post explains, the drug looked to be highly effective in a large clinical trial.

Age correction in monitoring audiometry: method to update OSHA age-correction tables to include older workers

PubMed Central

Dobie, Robert A; Wojcik, Nancy C

2015-01-01

Objectives The US Occupational Safety and Health Administration (OSHA) Noise Standard provides the option for employers to apply age corrections to employee audiograms to consider the contribution of ageing when determining whether a standard threshold shift has occurred. Current OSHA age-correction tables are based on 40-year-old data, with small samples and an upper age limit of 60 years. By comparison, recent data (1999–2006) show that hearing thresholds in the US population have improved. Because hearing thresholds have improved, and because older people are increasingly represented in noisy occupations, the OSHA tables no longer represent the current US workforce. This paper presents 2 options for updating the age-correction tables and extending values to age 75 years using recent population-based hearing survey data from the US National Health and Nutrition Examination Survey (NHANES). Both options provide scientifically derived age-correction values that can be easily adopted by OSHA to expand their regulatory guidance to include older workers. Methods Regression analysis was used to derive new age-correction values using audiometric data from the 1999–2006 US NHANES. Using the NHANES median, better-ear thresholds fit to simple polynomial equations, new age-correction values were generated for both men and women for ages 20–75 years. Results The new age-correction values are presented as 2 options. The preferred option is to replace the current OSHA tables with the values derived from the NHANES median better-ear thresholds for ages 20–75 years. The alternative option is to retain the current OSHA age-correction values up to age 60 years and use the NHANES-based values for ages 61–75 years. Conclusions Recent NHANES data offer a simple solution to the need for updated, population-based, age-correction tables for OSHA. The options presented here provide scientifically valid and relevant age-correction values which can be easily adopted by OSHA to expand their regulatory guidance to include older workers. PMID:26169804

Age correction in monitoring audiometry: method to update OSHA age-correction tables to include older workers.

PubMed

Dobie, Robert A; Wojcik, Nancy C

2015-07-13

The US Occupational Safety and Health Administration (OSHA) Noise Standard provides the option for employers to apply age corrections to employee audiograms to consider the contribution of ageing when determining whether a standard threshold shift has occurred. Current OSHA age-correction tables are based on 40-year-old data, with small samples and an upper age limit of 60 years. By comparison, recent data (1999-2006) show that hearing thresholds in the US population have improved. Because hearing thresholds have improved, and because older people are increasingly represented in noisy occupations, the OSHA tables no longer represent the current US workforce. This paper presents 2 options for updating the age-correction tables and extending values to age 75 years using recent population-based hearing survey data from the US National Health and Nutrition Examination Survey (NHANES). Both options provide scientifically derived age-correction values that can be easily adopted by OSHA to expand their regulatory guidance to include older workers. Regression analysis was used to derive new age-correction values using audiometric data from the 1999-2006 US NHANES. Using the NHANES median, better-ear thresholds fit to simple polynomial equations, new age-correction values were generated for both men and women for ages 20-75 years. The new age-correction values are presented as 2 options. The preferred option is to replace the current OSHA tables with the values derived from the NHANES median better-ear thresholds for ages 20-75 years. The alternative option is to retain the current OSHA age-correction values up to age 60 years and use the NHANES-based values for ages 61-75 years. Recent NHANES data offer a simple solution to the need for updated, population-based, age-correction tables for OSHA. The options presented here provide scientifically valid and relevant age-correction values which can be easily adopted by OSHA to expand their regulatory guidance to include older workers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Preservation of cardiac function by prolonged action potentials in mice deficient of KChIP2.

PubMed

Grubb, Søren; Aistrup, Gary L; Koivumäki, Jussi T; Speerschneider, Tobias; Gottlieb, Lisa A; Mutsaers, Nancy A M; Olesen, Søren-Peter; Calloe, Kirstine; Thomsen, Morten B

