Sample records for previous studies failed

  1. Effectiveness of Peer Counseling on High School Students Who Failed Two or More Classes in a Nine Week Quarter

    ERIC Educational Resources Information Center

    Reardon, Michelle Turner

    1990-01-01

    The purpose of this study was to examine the effectiveness of peer counseling on high school students who have previously failed two or more classes in a nine week quarter. This study was constructed by comparing who previously failed and were subsequently given peer counseling with a matched group of students who failed and did not receive peer…

  2. Free-floating Failed Star Artist Concept

    NASA Image and Video Library

    2013-09-05

    This artist concept portrays a free-floating brown dwarf, or failed star. A new study using data from NASA Spitzer Space Telescope shows that several of these objects are warmer than previously thought.

  3. A Comprehensive Reliability Methodology for Assessing Risk of Reusing Failed Hardware Without Corrective Actions with and Without Redundancy

    NASA Technical Reports Server (NTRS)

    Putcha, Chandra S.; Mikula, D. F. Kip; Dueease, Robert A.; Dang, Lan; Peercy, Robert L.

    1997-01-01

    This paper deals with the development of a reliability methodology to assess the consequences of using hardware, without failure analysis or corrective action, that has previously demonstrated that it did not perform per specification. The subject of this paper arose from the need to provide a detailed probabilistic analysis to calculate the change in probability of failures with respect to the base or non-failed hardware. The methodology used for the analysis is primarily based on principles of Monte Carlo simulation. The random variables in the analysis are: Maximum Time of Operation (MTO) and operation Time of each Unit (OTU) The failure of a unit is considered to happen if (OTU) is less than MTO for the Normal Operational Period (NOP) in which this unit is used. NOP as a whole uses a total of 4 units. Two cases are considered. in the first specialized scenario, the failure of any operation or system failure is considered to happen if any of the units used during the NOP fail. in the second specialized scenario, the failure of any operation or system failure is considered to happen only if any two of the units used during the MOP fail together. The probability of failure of the units and the system as a whole is determined for 3 kinds of systems - Perfect System, Imperfect System 1 and Imperfect System 2. in a Perfect System, the operation time of the failed unit is the same as that of the MTO. In an Imperfect System 1, the operation time of the failed unit is assumed as 1 percent of the MTO. In an Imperfect System 2, the operation time of the failed unit is assumed as zero. in addition, simulated operation time of failed units is assumed as 10 percent of the corresponding units before zero value. Monte Carlo simulation analysis is used for this study. Necessary software has been developed as part of this study to perform the reliability calculations. The results of the analysis showed that the predicted change in failure probability (P(sub F)) for the previously failed units is as high as 49 percent above the baseline (perfect system) for the worst case. The predicted change in system P(sub F) for the previously failed units is as high as 36% for single unit failure without any redundancy. For redundant systems, with dual unit failure, the predicted change in P(sub F) for the previously failed units is as high as 16%. These results will help management to make decisions regarding the consequences of using previously failed units without adequate failure analysis or corrective action.

  4. Implant failure and history of failed endodontic treatment: A retrospective case-control study.

    PubMed

    Chatzopoulos, Georgios S; Wolff, Larry F

    2017-11-01

    Residual bacterial biofilm and/or bacteria in planktonic form may be survived in the bone following an extraction of an infected tooth that was endodontically treated unsuccessfully Failed endodontic treatment may be associated with failure of implants to osseointegrate in the same sites. Therefore, the aim of this retrospective case-control study is to examine the risk of implant failure in previous failed endodontic sites. This retrospective case-control study is based on 94 dental records of implants placed at the University of Minnesota School of Dentistry. Dental records of patients who received an implant in sites with previously failed endodontic therapy in the dental school were identified from the electronic database, while control subjects were obtained from the same pool of patients with the requirement to have received an implant in a site that was not endodontically treated. The mean age of the population was 62.89±14.17 years with 57.4% of the sample being females and 42.6% of them being males. In regards to the socio-economic status and dental insurance, 84.0% of this population was classified as low socio-economic status and 68.1% had dental insurance. Tobacco use was self-reported by 9.6% and hypercholesterolemia was the most prevalent systemic medical condition. Dental implant failure was identified in two of the included records (2.1%), both of which were placed in sites with a history of failed endodontic treatment. Within the limitations of this retrospective case-control study, further investigation with a larger population group into implant failure of sites that previously had unsuccessful endodontic treatment would be warranted. Implant failure may be associated with a history of failed endodontic treatment. Key words: Implantology, endodontics, osseointegration, treatment outcome, case-control study.

  5. Impulsivity moderates the relationship between previous quit failure and cue-induced craving.

    PubMed

    Erblich, Joel; Michalowski, Alexandra

    2015-12-01

    Poor inhibitory control has been shown to be an important predictor of relapse to a number of drugs, including nicotine. Indeed, smokers who exhibit higher levels of impulsivity are thought to have impaired regulation of urges to smoke, and previous research has suggested that impulsivity may moderate cue-induced cigarette cravings. To that end, we conducted a study to evaluate the interplay between failed smoking cessation, cue-induced craving, and impulsivity. Current smokers (n=151) rated their cigarette cravings before and after laboratory to exposure to smoking cues, and completed questionnaires assessing impulsivity and previous failed quit attempts. Findings indicated that shorter duration of previous failed quit attempts was related to higher cue-induced cigarette craving, especially among smokers with higher levels of impulsivity. Results underscore the importance of considering trait impulsivity as a factor in better understanding the management of cue-induced cravings. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Impulsivity Moderates the Relationship between Previous Quit Failure and Cue-induced Craving

    PubMed Central

    Erblich, Joel; Michalowski, Alexandra

    2015-01-01

    Introduction Poor inhibitory control has been shown to be an important predictor of relapse to a number of drugs, including nicotine. Indeed, smokers who exhibit higher levels of impulsivity are thought to have impaired regulation of urges to smoke, and previous research has suggested that impulsivity may moderate cue-induced cigarette cravings. To that end, we conducted a study to evaluate the interplay between failed smoking cessation, cue-induced craving, and impulsivity. Methods Current smokers (n=151) rated their cigarette cravings before and after laboratory to exposure to smoking cues, and completed questionnaires assessing impulsivity and previous failed quit attempts. Results Findings indicated that shorter duration of previous failed quit attempts was related to higher cue-induced cigarette craving, especially among smokers with higher levels of impulsivity. Conclusions Results underscore the importance of considering trait impulsivity as a factor in better understanding the management of cue-induced cravings. PMID:26183443

  7. Acquisition of Mands and Tacts with Concurrent Echoic Training

    ERIC Educational Resources Information Center

    Kodak, Tiffany; Clements, Andrea

    2009-01-01

    Previous studies have identified a number of effective teaching procedures to increase verbal behavior in individuals with developmental disabilities. However, few studies have evaluated modifications of treatment procedures when children fail to acquire communication skills. In the present investigation, a 4-year-old boy with autism failed to…

  8. Transplantectomy is associated with presensitization with donor-reactive T cells and graft failure after kidney retransplantation: a cohort study.

    PubMed

    Schachtner, Thomas; Otto, Natalie M; Stein, Maik; Reinke, Petra

    2018-05-01

    The number of kidney transplant recipients (KTRs) being waitlisted for a subsequent transplantation has disproportionately increased to almost 25%. Evidence for the optimal management of the failed allograft, however, remains inconsistent. We studied 111 KTRs who underwent their second kidney transplantation from 1998 to 2015. In 51/111 KTRs (46%) the failed allograft was removed and in 60/111 (54%) the failed allograft was retained. KTRs with primary non-function and allograft loss <12  months of the first failed allograft were excluded from analysis. Samples were collected before transplantation and at  1  month posttransplantation and donor-reactive T cells were measured using an interferon-γ enzyme-linked immunosorbent spot assay. KTRs with the previous allograft removed showed significantly higher rates of acute cellular rejection compared with KTRs with the previous allograft retained [27/51 KTRs (53%) versus 18/60 KTRs (30%); P = 0.019]. KTRs with the previous allograft removed showed significantly inferior death-censored allograft survival compared with KTRs with the previous allograft retained (P = 0.022). Here, KTRs with the previous allograft removed showed significantly higher donor-reactive T cells pretransplantation compared with KTRs with the previous allograft retained (P = 0.012). Interestingly, no differences were observed for the presence of panel reactive antibodies and for the development of de novo donor-specific antibodies. Our data suggest higher cellular presensitization among KTRs with the previous allograft removed, which is associated with higher rates of acute cellular rejection and inferior allograft survival. Immunological mechanisms that may account for these differences may include prolonged maintenance immunosuppression to save urine output in KTRs with the first kidney allograft retained and cellular presensitization after withdrawal of maintenance immunosuppression, which lead to allograft rejection and ultimately to allograft nephrectomy.

  9. A Retrospective Analysis of Dental Implants Replacing Failed Implants in Grafted Maxillary Sinus: A Case Series.

    PubMed

    Manor, Yifat; Chaushu, Gavriel; Lorean, Adi; Mijiritzky, Eithan

    2015-01-01

    To evaluate the survival rate of dental implants replacing failed implants in grafted maxillary sinuses using the lateral approach vs nongrafted posterior maxillae. A retrospective analysis was conducted to study the survival of secondary dental implants inserted in the posterior maxilla in previously failed implant sites between the years 2000 and 2010. The study group consisted of patients who had also undergone maxillary sinus augmentation, and the control group consisted of patients in whom implants in the posterior maxilla had failed. Clinical and demographic data were analyzed using a structured form. Seventy-five patients with a total of 75 replaced implants were included in the study. The study group comprised 40 patients and the control group, 35 patients. None of the replaced implants in the study group failed, resulting in an overall survival of 100%; three replaced implants in the control group failed (92% survival). The main reason for the primary implant removal was lack of osseointegration (35 [87.5%] of 40 study group implants and 23 [65.7%] of 35 control group implants [P = .027]). The difference between the groups with regard to the timing of primary implant failure was statistically significant. The study group had more early failures of the primary implant than did the control group (77% vs 62%; P = .038). Dental implants replaced in the posterior maxilla had a high survival rate. A higher rate of survival was found in augmented maxillary sinus sites. Within the limits of the present study, it can be concluded that previous implant failures in the grafted maxillary sinus should not discourage practitioners from a second attempt.

  10. Examining the Relationships between Student Learning Habits and Post-Secondary Educational Outcomes: The Missing Component

    ERIC Educational Resources Information Center

    Goodlowe-Scott, Quinhon N.

    2017-01-01

    In high schools across the country, college readiness standards have emerged as an important post-secondary educational outcome. Previous reform efforts have largely focused on "failing schools" versus "failing students" (Weissberg, 2010). This study takes the view that student learning habits might be better determinants of…

  11. Physical and Emotional Development, Appetite and Body Image in Adolescents Who Failed to Thrive as Infants

    ERIC Educational Resources Information Center

    Drewett, R. F.; Corbett, S. S.; Wright, C. M.

    2006-01-01

    Background: Previous studies suggest that failure to thrive in infancy may be associated with adverse sequelae in childhood. Although cognitive abilities have been extensively investigated, little systematic research is available on other aspects of development. Methods: Eighty-nine children who failed to thrive as infants and 91 controls were…

  12. Measuring motivation using the transtheoretical (stages of change) model: A follow-up study of people who failed an online hearing screening.

    PubMed

    Ingo, Elisabeth; Brännström, K Jonas; Andersson, Gerhard; Lunner, Thomas; Laplante-Lévesque, Ariane

    2016-07-01

    Acceptance and readiness to seek professional help have shown to be important factors for favourable audiological rehabilitation outcomes. Theories from health psychology such as the transtheoretical (stages-of-change) model could help understand behavioural change in people with hearing impairment. In recent studies, the University of Rhode Island change assessment (URICA) has been found to have good predictive validity. In a previous study, 224 Swedish adults who had failed an online hearing screening completed URICA and two other measures of stages of change. This follow-up aimed to: (1) determine prevalence of help-seeking at a hearing clinic and hearing aid uptake, and (2) explore the predictive validity of the stages of change measures by a follow-up on the 224 participants who had failed a hearing screening 18 months previously. A total of 122 people (54%) completed the follow-up online questionnaire, including the three measures and questions regarding experience with hearing help-seeking and hearing aid uptake. Since failing the online hearing screening, 61% of participants had sought help. A good predictive validity for a one-item measure of stages of change was reported. The Staging algorithm was the stages of change measure with the best ability to predict help-seeking 18 months later.

  13. Acquisition of mands and tacts with concurrent echoic training.

    PubMed

    Kodak, Tiffany; Clements, Andrea

    2009-01-01

    Previous studies have identified a number of effective teaching procedures to increase verbal behavior in individuals with developmental disabilities. However, few studies have evaluated modifications of treatment procedures when children fail to acquire communication skills. In the present investigation, a 4-year-old boy with autism failed to acquire unprompted mands and tacts during mand-only and tact-only training. Results indicated that combining echoic training with mand or tact training increased unprompted manding and tacting.

  14. ACQUISITION OF MANDS AND TACTS WITH CONCURRENT ECHOIC TRAINING

    PubMed Central

    Kodak, Tiffany; Clements, Andrea

    2009-01-01

    Previous studies have identified a number of effective teaching procedures to increase verbal behavior in individuals with developmental disabilities. However, few studies have evaluated modifications of treatment procedures when children fail to acquire communication skills. In the present investigation, a 4-year-old boy with autism failed to acquire unprompted mands and tacts during mand-only and tact-only training. Results indicated that combining echoic training with mand or tact training increased unprompted manding and tacting. PMID:20514191

  15. 76 FR 82210 - Airworthiness Directives; The Boeing Company Airplanes

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-30

    ... fuse pins that can fail earlier than the previously determined safe life limit of the pins. A fractured... retract actuator fuse pins that can fail earlier than previously determined safe life limit of the pins. A... Friday, except Federal holidays. For service information identified in this proposed AD, contact Boeing...

  16. 77 FR 37781 - Airworthiness Directives; The Boeing Company Airplanes

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-25

    ... actuator fuse pins that can fail earlier than the previously determined safe life limit of the pins. A... that can fail earlier than the previously determined safe life limit of the pins. A fractured retract... July 30, 2012. ADDRESSES: For service information identified in this AD, contact Boeing Commercial...

  17. Combination alpha-interferon and lamivudine therapy for alpha-interferon-resistant chronic hepatitis B infection: results of a pilot study.

    PubMed

    Mutimer, D; Naoumov, N; Honkoop, P; Marinos, G; Ahmed, M; de Man, R; McPhillips, P; Johnson, M; Williams, R; Elias, E; Schalm, S

    1998-06-01

    Alpha-interferon achieves seroconversion in about one third of naive patients. Attempts to achieve seroconversion in patients who have previously failed alpha-interferon have proved disappointing. Combination chemotherapy (alpha-interferon with a nucleoside analogue) might provide a treatment alternative for these patients. We have undertaken a phase 2 study in 20 patients who had previously failed at least one course of alpha-interferon. The study was designed to assess the safety, tolerability and efficacy of the combination. All patients were treated for 16 weeks with alpha-interferon in combination with 12 or 16 weeks of Lamivudine (3'TC). Patients were followed for 16 weeks post-treatment. Pharmacokinetic studies were performed to identify/exclude significant pharmacokinetic drug interaction. The combination was well tolerated, and side-effects of the combination were indistinguishable from the recognised side-effects of alpha-interferon. Pharmacokinetic studies performed on days 1 and 29 did not show any significant interaction. All patients achieved HBV DNA clearance during treatment, but 19 relapsed at the end of treatment. HBeAg/anti-HBe seroconversion was observed for four patients, but was sustained for a single patient (who also had sustained DNA clearance). Combination therapy with alpha-interferon and lamivudine given for 16 weeks appears safe and is well tolerated. However, for this group of patients who had previously failed interferon monotherapy, the efficacy of combination interferon/lamivudine therapy appears disappointing, and other treatment strategies should be investigated.

  18. Two-week, high-dose proton pump inhibitor, moxifloxacin triple Helicobacter pylori therapy after failure of standard triple or non-bismuth quadruple treatments.

    PubMed

    Gisbert, Javier P; Romano, Marco; Molina-Infante, Javier; Lucendo, Alfredo J; Medina, Enrique; Modolell, Inés; Rodríguez-Tellez, Manuel; Gomez, Blas; Barrio, Jesús; Perona, Monica; Ortuño, Juan; Ariño, Inés; Domínguez-Muñoz, Juan Enrique; Perez-Aisa, Ángeles; Bermejo, Fernando; Domínguez, Jose Luis; Almela, Pedro; Gomez-Camarero, Judith; Millastre, Judith; Martin-Noguerol, Elisa; Gravina, Antonietta G; Martorano, Marco; Miranda, Agnese; Federico, Alessandro; Fernandez-Bermejo, Miguel; Angueira, Teresa; Ferrer-Barcelo, Luis; Fernández, Nuria; Marín, Alicia C; McNicholl, Adrián G

    2015-02-01

    Aim was to evaluate the efficacy and tolerability of a moxifloxacin-containing second-line triple regimen in patients whose previous Helicobacter pylori eradication treatment failed. Prospective multicentre study including patients in whom a triple therapy or a non-bismuth-quadruple-therapy failed. Moxifloxacin (400mg qd), amoxicillin (1g bid), and esomeprazole (40 mg bid) were prescribed for 14 days. Eradication was confirmed by (13)C-urea-breath-test. Compliance was determined through questioning and recovery of empty medication envelopes. 250 patients were consecutively included (mean age 48 ± 15 years, 11% with ulcer). Previous (failed) therapy included: standard triple (n = 179), sequential (n = 27), and concomitant (n = 44); 97% of patients took all medications, 4 were lost to follow-up. Intention-to-treat and per-protocol eradication rates were 82.4% (95% CI, 77-87%) and 85.7% (95% CI, 81-90%). Cure rates were similar independently of diagnosis (ulcer, 77%; dyspepsia, 82%) and previous treatment (standard triple, 83%; sequential, 89%; concomitant, 77%). At multivariate analysis, only age was associated with eradication (OR = 0.957; 95% CI, 0.933-0.981). Adverse events were reported in 25.2% of patients: diarrhoea (9.6%), abdominal pain (9.6%), and nausea (9.2%). 14-day moxifloxacin-containing triple therapy is an effective and safe second-line strategy in patients whose previous standard triple therapy or non-bismuth quadruple (sequential or concomitant) therapy has failed, providing a simple alternative to bismuth quadruple regimen. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  19. Helicobacter pylori second-line rescue therapy with levofloxacin- and bismuth-containing quadruple therapy, after failure of standard triple or non-bismuth quadruple treatments.

    PubMed

    Gisbert, J P; Romano, M; Gravina, A G; Solís-Muñoz, P; Bermejo, F; Molina-Infante, J; Castro-Fernández, M; Ortuño, J; Lucendo, A J; Herranz, M; Modolell, I; Del Castillo, F; Gómez, J; Barrio, J; Velayos, B; Gómez, B; Domínguez, J L; Miranda, A; Martorano, M; Algaba, A; Pabón, M; Angueira, T; Fernández-Salazar, L; Federico, A; Marín, A C; McNicholl, A G

    2015-04-01

    The most commonly used second-line Helicobacter pylori eradication regimens are bismuth-containing quadruple therapy and levofloxacin-containing triple therapy, both offering suboptimal results. Combining bismuth and levofloxacin may enhance the efficacy of rescue eradication regimens. To evaluate the efficacy and tolerability of a second-line quadruple regimen containing levofloxacin and bismuth in patients whose previous H. pylori eradication treatment failed. This was a prospective multicenter study including patients in whom a standard triple therapy (PPI-clarithromycin-amoxicillin) or a non-bismuth quadruple therapy (PPI-clarithromycin-amoxicillin-metronidazole, either sequential or concomitant) had failed. Esomeprazole (40 mg b.d.), amoxicillin (1 g b.d.), levofloxacin (500 mg o.d.) and bismuth (240 mg b.d.) was prescribed for 14 days. Eradication was confirmed by (13) C-urea breath test. Compliance was determined through questioning and recovery of empty medication envelopes. Incidence of adverse effects was evaluated by questionnaires. 200 patients were included consecutively (mean age 47 years, 67% women, 13% ulcer). Previous failed therapy included: standard clarithromycin triple therapy (131 patients), sequential (32) and concomitant (37). A total of 96% took all medications correctly. Per-protocol and intention-to-treat eradication rates were 91.1% (95%CI = 87-95%) and 90% (95%CI = 86-94%). Cure rates were similar regardless of previous (failed) treatment or country of origin. Adverse effects were reported in 46% of patients, most commonly nausea (17%) and diarrhoea (16%); 3% were intense but none was serious. Fourteen-day bismuth- and levofloxacin-containing quadruple therapy is an effective (≥90% cure rate), simple and safe second-line strategy in patients whose previous standard triple or non-bismuth quadruple (sequential or concomitant) therapies have failed. © 2015 John Wiley & Sons Ltd.

  20. Having "been there" doesn't mean I care: when prior experience reduces compassion for emotional distress.

    PubMed

    Ruttan, Rachel L; McDonnell, Mary-Hunter; Nordgren, Loran F

    2015-04-01

    The current research found that participants who had previously endured an emotionally distressing event (e.g., bullying) more harshly evaluated another person's failure to endure a similar distressing event compared with participants with no experience enduring the event or those currently enduring the event. These effects emerged for naturally occurring (Studies 1, 3, and 4) and experimentally induced (Study 2) distressing events. This effect was driven by the tendency for those who previously endured the distressing event to view the event as less difficult to overcome (Study 3). Moreover, we demonstrate that the effect is specific to evaluations of perceived failure: Compared with those with no experience, people who previously endured a distressing event made less favorable evaluations of an individual failing to endure the event, but made more favorable evaluations of an individual managing to endure the event (Study 4). Finally, we found that people failed to anticipate this effect of enduring distress, instead believing that individuals who have previously endured emotionally distressing events would most favorably evaluate others' failures to endure (Study 5). Taken together, these findings present a paradox such that, in the face of struggle or defeat, the people we seek for advice or comfort may be the least likely to provide it. (c) 2015 APA, all rights reserved).

  1. Visual Working Memory Cannot Trade Quantity for Quality.

    PubMed

    Ramaty, Ayelet; Luria, Roy

    2018-01-01

    Two main models have been proposed to describe how visual working memory (WM) allocates its capacity: the slot-model and the continuous resource-model. The purpose of the current study was to test a direct prediction of the resource model suggesting that WM can trade-off between the quantity and quality of the encoded information. Previous research reported equivocal results, with studies that failed to find such a trade-off and other studies that reported a trade-off. Following the design of previous studies, in Experiment 1 we replicated this trade-off, by presenting the memory array for 1200 ms. Experiment 2 failed to observe a trade-off between quantity and quality using a memory array interval of 300 ms (a standard interval for visual WM). Experiment 3 again failed to find this trade-off, when reinstating the 1200 ms memory array interval but adding an articulatory suppression manipulation. We argue that while participants can trade quantity for quality, this pattern depends on verbal encoding and transfer to long-term memory processes that were possible to perform only during the long retention interval. When these processes were eliminated, the trade-off disappeared. Thus, we didn't find any evidence that the trade-off between quantity for quality can occur within visual WM.

  2. Indications of caesarean section in overweight and obese versus normal-weight pregnant women: a retrospective cohort study.

    PubMed

    Fernández Alba, Juan Jesús; Paublete Herrera, Carmen; Vilar Sanchez, Angel; Gonzalez-Macias, Carmen; Castillo Lara, Maria; Torrejón, Rafael; Moreno Corral, Luis Javier

    2018-02-01

    The aim of this study was to test the hypothesis that indications of c-section in overweight or obese pregnant women are different from those with normal-weight. Retrospective cohort study at University Hospital of Puerto Real (Cádiz-Spain). We compared frequency distribution of c-section indications in overweight and obese versus normal-weight. The risk of c-section by different indications was calculated as relative risk. A total of 4685 births were included in the study. There are significant differences in the frequency distribution of caesarean indications among normal weight and overweight or obese women. In overweight, we found an increased risk of c-section due to previous c-section (RR: 1.73; confidence interval [CI] 95% 1.24-2.42), obstructed/non-progressive labour (RR: 1.34; CI 95% 1.03-1.75), failed induction of labour (RR: 2.38; CI 95% 1.30-4.34) and foetal distress (RR: 1.73; CI 95% 1.21-2.49). This risk was even higher in obese women: previous c-section (RR: 3.25; CI 95% 2.24-4.71), obstructed/non-progressive labour (RR: 2; CI 95% 1.45-2.77), failed induction (RR: 2.52; CI 95% 1.15-5.51) and foetal distress (RR: 2.35; CI 95% 1.51-3.65). The risk of caesarean section due to previous caesarean section, obstructed/non-progressive labour, failed induction of labour or foetal distress is greater in overweight and obese than in normal-weight. This increase in risk also increases progressively as maternal BMI increases.

  3. Peginterferon Alfa-2a plus Ribavirin in Japanese Patients Infected with Hepatitis C Virus Genotype 2 Who Failed Previous Interferon Therapy

    PubMed Central

    Kanda, Tatsuo; Nakamoto, Shingo; Nishino, Takayoshi; Takada, Nobuo; Tsubota, Akihito; Kato, Keizo; Miyamura, Tatsuo; Maruoka, Daisuke; Wu, Shuang; Tanaka, Takeshi; Arai, Makoto; Mikami, Shigeru; Fujiwara, Keiichi; Imazeki, Fumio; Yokosuka, Osamu

    2013-01-01

    Some patients infected with hepatitis C virus (HCV) genotype 2 could be cured with treatment shorter than 24 weeks using peginterferon plus ribavirin, but there are still treatment-refractory patients. Direct-acting antivirals (DAAs) are not currently available for HCV genotype 2 patients, different from genotype 1 patients, in clinical practice. We investigated 29 HCV genotype 2-infected Japanese patients who had been previously treated and failed to clear HCV. We retreated them with peginterferon alfa-2a plus ribavirin and measured HCV RNA level to assess the efficacy and safety of this treatment in patients who had failed previous therapy. We found that retreatment of HCV genotype 2-infected Japanese patients with peginterferon alfa-2a plus ribavirin for 24-48 weeks led to 60 to 66.6% sustained virological response (SVR) in patients previously treated with (peg-)interferon monotherapy and to 69.9% SVR in relapsers previously treated with peginterferon plus ribavirin. Attention should be paid to certain patients with unique features. Selection of patients according to their previous treatment could lead to optimal therapy in HCV genotype 2 treatment-experienced patients. PMID:23289004

  4. EUS-guided methylene blue cholangiopancreatography for benign biliopancreatic diseases after failed ERCP.

    PubMed

    Consiglieri, Claudia F; Gornals, Joan B; Albines, Gino; De-la-Hera, Meritxell; Secanella, Lluis; Pelaez, Nuria; Busquets, Juli

    2016-07-01

    When ERCP fails, EUS-guided interventional techniques may be an alternative. The aim of this study was to evaluate the general outcomes and safety of EUS-guided methylene blue cholangiopancreatography in patients with failed ERCP in benign biliopancreatic diseases. Patients with benign biliopancreatic diseases and failed ERCP were included. EUS-guided cholangiopancreatography plus injection of methylene blue was performed, and then ERCP using coloring agent flow as an indicator of papilla orifice was performed. Procedures were prospectively collected in this observational, single-center study. Technical success, clinical success, and adverse events were analyzed retrospectively. Eleven patients were included (10 choledocholithiasis, 1 pancreatic stricture). The main reason for failed ERCP was an unidentifiable papilla. EUS-guided ductal access with cholangiopancreatography and papilla orifice identification was obtained in all cases. Technical success and clinical success rates of 91% were achieved, with successful biliopancreatic drainage in 10 patients. Adverse events included 1 peripancreatic abscess attributed to a precut, which was successfully treated. No adverse events were related to the first EUS-guided stage. EUS-guided cholangiopancreatography with methylene blue injection seems to be a feasible and helpful technique for treatment in patients with benign biliopancreatic diseases with previous failed ERCP because of an undetectable papilla. Copyright © 2016 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  5. Impact of incomplete correspondence between document titles and texts on users' representations: a cognitive and linguistic analysis based on 25 technical documents.

    PubMed

    Eyrolle, Hélène; Virbel, Jacques; Lemarié, Julie

    2008-03-01

    Based on previous research in the field of cognitive psychology, highlighting the facilitatory effects of titles on several text-related activities, this paper looks at the extent to which titles reflect text content. An exploratory study of real-life technical documents investigated the content of their Subject lines, which linguistic analyses had led us to regard as titles. The study showed that most of the titles supplied by the writers failed to represent the documents' contents and that most users failed to detect this lack of validity.

  6. Design and implementation of a cross-sectional nutritional phenotyping study of healthy US adults

    USDA-ARS?s Scientific Manuscript database

    Metabolic imbalance is a key determinant of risk of chronic diseases. Metabolic health cannot be assessed solely by body mass calculations or by static, fasted state biochemical readouts. Although previous studies have described temporal responses to dietary challenges, these studies fail to assess ...

  7. Effects of dopamine on reinforcement learning and consolidation in Parkinson's disease.

    PubMed

    Grogan, John P; Tsivos, Demitra; Smith, Laura; Knight, Brogan E; Bogacz, Rafal; Whone, Alan; Coulthard, Elizabeth J

    2017-07-10

    Emerging evidence suggests that dopamine may modulate learning and memory with important implications for understanding the neurobiology of memory and future therapeutic targeting. An influential hypothesis posits that dopamine biases reinforcement learning. More recent data also suggest an influence during both consolidation and retrieval. Eighteen Parkinson's disease patients learned through feedback ON or OFF medication, with memory tested 24 hr later ON or OFF medication (4 conditions, within-subjects design with matched healthy control group). Patients OFF medication during learning decreased in memory accuracy over the following 24 hr. In contrast to previous studies, however, dopaminergic medication during learning and testing did not affect expression of positive or negative reinforcement. Two further experiments were run without the 24 hr delay, but they too failed to reproduce effects of dopaminergic medication on reinforcement learning. While supportive of a dopaminergic role in consolidation, this study failed to replicate previous findings on reinforcement learning.

  8. Use of a tubed pectoralis major myocutaneous flap for salvage of a failed colonic bypass of the esophagus.

    PubMed

    Doberneck, R C; Oschwald, D L; Orgel, M G

    1986-05-01

    The use of tube PMCF as salvage for a failed colon bypass of the esophagus has not been described previously. The present report describes the technique and successful use of a tubed PMCF as a solution to the problem of a failed cervical anastomosis after colon bypass of a long distal esophageal stricture.

  9. Peginterferon alfa-2b and ribavirin: effective in patients with hepatitis C who failed interferon alfa/ribavirin therapy.

    PubMed

    Poynard, Thierry; Colombo, Massimo; Bruix, Jordi; Schiff, Eugene; Terg, Ruben; Flamm, Steven; Moreno-Otero, Ricardo; Carrilho, Flair; Schmidt, Warren; Berg, Thomas; McGarrity, Thomas; Heathcote, E Jenny; Gonçales, Fernando; Diago, Moises; Craxi, Antonio; Silva, Marcelo; Bedossa, Pierre; Mukhopadhyay, Pabak; Griffel, Louis; Burroughs, Margaret; Brass, Clifford; Albrecht, Janice

    2009-05-01

    Treatment with peginterferon alfa and ribavirin produces a sustained virologic response (SVR) in approximately 60% of hepatitis C virus (HCV)-infected patients. Alternate options are needed for patients who relapse or do not respond to therapy. This prospective, international, multicenter, open-label study evaluated efficacy and safety of peginterferon alfa-2b (1.5 microg/kg/wk) plus weight-based ribavirin (800-1400 mg/day) in 2333 chronic HCV-infected patients with significant fibrosis/cirrhosis whose previous interferon alfa/ribavirin therapy failed. Patients with undetectable HCV-RNA at treatment week (TW) 12 received 48 weeks of therapy; patients with detectable HCV-RNA at TW12 could enter maintenance studies at TW18; 188 patients with low/detectable HCV-RNA at TW12 continued therapy at the investigator's request. Overall, 22% of the patients attained SVR (56% with undetectable HCV-RNA and 12% with low/detectable HCV-RNA at TW12). SVR was better in relapsers (38%) than nonresponders (14%), regardless of previous treatment, and in patients previously treated with interferon-alfa/ribavirin (25%) than peginterferon alfa-ribavirin (17%). Predictors of response in patients with undetectable HCV-RNA at TW12 were genotype (2/3 vs 1, respectively; odds ratio [OR] 2.4; P < .0001), fibrosis score (F2 vs F4; OR, 2.2; F3 vs F4; OR, 1.7; P < .0001), and baseline viral load (< or =600,000 vs >600,000 IU/mL; OR, 1.4; P = .0223). These factors plus previous treatment and response were overall predictors of SVR. Safety was similar among fibrosis groups. Peginterferon alfa-2b plus weight-based ribavirin is effective and safe in patients who failed interferon alfa/ribavirin therapy. Genotype, baseline viral load, and fibrosis stage were predictors of response.

  10. Is There Evidence of Failing to Fail in Our Schools of Nursing?

    PubMed

    Docherty, Angie; Dieckmann, Nathan

    2015-01-01

    To assess evidence for "failing to fail" in undergraduate nursing programs. Literature on grading practices largely focuses on clinical or academic grading. Reviewing both as distinct entities may miss a more systemic grading problem. A cross-sectional survey targeted 235 faculty within university and community colleges in a western state. Chi-square tests of independence explored the relation between institutional and faculty variables. The response rate was 34 percent. Results suggest failing to fail may be evident across the sector in both clinical and academic settings: 43 percent of respondents had awarded higher grades than merited; 17.7 percent had passed written examinations they felt should fail; 66 percent believed they had worked with students who should not have passed their previous placement. Failing to fail cuts across instructional settings. Further exploration is imperative if schools are to better engender a climate for rigorously measuring student attainment.

  11. Extensive cytotoxic lesions of the rat retrosplenial cortex reveal consistent deficits on tasks that tax allocentric spatial memory.

    PubMed

    Vann, Seralynne D; Aggleton, John P

    2002-02-01

    Despite the connections of the retrosplenial cortex strongly suggesting a role in spatial memory, the lesion data to date have been equivocal. Whether subjects are impaired after retrosplenial lesions seems to depend on whether the lesions were aspirative or excitotoxic, with the latter failing to produce an impairment. A shortcoming of previous excitotoxic lesion studies is that they spared the most caudal part of the retrosplenial cortex. The present study thus used rats with extensive neurotoxic lesions of the retrosplenial cortex that encompassed the entire rostrocaudal extent of this region. These rats were consistently impaired on several tests that tax allocentric memory. In contrast, they were unimpaired on an egocentric discrimination task. Although the lesions did not appear to affect object recognition, clear deficits were found for an object-in-place discrimination. The present study not only demonstrates a role for the retrosplenial cortex in allocentric spatial memory, but also explains why previous excitotoxic lesions have failed to detect any deficits.

  12. "Elite" Career-Changers and Their Experience of Initial Teacher Education

    ERIC Educational Resources Information Center

    Wilkins, Chris

    2017-01-01

    This study explores the motivation of "high-status" professionals to change career and enter teaching, and their experience of undertaking initial teacher education (ITE) programmes in England. The study builds on previous research which found that career-changers are disproportionately more likely to fail to complete their ITE studies,…

  13. Perceptual Completion in Newborn Human Infants

    ERIC Educational Resources Information Center

    Valenza, Eloisa; Leo, Irene; Gava, Lucia; Simion, Francesca

    2006-01-01

    Despite decades of studies of human infants, a still open question concerns the role of visual experience in the development of the ability to perceive complete shapes over partial occlusion. Previous studies show that newborns fail to manifest this ability, either because they lack the visual experience required for perceptual completion or…

  14. Effects of Juvenile Court Exposure on Crime in Young Adulthood

    ERIC Educational Resources Information Center

    Petitclerc, Amelie; Gatti, Uberto; Vitaro, Frank; Tremblay, Richard E.

    2013-01-01

    Background: The juvenile justice system's interventions are expected to help reduce recidivism. However, previous studies suggest that official processing in juvenile court fails to reduce adolescents' criminal behavior in the following year. Longer term effects have not yet been investigated with a rigorous method. This study used propensity…

  15. Gilligan's Moral Orientation Hypothesis: Strategies of Justification and Practical Deliberation.

    ERIC Educational Resources Information Center

    Keefer, Matthew Wilks

    Previous studies failed to determine whether Gilligan's (1982) justice and care perspectives represent two distinct orientations of moral reasoning. Using methods developed in research on reasoning and discourse processes, a study used a discursive framework to validate an alternate methodology for the investigation of moral orientation reasoning.…

  16. Why Do First-Generation Students Fail?

    ERIC Educational Resources Information Center

    Mehta, Sanjay S.; Newbold, John J.; O'Rourke, Matthew A.

    2011-01-01

    Previous studies have determined factors contributing to first-generation student success. This study finds that first-generation students are less involved, have less social and financial support, and do not show a preference for active coping strategies. First-generation students report less social and academic satisfaction as well as lower…

  17. Measurement of Negativity Bias in Personal Narratives Using Corpus-Based Emotion Dictionaries

    ERIC Educational Resources Information Center

    Cohen, Shuki J.

    2011-01-01

    This study presents a novel methodology for the measurement of negativity bias using positive and negative dictionaries of emotion words applied to autobiographical narratives. At odds with the cognitive theory of mood dysregulation, previous text-analytical studies have failed to find significant correlation between emotion dictionaries and…

  18. Considering a Merger?

    ERIC Educational Resources Information Center

    Thompson, Hugh L.

    1985-01-01

    A successful college merger is often conditioned by geography, previous cooperation, complementary instructional programs, academic excellence, and common political interest. Suggestions when considering a merger are offered. A case study of a failed merger between Detroit Institute of Technology and Wayne State University is presented. (MLW)

  19. When Phonology Fails: Orthographic Neighbourhood Effects in Dyslexia

    ERIC Educational Resources Information Center

    Lavidor, Michal; Johnston, Rhona; Snowling, Margaret J.

    2006-01-01

    Both cerebral hemispheres contain phonological, orthographic and semantic representations of words, however there are between-hemisphere differences in the relative engagement and specialization of the different representations. Taking orthographic processing for example, previous studies suggest that orthographic neighbourhood size (N) has…

  20. Evaluation of secondary surgery to enlarge the peeling of the internal limiting membrane following the failed surgery of idiopathic macular holes.

    PubMed

    Che, Xin; He, Fanglin; Lu, Linna; Zhu, Dongqing; Xu, Xiaofang; Song, Xin; Fan, Xianqun; Wang, Zhiliang

    2014-03-01

    The aim of the present study was to evaluate the clinical results of pars plana vitrectomy (PPV) combined with the surgical enlargement of internal limiting membrane (ILM) peeling in patients who had previously undergone failed idiopathic macular hole (IMH) surgery. In the study, 134 eyes from 130 IMH patients who had received PPV combined with ILM peeling surgery (2 disk diameters) were analyzed. Within this cohort, 14 eyes had IMHs that were not closed, of which 13 eyes underwent a second surgery involving enlargement of the ILM peeling. The extent of the ILM peeling was increased to the vascular arcades of the posterior fundus in the secondary surgery. Of the 13 eyes that underwent secondary surgery, five were in stage III and nine were in stage IV. The second surgery successfully achieved IMH closure in 61.5% (8/13) of the eyes. The IMH was completely closed following surgery and the logMAR vision increased from 0.98 to 0.84 (P=0.013) in the 8 successfully treated cases. The surgical enlargement of ILM peeling closed the IMHs and improved vision in the majority of patients. In addition, the procedures were safe. Therefore, the results of the present study indicate that enlargement of ILM peeling may be an effective therapy for patients who have previously undergone the failed surgical correction of an IMH.

  1. The Empirical Review of Meta-Analysis Published in Korea

    ERIC Educational Resources Information Center

    Park, Sunyoung; Hong, Sehee

    2016-01-01

    Meta-analysis is a statistical method that is increasingly utilized to combine and compare the results of previous primary studies. However, because of the lack of comprehensive guidelines for how to use meta-analysis, many meta-analysis studies have failed to consider important aspects, such as statistical programs, power analysis, publication…

  2. University Library Browsing: A Study Illustrating a Methodology.

    ERIC Educational Resources Information Center

    Ridley, Dennis R.; And Others

    Previous studies on use of library materials based on borrowing behavior failed to address the issue of how the measurement of library book use might be expanded to a broader definition of use, specifically to include browsing behavior. The development of a non-obtrusive and accurate measurement for browsing behavior has remained a challenge.…

  3. Laparoscopic revision of failed antireflux operations.

    PubMed

    Serafini, F M; Bloomston, M; Zervos, E; Muench, J; Albrink, M H; Murr, M; Rosemurgy, A S

    2001-01-01

    A small number of patients fail fundoplication and require reoperation. Laparoscopic techniques have been applied to reoperative fundoplications. We reviewed our experience with reoperative laparoscopic fundoplication. Reoperative laparoscopic fundoplication was undertaken in 28 patients, 19 F and 9 M, of mean age 56 years +/- 12. Previous antireflux procedures included 19 open and 12 laparoscopic antireflux operations. Symptoms were heartburn (90%), dysphagia (35%), and atypical symptoms (30%%). The mean interval from antireflux procedure to revision was 13 months +/- 4.2. The mean DeMeester score was 78+/-32 (normal 14.7). Eighteen patients (64%) had hiatal breakdown, 17 (60%) had wrap failure, 2 (7%) had slipped Nissen, 3 (11%) had paraesophageal hernias, and 1 (3%) had an excessively tight wrap. Twenty-five revisions were completed laparoscopically, while 3 patients required conversion to the open technique. Complications occurred in 9 of 17 (53%) patients failing previous open fundoplications and in 4 of 12 patients (33%) failing previous laparoscopic fundoplications and included 15 gastrotomies and 1 esophagotomy, all repaired laparoscopically, 3 postoperative gastric leaks, and 4 pneumothoraces requiring tube thoracostomy. No deaths occurred. Median length of stay was 5 days (range 2-90 days). At a mean follow-up of 20 months +/- 17, 2 patients (7%) have failed revision of their fundoplications, with the rest of the patients being essentially asymptomatic (93%). The results achieved with reoperative laparoscopic fundoplication are similar to those of primary laparoscopic fundoplications. Laparoscopic reoperations, particularly of primary open fundoplication, can be technically challenging and fraught with complications. Copyright 2001 Academic Press.