2015-08-01

Inherited ion channelopathies and electrical remodeling in heart disease alter the cardiac action potential with important consequences for excitation-contraction coupling. Potassium channel-interacting protein 2 (KChIP2) is reduced in heart failure and interacts under physiological conditions with both Kv4 to conduct the fast-recovering transient outward K(+) current (Ito,f) and with CaV1.2 to mediate the inward L-type Ca(2+) current (ICa,L). Anesthetized KChIP2(-/-) mice have normal cardiac contraction despite the lower ICa,L, and we hypothesized that the delayed repolarization could contribute to the preservation of contractile function. Detailed analysis of current kinetics shows that only ICa,L density is reduced, and immunoblots demonstrate unaltered CaV1.2 and CaVβ₂ protein levels. Computer modeling suggests that delayed repolarization would prolong the period of Ca(2+) entry into the cell, thereby augmenting Ca(2+)-induced Ca(2+) release. Ca(2+) transients in disaggregated KChIP2(-/-) cardiomyocytes are indeed comparable to wild-type transients, corroborating the preserved contractile function and suggesting that the compensatory mechanism lies in the Ca(2+)-induced Ca(2+) release event. We next functionally probed dyad structure, ryanodine receptor Ca(2+) sensitivity, and sarcoplasmic reticulum Ca(2+) load and found that increased temporal synchronicity of the Ca(2+) release in KChIP2(-/-) cardiomyocytes may reflect improved dyad structure aiding the compensatory mechanisms in preserving cardiac contractile force. Thus the bimodal effect of KChIP2 on Ito,f and ICa,L constitutes an important regulatory effect of KChIP2 on cardiac contractility, and we conclude that delayed repolarization and improved dyad structure function together to preserve cardiac contraction in KChIP2(-/-) mice. Copyright © 2015 the American Physiological Society.

CCA retention and its effects on the bonding performance of decommissioned treated wood: a preliminary study

Treesearch

Cheng Piao; Todd F. Shupe; Mark Gibson; Chung Y. Hse

2009-01-01

Chromated copper arsenate (CCA) continues to be widely used as a wood preservative for industrial uses in the U.S. Disposal of treated wood is a potential long-term environmental liability. Current practices for disposing of decommissioned preservative-treated wood include landfilling and incineration, which are increasingly impractical due to environmental...

Raw diffraction data preservation and reuse: Overview, update on practicalities and metadata requirements

DOE PAGES

Kroon-Batenburg, Loes M. J.; Helliwell, John R.; McMahon, Brian; ...

2017-01-01

A topical review is presented of the rapidly developing interest in and storage options for the preservation and reuse of raw data within the scientific domain of the IUCr and its Commissions, each of which operates within a great diversity of instrumentation. A résumé is included of the case for raw diffraction data deposition. An overall context is set by highlighting the initiatives of science policy makers towards an `Open Science' model within which crystallographers will increasingly work in the future; this will bring new funding opportunities but also new codes of procedure within open science frameworks. Skills education andmore » training for crystallographers will need to be expanded. Overall, there are now the means and the organization for the preservation of raw crystallographic diffraction dataviadifferent types of archive, such as at universities, discipline-specific repositories (Integrated Resource for Reproducibility in Macromolecular Crystallography, Structural Biology Data Grid), general public data repositories (Zenodo, ResearchGate) and centralized neutron and X-ray facilities. Formulation of improved metadata descriptors for the raw data types of each of the IUCr Commissions is in progress; some detailed examples are provided. Lastly, a number of specific case studies are presented, including an example research thread that provides complete open access to raw data.« less

Raw diffraction data preservation and reuse: overview, update on practicalities and metadata requirements

PubMed Central

Kroon-Batenburg, Loes M. J.

2017-01-01

A topical review is presented of the rapidly developing interest in and storage options for the preservation and reuse of raw data within the scientific domain of the IUCr and its Commissions, each of which operates within a great diversity of instrumentation. A résumé is included of the case for raw diffraction data deposition. An overall context is set by highlighting the initiatives of science policy makers towards an ‘Open Science’ model within which crystallographers will increasingly work in the future; this will bring new funding opportunities but also new codes of procedure within open science frameworks. Skills education and training for crystallographers will need to be expanded. Overall, there are now the means and the organization for the preservation of raw crystallographic diffraction data via different types of archive, such as at universities, discipline-specific repositories (Integrated Resource for Reproducibility in Macromol­ecular Crystallography, Structural Biology Data Grid), general public data repositories (Zenodo, ResearchGate) and centralized neutron and X-ray facilities. Formulation of improved metadata descriptors for the raw data types of each of the IUCr Commissions is in progress; some detailed examples are provided. A number of specific case studies are presented, including an example research thread that provides complete open access to raw data. PMID:28250944

Raw diffraction data preservation and reuse: Overview, update on practicalities and metadata requirements

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

Kroon-Batenburg, Loes M. J.; Helliwell, John R.; McMahon, Brian

A topical review is presented of the rapidly developing interest in and storage options for the preservation and reuse of raw data within the scientific domain of the IUCr and its Commissions, each of which operates within a great diversity of instrumentation. A résumé is included of the case for raw diffraction data deposition. An overall context is set by highlighting the initiatives of science policy makers towards an `Open Science' model within which crystallographers will increasingly work in the future; this will bring new funding opportunities but also new codes of procedure within open science frameworks. Skills education andmore » training for crystallographers will need to be expanded. Overall, there are now the means and the organization for the preservation of raw crystallographic diffraction dataviadifferent types of archive, such as at universities, discipline-specific repositories (Integrated Resource for Reproducibility in Macromolecular Crystallography, Structural Biology Data Grid), general public data repositories (Zenodo, ResearchGate) and centralized neutron and X-ray facilities. Formulation of improved metadata descriptors for the raw data types of each of the IUCr Commissions is in progress; some detailed examples are provided. Lastly, a number of specific case studies are presented, including an example research thread that provides complete open access to raw data.« less

Update on fertility preservation in young women undergoing breast cancer and ovarian cancer therapy.

PubMed

Lambertini, Matteo; Ginsburg, Elizabeth S; Partridge, Ann H

2015-02-01

The purpose of the article is to review the available options for fertility preservation in patients with breast and ovarian cancer, and the special issues faced by BRCA mutation carriers. Future fertility is an important consideration for many young patients with cancer. There are both experimental and standard available strategies for patients with breast and ovarian cancer to preserve fertility, and each has potential advantages and disadvantages. Embryo cryopreservation is widely available with a highly successful track record. Improvements in laboratory techniques have led to oocyte cryopreservation recently being recategorized as nonexperimental. Conservative gynecologic surgery is a standard consideration for patients with stage I ovarian cancer who desire future fertility. Ovarian tissue cryopreservation as well as ovarian suppression with luteinizing hormone-releasing hormone analogs during chemotherapy are considered experimental methods at this time, although recent data suggest both safety and efficacy for the use of luteinizing hormone-releasing hormone analogs in women receiving (neo)adjuvant chemotherapy for breast cancer. Special issues should be considered for women with BRCA mutations because of the need to undergo preventive surgery at young age. Multidisciplinary teams and well functioning relationships between the oncology and reproductive units are crucial to manage the fertility issues of young women with cancer.

Does thimerosal or other mercury exposure increase the risk for autism? A review of current literature.

PubMed

Schultz, Stephen T

2010-01-01

This report reviews current literature regarding the association of the pharmaceutical preservative thimerosal and other mercury exposures with the risk for autism. The evidence presented here does not support a causal association between autism and mercury exposure from the preservative thimerosal. The risk for autism from other mercury exposures such as from dental amalgam restorations or environmental mercury release into the atmosphere is ambiguous. Since mercury is a known neurotoxin, more research should be done to ensure that mercury exposure from any source does not contribute to autism.

Safety and usefulness of cryopreservation of ovarian tissue to preserve fertility: a 12-year retrospective analysis.

PubMed

Imbert, R; Moffa, F; Tsepelidis, S; Simon, P; Delbaere, A; Devreker, F; Dechene, J; Ferster, A; Veys, I; Fastrez, M; Englert, Y; Demeestere, I