  4. Public Expenditures and the Production of Education

    ERIC Educational Resources Information Center

    Neely, Stephen R.; Diebold, Jeffrey

    2016-01-01

    The relationship between public education expenditures and student outcomes remains an important concern for policy analysts, educational administrators, and the public at large. While previous studies have failed to identify a consistent relationship between public investments in education and positive student outcomes, most analyses have not…

  5. Effects of dopamine on reinforcement learning and consolidation in Parkinson’s disease

    PubMed Central

    Grogan, John P; Tsivos, Demitra; Smith, Laura; Knight, Brogan E; Bogacz, Rafal; Whone, Alan; Coulthard, Elizabeth J

    2017-01-01

    Emerging evidence suggests that dopamine may modulate learning and memory with important implications for understanding the neurobiology of memory and future therapeutic targeting. An influential hypothesis posits that dopamine biases reinforcement learning. More recent data also suggest an influence during both consolidation and retrieval. Eighteen Parkinson’s disease patients learned through feedback ON or OFF medication, with memory tested 24 hr later ON or OFF medication (4 conditions, within-subjects design with matched healthy control group). Patients OFF medication during learning decreased in memory accuracy over the following 24 hr. In contrast to previous studies, however, dopaminergic medication during learning and testing did not affect expression of positive or negative reinforcement. Two further experiments were run without the 24 hr delay, but they too failed to reproduce effects of dopaminergic medication on reinforcement learning. While supportive of a dopaminergic role in consolidation, this study failed to replicate previous findings on reinforcement learning. DOI: http://dx.doi.org/10.7554/eLife.26801.001 PMID:28691905

  6. 13 CFR 113.5 - Compliance information.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ..., institution or person; and such agency, institution or person shall fail or refuse to furnish this information... individuals under this regulation, have failed to overcome these consequences, it will become necessary for... racial, qualified handicapped, nationality groups and persons who because of their sex were previously...

  7. 13 CFR 113.5 - Compliance information.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., institution or person; and such agency, institution or person shall fail or refuse to furnish this information... individuals under this regulation, have failed to overcome these consequences, it will become necessary for... racial, qualified handicapped, nationality groups and persons who because of their sex were previously...

  8. 13 CFR 113.5 - Compliance information.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ..., institution or person; and such agency, institution or person shall fail or refuse to furnish this information... individuals under this regulation, have failed to overcome these consequences, it will become necessary for... racial, qualified handicapped, nationality groups and persons who because of their sex were previously...

  9. 13 CFR 113.5 - Compliance information.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ..., institution or person; and such agency, institution or person shall fail or refuse to furnish this information... individuals under this regulation, have failed to overcome these consequences, it will become necessary for... racial, qualified handicapped, nationality groups and persons who because of their sex were previously...

  10. 13 CFR 113.5 - Compliance information.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ..., institution or person; and such agency, institution or person shall fail or refuse to furnish this information... individuals under this regulation, have failed to overcome these consequences, it will become necessary for... racial, qualified handicapped, nationality groups and persons who because of their sex were previously...

  11. Approaches to Studying and Academic Performance in Short Essay Exams

    ERIC Educational Resources Information Center

    Minbashian, Amirali; Huon, Gail F.; Bird, Kevin D.

    2004-01-01

    Previous research has generally failed to find a relation between the way students approach the task of studying and their exam grades. The present study investigated why it is that a deep approach to studying, which has been shown to result in a higher quality of learning, does not consistently result in higher exam grades. The participants in…

  12. Familiarity from the configuration of objects in 3-dimensional space and its relation to déjà vu: a virtual reality investigation.

    PubMed

    Cleary, Anne M; Brown, Alan S; Sawyer, Benjamin D; Nomi, Jason S; Ajoku, Adaeze C; Ryals, Anthony J

    2012-06-01

    Déjà vu is the striking sense that the present situation feels familiar, alongside the realization that it has to be new. According to the Gestalt familiarity hypothesis, déjà vu results when the configuration of elements within a scene maps onto a configuration previously seen, but the previous scene fails to come to mind. We examined this using virtual reality (VR) technology. When a new immersive VR scene resembled a previously-viewed scene in its configuration but people failed to recall the previously-viewed scene, familiarity ratings and reports of déjà vu were indeed higher than for completely novel scenes. People also exhibited the contrasting sense of newness and of familiarity that is characteristic of déjà vu. Familiarity ratings and déjà vu reports among scenes recognized as new increased with increasing feature-match of a scene to one stored in memory, suggesting that feature-matching can produce familiarity and déjà vu when recall fails. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Academic Success Is about Self-Efficacy Rather than Frequency of Use of the Learning Management System

    ERIC Educational Resources Information Center

    Broadbent, Jaclyn

    2016-01-01

    Previous studies have investigated the association between the frequency of student learning management system (LMS) use (logins, discussion board use, resources used, etc.) and academic achievement. These studies indicate that low LMS use by students is likely to result in less academic success. However, these models fail to take into account…

  14. The Interaction between Family Structure and Child Gender on Behavior Problems in Urban Ethnic Minority Children

    ERIC Educational Resources Information Center

    Mokrue, Kathariya; Chen, Yung Y.; Elias, Maurice

    2012-01-01

    Previous studies have reported that children from single-parent households fare worse behaviorally than those from two-parent households. Studies examining single-parent households often fail to distinguish between single-mother and single-father households. Further, there are inconsistent findings regarding the effect of family structure on boys…

  15. Adolescent Work and Alcohol Use Revisited: Variations by Family Structure

    ERIC Educational Resources Information Center

    Rocheleau, Gregory C.; Swisher, Raymond R.

    2012-01-01

    Previous research finds adolescent work hours to be associated with increased alcohol use. Most studies, however, fail to account for possible selection effects that lead youth to both work and substance use. Using data from the first two waves of the National Longitudinal Study of Adolescent Health (N = 12,620), a fixed effects regression method…

  16. Why fish oil fails: a comprehensive 21st century lipids-based physiologic analysis.

    PubMed

    Peskin, B S

    2014-01-01

    The medical community suffered three significant fish oil failures/setbacks in 2013. Claims that fish oil's EPA/DHA would stop the progression of heart disease were crushed when The Risk and Prevention Study Collaborative Group (Italy) released a conclusive negative finding regarding fish oil for those patients with high risk factors but no previous myocardial infarction. Fish oil failed in all measures of CVD prevention-both primary and secondary. Another major 2013 setback occurred when fish oil's DHA was shown to significantly increase prostate cancer in men, in particular, high-grade prostate cancer, in the Selenium and Vitamin E Cancer Prevention Trial (SELECT) analysis by Brasky et al. Another monumental failure occurred in 2013 whereby fish oil's EPA/DHA failed to improve macular degeneration. In 2010, fish oil's EPA/DHA failed to help Alzheimer's victims, even those with low DHA levels. These are by no means isolated failures. The promise of fish oil and its so-called active ingredients EPA / DHA fails time and time again in clinical trials. This lipids-based physiologic review will explain precisely why there should have never been expectation for success. This review will focus on underpublicized lipid science with a focus on physiology.

  17. Why Fish Oil Fails: A Comprehensive 21st Century Lipids-Based Physiologic Analysis

    PubMed Central

    Peskin, B. S.

    2014-01-01

    The medical community suffered three significant fish oil failures/setbacks in 2013. Claims that fish oil's EPA/DHA would stop the progression of heart disease were crushed when The Risk and Prevention Study Collaborative Group (Italy) released a conclusive negative finding regarding fish oil for those patients with high risk factors but no previous myocardial infarction. Fish oil failed in all measures of CVD prevention—both primary and secondary. Another major 2013 setback occurred when fish oil's DHA was shown to significantly increase prostate cancer in men, in particular, high-grade prostate cancer, in the Selenium and Vitamin E Cancer Prevention Trial (SELECT) analysis by Brasky et al. Another monumental failure occurred in 2013 whereby fish oil's EPA/DHA failed to improve macular degeneration. In 2010, fish oil's EPA/DHA failed to help Alzheimer's victims, even those with low DHA levels. These are by no means isolated failures. The promise of fish oil and its so-called active ingredients EPA / DHA fails time and time again in clinical trials. This lipids-based physiologic review will explain precisely why there should have never been expectation for success. This review will focus on underpublicized lipid science with a focus on physiology. PMID:24551453

  18. Business Services' Impact on Student Retention: Exploring Student and Administrator Perceptions

    ERIC Educational Resources Information Center

    Hassabis, Haris

    2014-01-01

    High student attrition rates for first-year university students affect the financial and long-term sustainability of institutions. Previous researchers failed to provide workable solutions to improving student retention. This study was an exploration of students' and administrators' perceptions of business services and their potential impact on…

  19. Students' Views on the Effectiveness of Motivational Interviewing for Challenging Disaffection

    ERIC Educational Resources Information Center

    Snape, Laura; Atkinson, Cathy

    2017-01-01

    Emerging evidence suggests motivational interviewing (MI) is an effective intervention for supporting disaffected students. However, previous literature has failed to establish students' views on MI. In the present study, three students took part in an individual MI intervention, delivered by three educational psychologists (EPs). Self-report…

  20. Season of Birth in Autism: A Fiction Revisited.

    ERIC Educational Resources Information Center

    Landau, Edwina C.; Cicchetti, Domenic V.; Klin, Ami; Volkmar, Fred R.

    1999-01-01

    This study attempted to replicate previously reported increases in birth rates in March and August for individuals with autism. Statistical analysis of 904 cases revealed no significant seasonal effect. Samples were subcategorized into verbal and mute groups and again results failed to support the seasonal hypothesis. (Author/DB)

  1. Exploring Engaging Gamification Mechanics in Massive Online Open Courses

    ERIC Educational Resources Information Center

    Chang, Jen-Wei; Wei, Hung-Yu

    2016-01-01

    Massive open online courses (MOOCs) have developed rapidly and become tremendously popular because of their plentiful gamification designs, such as reputation points, rewards, and goal setting. Although previous studies have mentioned a broad range of gamification designs that might influence MOOC learner engagement, most gamified MOOCs fail to…

  2. Better off Jobless? Scarring Effects of Contingent Employment in Japan

    ERIC Educational Resources Information Center

    Yu, Wei-hsin

    2012-01-01

    Previous research fails to address whether contingent employment benefits individuals' careers more than the alternative they often face: being without a job. Using work history data from Japan, this study shows that accepting a contingent job delays individuals' transition to standard employment more than remaining jobless. Moreover, having a…

  3. 77 FR 42318 - Orthopaedic and Rehabilitation Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-18

    ... regarding the classification of posterior cervical screws, including pedicle and lateral mass screws. Cervical pedicle and lateral mass screws are components of rigid, posterior spinal screw and rod systems... neck pain confirmed by radiographic studies), trauma, deformity, failed previous fusion, tumor...

  4. Recategorized WISC-R Scores of Juvenile Delinquents.

    ERIC Educational Resources Information Center

    Groff, Martin G.; Hubble, Larry M.

    1981-01-01

    Wechsler Intelligence Scale for Children-Revised scores of a male delinquent sample were grouped by A. Bannatyne's classification of Wechsler's subtests, and these recategorized scores were compared with results of a previous study of learning disabled children. Findings failed to support a theory that learning disabled youth possess a unique…

  5. Rural Community Development: What Sort of Social Change?

    ERIC Educational Resources Information Center

    Wright, Susan

    1992-01-01

    Describes the role of the rural community development worker in achieving social change by encouraging participatory decision making. Presents results of a participatory research study in which the author, as a community worker, empowers a village with a failed water supply to seek change where they had previously experienced resistance by…

  6. Predicting Recidivism with the Psychopathy Checklist: Are Factor Score Composites Really Necessary?

    ERIC Educational Resources Information Center

    Walters, Glenn D.; Wilson, Nick J.; Glover, Anthony J. J.

    2011-01-01

    In two previous studies on general and violent recidivism (Walters & Heilbrun, 2010; Walters, Knight, Grann, & Dahle, 2008), the summed composite antisocial facet of the Psychopathy Checklist displayed incremental validity relative to the other 3 facets (interpersonal, affective, lifestyle), whereas the other 3 facets generally failed to…

  7. Academic Capitalism in the Pasteur's Quadrant

    ERIC Educational Resources Information Center

    Mendoza, Pilar

    2009-01-01

    Based on previous empirical studies, in this work the author presents an analysis of the role of context in academic capitalism. In particular, she argues that the literature on academic capitalism fails to properly acknowledge disciplinary and institutional differences, which results in an oversimplification of the effects of industry-academia…

  8. Online Learning: A New Testament

    ERIC Educational Resources Information Center

    Baggaley, Jon

    2014-01-01

    The statement by Hunter R. Rawlings III that "there are no good studies on what constitutes bad online pedagogy" coincides with the creation of a Global Learning Council to define the guidelines that previous online educators have allegedly failed to identify. This article discusses these disparaging remarks by the President of the…

  9. Maltase-glucoamylase: Mucosal regulator of prandial starch glucogenesis and complimentary hepatic gluconeogenesis of mice

    USDA-ARS?s Scientific Manuscript database

    In previous studies we have shown that maltase-glucoamylase (Mgam) is required for efficient starch digestion and insulin response to starch feeding. It was hypothesized that the slower rate of starch digestion by residual sucrase-isomaltase (Si) maltase failed to regulate gluconeogenesis. Here, rat...

  10. Survival of dental implants placed in sites of previously failed implants.

    PubMed

    Chrcanovic, Bruno R; Kisch, Jenö; Albrektsson, Tomas; Wennerberg, Ann

    2017-11-01

    To assess the survival of dental implants placed in sites of previously failed implants and to explore the possible factors that might affect the outcome of this reimplantation procedure. Patients that had failed dental implants, which were replaced with the same implant type at the same site, were included. Descriptive statistics were used to describe the patients and implants; survival analysis was also performed. The effect of systemic, environmental, and local factors on the survival of the reoperated implants was evaluated. 175 of 10,096 implants in 98 patients were replaced by another implant at the same location (159, 14, and 2 implants at second, third, and fourth surgeries, respectively). Newly replaced implants were generally of similar diameter but of shorter length compared to the previously placed fixtures. A statistically significant greater percentage of lost implants were placed in sites with low bone quantity. There was a statistically significant difference (P = 0.032) in the survival rates between implants that were inserted for the first time (94%) and implants that replaced the ones lost (73%). There was a statistically higher failure rate of the reoperated implants for patients taking antidepressants and antithrombotic agents. Dental implants replacing failed implants had lower survival rates than the rates reported for the previous attempts of implant placement. It is suggested that a site-specific negative effect may possibly be associated with this phenomenon, as well as the intake of antidepressants and antithrombotic agents. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Learning from an Unsuccessful Study Idea: Reflection and Application of Innovative Techniques to Prevent Future Failures.

    PubMed

    Fujihara, Yuki; Saito, Taichi; Huetteman, Helen E; Sterbenz, Jennifer M; Chung, Kevin C

    2018-04-01

    A well-organized, thoughtful study design is essential for creating an impactful study. However, pressures promoting high output from researchers can lead to rushed study proposals that overlook critical weaknesses in the study design that can affect the validity of the conclusions. Researchers can benefit from thorough review of past failed proposals when crafting new research ideas. Conceptual frameworks and root cause analysis are two innovative techniques that can be used during study development to identify flaws and prevent study failures. In addition, conceptual frameworks and root cause analysis can be combined to complement each other to provide both a big picture and detailed view of a study proposal. This article describes these two common analytical methods and provides an example of how they can be used to evaluate and improve a study design by critically examining a previous failed research idea.

  12. Evidence-Based Practices for Children, Youth, and Young Adults with Autism Spectrum Disorder: A Comprehensive Review

    ERIC Educational Resources Information Center

    Wong, Connie; Odom, Samuel L.; Hume, Kara A.; Cox, Ann W.; Fettig, Angel; Kucharczyk, Suzanne; Brock, Matthew E.; Plavnick, Joshua B.; Fleury, Veronica P.; Schultz, Tia R.

    2015-01-01

    The purpose of this study was to identify evidenced-based, focused intervention practices for children and youth with autism spectrum disorder. This study was an extension and elaboration of a previous evidence-based practice review reported by Odom et al. ("Prev Sch Fail" 54:275-282, 2010b, doi:10.?1080/?1045988100378550?6). In the…

  13. Getting Back to the Main Point: A Reply to Miller et al.

    ERIC Educational Resources Information Center

    Harrison, Allyson G.; Holmes, Alana; Silvestri, Robert; Armstrong, Irene T.

    2015-01-01

    Miller et al. have challenged the findings of our two previous studies, based largely on the assumption that our findings are biased due to the clinical sample used. However, they fail to address the primary tenet of our studies, namely, that clinicians will obtain different scores on the Wechsler Adult Intelligence Scale-IV (WAIS-IV) depending on…

  14. Stable Individual Differences in Number Discrimination in Infancy

    ERIC Educational Resources Information Center

    Libertus, Melissa E.; Brannon, Elizabeth M.

    2010-01-01

    Previous studies have shown that as a group 6-month-old infants successfully discriminate numerical changes when the values differ by at least a 1:2 ratio but fail at a 2:3 ratio (e.g. 8 vs. 16 but not 8 vs. 12). However, no studies have yet examined individual differences in number discrimination in infancy. Using a novel numerical change…

  15. Closure of oroantral communication with buccal fat pad after removing bilateral failed zygomatic implants: A case report and 6-month follow-up.

    PubMed

    Peñarrocha-Oltra, David; Alonso-González, Rocio; Pellicer-Chover, Hilario; Aloy-Prósper, Amparo; Peñarrocha-Diago, María

    2015-02-01

    The aim of this study was to assess the use of buccal fat pad (BFP) technique as an option to close oroantral communications (OAC) after removing failed zygomatic implants in a patient with a severely resorbed maxilla, and to determine the degree of patient satisfaction. A 64-year-old woman presented recurrent sinusitis and permanent oroantral communication caused by bilateral failed zygomatic implants, 3 years after prosthetic loading. Zygomatic implants were removed previous antibiotic treatment and the BFP flap technique was used to treat the OAC and maxillary defect. The degree of patient satisfaction after treatment was assessed through a visual analogue scale (VAS). At 6-months follow-up, patient showed complete healing and good function and the results in terms of phonetics, aesthetics and chewing were highly rated by the patient. Key words:Bichat fat pad, buccal fat pad, zygomatic implants, oroantral communication.

  16. The Sex Determination Gene Shows No Founder Effect in the Giant Honey Bee, Apis dorsata

    PubMed Central

    Yan, Wei Yu; Wu, Xiao Bo; Zeng, Zhi Jiang; Huang, Zachary Y.