2014-09-01

Do the benefits of ovarian tissue cryopreservation outweigh the risks for patients seeking to preserve fertility before gonadotoxic treatment in various indications? In >90% of the patients undergoing cryopreservation of ovarian tissue, oncological treatment was associated with a reduced ovarian reserve and in 30% of patients, premature ovarian failure (POF) occurred within 5 years. Ovarian tissue cryopreservation is an effective fertility preservation option, especially for pre-pubertal patients and patients who have a short time between diagnosis of a disease and gonadotoxic treatment. This study retrospectively analysed ovarian function and fertility recovery rates, as well as ovarian tissue characteristics, of patients who underwent ovarian tissue cryopreservation at Erasme Hospital between 1999 and 2011. A total of 225 patients referred from 15 Belgian oncological units underwent cryopreservation of ovarian tissue before gonadotoxic therapy for malignant or benign diseases. There were 28 patients (12.4%) who died during follow-up due to recurrence of disease. One severe adverse event occurred during anaesthesia for ovarian tissue collection, leading to the death of the patient. Ovarian function and fertility outcomes were available for 114 patients including 13 girls who were pre-pubertal at the time of the procedure. Eight patients had undergone ovarian tissue transplantation in order to restore their fertility after remission of the disease. Breast cancer and haematological disease were the most frequent indications for ovarian tissue cryopreservation. Overall, 90% of post-pubertal patients were diagnosed with poor ovarian reserve (AMH < 0.5 ng/ml) after a mean of 50 months of follow-up (11-125 months), including 30% with POF (FSH > 40 IU/ml). Breast cancer patients had a lower rate of POF than did post-pubertal patients with haematological diseases (11 versus 34.5%, respectively), despite the older age (mean 31 versus 23.5 years old, respectively) of the breast cancer patients. Ovarian function returned in 71 post-pubertal patients without the need for grafts of cryopreserved tissue. Spontaneous pregnancies were reported for 33 of them, leading to 34 live births. Among the 13 pre-pubertal patients who reached pubertal age during the follow-up, 10 had POF. Eight patients received cryopreserved ovarian grafts to reverse POF and three of them have already become pregnant. This study is a retrospective analysis. The cohort was not compared with a control group of patients who did not undergo the procedure. After careful evaluation of the surgical risks, ovarian tissue cryopreservation can be proposed as an efficient option to preserve the fertility of children and young adults facing gonadotoxic therapies. However, alternative procedures such as oocyte or embryo cryopreservation should be considered as first options especially for older patients or if there is high risk of neoplastic cells within the ovaries. This study was supported by the Télévie, FNRS-FRSM and Fondation Belge contre le cancer. There are no competing interests to report. © The Author 2014. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Carbon tax and greenhouse gas control : options and considerations for Congress

DOT National Transportation Integrated Search

2009-02-23

This report prepared by the Congressional Research Service discusses the current policy tools available for use in bridging the gap between a carbon tax and a cap-and-trade program, implementation issues and options for revenue distribution.

The origins of options.

PubMed

Smaldino, Paul E; Richerson, Peter J

2012-01-01

Most research on decision making has focused on how human or animal decision makers choose between two or more options, posed in advance by the researchers. The mechanisms by which options are generated for most decisions, however, are not well understood. Models of sequential search have examined the trade-off between continued exploration and choosing one's current best option, but still cannot explain the processes by which new options are generated. We argue that understanding the origins of options is a crucial but untapped area for decision making research. We explore a number of factors which influence the generation of options, which fall broadly into two categories: psycho-biological and socio-cultural. The former category includes factors such as perceptual biases and associative memory networks. The latter category relies on the incredible human capacity for culture and social learning, which doubtless shape not only our choices but the options available for choice. Our intention is to start a discussion that brings us closer toward understanding the origins of options.

The Origins of Options

PubMed Central

Smaldino, Paul E.; Richerson, Peter J.

2012-01-01

Most research on decision making has focused on how human or animal decision makers choose between two or more options, posed in advance by the researchers. The mechanisms by which options are generated for most decisions, however, are not well understood. Models of sequential search have examined the trade-off between continued exploration and choosing one’s current best option, but still cannot explain the processes by which new options are generated. We argue that understanding the origins of options is a crucial but untapped area for decision making research. We explore a number of factors which influence the generation of options, which fall broadly into two categories: psycho-biological and socio-cultural. The former category includes factors such as perceptual biases and associative memory networks. The latter category relies on the incredible human capacity for culture and social learning, which doubtless shape not only our choices but the options available for choice. Our intention is to start a discussion that brings us closer toward understanding the origins of options. PMID:22514515

Endoscopic Management of Upper Urinary Tract Urothelial Carcinoma.

PubMed

Samson, Patrick; Smith, Arthur D; Hoenig, David; Okeke, Zeph

2018-05-01

Endoscopic management of upper tract urothelial carcinoma has become more popular over the last few decades as there has been an impetus for renal preservation in these patients. While radical nephroureterectomy has been the gold standard in treatment of this disease, ureteroscopic and percutaneous management has become a viable option for select patients. The literature on endoscopic management of upper urinary tract tumors was explored. Different management methods are discussed, both from published literature and experience of the authors of this chapter. We review the indications, details of the procedure, and troubleshooting methods in the endoscopic management of upper tract urothelial carcinoma. Imperative indications as well as controversial indications are discussed. The role and efficacy of adjuvant intrarenal topical agents are examined as well as the protocol for administering these agents. Follow-up protocols are also reviewed. In select patients, endoscopic management with ureteroscopy and/or percutaneous resection of upper tract urothelial tumors is appropriate and can preserve renal function while obtaining comparable oncologic control compared with radical surgery.

Ideal Internal Carotid Artery Trapping Technique without Bypass in a Patient with Insufficient Collateral Flow.

PubMed

Chung, Joon Ho; Shin, Yong Sam; Lim, Yong Cheol; Park, Minjung

2009-04-01

Internal carotid artery (ICA) trapping can be used for treating intracranial giant aneurysm, blood blister-like aneurysms and ICA rupture during the surgery. We present a novel ICA trapping technique which can be used with insufficient collaterals flow via anterior communicating artery (AcoA) and posterior communicating artery (PcoA). A patient was admitted with severe headache and the cerebral angiography demonstrated a typical blood blister-like aneurysm at the contralateral side of PcoA. For trapping the aneurysm, the first clip was placed at the ICA just proximal to the aneurysm whereas the distal clip was placed obliquely proximal to the origin of the PcoA to preserve blood flow from the PcoA to the distal ICA. The patient was completely recovered with good collaterals filling to the right ICA territories via AcoA and PcoA. This technique may be an effective treatment option for trapping the aneurysm, especially when the PcoA preservation is mandatory.

Work, exercise, and space flight. 3: Exercise devices and protocols

NASA Technical Reports Server (NTRS)

Thornton, William

1989-01-01

Preservation of locomotor capacity by earth equivalent, exercise in space is the crucial component of inflight exercise. At this time the treadmill appears to be the only way possible to do this. Work is underway on appropriate hardware but this and a proposed protocol to reduce exercise time must be tested. Such exercise will preserve muscle, bone Ca(++) and cardiovascular-respiratory capacity. In addition, reasonable upper body exercise can be supplied by a new force generator/measurement system-optional exercise might include a rowing machine and bicycle ergometer. A subject centered monitoring-evaluation program will allow real time adjustments as required. Absolute protection for any astronaut will not be possible and those with hypertrophied capacities such as marathoners or weight lifters will suffer significant loss. However, the program described should return the crew to earth with adequate capacity of typical activity on earth including immediate ambulation and minimal recovery time and without permanent change. An understanding of the practical mechanics and biomechanics involved is essential to a solution of the problem.

Self-preserving cosmetics.

PubMed

Varvaresou, A; Papageorgiou, S; Tsirivas, E; Protopapa, E; Kintziou, H; Kefala, V; Demetzos, C

2009-06-01

Preservatives are added to products for two reasons: first, to prevent microbial spoilage and therefore to prolong the shelf life of the product; second, to protect the consumer from a potential infection. Although chemical preservatives prevent microbial growth, their safety is questioned by a growing segment of consumers. Therefore, there is a considerable interest in the development of preservative-free or self-preserving cosmetics. In these formulations traditional/chemical preservatives have been replaced by other cosmetic ingredients with antimicrobial properties that are not legislated as preservatives according to the Annex VI of the Commission Directive 76/768/EEC and the amending directives (2003/15/EC, 2007/17/EC and 2007/22/EC). 'Hurdle Technology', a technology that has been used for the control of product safety in the food industry since 1970s, has also been applied for the production of self-preserving cosmetics. 'Hurdle Technology' is a term used to describe the intelligent combination of different preservation factors or hurdles to deteriorate the growth of microorganisms. Adherence to current good manufacturing practice, appropriate packaging, careful choice of the form of the emulsion, low water activity and low or high pH values are significant variables for the control of microbial growth in cosmetic formulations. This paper describes the application of the basic principles of 'Hurdle Technology' in the production of self-preserving cosmetics. Multifunctional antimicrobial ingredients and plant-derived essential oils and extracts that are used as alternative or natural preservatives and are not listed in Annex VI of the Cosmetic Directive are also reported.