    2012-01-01

    Background All honey bee species (Apis spp) share the same sex determination mechanism using the complementary sex determination (csd) gene. Only individuals heterogeneous at the csd allele develop into females, and the homozygous develop into diploid males, which do not survive. The honeybees are therefore under selection pressure to generate new csd alleles. Previous studies have shown that the csd gene is under balancing selection. We hypothesize that due to the long separation from the mainland of Hainan Island, China, that the giant honey bees (Apis dorsata) should show a founder effect for the csd gene, with many different alleles clustered together, and these would be absent on the mainland. Methodology/Principal Findings We sampled A. dorsata workers from both Hainan and Guangxi Provinces and then cloned and sequenced region 3 of the csd gene and constructed phylogenetic trees. We failed to find any clustering of the csd alleles according to their geographical origin, i.e. the Hainan and Guangxi samples did not form separate clades. Further analysis by including previously published csd sequences also failed to show any clade-forming in both the Philippines and Malaysia. Conclusions/Significance Results from this study and those from previous studies did not support the expectations of a founder effect. We conclude that because of the extremely high mating frequency of A. dorsata queens, a founder effect does not apply in this species. PMID:22511940

  17. The sex determination gene shows no founder effect in the giant honey bee, Apis dorsata.

    PubMed

    Liu, Zhi Yong; Wang, Zi Long; Yan, Wei Yu; Wu, Xiao Bo; Zeng, Zhi Jiang; Huang, Zachary Y

    2012-01-01

    All honey bee species (Apis spp) share the same sex determination mechanism using the complementary sex determination (csd) gene. Only individuals heterogeneous at the csd allele develop into females, and the homozygous develop into diploid males, which do not survive. The honeybees are therefore under selection pressure to generate new csd alleles. Previous studies have shown that the csd gene is under balancing selection. We hypothesize that due to the long separation from the mainland of Hainan Island, China, that the giant honey bees (Apis dorsata) should show a founder effect for the csd gene, with many different alleles clustered together, and these would be absent on the mainland. We sampled A. dorsata workers from both Hainan and Guangxi Provinces and then cloned and sequenced region 3 of the csd gene and constructed phylogenetic trees. We failed to find any clustering of the csd alleles according to their geographical origin, i.e. the Hainan and Guangxi samples did not form separate clades. Further analysis by including previously published csd sequences also failed to show any clade-forming in both the Philippines and Malaysia. Results from this study and those from previous studies did not support the expectations of a founder effect. We conclude that because of the extremely high mating frequency of A. dorsata queens, a founder effect does not apply in this species.

  18. Aqueous 2% Geraniol as a mosquito repellent failed against Aedes Aegypti on ponies

    USDA-ARS?s Scientific Manuscript database

    Organic insect repellents are of interest to many agricultural producers and animal owners. Geraniol, a plant-derived alcohol is naturally produced by a wide range of plants and is an EPA “minimum risk pesticide”. Previous studies have shown various concentrations of geraniol to repel or kill mosqui...

  19. Using Behavioural Skills Training to Treat Aggression in Adults with Mild Intellectual Disability in a Forensic Setting

    ERIC Educational Resources Information Center

    Travis, Robert W.; Sturmey, Peter

    2013-01-01

    Background: Previous studies of anger management in people with intellectual disability failed to control for the effects of the number of provocative stimuli presented and lacked direct measures of behaviour and treatment integrity data. Methods: This experiment systematically assessed and presented discriminative stimuli for aggressive…

  20. Preferences Regarding School Sexuality Education among Elementary Schoolchildren's Parents

    ERIC Educational Resources Information Center

    Dake, Joseph A.; Price, James H.; Baksovich, Christine M.; Wielinski, Margaret

    2014-01-01

    Background: A comprehensive review of the literature failed to find any studies to assess elementary school parents' preferred philosophical approach to teaching sexuality education and sexuality education topics discussed by parents. All previous research reported parent data for grades K-12 or grades 9-12 only. Methods: A random sample of 2400…

  1. Chewing Gum as a Treatment for Rumination in a Child with Autism

    ERIC Educational Resources Information Center

    Rhine, Denise; Tarbox, Jonathan

    2009-01-01

    Rumination involves regurgitation of previously ingested food, rechewing the food, and reswallowing it. In the current study, a child with autism displayed chronic rumination, resulting in the decay and subsequent removal of several teeth. After several treatments failed, including thickened liquids and starch satiation, the participant was taught…

  2. "Set Up to Fail": Institutional Racism and the Sabotage of School Improvement

    ERIC Educational Resources Information Center

    Taylor, Dianne L.; Clark, Menthia P.

    2009-01-01

    Data from two previous studies are reanalyzed using the lens of institutional racism to examine district decisions that undermined, or sabotaged, improvement efforts at schools attended by students of color. Opportunities to rectify the sabotage were available but not pursued. A model portrays the interaction between decision-maker intent,…

  3. Mania and Behavioral Equivalents: A Preliminary Study

    ERIC Educational Resources Information Center

    Sturmey, Peter; Laud, Rinita B.; Cooper, Christopher L.; Matson, Johnny L.; Fodstad, Jill C.

    2010-01-01

    Previous research has failed to address the possibility of behavioral equivalents in people with ID and mania. The relationship between a measure of mania and possible behavioral equivalents was assessed in 693 adults, most with severe or profound ID, living in a large residential setting. The mania subscale of the DASH-II proved to be a…

  4. Determination of Global Stability of the Slosh Motion in a Spacecraft via Num Erical Experiment

    NASA Astrophysics Data System (ADS)

    Kang, Ja-Young

    2003-12-01

    The global stability of the attitude motion of a spin-stabilized space vehicle is investigated by performing numerical experiment. In the previous study, a stationary solution and a particular resonant condition for a given model were found by using analytical method but failed to represent the system stability over parameter values near and off the stationary points. Accordingly, as an extension of the previous work, this study performs numerical experiment to investigate the stability of the system across the parameter space and determines stable and unstable regions of the design parameters of the system.

  5. Improving the Enterprise Requirements and Acquisition Model’s Developmental Test and Evaluation Process Fidelity

    DTIC Science & Technology

    2014-03-27

    and excluded from the model. The “Check SVR Loop” prevents programs from failing the SVR a second time. If a program has not previously failed the SVR...and Acquisition Management Plan Initiative. Briefing, Peterson AFB, CO: HQ AFSPC/A5X, 2011. Gilmore, Michael J., Key Issues Causing Prgram Delays

  6. Formation of Verbal Behavior of Deaf-Blind Children.

    ERIC Educational Resources Information Center

    Umezu, Hachizo

    The monograph describes the development of verbal behavior over a 20-year period in two deaf Japanese children (5- and 7-years-old when first contacted by the author) with whom previous training attempts had failed. It is noted that prior training methods which had succeeded with Laura Bridgman and Helen Keller failed with these two children. A…

  7. Comparative effectiveness of switching to alternative tumour necrosis factor (TNF) antagonists versus switching to rituximab in patients with rheumatoid arthritis who failed previous TNF antagonists: the MIRAR Study.

    PubMed

    Gomez-Reino, Juan J; Maneiro, Jose Ramon; Ruiz, Jorge; Roselló, Rosa; Sanmarti, Raimon; Romero, Ana Belen

    2012-11-01

    To compare the effectiveness of switching to rituximab (RTX) with switching to alternative tumour necrosis factor (TNF) antagonists in patients with rheumatoid arthritis (RA) failing on TNF antagonists. A multicentre prospective 3-year observational study was performed in patients with RA treated with RTX or an alternative TNF antagonist. The baseline 28-joint disease activity score (DAS28) and Health Assessment Questionnaire (HAQ) score were compared with 6, 9 and 12 month values, adjusting for propensity score quintiles. Propensity scores were estimated for each patient using logistic regression with treatment as the dependent variable and baseline prior number of TNFs >1, years from diagnosis >5, extra-articular manifestations, previous toxicity, use of ≥2 disease-modifying antirheumatic drugs, age and sex as independent variables. 1124 patients were treated with either RTX (n=591, 52.6%) or alternative TNF antagonists (n=533, 47.4%). RTX-treated patients had longer disease duration (p=0.0001), larger numbers of previous TNF antagonists (p<0.0001) and tender and swollen joints (p<0.0001). There was no significant difference in the reduction in DAS28 at 6, 9 and 12 months between RTX-treated patients and those treated with TNF antagonists. However, the reduction in DAS28 was significantly different between RTX-treated patients and adalimumab/infliximab-treated patients (p=0.001 and p=0.05, respectively). There was a marginally significant difference at any time period in the proportion of patients achieving an improvement in the HAQ score of >0.22 (p=0.06). Optimal treatment for patients with RA failing on treatment with TNF antagonists may include RTX. This study suggests that the improvement in DAS28 is larger in patients treated with RTX than in those treated with monoclonal anti-TNF agents.

  8. Editorial Commentary: In a World of Endless Options, Is There a Single Solution? Management Options for Failed Anterior Instability Surgery in Athletes.

    PubMed

    Matzkin, Elizabeth

    2018-05-01

    There are many options to manage anterior instability of the shoulder. The management of athletes who have failed previous operative stabilization can make choosing a treatment solution difficult. A modified Latarjet without capsulolabral repair has been demonstrated to be a good choice when treating failed stabilization in a high-risk population with sufficient return to play and outcomes. Copyright © 2018 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  9. The Impacts of Virtual Manipulatives and Prior Knowledge on Geometry Learning Performance in Junior High School

    ERIC Educational Resources Information Center

    Lee, Chun-Yi; Chen, Ming-Jang

    2014-01-01

    Previous studies on the effects of virtual and physical manipulatives have failed to consider the impact of prior knowledge on the efficacy of manipulatives. This study focuses on the learning of plane geometry in junior high schools, including the sum of interior angles in polygons, the sum of exterior angles in polygons, and the properties of…

  10. Rational Action Selection in 1 1/2- to 3-Year-Olds Following an Extended Training Experience

    ERIC Educational Resources Information Center

    Klossek, Ulrike M. H.; Dickinson, Anthony

    2012-01-01

    Previous studies failed to find evidence for rational action selection in children under 2 years of age. The current study investigated whether younger children required more training to encode the relevant causal relationships. Children between 1 1/2 and 3 years of age were trained over two sessions to perform actions on a touch-sensitive screen…

  11. Agarra, agarran: Evidence of early comprehension of subject-verb agreement in Spanish.

    PubMed

    Gonzalez-Gomez, Nayeli; Hsin, Lisa; Barrière, Isabelle; Nazzi, Thierry; Legendre, Géraldine

    2017-08-01

    Studies across many languages (e.g., Dutch, English, Farsi, Spanish, Xhosa) have failed to show early acquisition of subject-verb (SV) agreement, whereas recent studies on French reveal acquisition by 30months of age. Using a similar procedure as in previous French studies, the current study evaluated whether earlier comprehension of SV agreement in (Mexican) Spanish can be revealed when task demands are lowered. Two experiments using a touch-screen pointing task tested comprehension of SV agreement by monolingual Spanish-speaking children growing up in Mexico City between about 3 and 5years of age. In Experiment 1, the auditory stimuli consisted of a transitive verb+pseudonoun object (e.g., agarra el micho 'he throws the micho' vs. agarran el duco 'they throw the duco'); results failed to show early comprehension of SV agreement, replicating previous findings. In Experiment 2, the same stimuli were used, with the crucial difference that the word objeto 'object' replaced all pseudonouns; results revealed SV agreement comprehension as early as 41 to 50months. Taken together, our findings show that comprehension at this age is facilitated when task demands are lowered, here by not requiring children to process pseudowords (even when these were not critical to the task). Hence, these findings underscore the importance of task-specific/stimulus-specific features when testing early morphosyntactic development and suggest that previous results may have underestimated Spanish-speaking children's competence. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Long-term outcome of urethroplasty after failed urethrotomy versus primary repair.

    PubMed

    Barbagli, G; Palminteri, E; Lazzeri, M; Guazzoni, G; Turini, D

    2001-06-01

    A urethral stricture recurring after repeat urethrotomy challenges even a skilled urologist. To address the question of whether to repeat urethrotomy or perform open reconstructive surgery, we retrospectively review a series of 93 patients comparing those who underwent primary repair versus those who had undergone urethrotomy and underwent secondary treatment. From 1975 to 1998, 93 males between age 13 and 78 years (mean 39) underwent surgical treatment for bulbar urethral stricture. In 46 (49%) of the patients urethroplasty was performed as primary repair, and in 47 (51%) after previously failed urethrotomy. The strictures were localized in the bulbous urethra without involvement of penile or membranous tracts. The etiology was ischemic in 37 patients, traumatic in 23, unknown in 17 and inflammatory in 16. To simplify evaluation of the results, the clinical outcome was considered either a success or a failure at the time any postoperative procedure was needed, including dilation. In our 93 patients primary urethroplasty had a final success rate of 85%, and after failed urethrotomy 87%. Previously failed urethrotomy did not influence the long-term outcome of urethroplasty. The long-term results of different urethroplasty techniques had a final success rate ranging from 77% to 96%. We conclude that failed urethrotomy does not condition the long-term result of surgical repair. With extended followup, the success rate of urethroplasty decreases with time but it is in fact still higher than that of urethrotomy.

  13. Five-year efficacy and safety of tenofovir-based salvage therapy for patients with chronic hepatitis B who previously failed LAM/ADV therapy.

    PubMed

    Lim, Lucy; Thompson, Alexander; Patterson, Scott; George, Jacob; Strasser, Simone; Lee, Alice; Sievert, William; Nicoll, Amanda; Desmond, Paul; Roberts, Stuart; Marion, Kaye; Bowden, Scott; Locarnini, Stephen; Angus, Peter

    2017-06-01

    Multidrug-resistant HBV continues to be an important clinical problem. The TDF-109 study demonstrated that TDF±LAM is an effective salvage therapy through 96 weeks for LAM-resistant patients who previously failed ADV add-on or switch therapy. We evaluated the 5-year efficacy and safety outcomes in patients receiving long-term TDF±LAM in the TDF-109 study. A total of 59 patients completed the first phase of the TDF-109 study and 54/59 were rolled over into a long-term prospective open-label study of TDF±LAM 300 mg daily. Results are reported at the end of year 5 of treatment. At year 5, 75% (45/59) had achieved viral suppression by intent-to-treat analysis. Per-protocol assessment revealed 83% (45/54) were HBV DNA undetectable. Nine patients remained HBV DNA detectable, however 8/9 had very low HBV DNA levels (<264IU/mL) and did not meet virological criteria for virological breakthrough (VBT). One patient experienced VBT, but this was in the setting of documented non-compliance. The response was independent of baseline LAM therapy or mutations conferring ADV resistance. Four patients discontinued TDF, one patient was lost to follow-up and one died from hepatocellular carcinoma. Long-term TDF treatment appears to be safe and effective in patients with prior failure of LAM and a suboptimal response to ADV therapy. These findings confirm that TDF has a high genetic barrier to resistance is active against multidrug-resistant HBV, and should be the preferred oral anti-HBV agent in CHB patients who fail treatment with LAM and ADV. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Training Non-Clinical Community Psychologists at the Master's Level: A Case Study of Outcomes.

    ERIC Educational Resources Information Center

    Hoffnung, Robert J.; And Others

    Previous research on training for community psychology has failed to distinguish between the effects of different types of training programs or to address the viability of master's level training in community psychology. To explore the value of master's level training in non-clinical community psychology, 83 of 112 students who earned master's…

  15. Bimodal Emotion Congruency Is Critical to Preverbal Infants' Abstract Rule Learning

    ERIC Educational Resources Information Center

    Tsui, Angeline Sin Mei; Ma, Yuen Ki; Ho, Anna; Chow, Hiu Mei; Tseng, Chia-huei

    2016-01-01

    Extracting general rules from specific examples is important, as we must face the same challenge displayed in various formats. Previous studies have found that bimodal presentation of grammar-like rules (e.g. ABA) enhanced 5-month-olds' capacity to acquire a rule that infants failed to learn when the rule was presented with visual presentation of…

  16. Evaluating Courses: An Examination of the Impact of Student Gender

    ERIC Educational Resources Information Center

    Darby, Jenny A.

    2006-01-01

    Previous research into the effects of gender differences on course evaluations has failed to take into account a number of intervening variables. In part 1 of the present study a questionnaire was administered to 504 female and male students measuring whether they noticed, remembered things, and related to others. These are all measures which have…

  17. 75 FR 59077 - Airworthiness Directives; GROB-WERKE (Type Certificate Previously Held by BURKHART GROB Luft- und...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-27

    ... product. The MCAI describes the unsafe condition as: The manufacturer has received a report of a failed... manufacturer has received a report of a failed canopy jettison test, during a regular maintenance check. The... take about 3 work-hours and require parts costing $68, for a cost of $323 per product. We have no way...

  18. Design of the Electronic Brake Pressure Modulator Using a Direct Adaptive Fuzzy Controller in Commercial Vehicles for the Safety of Braking in Fail

    NASA Astrophysics Data System (ADS)

    Kim, Hunmo

    In the brake systems, it is important to reduce the rear brake pressure in order to secure the safety of the vehicle in braking. So, there was some research that reduced and controlled the rear brake pressure exactly like a L. S. P. V and a E. L. S. P. V. However, the previous research has some weaknesses: the L. S. P. V is a mechanical system and its brake efficiency is lower than the efficiency of E. L. S. P. V. But, the cost of E. L. S. P. V is very higher so its application to the vehicle is very difficult. Additionally, when a fail appears in the circuit which controls the valves, the fail results in some wrong operation of the valves. But, the previous researchers didn't take the effect of fail into account. Hence, the efficiency of them is low and the safety of the vehicle is not confirmed. So, in this paper we develop a new economical pressure modulator that exactly controls brake pressure and confirms the safety of the vehicle in any case using a direct adaptive fuzzy controller.

  19. Use of flow-diverting stents as salvage treatment following failed stent-assisted embolization of intracranial aneurysms.

    PubMed

    Heiferman, Daniel M; Billingsley, Joshua T; Kasliwal, Manish K; Johnson, Andrew K; Keigher, Kiffon M; Frudit, Michel E; Moftakhar, Roham; Lopes, Demetrius K

    2016-07-01

    Flow-diverting stents, including the Pipeline embolization device (PED) and Silk, have been beneficial in the treatment of aneurysms previously unable to be approached via endovascular techniques. Recurrent aneurysms for which stent-assisted embolization has failed are a therapeutic challenge, given the existing intraluminal construct with continued blood flow into the aneurysm. We report our experience using flow-diverting stents in the repair of 25 aneurysms for which stent-assisted embolization had failed. Nineteen (76%) of these aneurysms at the 12-month follow-up showed improved Raymond class occlusion, with 38% being completely occluded, and all aneurysms demonstrated decreased filling. One patient developed a moderate permanent neurologic deficit. Appropriate stent sizing, proximal and distal construct coverage, and preventing flow diverter deployment between the previously deployed stent struts are important considerations to ensure wall apposition and prevention of endoleak. Flow diverters are shown to be a reasonable option for treating previously stented recurrent cerebral aneurysms. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  20. Daily rhythmicity of body temperature in the dog.

    PubMed

    Refinetti, R; Piccione, G

    2003-08-01

    Research over the past 50 years has demonstrated the existence of circadian or daily rhythmicity in the body core temperature of a large number of mammalian species. However, previous studies have failed to identify daily rhythmicity of body temperature in dogs. We report here the successful recording of daily rhythms of rectal temperature in female Beagle dogs. The low robustness of the rhythms (41% of maximal robustness) and the small range of excursion (0.5 degrees C) are probably responsible for previous failures in detecting rhythmicity in dogs.

  1. Immunological approach in schistosomiasis. Annual report

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

    Hassan, F.; Seddik, S.; Shetta, A.

    1979-06-01

    Study No. 1 with reference to our last report of 1978 immunization experiments with high doses of irradiation with Cobalt 60 are terminated and the study with its results are as follows. In a previous study a trial of inducing protection by Immunization of mice with low doses of cobalt 60 irradiated cercariae was carried out. The results were rather encouraging yet follow up of immunized animals failed to give satisfactory resistance to new infection.

  2. Intellectual and Emotional Development and School Adjustment in Preterm Children at 6 and 7 Years of Age. Continuation of a Follow-Up Study.

    ERIC Educational Resources Information Center

    Grigoroiu-Serbanescu, Maria

    1984-01-01

    Continues a previous five-year follow-up of preterm and full-term children by studying the continuity in their intellectual and emotional development. Prematurity was predictive for school adjustment at ages six and seven only when regression was performed on the preterm group, but failed to be predictive when mixed groups of preterm and full-term…

  3. Socioeconomic Status and Intelligence Quotient as Predictors of Psychiatric Disorders in Children and Adolescents with High-Functioning Autism Spectrum Disorder and in Their Siblings

    ERIC Educational Resources Information Center

    Rosa, Mireia; Puig, Olga; Lázaro, Luisa; Calvo, Rosa

    2016-01-01

    Previous studies have shown high rates of comorbid disorders in children and adolescents with autism spectrum disorder, but failed to compare them with general population and few of them have identified predictors of comorbidity. This study compared the rates of psychiatric disorders in 50 children and adolescents with autism spectrum disorder, 24…

  4. Is there an association between study materials and scores on the American Board of Orthopaedic Surgeons Part 1 examination?

    PubMed

    Krueger, Chad A; Aden, James

    2014-01-01

    Previous studies have shown that certain orthopaedic in-training examination scores can be used to identify which residents may be at risk for failing the American Board of Orthopaedic Surgeons (ABOS) Part 1 examination. However, no studies have examined how study resources may affect residents' ABOS Part 1 scores. The goal of this study is to determine which review sources or review courses, if any, are associated with improved ABOS Part 1 scores. A survey was sent to 221 of the 865 examinees who took the ABOS Part 1 examination in 2012. The questions inquired the respondents how well they performed on previous orthopaedic in-training examinations and ABOS Part 1, along with the study sources they most commonly used, review courses they attended, and resources they would recommended if they were to retake ABOS Part 1 examination. Overall, 118 of the 221 (53%) survey recipients completed the survey. Six (5%) of the respondents failed ABOS Part 1 examination. Orthobullets and the American Academy of Orthopaedic Surgeons self-assessment examinations were recommended as the primary study source significantly more (p < 0.01) than most other resources, but there was no significant association between study source and passing ABOS Part 1 or scoring in a certain percentile on ABOS Part 1. Similarly, there were no associations between attending a review course and either passing or scoring in a certain percentile for ABOS Part 1. Half of the respondents who failed ABOS Part 1 attended multiple review courses. There does not appear to be an association between improved ABOS Part 1 scores and orthopedic study materials or review courses. Further research into the value of certain educational modalities should be conducted to determine the best ways to educate orthopedic residents and determine the value of some of these commonly used orthopedic review modalities. Published by Association of Program Directors in Surgery on behalf of Association of Program Directors in Surgery.

  5. Predictive value of CHA2DS2-VASc and CHA2DS2-VASc-HS scores for failed reperfusion after thrombolytic therapy in patients with ST-elevation myocardial ınfarction.

    PubMed

    Kilic, Salih; Kocabas, Umut; Can, Levent Hurkan; Yavuzgil, Oğuz; Çetin, Mustafa; Zoghi, Mehdi

    2018-03-07

    Thrombolytic therapy is recommended for patients with acute ST-segment elevation myocardial infarction (STEMI) who cannot undergo primary percutaneous coronary intervention within the first 120 min. The aim of this study wasz to demonstrate the value of CHA₂DS₂-VASc and CHA₂DS₂-VASc-HS scores in predicting failed reperfusion in STEMI patients treated with thrombolytic therapy. A total of 537 consecutive patients were enrolled in the study; 139 had failed thrombolysis while the remaining 398 fulfilled the criteria for successful thrombolysis. Thrombolysis failure was defined with the lack of symptom relief, < 50% ST resolution-related electrocardiography within 90 min from initiation of the thrombolytic therapy, presence of hemodynamic or electrical instability or in-hospital mortality. CHA₂DS₂-VASc and CHA₂DS₂-VASc-HS scores, which incorporate hyperlipidemia, smoking, switches between female and male gender, were previously shown to be markers of the severity of coronary artery disease (CAD). History of hypertension, diabetes mellitus, hyperlipidemia, heart failure, smoking, and CAD were significantly common in failed reperfusion patients (for all; p < 0.05). For prediction of failed reperfusion, the cut-off value of CHA₂DS₂-VASc score was ≥ 2 with a sensitivity of 80.90% and a specificity of 41.01% (area under curve [AUC] 0.660; 95% confidence interval [CI] 0.618-0.700; p < 0.001) and the cut-off value of CHA₂DS₂-VASc-HS score was ≥ 3 with a sensitivity of 76.13% and a specificity of 67.63% (AUC 0.764; 95% CI 0.725-0.799; p < 0.001). The CHA₂DS₂-VASc-HS score was found to be statistically and significantly better than CHA₂DS₂-VASc score to predict failed reperfusion (p < 0.001). The findings suggest that the CHA₂DS₂-VASc and especially CHA₂DS₂-VASc-HS scores could be considered as predictors of risk of failed reperfusion in STEMI patients.

  6. HIT and brain reward function: A case of mistaken identity (theory).

    PubMed

    Wright, Cory; Colombo, Matteo; Beard, Alexander

    2017-08-01

    This paper employs a case study from the history of neuroscience-brain reward function-to scrutinize the inductive argument for the so-called 'Heuristic Identity Theory' (HIT). The case fails to support HIT, illustrating why other case studies previously thought to provide empirical support for HIT also fold under scrutiny. After distinguishing two different ways of understanding the types of identity claims presupposed by HIT and considering other conceptual problems, we conclude that HIT is not an alternative to the traditional identity theory so much as a relabeling of previously discussed strategies for mechanistic discovery. Copyright © 2017. Published by Elsevier Ltd.

  7. Functional status and failed rotator cuff repair predict outcomes after arthroscopic-assisted latissimus dorsi transfer for irreparable massive rotator cuff tears.

    PubMed

    Castricini, Roberto; De Benedetto, Massimo; Familiari, Filippo; De Gori, Marco; De Nardo, Pasquale; Orlando, Nicola; Gasparini, Giorgio; Galasso, Olimpio

    2016-04-01

    Arthroscopic-assisted latissimus dorsi tendon transfer (LDTT) has been recently introduced for treatment of irreparable, posterosuperior massive rotator cuff tears. We sought to evaluate the functional outcomes of this technique and to check for possible outcome predictors. The study reviewed 86 patients (aged 59.8 ± 5.9 years) who underwent an arthroscopic-assisted latissimus dorsi tendon transfer after 36.4 ± 9 months of follow-up. Of these, 14 patients (16.3%) sustained an irreparable massive rotator cuff tear after a failed arthroscopic rotator cuff repair. The Constant and Murley score (CMS) was used to assess patients' functionality preoperatively and at follow-up. As a group, the CMS improved with surgery from 35.5 ± 6.1 to 69.5 ± 12.3 (P < .001). A lower preoperative CMS and a previous failed rotator cuff repair resulted in lower postoperative range of motion (P = .044 and P = .007, respectively) and CMS (P = .042 and P = .018, respectively). A previous rotator cuff repair resulted in lower satisfaction with surgery (P = .009). Gender and age did not affect the clinical outcomes. Our results support the effectiveness of arthroscopic-assisted LDTT in the treatment of patients with an irreparable, posterosuperior massive rotator cuff tears in pain relief, functional recovery, and postoperative satisfaction. Patients with lower preoperative CMS and a history of failed rotator cuff repair have a greater likelihood of having a lower clinical result. However, the favorable values of summary postoperative scores do not exclude these patients as candidates for arthroscopic-assisted LDTT. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  8. FEDAL SYSTEM OPERATION DURING STATION START-UP. Test Results (T-643734). Core I, Seed 2. Section I

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

    None

    An investigation was conducted to determine if any failed blanket fuel elements exist in core locations previously found to have high levels of delayed neutron emitter activity. Data from Fedal System monitors indicate that J5 may have a failed blanket element, there is no evidence of failure at core location F7. (J.R.D.)

  9. Dermatoglyphs in congenital heart disease.

    PubMed Central

    David, T J

    1981-01-01

    The palmar dermatoglyphs of 800 patients with anatomically proven congenital heart disease were compared with prints from 1000 controls. A review of the previous studies revealed major technical deficiencies, and the present study failed to confirm most of the previously reported positive findings. An overall increase in the incidence of hypothenar patterns was found, probably explaining the previous suggestion of increased atd angle in congenital heart disease. A large number of statistical comparisons inevitably produced a few 'significant' results, most of which were inconsistent in various ways. Two percent of cases were found to have rare epidermal ridge malformation, ridge dissociation. The nature of the relationship between this and congenital heart disease is obscure. Claims that there are diagnostically useful dermatoglyphic changes in congenital heart disease can be disregarded. PMID:7328614

  10. A rare case of failed healing in previously burned skin after a secondary burns.

    PubMed

    Goldie, Stephen J; Parsons, Shaun; Menezes, Hana; Ives, Andrew; Cleland, Heather

    2017-01-01

    Patients presenting with large surface area burns are common in our practice; however, patients with a secondary large burn on pre-existing burn scars and grafts are rare and not reported. We report on an unusual case of a patient sustaining a secondary large burn to areas previously injured by a burn from a different mechanism. We discuss the potential implications when managing a case like this and suggest potential biological reasons why the skin may behave differently. Our patient was a 33-year-old man who presented with a 5% TBSA burn on skin scarred by a previous 40% total body surface area (TBSA) burn and skin grafts. Initially assessed as superficial partial thickness in depth, the wounds were treated conservatively with dressings; however, they failed to heal and became infected requiring surgical management. Burns sustained in areas of previous burn scars and grafts may behave differently to normal patterns of healing, requiring more aggressive management and surgical intervention at an early stage.

  11. Outcome of locking compression plates in humeral shaft nonunions

    PubMed Central

    Kumar, Malhar N; Ravindranath, V Pratap; Ravishankar, MR

    2013-01-01

    Background: Nonunion of diaphyseal fractures of the humerus are frequently seen in clinical practice (incidence of up to 15% in certain studies) and osteosynthesis using dynamic compression plates, intra medullary nails and Ilizarov fixators have been reported previously. Locking compression plates (LCP) are useful in the presence of disuse osteoporosis, segmental bone loss and cortical defects that preclude strong fixation. We report a prospective followup study of the outcome of the use of LCP for humeral nonunion following failed internal fixation in which implants other than LCP had been used. Materials and Methods: Twenty four patients with nonunion of humeral shaft fractures following failed internal fixation were included in the study. The mean followup period was 3.4 years (range: 2.4 to 5.7 years) and the minimum followup period was 2 years. Mean age of the patients was 41.04 years (range: 24 to 57 years). All 24 patients underwent osteosynthesis using LCP and autologous bone grafting (cortico-cancellous iliac crest graft combined with or without fibular strut graft). Main outcome measurements included radiographic assessment of fracture union and pre and postoperative functional evaluation using the modified Constant and Murley scoring system. Results: 23 out of 24 fractures united following osteosynthesis. Average time to union was 16 weeks (range: 10 to 28 weeks). Complications included delayed union (n = 2), transient radial nerve palsy (n = 2) and persistent nonunion (n = 1). Functional evaluation using the Constant and Murley score showed excellent results in 11, good in 10, fair in two and poor outcome in one patient. Conclusions: Locking compression plating and cancellous bone grafting is a reliable option for achieving union in humeral diaphyseal nonunion with failed previous internal fixation and results in good functional outcome in patients with higher physiological demands. PMID:23682176

  12. An "XL" endodontics intervention for dental students required to repeat the course: changing frustration to improved grades and attitudes.

    PubMed

    Alcota, Marcela; Fuenzalida, Alejandra; Barrientos, Claudia; Garrido, Mauricio; Ruiz de Gauna, Pilar; González, Fermín E

    2015-04-01

    Given the psychological and financial costs involved with failing a clinical course, especially in developing countries, an alternative educational method was tested with students who had to repeat the year-long endodontic course at the University of Chile Faculty of Dentistry. The objectives of the intervention were to deepen theoretical knowledge and practical experiences, as well as to reinforce personal confidence in an endodontic clinical setting for students who failed the regular endodontic course. The aim of this study was to evaluate the success of this new model of educational intervention. In the study, 28 students who had failed the endodontic course repeated it with an alternative teaching method. The students attended patients immediately following practical competence exams, and they had access to simulated models that used rotary instruments and access cavities and had emergency care practice. Feedback sessions were held after each clinical session. Final grades were compared with those of other students who repeated the course without the intervention from 2007 to 2009. A survey was administered to understand the causes of initial failure and their opinions of the intervention. Students who participated in the alternative course did significantly better than their counterparts from previous years who did not receive the intervention (5.7±0.3 vs. 5.4±0.2; p<0.05). Their overall perception of the intervention was positive, and the main cause for previous course failure was personal insecurity and slow clinical care performance (54.2% of the students). The intervention course not only improved grades but also generated interest in endodontics, a contrasting perspective to the frustration students usually express after repeating the course. The results of this study support the introduction of similar interventions in endodontics and perhaps other courses.

  13. Rapid diversification of the cotton genus (Gossypium: Malvaceae) revealed by analysis of sixteen nuclear and chloroplast genes.

    Treesearch

    Richard C. Cronn; Randall L. Small; Tamara Hanselkorn; Jonathan F. Wendel

    2002-01-01

    Previous molecular phylogenetic studies have failed to resolve the branching order among the major cotton (Gossypium) lineages, and it has been unclear whether this reflects actual history (rapid radiation) or sampling properties of the genes evaluated. In this paper, we reconsider the phylogenetic relationships of diploid cotton genome groups using DNA sequences from...

  14. Overcoming the Effects of Variation in Infant Speech Segmentation: Influences of Word Familiarity

    ERIC Educational Resources Information Center

    Singh, Leher; Nestor, Sarah S.; Bortfeld, Heather

    2008-01-01

    Previous studies have shown that 7.5-month-olds can track and encode words in fluent speech, but they fail to equate instances of a word that contrast in talker gender, vocal affect, and fundamental frequency. By 10.5 months, they succeed at generalizing across such variability, marking a clear transition period during which infants' word…

  15. Vitamin D fails to prevent serum starvation- or staurosporine-induced apoptosis in human and rat osteosarcoma-derived cell lines

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

    Witasp, Erika; Division of Biochemical Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm; Gustafsson, Ann-Catrin

    2005-05-13

    Previous studies have suggested that 1,25(OH){sub 2}D{sub 3}, the active form of vitamin D{sub 3}, may increase the survival of bone-forming osteoblasts through an inhibition of apoptosis. On the other hand, vitamin D{sub 3} has also been shown to trigger apoptosis in human cancer cells, including osteosarcoma-derived cell lines. In the present study, we show that 1,25(OH){sub 2}D{sub 3} induces a time- and dose-dependent loss of cell viability in the rat osteosarcoma cell line, UMR-106, and the human osteosarcoma cell line, TE-85. We were unable, however, to detect nuclear condensation, phosphatidylserine externalization, or other typical signs of apoptosis in thismore » model. Moreover, 1,25(OH){sub 2}D{sub 3} failed to protect against apoptosis induced by serum starvation or incubation with the protein kinase inhibitor, staurosporine. These in vitro findings are thus at variance with several previous reports in the literature and suggest that induction of or protection against apoptosis of bone-derived cells may not be a primary function of vitamin D{sub 3}.« less

  16. Procedure-specific assessment tool for flexible pharyngo-laryngoscopy: gathering validity evidence and setting pass-fail standards.

    PubMed

    Melchiors, Jacob; Petersen, K; Todsen, T; Bohr, A; Konge, Lars; von Buchwald, Christian

    2018-06-01

    The attainment of specific identifiable competencies is the primary measure of progress in the modern medical education system. The system, therefore, requires a method for accurately assessing competence to be feasible. Evidence of validity needs to be gathered before an assessment tool can be implemented in the training and assessment of physicians. This evidence of validity must according to the contemporary theory on validity be gathered from specific sources in a structured and rigorous manner. The flexible pharyngo-laryngoscopy (FPL) is central to the otorhinolaryngologist. We aim to evaluate the flexible pharyngo-laryngoscopy assessment tool (FLEXPAT) created in a previous study and to establish a pass-fail level for proficiency. Eighteen physicians with different levels of experience (novices, intermediates, and experienced) were recruited to the study. Each performed an FPL on two patients. These procedures were video recorded, blinded, and assessed by two specialists. The score was expressed as the percentage of a possible max score. Cronbach's α was used to analyze internal consistency of the data, and a generalizability analysis was performed. The scores of the three different groups were explored, and a pass-fail level was determined using the contrasting groups' standard setting method. Internal consistency was strong with a Cronbach's α of 0.86. We found a generalizability coefficient of 0.72 sufficient for moderate stakes assessment. We found a significant difference between the novice and experienced groups (p < 0.001) and strong correlation between experience and score (Pearson's r = 0.75). The pass/fail level was established at 72% of the maximum score. Applying this pass-fail level in the test population resulted in half of the intermediary group receiving a failing score. We gathered validity evidence for the FLEXPAT according to the contemporary framework as described by Messick. Our results support a claim of validity and are comparable to other studies exploring clinical assessment tools. The high rate of physicians underperforming in the intermediary group demonstrates the need for continued educational intervention. Based on our work, we recommend the use of the FLEXPAT in clinical assessment of FPL and the application of a pass-fail level of 72% for proficiency.

  17. Patching compliance with full-time vs. part-time occlusion therapy.

    PubMed

    Kane, Jessica; Biernacki, Ron; Fraine, Lisa; Fukuda, Neva; Haskins, Kelsie; Morrison, David G

    2013-01-01

    Amblyopia is commonly treated with part-time occlusion (PTO) therapy. We have made two anecdotal observations regarding this therapy. First, children undergoing full-time occlusion seem to have better success and compliance rates. Secondly, a subset of children exists that fail PTO but can improve with more aggressive therapy. A retrospective review where treatment, visual outcome, and compliance scores were recorded. Compliance was graded on percent adherence reported by family. Patients scored “1” (for no compliance), “2” (for 1–25% of prescribed treatment performed), “3” (for 26–50%), “4” (for 51–75%), or “5” (for 76–100%). Seventy-six children were enrolled in the study: forty-five were treated with part-time occlusion, twenty-two were treated with full time occlusion (FTO), and nine had a history of failed PTO and were subsequently treated with FTO. Visual outcomes for FTO versus PTO were not statistically significant (P = 0.82). However, compliance rates in FTO were significantly better (P = 0.02). Of the nine patients that failed PTO, four improved an average of three lines with full-time occlusion, and five had no change with more aggressive patching. This study confirms previous reports of similar visual outcomes between PTO and FTO. However, compliance rates for FTO seem to be higher and some children who have failed PTO may improve with FTO.

  18. Experiences of visually impaired students in higher education: Bodily perspectives on inclusive education.

    PubMed

    Lourens, Heidi; Swartz, Leslie

    Although previous literature sheds light on the experiences of visually impaired students on tertiary grounds, these studies failed to provide an embodied understanding of their lives. In-depth interviews with 15 visually impaired students at one university demonstrated the ways in which they experienced their disability and the built environment in their bodies. At the same time, lost, fearful, shameful and aching bodies revealed prevailing gaps in provision for disabled students. Through this research it becomes clear how the environment is acutely felt within fleshly worlds, while bodies do not fail to tell of disabling societal structures. Based on the bodily stories, we thus make recommendations to improve the lives of visually impaired students on tertiary campuses.

  19. Experiences of visually impaired students in higher education: Bodily perspectives on inclusive education

    PubMed Central

    Lourens, Heidi; Swartz, Leslie

    2016-01-01

    Although previous literature sheds light on the experiences of visually impaired students on tertiary grounds, these studies failed to provide an embodied understanding of their lives. In-depth interviews with 15 visually impaired students at one university demonstrated the ways in which they experienced their disability and the built environment in their bodies. At the same time, lost, fearful, shameful and aching bodies revealed prevailing gaps in provision for disabled students. Through this research it becomes clear how the environment is acutely felt within fleshly worlds, while bodies do not fail to tell of disabling societal structures. Based on the bodily stories, we thus make recommendations to improve the lives of visually impaired students on tertiary campuses. PMID:27917028

  20. Supply Rate and Equilibrium Inventory of Air Force Enlisted Personnel: A Simultaneous Model of the Accession and Retention Markets Incorporating Force Level Constraints. Final Report for Period July 1969-June 1976.

    ERIC Educational Resources Information Center

    DeVany, Arthur S.; And Others

    This research was designed to develop and test a model of the Air Force manpower market. The study indicates that previous manpower supply studies failed to account for simultaneous determination of enlistments and retentions and misinterpreted regressions as supply equations. They are, instead, reduced form equations resulting from joint…

  1. School Bond Referenda Reloaded: An Examination of a School District in Passing a Subsequent Bond Referendum after Failing to Pass Previous Bond Referenda

    ERIC Educational Resources Information Center

    Benzaquen, Eitan Yacov

    2016-01-01

    In April 2008, the Wisconsin Erie School District attempted and failed to pass a school bond referendum to renovate its high school. In November 2008, again the school district did not pass a referendum. Interestingly, in the 2009-2010 school year, the district was successful in passing a bond referendum. Although the original bond measure called…

  2. The usefulness and scientific accuracy of private sector Arabic language patient drug information leaflets.

    PubMed

    Sukkari, Sana R; Al Humaidan, Abdullah S; Sasich, Larry D

    2012-07-01

    Inadequate access to useful scientifically accurate patient information is a major cause of the inappropriate use of drugs resulting in serious personal injury and related costs to the health care system. The definition of useful scientifically accurate patient information for prescription drugs was accepted by the US Secretary of the Department of Health and Human Services in 1996 as that derived from or consistent with the US FDA approved professional product label for a drug. Previous quality content studies found that English language patient drug information leaflets distributed by US pharmacies failed to meet minimum criteria defining useful and scientifically accurate information. Evaluation forms containing the explicit elements that define useful scientifically accurate information for three drugs with known serious adverse drug reactions were created based on the current US FDA approved professional product labels. The Arabic language patient drug information leaflets for celecoxib, paroxetine, and lamotrigine were obtained locally and evaluated using a methodology similar to that used in previous quality content patient drug information studies in the US. The Arabic leaflets failed to meet the definition of useful scientifically accurate information. The celecoxib leaflet contained 30% of the required information and the paroxetine and lamotrigine leaflets contained 24% and 20%, respectively. There are several limitations to this study. The Arabic leaflets from only one commercial North American vendor were evaluated and the evaluation included a limited number of drugs. A larger study is necessary to be able to generalize these results. The study results are consistent with those of previous quality content studies of commercially available English patient drug information leaflets. The results have important implications for patients as access to a reliable source of drug information may prevent harm or limit the suffering from serious adverse drug reactions.