Environmental impact assessment of Gonabad municipal waste landfill site using Leopold Matrix

PubMed Central

Sajjadi, Seyed Ali; Aliakbari, Zohreh; Matlabi, Mohammad; Biglari, Hamed; Rasouli, Seyedeh Samira

2017-01-01

Introduction An environmental impact assessment (EIA) before embarking on any project is a useful tool to reduce the potential effects of each project, including landfill, if possible. The main objective of this study was to assess the environmental impact of the current municipal solid waste disposal site of Gonabad by using the Iranian Leopold matrix method. Methods This cross-sectional study was conducted to assess the environmental impacts of a landfill site in Gonabad in 2015 by an Iranian matrix (modified Leopold matrix). This study was conducted based on field visits of the landfill, and collected information from various sources and analyzing and comparing between five available options, including the continuation of the current disposal practices, construction of new sanitary landfills, recycling plans, composting, and incineration plants was examined. The best option was proposed to replace the existing landfill. Results The current approach has a score of 2.35, the construction of new sanitary landfill has a score of 1.59, a score of 1.57 for the compost plant, and recycling and incineration plant, respectively, have scores of 1.68 and 2.3. Conclusion Results showed that continuation of the current method of disposal, due to severe environmental damage and health problems, is rejected. A compost plant with the lowest negative score is the best option for the waste disposal site of Gonabad City and has priority over the other four options. PMID:28465797

Environmental impact assessment of Gonabad municipal waste landfill site using Leopold Matrix.

PubMed

Sajjadi, Seyed Ali; Aliakbari, Zohreh; Matlabi, Mohammad; Biglari, Hamed; Rasouli, Seyedeh Samira

2017-02-01

An environmental impact assessment (EIA) before embarking on any project is a useful tool to reduce the potential effects of each project, including landfill, if possible. The main objective of this study was to assess the environmental impact of the current municipal solid waste disposal site of Gonabad by using the Iranian Leopold matrix method. This cross-sectional study was conducted to assess the environmental impacts of a landfill site in Gonabad in 2015 by an Iranian matrix (modified Leopold matrix). This study was conducted based on field visits of the landfill, and collected information from various sources and analyzing and comparing between five available options, including the continuation of the current disposal practices, construction of new sanitary landfills, recycling plans, composting, and incineration plants was examined. The best option was proposed to replace the existing landfill. The current approach has a score of 2.35, the construction of new sanitary landfill has a score of 1.59, a score of 1.57 for the compost plant, and recycling and incineration plant, respectively, have scores of 1.68 and 2.3. Results showed that continuation of the current method of disposal, due to severe environmental damage and health problems, is rejected. A compost plant with the lowest negative score is the best option for the waste disposal site of Gonabad City and has priority over the other four options.

Treatment options for demodex blepharitis: patient choice and efficacy.

PubMed

Hirsch-Hoffmann, S; Kaufmann, C; Bänninger, P B; Thiel, M A

2015-04-01

Demodex mites are microscopic parasites that live around hair follicles or sebaceous glands and may cause chronic blepharitis. The aim of this outcome analysis was to assess the efficacy and patient preferences with regard to the currently recommended treatment options. All patients with microscopic evidence for Demodex blepharitis were informed about the currently published treatments and instructed about daily lid hygiene. Additional topical treatment options included tea tree oil (TTO) 5%, a cleansing foam containing 0.02% TTO (Naviblef®), and metronidazole 2% ointment. Systemic treatment options included oral ivermectin 6 mg on day 1 and 14 and metronidazole 500 mg twice daily for 10 days. All patients were reviewed after 2 months for symptoms and for a mite count on 10 epilated lashes. Ninety-four of 96 patients with Demodex blepharitis opted for an additional treatment. The mean mite count after 2 months of treatment were 13.3 with 5% TTO (n=6), 12.0 with 0.02% TTO (n=38), 9.4 with metronidazole ointment (n=5), 12.8 with ivermectin (n=27) and 22.0 with oral metronidazole (n=5). While there are several published treatment options available, none of these options seem to be clearly effective in Demodex blepharitis. Georg Thieme Verlag KG Stuttgart · New York.