  3. Outcome of the use of tension-free vaginal tape in women with mixed urinary incontinence, previous failed surgery, or low valsalva pressure.

    PubMed

    Abdel-Hady, El-Said; Constantine, Glyn

    2005-02-01

    To assess the safety and efficacy of the use of tension-free vaginal tape (TVT) for the treatment of stress urinary incontinence (SUI) in women with mixed incontinence, previous failed incontinence surgery or low valsalva leak point pressure (VLPP). Six hundred and fifty-eight women with SUI underwent the TVT procedure. These included women with mixed stress and urge incontinence (n=128), previous surgery for SUI (n=118), low VLPP (n=80), and those over 70 years old (n=68). The procedure was carried out under spinal anesthetic and operative and immediate postoperative data was collected for all women. Six-month follow-up data was available on 454 women, with the first 300 women completing a quality of life (QOL) questionnaire before and after surgery. The overall subjective cure rate at 6 months was 91%, with 8% of women reporting significant (>50%) improvement in their symptoms. Subgroups with a body mass index > 30, age > 70 years, coexisting instability, previous failed surgery, and low VLPP showed cure rates of 81-89%. QOL improvements for all groups were highly significant. Significant complications included voiding difficulties in 29 women (4.4%), retropubic hematomas in four (0.6%), and thromboembolic episodes in three (0.5%). The simplicity and high efficacy of the TVT makes it the first choice for the treatment of women with SUI, including those with more complex problems or coexisting risk factors.

  4. Revision allograft reconstruction of the lateral collateral ligament complex in elbows with previous failed reconstruction and persistent posterolateral rotatory instability.

    PubMed

    Baghdadi, Yaser M K; Morrey, Bernard F; O'Driscoll, Shawn W; Steinmann, Scott P; Sanchez-Sotelo, Joaquin

    2014-07-01

    Primary reconstruction of the lateral collateral ligament complex (LCLC) using graft tissue restores elbow stability in many, but not all, elbows with acute or chronic posterolateral rotatory instability (PLRI). Revision reconstruction using a tendon allograft is occasionally considered for persistent PLRI, but the outcome of revision ligament reconstruction in this setting is largely unknown. We determined whether revision allograft ligament reconstruction can (1) restore the stability and (2) result in improved elbow scores for patients with persistent PLRI of the elbow after a previous failed primary reconstructive attempt and in the context of the diverse pathology being addressed. Between 2001 and 2011, 160 surgical elbow procedures were performed at our institution for the LCLC reconstruction using allograft tissue. Only patients undergoing revision allograft reconstruction of the LCLC for persistent PLRI with a previous failed primary reconstructive attempt using graft tissue and at least I year of followup were included in the study. Eleven patients (11 elbows) fulfilled our inclusion criteria and formed our study cohort. The cohort consisted of six female patients and five male patients. The mean age at the time of revision surgery was 36 years (range, 14-59 years). The revision allograft reconstruction was carried out after a mean of 3 years (range, 2.5 months to 9 years) from a failed attempted reconstruction of the LCLC. Osseous deficiency to some extent was identified in the preoperative radiographs of eight elbows. Mean followup was 5 years (range, 1-12 years). Revision allograft reconstruction of the LCLC restored elbow stability in eight of the 11 elbows; two of the three elbows with persistent instability were operated on a third time (at 6 and 7 months after allograft revision reconstruction). For elbows with no persistent instability, the mean Mayo Elbow Performance Score at most recent followup was 83 points (range, 60-100 points), and six elbows were rated with a good or excellent result. All patients with persistent instability had some degree of preoperative bone loss. Revision allograft reconstruction of the LCLC is an option for treating recurrent PLRI, although this is a complex and resistant problem, and nearly ½ of the patients in this cohort either had persistent instability and/or had a fair or poor elbow score. Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.

  5. Do At-Risk Students Benefit When NovaNET Is Used for Credit Recovery?

    ERIC Educational Resources Information Center

    Volkerding, Rebecca Lynn

    2012-01-01

    The purpose of this study was to determine if it is effective and appropriate to place all students needing credit recovery in computer-based classes regardless of age, risk ratio, and their previous failing grade. Driven by the NCLB mandate for schools to produce greater gains and graduate all students in 4.5 years, districts are now using online…

  6. Lessons Learnt from Applying Action Research to Support Strategy Formation Processes in Long-Term Care Networks

    ERIC Educational Resources Information Center

    Cramer, Hendrik; Dewulf, Geert; Voordijk, Hans

    2015-01-01

    This study demonstrates how action research (AR) that is aimed at scaling-up experiments can be applied to support a strategy formation process (SFP) in a subsidized long-term care network. Previous research has developed numerous AR frameworks to support experiments in various domains, but has failed to explain how to apply AR and action learning…

  7. Constructing Geometric Properties of Rectangle, Square, and Triangle in the Third Grade of Indonesian Primary Schools

    ERIC Educational Resources Information Center

    Rizkianto, Ilham; Zulkardi; Darmawijaya

    2013-01-01

    Previous studies have provided that when learning shapes for the first time, young children tend to use the prototype as the reference point for comparisons, but often fail when doing so since they do not yet think about the defining attributes or the geometric properties of the shapes. Most of the time, elementary students learn geometric…

  8. Psychometric properties of the Liebowitz Social Anxiety Scale (LSAS) in a longitudinal study of African Americans with anxiety disorders.

    PubMed

    Beard, Courtney; Rodriguez, Benjamin F; Moitra, Ethan; Sibrava, Nicholas J; Bjornsson, Andri; Weisberg, Risa B; Keller, Martin B

    2011-06-01

    The Liebowitz Social Anxiety Scale (LSAS) is a widely used measure of social anxiety. However, no study has examined the psychometric properties of the LSAS in an African American sample. The current study examined the LSAS characteristics in 97 African Americans diagnosed with an anxiety disorder. Overall, the original LSAS subscales showed excellent internal consistency and temporal stability. Similar to previous reports, fear and avoidance subscales were so highly correlated that they yielded redundant information. Confirmatory factor analyses for three previously proposed models failed to demonstrate an excellent fit to our data. However, a four-factor model showed minimally acceptable fit. Overall, the LSAS performed similarly in our African American sample as in previous European American samples. Exploratory factor analyses are warranted to determine whether a better factor structure exists for African Americans. Copyright © 2011 Elsevier Ltd. All rights reserved.

  9. Management of cardiovascular risk factors with pioglitazone combination therapies in type 2 diabetes: an observational cohort study

    PubMed Central

    2011-01-01

    Background Type 2 diabetes (T2D) is strongly associated with cardiovascular risk and requires medications that improve glycemic control and other cardiovascular risk factors. The authors aimed to assess the relative effectiveness of pioglitazone (Pio), metformin (Met) and any sulfonylurea (SU) combinations in non-insulin-treated T2D patients who were failing previous hypoglycemic therapy. Methods Over a 1-year period, two multicenter, open-labeled, controlled, 1-year, prospective, observational studies evaluated patients with T2D (n = 4585) from routine clinical practice in Spain and Greece with the same protocol. Patients were eligible if they had been prescribed Pio + SU, Pio + Met or SU + Met serving as a control cohort, once they had failed with previous therapy. Anthropometric measurements, lipid and glycemic profiles, blood pressure, and the proportions of patients at microvascular and macrovascular risk were assessed. Results All study treatment combinations rendered progressive 6-month and 12-month lipid, glycemic, and blood pressure improvements. Pio combinations, especially Pio + Met, were associated with increases in HDL-cholesterol and decreases in triglycerides and in the atherogenic index of plasma. The proportion of patients at high risk decreased after 12 months in all study cohorts. Minor weight changes (gain or loss) and no treatment-related fractures occurred during the study. The safety profile was good and proved similar among treatments, except for more hypoglycemic episodes in patients receiving SU and for the occurrence of edema in patients using Pio combinations. Serious cardiovascular events were rarely reported. Conclusions In patients with T2D failing prior hypoglycemic therapies, Pio combinations with SU or Met (especially Pio + Met) improved blood lipid and glycemic profiles, decreasing the proportion of patients with a high microvascular or macrovascular risk. The combination of Pio with SU or Met may therefore be recommended for T2D second-line therapy in the routine clinical practice, particularly in patients with dyslipidemia. PMID:21314919

  10. Arthrodesis Using Pedicled Fibular Flap After Failed Infected Knee Arthroplasty

    PubMed Central

    Minear, Steve C.; Lee, Gordon; Kahn, David; Goodman, Stuart

    2011-01-01

    Objective: Severe bone loss associated with failed revision total knee arthroplasty is a challenging scenario. The pedicled fibular flap is a method to obtain vascularized bone for use in knee arthrodesis after failure of a total knee arthroplasty, with substantial loss of bone. Methods: We report 2 successful knee arthrodeses using this method in patients with infected, failed multiply revised total knee arthroplasties. The failed prosthesis was removed, and the bones were aligned and stabilized. The fibular flap was then harvested, fed through a subcutaneous tunnel, and placed within the medullary canal at the arthrodesis site. The soft tissue was closed over the grafts and flaps. Results: Two elderly women presented with pain and drainage from previous total knee arthroplasties after multiple revisions. Arthrodeses were performed as described, and both patients were pain-free with the knee fused at 1 year. Conclusions: Thus, pedicled vascularized flaps are a viable alternative in the treatment of failed revision arthroplasty with large segmental bone loss. PMID:22132250

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

    Farmer, M. T.

    The overall objective of the current work is to carry out a scoping analysis to determine the impact of ATF on late phase accident progression; in particular, the molten core-concrete interaction portion of the sequence that occurs after the core debris fails the reactor vessel and relocates into containment. This additional study augments previous work by including kinetic effects that govern chemical reaction rates during core-concrete interaction. The specific ATF considered as part of this study is SiC-clad UO 2.

  12. Salvage Percutaneous Vertebral Augmentation Using Polymethyl Methacrylate in Patients with Failed Interbody Fusion.

    PubMed

    Yun, Dong-Ju; Hwang, Byeong-Wook; Oh, Hyeong-Seok; Kim, Jin-Sung; Jeon, Sang-Hyeop; Lee, Sang-Ho

    2016-11-01

    Percutaneous vertebral augmentation with cement is used as a salvage procedure for failed instrumentation. Few studies have reported the use of this procedure for failed anterior lumbar fusion in elderly patients with osteoporosis and other complicated diseases who have undergone a previous major operation. Between January 2007 and December 2015, the clinical and radiographic results of 8 patients with osteoporosis who showed subsidence and migration of the implant after an initial operation were examined. After the development of implant failure, the patients underwent vertebral augmentation with polymethyl methacrylate. Mean patient age was 73.4 years (range, 67-78 years), and mean bone mineral density was -2.96 (range, -2.1 to -3.8). The mean radiologic follow-up period between augmentation and the last follow-up examination was 16 months (range, 3-38 months). Although the subjective clinical outcome was not satisfying to the patients, no loss of correction, fractures, or screw loosening occurred during the follow-up period. The injection of cement around the instrument might help to stabilize it by providing strength to the axis and preventing further loosening. This salvage procedure could be an alternative in the management of cases with failed interbody fusion. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Drain Failure in Intra-Abdominal Abscesses Associated with Appendicitis.

    PubMed

    Horn, Christopher B; Coleoglou Centeno, Adrian A; Guerra, Jarot J; Mazuski, John E; Bochicchio, Grant V; Turnbull, Isaiah R

    2018-04-01

    Previous studies have suggested that percutaneous drainage and interval appendectomy is an effective treatment for appendicitis with associated abscess. Few studies to date have analyzed risk factors for failed drain management. We hypothesized that older patients with more co-morbidities would be at higher risk for failing conservative treatment. The 2010-2014 editions of the National Inpatient Sample (NIS) were queried for patients with diagnoses of peri-appendiceal abscesses. Minors and elective admissions were excluded. We identified patients who underwent percutaneous drainage and defined drain failure as undergoing a surgical operation after drainage but during the same inpatient visit to assess for factors associated with failure of drainage alone as a treatment. After univariable analysis, binomial logistic regression was used to assess for independent risk factors. Frequencies were analyzed by χ 2 and continuous variables by Student's t-test. A total of 2,209 patients with appendiceal abscesses received drains; 561 patients (25.4%) failed conservative management and underwent operative intervention. On univariable analysis, patients who failed conservative management were younger, more likely to be Hispanic, have more inpatient diagnoses, and to have undergone drainage earlier in the hospital course. Multivariable regression demonstrated that the number of diagnoses, female sex, and Hispanic race were predictive of failure of drainage alone. Older age, West and Midwest census regions, and later drain placement were predictive of successful treatment with drainage alone. Failure was associated with more charges and longer hospital stay but not with a higher mortality rate. Approximately a quarter of patients will fail management of appendiceal abscess with percutaneous drain placement alone. Risk factors for failure are patient complexity, female sex, earlier drainage, and Hispanic race. Failure of drainage is associated with higher total charges and longer hospital stay; however, no change in the mortality rate was noted.

  14. Sleep quality, internet addiction and depressive symptoms among undergraduate students in Nepal.

    PubMed

    Bhandari, Parash Mani; Neupane, Dipika; Rijal, Shristi; Thapa, Kiran; Mishra, Shiva Raj; Poudyal, Amod Kumar

    2017-03-21

    Evidence on the burden of depression, internet addiction and poor sleep quality in undergraduate students from Nepal is virtually non-existent. While the interaction between sleep quality, internet addiction and depressive symptoms is frequently assessed in studies, it is not well explored if sleep quality or internet addiction statistically mediates the association between the other two variables. We enrolled 984 students from 27 undergraduate campuses of Chitwan and Kathmandu, Nepal. We assessed sleep quality, internet addiction and depressive symptoms in these students using Pittsburgh Sleep Quality Index, Young's Internet Addiction Test and Patient Health Questionnaire-9 respectively. We included responses from 937 students in the data analysis after removing questionnaires with five percent or more fields missing. Via bootstrap approach, we assessed the mediating role of internet addiction in the association between sleep quality and depressive symptoms, and that of sleep quality in the association between internet addiction and depressive symptoms. Overall, 35.4%, 35.4% and 21.2% of students scored above validated cutoff scores for poor sleep quality, internet addiction and depression respectively. Poorer sleep quality was associated with having lower age, not being alcohol user, being a Hindu, being sexually active and having failed in previous year's board examination. Higher internet addiction was associated with having lower age, being sexually inactive and having failed in previous year's board examination. Depressive symptoms were higher for students having higher age, being sexually inactive, having failed in previous year's board examination and lower years of study. Internet addiction statistically mediated 16.5% of the indirect effect of sleep quality on depressive symptoms. Sleep quality, on the other hand, statistically mediated 30.9% of the indirect effect of internet addiction on depressive symptoms. In the current study, a great proportion of students met criteria for poor sleep quality, internet addiction and depression. Internet addiction and sleep quality both mediated a significant proportion of the indirect effect on depressive symptoms. However, the cross-sectional nature of this study limits causal interpretation of the findings. Future longitudinal study, where the measurement of internet addiction or sleep quality precedes that of depressive symptoms, are necessary to build upon our understanding of the development of depressive symptoms in students.

  15. A two-stage genome-wide association study of sporadic amyotrophic lateral sclerosis.

    PubMed

    Chiò, Adriano; Schymick, Jennifer C; Restagno, Gabriella; Scholz, Sonja W; Lombardo, Federica; Lai, Shiao-Lin; Mora, Gabriele; Fung, Hon-Chung; Britton, Angela; Arepalli, Sampath; Gibbs, J Raphael; Nalls, Michael; Berger, Stephen; Kwee, Lydia Coulter; Oddone, Eugene Z; Ding, Jinhui; Crews, Cynthia; Rafferty, Ian; Washecka, Nicole; Hernandez, Dena; Ferrucci, Luigi; Bandinelli, Stefania; Guralnik, Jack; Macciardi, Fabio; Torri, Federica; Lupoli, Sara; Chanock, Stephen J; Thomas, Gilles; Hunter, David J; Gieger, Christian; Wichmann, H Erich; Calvo, Andrea; Mutani, Roberto; Battistini, Stefania; Giannini, Fabio; Caponnetto, Claudia; Mancardi, Giovanni Luigi; La Bella, Vincenzo; Valentino, Francesca; Monsurrò, Maria Rosaria; Tedeschi, Gioacchino; Marinou, Kalliopi; Sabatelli, Mario; Conte, Amelia; Mandrioli, Jessica; Sola, Patrizia; Salvi, Fabrizio; Bartolomei, Ilaria; Siciliano, Gabriele; Carlesi, Cecilia; Orrell, Richard W; Talbot, Kevin; Simmons, Zachary; Connor, James; Pioro, Erik P; Dunkley, Travis; Stephan, Dietrich A; Kasperaviciute, Dalia; Fisher, Elizabeth M; Jabonka, Sibylle; Sendtner, Michael; Beck, Marcus; Bruijn, Lucie; Rothstein, Jeffrey; Schmidt, Silke; Singleton, Andrew; Hardy, John; Traynor, Bryan J

    2009-04-15

    The cause of sporadic amyotrophic lateral sclerosis (ALS) is largely unknown, but genetic factors are thought to play a significant role in determining susceptibility to motor neuron degeneration. To identify genetic variants altering risk of ALS, we undertook a two-stage genome-wide association study (GWAS): we followed our initial GWAS of 545 066 SNPs in 553 individuals with ALS and 2338 controls by testing the 7600 most associated SNPs from the first stage in three independent cohorts consisting of 2160 cases and 3008 controls. None of the SNPs selected for replication exceeded the Bonferroni threshold for significance. The two most significantly associated SNPs, rs2708909 and rs2708851 [odds ratio (OR) = 1.17 and 1.18, and P-values = 6.98 x 10(-7) and 1.16 x 10(-6)], were located on chromosome 7p13.3 within a 175 kb linkage disequilibrium block containing the SUNC1, HUS1 and C7orf57 genes. These associations did not achieve genome-wide significance in the original cohort and failed to replicate in an additional independent cohort of 989 US cases and 327 controls (OR = 1.18 and 1.19, P-values = 0.08 and 0.06, respectively). Thus, we chose to cautiously interpret our data as hypothesis-generating requiring additional confirmation, especially as all previously reported loci for ALS have failed to replicate successfully. Indeed, the three loci (FGGY, ITPR2 and DPP6) identified in previous GWAS of sporadic ALS were not significantly associated with disease in our study. Our findings suggest that ALS is more genetically and clinically heterogeneous than previously recognized. Genotype data from our study have been made available online to facilitate such future endeavors.

  16. A two-stage genome-wide association study of sporadic amyotrophic lateral sclerosis

    PubMed Central

    Chiò, Adriano; Schymick, Jennifer C.; Restagno, Gabriella; Scholz, Sonja W.; Lombardo, Federica; Lai, Shiao-Lin; Mora, Gabriele; Fung, Hon-Chung; Britton, Angela; Arepalli, Sampath; Gibbs, J. Raphael; Nalls, Michael; Berger, Stephen; Kwee, Lydia Coulter; Oddone, Eugene Z.; Ding, Jinhui; Crews, Cynthia; Rafferty, Ian; Washecka, Nicole; Hernandez, Dena; Ferrucci, Luigi; Bandinelli, Stefania; Guralnik, Jack; Macciardi, Fabio; Torri, Federica; Lupoli, Sara; Chanock, Stephen J.; Thomas, Gilles; Hunter, David J.; Gieger, Christian; Wichmann, H. Erich; Calvo, Andrea; Mutani, Roberto; Battistini, Stefania; Giannini, Fabio; Caponnetto, Claudia; Mancardi, Giovanni Luigi; La Bella, Vincenzo; Valentino, Francesca; Monsurrò, Maria Rosaria; Tedeschi, Gioacchino; Marinou, Kalliopi; Sabatelli, Mario; Conte, Amelia; Mandrioli, Jessica; Sola, Patrizia; Salvi, Fabrizio; Bartolomei, Ilaria; Siciliano, Gabriele; Carlesi, Cecilia; Orrell, Richard W.; Talbot, Kevin; Simmons, Zachary; Connor, James; Pioro, Erik P.; Dunkley, Travis; Stephan, Dietrich A.; Kasperaviciute, Dalia; Fisher, Elizabeth M.; Jabonka, Sibylle; Sendtner, Michael; Beck, Marcus; Bruijn, Lucie; Rothstein, Jeffrey; Schmidt, Silke; Singleton, Andrew; Hardy, John; Traynor, Bryan J.

    2009-01-01

    The cause of sporadic amyotrophic lateral sclerosis (ALS) is largely unknown, but genetic factors are thought to play a significant role in determining susceptibility to motor neuron degeneration. To identify genetic variants altering risk of ALS, we undertook a two-stage genome-wide association study (GWAS): we followed our initial GWAS of 545 066 SNPs in 553 individuals with ALS and 2338 controls by testing the 7600 most associated SNPs from the first stage in three independent cohorts consisting of 2160 cases and 3008 controls. None of the SNPs selected for replication exceeded the Bonferroni threshold for significance. The two most significantly associated SNPs, rs2708909 and rs2708851 [odds ratio (OR) = 1.17 and 1.18, and P-values = 6.98 × 10−7 and 1.16 × 10−6], were located on chromosome 7p13.3 within a 175 kb linkage disequilibrium block containing the SUNC1, HUS1 and C7orf57 genes. These associations did not achieve genome-wide significance in the original cohort and failed to replicate in an additional independent cohort of 989 US cases and 327 controls (OR = 1.18 and 1.19, P-values = 0.08 and 0.06, respectively). Thus, we chose to cautiously interpret our data as hypothesis-generating requiring additional confirmation, especially as all previously reported loci for ALS have failed to replicate successfully. Indeed, the three loci (FGGY, ITPR2 and DPP6) identified in previous GWAS of sporadic ALS were not significantly associated with disease in our study. Our findings suggest that ALS is more genetically and clinically heterogeneous than previously recognized. Genotype data from our study have been made available online to facilitate such future endeavors. PMID:19193627

  17. Back on Track: Exploring How a Further Education College Re-Motivates Learners to Re-Sit Previously Failed Qualifications at GCSE

    ERIC Educational Resources Information Center

    Anderson, Nadia; Peart, Sheine

    2016-01-01

    Underachievement at GCSE level has significant effects on an individual's life chances. Each year, around half of 16-year-olds leave school without having achieved a full level-2 qualification (five GCSEs at A*-C including English and maths). Many of these students enrol on a programme of study at local further education (FE) colleges. Recent…

  18. Can the 2014 Comprehensive Agreement on the Bangsamoro (CAB) Succeed in Mindanao Where Previous Agreements Failed?

    DTIC Science & Technology

    2015-03-01

    International Studies (RSIS) at Nanyang Technological University , Singapore, argues that “small arms proliferation and a weak rule of law” will hurt...NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA THESIS Approved for public release; distribution is unlimited CAN THE 2014...0704-0188 Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing

  19. School Improvement Planning and Student Achievement: A Case Study for Best Practices in School and District Leadership

    ERIC Educational Resources Information Center

    Napoleone, Antonio

    2012-01-01

    Across the nation, 48% of schools have failed to meet No Child Left Behind's testing targets (Center of Education Policy, 2011). In 2011, more schools had not made Adequate Yearly Progress (AYP) than in any previous year, according to stateby-state data for the 2011 school year. Out of a total of 980 schools 461, or 47%, did not make AYP in…

  20. Cardiovascular disease risk factors in persons with paraplegia: the Stockholm spinal cord injury study.

    PubMed

    Wahman, Kerstin; Nash, Mark S; Westgren, Ninni; Lewis, John E; Seiger, Ake; Levi, Richard

    2010-03-01

    To examine cardiovascular disease risk factors and risk clusters in Swedish persons with traumatic wheelchair-dependent paraplegia. Prospective examination. A total of 135 individuals aged 18-79 years with chronic (>or= 1 year) post-traumatic paraplegia. Cardiovascular disease risk factors; dyslipidemia, impaired fasting glucose, hypertension, overweight, smoking, and medication usage for dyslipidemia, hypertension, and diabetes mellitus, were analyzed according to authoritative guidelines. Stepwise regression tested the effects of age, gender, and injury characteristics on cardiovascular disease risks. High-prevalence risk factors were dyslipidemia (83.1%), hypertension (39.3%), and overweight (42.2%) with pervasive clustering of these risks. Being older was related to increased cardiovascular disease risk, except for dyslipidemia. Hypertension was more common in low-level paraplegia. Prevalence of impaired fasting glucose was lower than previously reported after paraplegia. A high percentage of persons being prescribed drug treatment for dyslipidemia and hypertension failed to reach authoritative targets for cardiovascular disease risk reduction. Swedish persons with paraplegia are at high risk for dyslipidemia, hypertension, and overweight. Impaired fasting glucose was not as common as reported in some previous studies. Pharmacotherapy for dyslipidemia and hypertension often failed to achieve recommended targets. Population-based screening and therapeutic countermeasures to these cardiovascular disease risks are indicated.

  1. Surgical results of trabeculectomy and Ahmed valve implantation following a previous failed trabeculectomy in primary congenital glaucoma patients.

    PubMed

    Lee, Naeun; Ma, Kyoung Tak; Bae, Hyoung Won; Hong, Samin; Seong, Gong Je; Hong, Young Jae; Kim, Chan Yun

    2015-04-01

    To compare the surgical results of trabeculectomy and Ahmed glaucoma valve implantation after a previous failed trabeculectomy. A retrospective comparative case series review was performed on 31 eye surgeries in 20 patients with primary congenital glaucoma who underwent trabeculectomy or Ahmed glaucoma valve implantation after a previous failed trabeculectomy with mitomycin C. The preoperative mean intraocular pressure was 25.5 mmHg in the trabeculectomy group and 26.9 mmHg in the Ahmed glaucoma valve implantation group (p = 0.73). The 48-month postoperative mean intraocular pressure was 19.6 mmHg in the trabeculectomy group and 20.2 mmHg in the Ahmed glaucoma valve implantation group (p = 0.95). The 12-month trabeculectomy success rate was 69%, compared with 64% for Ahmed glaucoma valve implantation, and the 48-month success rates were 42% and 36% for trabeculectomy and valve implantation, respectively. The success rates following the entire follow-up period were not significantly different between the two groups (p > 0.05 by log rank test). Postoperative complications occurred in 25% of the trabeculectomy-operated eyes and 9% of the Ahmed-implanted eyes (p = 0.38). There was no significant difference in surgical outcome between the trabeculectomy and Ahmed glaucoma valve implantation groups, neither of which had favorable results. However, the trabeculectomy group demonstrated a higher prevalence of adverse complications such as post-operative endophthalmitis.

  2. Experimental study of inequality and unpredictability in an artificial cultural market.

    PubMed

    Salganik, Matthew J; Dodds, Peter Sheridan; Watts, Duncan J

    2006-02-10

    Hit songs, books, and movies are many times more successful than average, suggesting that "the best" alternatives are qualitatively different from "the rest"; yet experts routinely fail to predict which products will succeed. We investigated this paradox experimentally, by creating an artificial "music market" in which 14,341 participants downloaded previously unknown songs either with or without knowledge of previous participants' choices. Increasing the strength of social influence increased both inequality and unpredictability of success. Success was also only partly determined by quality: The best songs rarely did poorly, and the worst rarely did well, but any other result was possible.

  3. Recent human evolution has shaped geographical differences in susceptibility to disease

    PubMed Central

    2011-01-01

    Background Searching for associations between genetic variants and complex diseases has been a very active area of research for over two decades. More than 51,000 potential associations have been studied and published, a figure that keeps increasing, especially with the recent explosion of array-based Genome-Wide Association Studies. Even if the number of true associations described so far is high, many of the putative risk variants detected so far have failed to be consistently replicated and are widely considered false positives. Here, we focus on the world-wide patterns of replicability of published association studies. Results We report three main findings. First, contrary to previous results, genes associated to complex diseases present lower degrees of genetic differentiation among human populations than average genome-wide levels. Second, also contrary to previous results, the differences in replicability of disease associated-loci between Europeans and East Asians are highly correlated with genetic differentiation between these populations. Finally, highly replicated genes present increased levels of high-frequency derived alleles in European and Asian populations when compared to African populations. Conclusions Our findings highlight the heterogeneous nature of the genetic etiology of complex disease, confirm the importance of the recent evolutionary history of our species in current patterns of disease susceptibility and could cast doubts on the status as false positives of some associations that have failed to replicate across populations. PMID:21261943

  4. Influence of the local-spin-density correlation functional on the stability of bcc ferromagnetic iron

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

    Singh, D.; Clougherty, D.P.; MacLaren, J.M.

    1991-10-01

    The influence of local-spin-dependent correlation effects on the predicted stable ground-state phase of iron is reexamined with use of general-potential linearized augmented-plane-wave calculations. Differences in the form of the Vosko-Wilk-Nusair (VWN) local-spin-density functional used in previous studies are noted, since in previous studies significant additional approximations were made with respect to those of Vosko, Wilk, and Nusan (Can. J. Phys. 58, 1200 (1980)) and of MacLaren, Clougherty, and Albers (Phys. Rev. B 42, 3205 (1990)). While the results of previous linear muffin-tin orbital calculations using the VWN functional predict a bcc ferromagnetic ground state, the present calculations show that themore » VWN spin-correlation effects fail to stabilize a bcc ground state. Considerable sensitivity to the form of the spin interpolation is found.« less

  5. Magnetoencephalography and ictal SPECT in patients with failed epilepsy surgery.

    PubMed

    El Tahry, Riёm; Wang, Z Irene; Thandar, Aung; Podkorytova, Irina; Krishnan, Balu; Tousseyn, Simon; Guiyun, Wu; Burgess, Richard C; Alexopoulos, Andreas V

    2018-06-06

    Selected patients with intractable focal epilepsy who have failed a previous epilepsy surgery can become seizure-free with reoperation. Preoperative evaluation is exceedingly challenging in this cohort. We aim to investigate the diagnostic value of two noninvasive approaches, magnetoencephalography (MEG) and ictal single-photon emission computed tomography (SPECT), in patients with failed epilepsy surgery. We retrospectively included a consecutive cohort of patients who failed prior resective epilepsy surgery, underwent re-evaluation including MEG and ictal SPECT, and had another surgery after the re-evaluation. The relationship between resection and localization from each test was determined, and their association with seizure outcomes was analyzed. A total of 46 patients were included; 21 (46%) were seizure-free at 1-year followup after reoperation. Twenty-seven (58%) had a positive MEG and 31 (67%) had a positive ictal SPECT. The resection of MEG foci was significantly associated with seizure-free outcome (p = 0.002). Overlap of ictal SPECT hyperperfusion zones with resection was significantly associated with seizure-free outcome in the subgroup of patients with injection time ≤20 seconds(p = 0.03), but did not show significant association in the overall cohort (p = 0.46) although all injections were ictal. Patients whose MEG and ictal SPECT were concordant on a sublobar level had a significantly higher chance of seizure freedom (p = 0.05). MEG alone achieved successful localization in patients with failed epilepsy surgery with a statistical significance. Only ictal SPECT with early injection (≤20 seconds) had good localization value. Sublobar concordance between both tests was significantly associated with seizure freedom. SPECT can provide essential information in MEG-negative cases and vice versa. Our results emphasize the importance of considering a multimodal presurgical evaluation including MEG and SPECT in all patients with a previous failed epilepsy surgery. Copyright © 2018 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  6. Endovascular thrombectomy for acute ischemic stroke in failed intravenous tissue plasminogen activator versus non-intravenous tissue plasminogen activator patients: revascularization and outcomes stratified by the site of arterial occlusions.

    PubMed

    Shi, Zhong-Song; Loh, Yince; Walker, Gary; Duckwiler, Gary R

    2010-06-01

    Intracranial mechanical thrombectomy is a therapeutic option for acute ischemic stroke patients failing intravenous tissue plasminogen activator (IV tPA). We compared patients treated by mechanical embolus removal in cerebral ischemia (MERCI) thrombectomy after failed IV tPA with those treated with thrombectomy alone. We pooled MERCI and Multi MERCI study patients, grouped them either as failed IV tPA or non-IV tPA, and assessed revascularization rates, procedural complications, symptomatic hemorrhage rates, clinical outcomes, and mortality. We also evaluated outcomes stratified by the occlusion site and final revascularization. Among 305 patients, 48 failed, and 257 were ineligible for IV tPA. Nonresponders to IV tPA trended toward a higher revascularization rate (73% versus 63%) and less mortality (27.7% versus 40.1%) and had similar rates of symptomatic hemorrhage and procedural complications. Favorable 90-day outcomes were similar in failed and non-IV tPA patients (38% versus 31%), with no difference according to occlusion site. Among patients failing IV tPA, good outcomes tended to occur more frequently in revascularized patients (47.1% versus 15.4%), although this relationship was attributable solely to middle cerebral artery and not internal carotid artery occlusions, with no difference in mortality. Among IV tPA-ineligible patients, revascularization correlated with good outcome (47.4% versus 4.4%) and less mortality (28.5% versus 59.6%). The risks of hemorrhage and procedure-related complications after mechanical thrombectomy do not differ with respect to previous IV tPA administration. Thrombectomy after IV tPA achieves similar rates of good outcomes, a tendency toward lower mortality, and similar revascularization rates when stratified by clot location. Good outcomes correlate with successful revascularization except with internal carotid artery occlusions in tPA-nonresponders.

  7. Traumatic brain injury may not increase the risk of Alzheimer disease.

    PubMed

    Weiner, Michael W; Crane, Paul K; Montine, Thomas J; Bennett, David A; Veitch, Dallas P

    2017-10-31

    Traumatic brain injury (TBI) commonly occurs in civilian and military populations. Some epidemiologic studies previously have associated TBI with an increased risk of Alzheimer disease (AD). Recent clinicopathologic and biomarker studies have failed to confirm the relationship of TBI to the development of AD dementia or pathologic changes, and suggest that other neurodegenerative processes might be linked to TBI. Additional studies are required to determine the long-term consequences of TBI. Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

  8. An assessment of the effects of serotonin 6 (5-HT6) receptor antagonists in rodent models of learning.

    PubMed

    Lindner, Mark D; Hodges, Donald B; Hogan, John B; Orie, Anitra F; Corsa, Jason A; Barten, Donna M; Polson, Craig; Robertson, Barbara J; Guss, Valerie L; Gillman, Kevin W; Starrett, John E; Gribkoff, Valentin K

    2003-11-01

    Antagonists of serotonin 6 (5-HT6) receptors have been reported to enhance cognition in animal models of learning, although this finding has not been universal. We have assessed the therapeutic potential of the specific 5-HT6 receptor antagonists 4-amino-N-(2,6-bis-methylamino-pyrimidin-4-yl)-benzenesulfonamide (Ro 04-6790) and 5-chloro-N-(4-methoxy-3-piperazin-1-yl-phenyl)-3-methyl-2-benzothiophenesulfonamide (SB-271046) in rodent models of cognitive function. Although mice express the 5-HT6 receptor and the function of this receptor has been investigated in mice, all reports of activity with 5-HT6 receptor antagonists have used rat models. In the present study, receptor binding revealed that the pharmacological properties of the mouse receptor are different from the rat and human receptor: Ro 04-6790 does not bind to the mouse 5-HT6 receptor, so all in vivo testing included in the present report was conducted in rats. We replicated previous reports that 5-HT6 receptor antagonists produce a stretching syndrome previously shown to be mediated through cholinergic mechanisms, but Ro 04-6790 and SB-271046 failed to attenuate scopolamine-induced deficits in a test of contextual fear conditioning. We also failed to replicate the significant effects reported previously in both an autoshaping task and in a version of the Morris water maze. The results of our experiments are not consistent with previous reports that suggested that 5-HT6 antagonists might have therapeutic potential for cognitive disorders.

  9. Sofosbuvir + velpatasvir + voxilaprevir for the treatment of hepatitis C infection.

    PubMed

    Cory, Theodore J; Mu, Ying; Gong, Yuqing; Kodidela, Sunitha; Kumar, Santosh

    2018-05-01

    Hepatitis C is a disease with a significant global impact. Over the last several years, the treatment of the disease has been revolutionized. Therapy has transformed over the last several years with the approval of second generation direct acting antivirals, and currently utilized medications for the treatment of hepatitis C are significantly more efficacious with better safety profiles than previously approved treatments. Treatment for individuals who have failed therapy on direct acting antivirals has, until recently, been complex and difficult to treat, but the approval of sofosbuvir/velpatasvir/voxilaprevir represents a new therapeutic option for these individuals. Areas covered: Sofosbuvir/velpatasvir/voxilaprevir is a recently approved therapeutic combination for the treatment of hepatitis C. This article reviews the studies leading to the approval of the combination, and its efficacy and safety profile. Expert opinion: Sofosbuvir/velpatasvir/voxilaprevir fills one of the previously unfilled niches for the treatment of hepatitis C, that of the treatment of individuals who have failed therapy with resistant virus. With the filling of this niche, there appears to be a general slowing of the development of new therapeutics. Although understandable, in the long term, there are considerable risks associated with the decreased development of new drugs to treat hepatitis C.

  10. Identification of susceptibility loci for colorectal cancer in a genome-wide meta-analysis

    PubMed Central

    Whiffin, Nicola; Hosking, Fay J.; Farrington, Susan M.; Palles, Claire; Dobbins, Sara E.; Zgaga, Lina; Lloyd, Amy; Kinnersley, Ben; Gorman, Maggie; Tenesa, Albert; Broderick, Peter; Wang, Yufei; Barclay, Ella; Hayward, Caroline; Martin, Lynn; Buchanan, Daniel D.; Win, Aung Ko; Hopper, John; Jenkins, Mark; Lindor, Noralane M.; Newcomb, Polly A.; Gallinger, Steve; Conti, David; Schumacher, Fred; Casey, Graham; Liu, Tao; Campbell, Harry; Lindblom, Annika; Houlston, Richard S.; Tomlinson, Ian P.; Dunlop, Malcolm G.

    2014-01-01

    To identify common variants influencing colorectal cancer (CRC) risk, we performed a meta-analysis of five genome-wide association studies, comprising 5626 cases and 7817 controls of European descent. We conducted replication of top ranked single nucleotide polymorphisms (SNPs) in additional series totalling 14 037 cases and 15 937 controls, identifying a new CRC risk locus at 10q24.2 [rs1035209; odds ratio (OR) = 1.13, P = 4.54 × 10−11]. We also performed meta-analysis of our studies, with previously published data, of several recently purported CRC risk loci. We failed to find convincing evidence for a previously reported genome-wide association at rs11903757 (2q32.3). Of the three additional loci for which evidence of an association in Europeans has been previously described we failed to show an association between rs59336 (12q24.21) and CRC risk. However, for the other two SNPs, our analyses demonstrated new, formally significant associations with CRC. These are rs3217810 intronic in CCND2 (12p13.32; OR = 1.19, P = 2.16 × 10−10) and rs10911251 near LAMC1 (1q25.3; OR = 1.09, P = 1.75 × 10−8). Additionally, we found some evidence to support a relationship between, rs647161, rs2423297 and rs10774214 and CRC risk originally identified in East Asians in our European datasets. Our findings provide further insights into the genetic and biological basis of inherited genetic susceptibility to CRC. PMID:24737748

  11. Evolution of Endovascular Therapy in Acute Stroke: Implications of Device Development

    PubMed Central

    Balasubramaian, Adithya; Mitchell, Peter; Dowling, Richard

    2015-01-01

    Intravenous thrombolysis is an effective treatment for acute ischaemic stroke. However, vascular recanalization rates remain poor especially in the setting of large artery occlusion. On the other hand, endovascular intra-arterial therapy addresses this issue with superior recanalization rates compared with intravenous thrombolysis. Although previous randomized controlled studies of intra-arterial therapy failed to demonstrate superiority, the failings may be attributed to a combination of inferior intra-arterial devices and suboptimal selection criteria. The recent results of several randomized controlled trials have demonstrated significantly improved outcomes, underpinning the advantage of newer intra-arterial devices and superior recanalization rates, leading to renewed interest in establishing intra-arterial therapy as the gold standard for acute ischaemic stroke. The aim of this review is to outline the history and development of different intra-arterial devices and future directions in research. PMID:26060800

  12. Improved inflammatory activity with peginterferon alfa-2b maintenance therapy in non-cirrhotic prior non-responders: a randomized study.