Fertility preservation and cancer: Challenges for adolescent and young adult patients

PubMed Central

Benedict, Catherine; Thom, Bridgette; Kelvin, Joanne

2016-01-01

Purpose of review With increasing survival rates, fertility is an important quality of life concern for many young cancer patients. There is a critical need for improvements in clinical care to ensure patients are well informed about infertility risks and fertility preservation (FP) options and to support them in their reproductive decision-making prior to treatment. Recent findings A number of barriers prevent fertility from being adequately addressed in the clinical context. Providers’ and patients’ incomplete or inaccurate understanding of infertility risks exacerbate patients’ reproductive concerns. For female patients in particular, making decisions about FP before treatment often leads to decision conflict, reducing the likelihood of making informed, values-based decisions, and post-treatment regret and distress. Recent empirically-based interventions to improve provider training around fertility issues and to support patient decision-making about FP show promise. Summary Providers should be knowledgeable about the infertility risks associated with cancer therapies and proactively address fertility with all patients who might one day wish to have a child. Comprehensive counseling should also include related issues such as contraceptive use and health implications of early menopause, regardless of desire for future children. Although the negative psychosocial impact of cancer-related infertility is now well accepted, limited work has been done to explore how to improve clinical management of fertility issues in the context of cancer care. Evidence-based interventions should be developed to address barriers and provide psychosocial and decision-making support to patients who are concerned about their fertility and interested in FP options. PMID:26730794

The Human Oocyte Preservation Experience (HOPE) a phase IV, prospective, multicenter, observational oocyte cryopreservation registry.

PubMed

Ezcurra, Diego; Rangnow, Jennifer; Craig, Maryellen; Schertz, Joan

2009-05-27

It has been recommended by the American Society of Clinical Oncology and the American Society of Reproductive Medicine that options to preserve fertility be presented at the outset of treatment for cancer. This recommendation may have arisen, in part, to the increasing survival of patients with cancer and the realization that certain forms of cancer treatment can lead to infertility. One option for these patients, particularly those with ethical or religious objections to freezing embryos is oocyte cryopreservation. However universal acceptance of these procedures has yet to be established, most likely due to a poor history of success and concerns that there has yet to be a comprehensive approach to evaluating these techniques. In light of this, a registry of patients undergoing oocyte cryopreservation, called the HOPE registry, is being implemented. The intent of the HOPE Registry is to enroll approximately 400 women of reproductive age who will undergo thawing/warming of oocytes and subsequent transfer. Data from the patients enrolled will be collected via a uniform, standardized form and will document important parameters such as demographics, laboratory procedures and outcomes, including following the outcomes of babies born for one year after birth. The results of the registry will be published on a yearly basis. A patient registry has been established in order to systematically document the techniques and outcomes of oocyte cryopreservation procedures. The results will be published in order to provide a widely accessible resource that will allow patients who are considering these procedures validated information in order to make informed decisions as to how their treatment will proceed.

[Management of penile cancer patients: new aspects of a rare tumour entity].

PubMed

Roiner, M; Maurer, O; Lebentrau, S; Gilfrich, C; Schäfer, C; Haberl, C; Brookman-May, S D; Burger, M; May, M; Hakenberg, O W

2018-06-01

Over the past few decades, some principles in the treatment of penile cancer have changed fundamentally. While 15 years ago a negative surgical margin of at least 2 cm was considered mandatory, organ-sparing surgery permitting minimal negative surgical margins has a high priority nowadays. The current treatment principle requires as much organ preservation as possible and as much radicality as necessary. The implementation of organ-sparing and reconstructive surgical techniques has improved the quality of life of surviving patients. However, oncological and functional outcomes are still unsatisfactory. Alongside with adequate local treatment of the primary tumour, a consistent management of inguinal lymph nodes is of fundamental prognostic significance. In particular, clinically inconspicuous inguinal lymph nodes staged T1b and upwards need a surgical approach. Sentinel node biopsy, minimally-invasive surgical techniques and modified inguinal lymphadenectomy have reduced morbidity compared to conventional inguinal lymph node dissection. Multimodal treatment with surgery and chemotherapy is required in all patients with lymph node-positive disease; neoadjuvant chemotherapy has been established for patients with locally advanced lymph node disease, and adjuvant treatment after radical inguinal lymphadenectomy for lymph node-positive disease. An increasing understanding of the underlying tumour biology, in particular the role of the human papilloma virus (HPV) and epidermal growth factor receptor (EGFR) status, has led to a new pathological classification and may further enhance treatment options. This review summarises current aspects in the therapeutic management of penile cancer. © Georg Thieme Verlag KG Stuttgart · New York.

Combined Transcranial Direct Current Stimulation and Virtual Reality-Based Paradigm for Upper Limb Rehabilitation in Individuals with Restricted Movements. A Feasibility Study with a Chronic Stroke Survivor with Severe Hemiparesis.

PubMed

Fuentes, María Antonia; Borrego, Adrián; Latorre, Jorge; Colomer, Carolina; Alcañiz, Mariano; Sánchez-Ledesma, María José; Noé, Enrique; Llorens, Roberto

2018-04-02

Impairments of the upper limb function are a major cause of disability and rehabilitation. Most of the available therapeutic options are based on active exercises and on motor and attentional inclusion of the affected arm in task oriented movements. However, active movements may not be possible after severe impairment of the upper limbs. Different techniques, such as mirror therapy, motor imagery, and non-invasive brain stimulation have been shown to elicit cortical activity in absence of movements, which could be used to preserve the available neural circuits and promote motor learning. We present a virtual reality-based paradigm for upper limb rehabilitation that allows for interaction of individuals with restricted movements from active responses triggered when they attempt to perform a movement. The experimental system also provides multisensory stimulation in the visual, auditory, and tactile channels, and transcranial direct current stimulation coherent to the observed movements. A feasibility study with a chronic stroke survivor with severe hemiparesis who seemed to reach a rehabilitation plateau after two years of its inclusion in a physical therapy program showed clinically meaningful improvement of the upper limb function after the experimental intervention and maintenance of gains in both the body function and activity. The experimental intervention also was reported to be usable and motivating. Although very preliminary, these results could highlight the potential of this intervention to promote functional recovery in severe impairments of the upper limb.

Incretin Therapy – Present and Future

PubMed Central

Garber, Alan J.

2011-01-01

Although newer treatments for type 2 diabetes (T2D) patients have produced continual improvements in outcome, a large and growing population with prediabetes remains under-treated. In the last few years, incretin-based therapies have become an important treatment option for patients with T2D. There are two classes of incretin agents: the dipeptidyl peptidase-4 (DPP-4) inhibitors and the glucagon like peptide 1 (GLP-1) receptor agonists. The ultimate goal of agents within both of these classes is to increase GLP-1 signaling, which results in augmented glucose-induced insulin secretion, inhibition of glucagon secretion, and decreased appetite. This should result in improved regulation of glucose homeostasis. GLP-1 receptor agonists enable patients to achieve significant weight loss. In contrast, DPP-4 inhibitors result in a less dramatic increase in GLP-1 levels; therefore, they are weight neutral. Incretin therapies are currently recommended for use early in the treatment algorithm for T2D patients whose disease is not manageable by diet and exercise alone, but the potential for these agents may be farther reaching. Current studies are evaluating the potential benefits of combining incretin therapies with basal insulin to provide continuous glucose control before and after meals. In addition, these agents may be promising for patients with prediabetes since they effectively reduce glycosylated hemoglobin levels and fasting plasma glucose levels, enable weight control, and have the potential to preserve β-cell function. Clearly, all of these properties are desirable for patients with prediabetes. PMID:22262069

How the design of a sleeping bag can support counter-measuring fatigue

NASA Astrophysics Data System (ADS)

Imhof, Barbara; Hoheneder, Waltraut; Vogel, Kaspar; Drudi, Laura

2013-10-01

The paper discusses six case studies of sleeping bag design, one used by astronauts onboard the Space Shuttle and another currently being used on the ISS, which was developed by a Russian company. Two inflatable designs, one by Wubbo Ockels for ESA and one by the University of Technology in Munich in cooperation with NASA are chosen as case studies as well. Two recent designs set a new paradigm and option of sleeping in zero-g. The cut of the sleeping bag of these two design case studies allows the person to relax and sleep in the neutral body position. They were developed by Toshiroh Ikegami from Kyoto City University of Arts and astronaut Chiaki Mukai for JAXA, and by the Vienna based team LIQUIFER Systems Group in cooperation with ESA-astronaut Gerhard Thiele. Currently there is an increased interest in astronauts' and cosmonauts' sleep quality and related comfort because analysis of their sleep quality showed that sleep during long exposure to microgravity does not always ensure good recovery of cognitive and functional capabilities. Present research in the area of sleep and performance preservation include studies by the Institute of Biomedical Problems (IBMP) in Moscow and the NASA-JSC study from the Behavioral Health and Performance Element Human Research Program about improving sleep quality on ISS. In the context of the paper the operational medical challenges of sleep quality will be described in order to establish the relevance of effective sleeping bag designs to support spaceflight crewmembers' well-being.