    PubMed

    Poynard, Thierry; Bruix, Jordi; Schiff, Eugene R; Diago, Moises; Berg, Thomas; Moreno-Otero, Ricardo; Lyra, Andre C; Carrilho, Flair; Griffel, Louis H; Boparai, Navdeep; Jiang, Ruiyun; Burroughs, Margaret; Brass, Clifford A; Albrecht, Janice K

    2013-03-01

    Therapeutic options for patients failing hepatitis C retreatment are limited. EPIC(3) included a prospective trial assessing long-term peginterferon alfa-2b (PegIFNα-2b) maintenance therapy in patients with METAVIR fibrosis scores (MFS) of F2 or F3 who previously failed hepatitis C retreatment. Patients with F2/F3 MFS who failed retreatment were randomized to PegIFNα-2b (0.5 μg/kg/week, n=270) or observation (n=270) for 36 months. Blinded liver biopsies obtained before retreatment and after maintenance therapy were evaluated using MFS and activity scores, and confirmatory testing was performed using FibroTest and ActiTest. In total, 348 patients had paired biopsies: 192 patients had missing post-treatment biopsies and were considered as having no change in fibrosis/activity scores. In total, 16% of patients receiving PegIFNα-2b and 11% of observation patients had improvement in MFS (p=0.32). More PegIFNα-2b than observation patients had improvement in activity score (20% vs. 9%; p <0.001). Among patients treated for >2.5 years, improvement in MFS or activity score was more common with PegIFNα-2b than observation (21% vs. 14%, p=0.08 and 26% vs. 10%, p <0.001). FibroTest and ActiTest evaluations indicated significant benefit associated with PegIFNα-2b in terms of reduced fibrosis progression and improved activity score. The safety profile of PegIFNα-2b was similar to previous studies. PegIFNα-2b did not significantly improve MFS estimated by biopsy compared with observation; however, activity scores were significantly improved and MFS trended toward increased improvement with treatment durations >2.5 years. Both FibroTest and ActiTest were significantly improved during maintenance therapy. Copyright © 2012 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

  13. The Interaction of the Space Shuttle Launch and Entry Suits and Sustained Weightless on Astronaut Egress Locomotion

    NASA Technical Reports Server (NTRS)

    Greenisen, M. C.; Bishop, P. A.; Sothmann, M.

    2008-01-01

    The purpose of this study was to determine the consequences of extended periods of weightlessness during space missions on astronauts f ability to perform a simulated contingency egress while wearing either of the Launch and Entry suits immediately after space flight. In our previous lab-based study of simulated contingency egress, we found only 4 of 12 non-astronauts wearing the Launch and Entry Suit (LES) successfully completed the simulated egress. However, 4 of 4 of the previous failures (when tested wearing the LES), were then successful in completing the test wearing the Advanced Crew Escape Suit (ACES). Therefore, this study tested 21 Astronaut Volunteers wearing either the LES or ACES while performing a simulated egress on a treadmill (TM) onboard the Crew Transportation Vehicle immediately after space flight at either the Kennedy Space Center or Edwards AFB. Astronauts walked for 400 meters at 1.6m/sec with g-suit inflation level set to preflight testing levels, visor down, breathing from the suit emergency O2 supply. Metabolic, heartrate, and perceived exertion data were collected during these post-flight tests. Exactly the same preflight simulated egress tests on a TM were performed in the lab at NASA/JSC by each crewmember at L-60. Preflight testing found 2 of the 21 crewmembers were unable to complete the simulated contingency egress. Postflight, 9 crew (8 ACES, 1 LES) completed the simulated contingency egress of 400 meters at 1.6m/sec. and 12 failed to meet that standard (7 ACES, 5 LES). Preflight physiological response tests failed to identify crew capable of performing the egress vs. those who failed. However, 18 of the 21 crew did make at least 2.67 minutes into the postflight egress testing. At that point in time, heartrate was higher (P <=.20) for the failures compared to the finishers. These findings indicate that NASA fs switch to the ACES for space flight crews should be expedited.

  14. Next-generation sequencing sheds light on the natural history of hepatitis C infection in patients who fail treatment.

    PubMed

    Abdelrahman, Tamer; Hughes, Joseph; Main, Janice; McLauchlan, John; Thursz, Mark; Thomson, Emma

    2015-01-01

    High rates of sexually transmitted infection and reinfection with hepatitis C virus (HCV) have recently been reported in human immunodeficiency virus (HIV)-infected men who have sex with men and reinfection has also been described in monoinfected injecting drug users. The diagnosis of reinfection has traditionally been based on direct Sanger sequencing of samples pre- and posttreatment, but not on more sensitive deep sequencing techniques. We studied viral quasispecies dynamics in patients who failed standard of care therapy in a high-risk HIV-infected cohort of patients with early HCV infection to determine whether treatment failure was associated with reinfection or recrudescence of preexisting infection. Paired sequences (pre- and posttreatment) were analyzed. The HCV E2 hypervariable region-1 was amplified using nested reverse-transcription polymerase chain reaction (RT-PCR) with indexed genotype-specific primers and the same products were sequenced using both Sanger and 454 pyrosequencing approaches. Of 99 HIV-infected patients with acute HCV treated with 24-48 weeks of pegylated interferon alpha and ribavirin, 15 failed to achieve a sustained virological response (six relapsed, six had a null response, and three had a partial response). Using direct sequencing, 10/15 patients (66%) had evidence of a previously undetected strain posttreatment; in many studies, this is interpreted as reinfection. However, pyrosequencing revealed that 15/15 (100%) of patients had evidence of persisting infection; 6/15 (40%) patients had evidence of a previously undetected variant present in the posttreatment sample in addition to a variant that was detected at baseline. This could represent superinfection or a limitation of the sensitivity of pyrosequencing. In this high-risk group, the emergence of new viral strains following treatment failure is most commonly associated with emerging dominance of preexisting minority variants rather than reinfection. Superinfection may occur in this cohort but reinfection is overestimated by Sanger sequencing. © 2014 The Authors. Hepatology published by Wiley on behalf of the American Association for the Study of Liver Diseases.

  15. What happens to patients when we do not repair their cuff tears? Five-year rotator cuff quality-of-life index outcomes following nonoperative treatment of patients with full-thickness rotator cuff tears.

    PubMed

    Boorman, Richard S; More, Kristie D; Hollinshead, Robert M; Wiley, James P; Mohtadi, Nicholas G; Lo, Ian K Y; Brett, Kelly R

    2018-03-01

    The purpose of this study was to examine 5-year outcomes in a prospective cohort of patients previously enrolled in a nonoperative rotator cuff tear treatment program. Patients with chronic (>3 months), full-thickness rotator cuff tears (demonstrated on imaging) who were referred to 1 of 2 senior shoulder surgeons were enrolled in the study between October 2008 and September 2010. They participated in a comprehensive, nonoperative, home-based treatment program. After 3 months, the outcome in these patients was defined as "successful" or "failed." Patients in the successful group were essentially asymptomatic and did not require surgery. Patients in the failed group were symptomatic and consented to undergo surgical repair. All patients were followed up at 1 year, 2 years, and 5 or more years. At 5 or more years, all patients were contacted for follow-up; the response rate was 84%. Approximately 75% of patients remained successfully treated with nonoperative treatment at 5 years and reported a mean rotator cuff quality-of-life index score of 83 of 100 (SD, 16). Furthermore, between 2 and 5 years, only 3 patients who had previously been defined as having a successful outcome became more symptomatic and underwent surgical rotator cuff repair. Those in whom nonoperative treatment had failed and who underwent surgical repair had a mean rotator cuff quality-of-life index score of 89 (SD, 11) at 5-year follow-up. The operative and nonoperative groups at 5-year follow-up were not significantly different (P = .11). Nonoperative treatment is an effective and lasting option for many patients with a chronic, full-thickness rotator cuff tear. While some clinicians may argue that nonoperative treatment delays inevitable surgical repair, our study shows that patients can do very well over time. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  16. A Targeted Swallow Screen for the Detection of Postoperative Dysphagia.

    PubMed

    Gee, Erica; Lancaster, Elizabeth; Meltzer, Jospeh; Mendelsohn, Abie H; Benharash, Peyman

    2015-10-01

    Postoperative dysphagia leads to aspiration pneumonia, prolonged hospital stay, and is associated with increased mortality. A simple and sensitive screening test to identify patients requiring objective dysphagia evaluation is presently lacking. In this study, we evaluated the efficacy of a novel targeted swallow screen evaluation. This was a prospective trial involving all adult patients who underwent elective cardiac surgery with cardiopulmonary bypass at our institution over an 8-week period. Within 24 hours of extubation and before the initiation of oral intake, all postsurgical patients were evaluated using the targeted swallow screen. A fiberoptic endoscopic evaluation of swallowing was requested for failed screenings. During the study, 50 postcardiac surgery patients were screened. Fifteen (30%) failed the targeted swallow screen, and ten of the fifteen (66%) failed the subsequent fiberoptic endoscopic evaluation of swallowing exam and were confirmed to have dysphagia. The screening test had 100 per cent sensitivity for detecting dysphagia in our patient population, and a specificity of 87.5 per cent. The overall incidence of dysphagia was 20 per cent. We have shown that a targeted swallow evaluation can efficiently screen patients during the postcardiac surgery period. Furthermore, we have shown that the true incidence of dysphagia after cardiac surgery is significantly higher than previously recognized in literature.

  17. Retreatment with sofosbuvir/velpatasvir in cirrhotic patients with genotype 4 who failed a previous interferon-free regimen: a case series.

    PubMed

    Boglione, Lucio; Pinna, Simone Mornese; Lupia, Tommaso; Cariti, Giuseppe; Di Perri, Giovanni

    2018-02-14

    The novel available interferon (IFN)-free regimens significantly improved the sustained virological response (SVR) in patients with chronic hepatitis C (CHC), without important side-effects and with shorter duration of treatment. In a subset of patients, however, the treatment failure (TF) was due to the presence of resistance-associated substitutions (RAS) that lead to virological breakthrough (BT) or relapse. We analyzed in this case-series the role of RAS on the TF in cirrhotic patients with GT4, treated with a previous IFN-free regimen, and retreated with the combination of sofosbuvir (SOF)/velpatasvir (VEL) for 12 or 24 weeks, without ribavirin (RBV). We included in this analysis all patients with GT4 who failed a previous IFN-free treatment, with the presence of RAS at BT or relapse. All patients were retreated with a fixed combination of SOF/VEL for 12/24 weeks, without RBV. We evaluated the SVR and the MELD score change after the treatment. Seven patients were described. All were cirrhotic, Child-Pug A (n=5), B (n=2); baseline RAS were detected in 4/7 subjects; at post-treatment detection, NS5 RAS were: F28S (n=1), Q30K (n=2), S30G (n=1), NS3 were: S122R (n=1), S122G (n=2), D168V (n=3). All retreated patients gained the SVR. MELD score improved in all subjects with a median change of 3 points. No significant side-effects or adverse events were reported. The combination SOF/VEL could be considered for the retreatment of cirrhotic GT4 patients who failed a previous IFN-free treatment with the presence of RAS in NS3 or NS5 regions.

  18. Retreatment with sofosbuvir/velpatasvir in cirrhotic patients with genotype-4 who failed a previous interferon-free regimen: a case series.

    PubMed

    Boglione, Lucio; Pinna, Simone Mornese; Lupia, Tommaso; Cariti, Giuseppe; Di Perri, Giovanni

    2018-02-14

    The novel available interferon (IFN)-free regimens significantly improved the sustained virological response (SVR) in patients with chronic hepatitis C (CHC), without important side effects and with shorter duration of treatment. In a subset of patients, however, the treatment failure (TF) was due to the presence of resistance-associated substitutions (RAS) that lead to virological breakthrough (BT) or relapse. We analysed in this case series the role of RAS on the TF in cirrhotic patients with genotype (GT)4, treated with a previous IFN-free regimen, and retreated with the combination of sofosbuvir (SOF)/velpatasvir (VEL) for 12 or 24 weeks, without ribavirin (RBV). We included in this analysis all patients with GT4 who failed a previous IFN-free treatment, with the presence of RAS at BT or relapse. All patients were retreated with a fixed combination of SOF/VEL for 12/24 weeks, without RBV. We evaluated the SVR and the MELD score change after the treatment. Seven patients were described. All were cirrhotic, Child-Pugh A (n=5), B (n=2); baseline RAS were detected in 4/7 subjects; at post-treatment detection, NS5 RAS were: F28S (n=1), Q30K (n=2), S30G (n=1), NS3 were: S122R (n=1), S122G (n=2), D168V (n=3). All retreated patients gained SVR. MELD score improved in all subjects with a median change of 3 points. No significant side effects or adverse events were reported. The combination SOF/VEL could be considered for the retreatment of cirrhotic GT4 patients who failed a previous IFN-free treatment with the presence of RAS in NS3 or NS5 regions.

  19. Beyond Turnaround: A Synthesis of Relevant Frameworks for Leaders of Sustained Improvement in Previously Low-Performing Schools

    ERIC Educational Resources Information Center

    Hitt, Dallas Hambrick; Meyers, Coby V.

    2018-01-01

    We understand very little about what is special that leaders do to facilitate improvement that is both transformational and lasting in previously persistently failing schools in the United States. Relatively little is understood about change not just during the initial turnaround stage, but that "endures" on the larger journey as the…

  20. Influence of Previous Failed Antispasticity Therapy on the Efficacy and Tolerability of THC:CBD Oromucosal Spray for Multiple Sclerosis Spasticity.

    PubMed

    Haupts, Michael; Vila, Carlos; Jonas, Anna; Witte, Kerstin; Álvarez-Ossorio, Lourdes

    2016-01-01

    Sativex® (THC:CBD oromucosal spray) is indicated as add-on treatment for patients with moderate to severe multiple sclerosis (MS) spasticity. We aimed to determine whether antispasticity treatment history influenced the efficacy and safety of add-on THC:CBD oromucosal spray in MS spasticity patients. Post hoc analysis of an enriched-design clinical trial of THC:CBD oromucosal spray versus placebo, using records of patients under previous and current ineffective antispasticity therapies. Subgroups were patients with at least 1 failed therapy attempt with either baclofen or tizanidine (Group 1) or at least 2 failed therapy attempts with both baclofen and tizanidine (Group 2). Of 241 patients in the intent-to-treat population, 162 and 57 patients met the criteria for Groups 1 and 2, respectively. In all groups, response on the spasticity 0-10 Numerical Rating Scale was significantly greater with THC:CBD oromucosal spray versus placebo, for minimal clinically important difference (MCID ≥18% improvement vs. baseline) and clinically important difference (CID, ≥30% improvement vs. baseline). THC:CBD oromucosal spray improved spasticity-related symptoms such as sleep quality and timed 10-meter walk independent of the number of prior failed therapy attempts. Tolerability was not influenced by pre-treatment history. THC:CBD oromucosal spray provided consistent relief with good tolerability in MS spasticity patients irrespective of their antispasticity pre-treatment history. © 2016 S. Karger AG, Basel.

  1. 40 CFR 2.107 - Fees.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... assessment, they will be placed on a delinquency list. Subsequent FOIA requests will not be processed until... requester that has a history of prompt payment. (3) When a requester has previously failed to pay a properly...

  2. Surgical Results of Trabeculectomy and Ahmed Valve Implantation Following a Previous Failed Trabeculectomy in Primary Congenital Glaucoma Patients

    PubMed Central

    Lee, Naeun; Ma, Kyoung Tak; Bae, Hyoung Won; Hong, Samin; Seong, Gong Je; Hong, Young Jae

    2015-01-01

    Purpose To compare the surgical results of trabeculectomy and Ahmed glaucoma valve implantation after a previous failed trabeculectomy. Methods A retrospective comparative case series review was performed on 31 eye surgeries in 20 patients with primary congenital glaucoma who underwent trabeculectomy or Ahmed glaucoma valve implantation after a previous failed trabeculectomy with mitomycin C. Results The preoperative mean intraocular pressure was 25.5 mmHg in the trabeculectomy group and 26.9 mmHg in the Ahmed glaucoma valve implantation group (p = 0.73). The 48-month postoperative mean intraocular pressure was 19.6 mmHg in the trabeculectomy group and 20.2 mmHg in the Ahmed glaucoma valve implantation group (p = 0.95). The 12-month trabeculectomy success rate was 69%, compared with 64% for Ahmed glaucoma valve implantation, and the 48-month success rates were 42% and 36% for trabeculectomy and valve implantation, respectively. The success rates following the entire follow-up period were not significantly different between the two groups (p > 0.05 by log rank test). Postoperative complications occurred in 25% of the trabeculectomy-operated eyes and 9% of the Ahmed-implanted eyes (p = 0.38). Conclusions There was no significant difference in surgical outcome between the trabeculectomy and Ahmed glaucoma valve implantation groups, neither of which had favorable results. However, the trabeculectomy group demonstrated a higher prevalence of adverse complications such as post-operative endophthalmitis. PMID:25829827

  3. Deoxycholate-Based Glycosides (DCGs) for Membrane Protein Stabilisation.

    PubMed

    Bae, Hyoung Eun; Gotfryd, Kamil; Thomas, Jennifer; Hussain, Hazrat; Ehsan, Muhammad; Go, Juyeon; Loland, Claus J; Byrne, Bernadette; Chae, Pil Seok

    2015-07-06

    Detergents are an absolute requirement for studying the structure of membrane proteins. However, many conventional detergents fail to stabilise denaturation-sensitive membrane proteins, such as eukaryotic proteins and membrane protein complexes. New amphipathic agents with enhanced efficacy in stabilising membrane proteins will be helpful in overcoming the barriers to studying membrane protein structures. We have prepared a number of deoxycholate-based amphiphiles with carbohydrate head groups, designated deoxycholate-based glycosides (DCGs). These DCGs are the hydrophilic variants of previously reported deoxycholate-based N-oxides (DCAOs). Membrane proteins in these agents, particularly the branched diglucoside-bearing amphiphiles DCG-1 and DCG-2, displayed favourable behaviour compared to previously reported parent compounds (DCAOs) and conventional detergents (LDAO and DDM). Given their excellent properties, these agents should have significant potential for membrane protein studies. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  4. Extensive numerical study of a D-brane, anti-D-brane system in AdS 5 /CFT 4

    NASA Astrophysics Data System (ADS)

    Hegedűs, Árpád

    2015-04-01

    In this paper the hybrid-NLIE approach of [38] is extended to the ground state of a D-brane anti-D-brane system in AdS/CFT. The hybrid-NLIE equations presented in the paper are finite component alternatives of the previously proposed TBA equations and they admit an appropriate framework for the numerical investigation of the ground state of the problem. Straightforward numerical iterative methods fail to converge, thus new numerical methods are worked out to solve the equations. Our numerical data confirm the previous TBA data. In view of the numerical results the mysterious L = 1 case is also commented in the paper.

  5. When Does Maluma/Takete Fail? Two Key Failures and a Meta-Analysis Suggest That Phonology and Phonotactics Matter.

    PubMed

    Styles, Suzy J; Gawne, Lauren

    2017-01-01

    Eighty-seven years ago, Köhler reported that the majority of students picked the same answer in a quiz: Which novel word form ('maluma' or 'takete') went best with which abstract line drawing (one curved, one angular). Others have consistently shown the effect in a variety of contexts, with only one reported failure by Rogers and Ross. In the spirit of transparency, we report our own failure in the same journal. In our study, speakers of Syuba, from the Himalaya in Nepal, do not show a preference when matching word forms 'kiki' and 'bubu' to spiky versus curvy shapes. We conducted a meta-analysis of previous studies to investigate the relationship between pseudoword legality and task effects. Our combined analyses suggest a common source for both of the failures: 'wordiness' - We believe these tests fail when the test words do not behave according to the sound structure of the target language.

  6. The "Wallpaper Effect" Revisited: Divergent Findings on the Effects of Intergroup Contact on Attitudes in Diverse Versus Nondiverse Contexts.

    PubMed

    Schmid, Katharina; Wölfer, Ralf; Swart, Herman; Christ, Oliver; Al Ramiah, Ananthi; Vertovec, Steven; Hewstone, Miles

    2017-09-01

    This article reexamines the so-called "wallpaper effect" of intergroup contact, which contends that for minority group members living in areas more densely populated by majority group members, intergroup contact fails to reduce prejudice. We tested this claim in five studies, using data from five countries, two types of contexts, a range of measures, and involving different minority versus majority groups. Using multilevel cross-level interaction models, we considered whether effects of contact on outgroup attitudes were moderated by relative outgroup size. Results failed to replicate the previously reported findings, revealing, by and large, nonsignificant cross-level moderation effects; instead, we witnessed consistent positive contact effects on attitudes. Findings are discussed against the backdrop of recent research on the consequences of diversity, as well as context-based considerations regarding minority versus majority constellations. We also discuss some exceptions to our findings that emerged for some respondent groups and contexts across the five studies.

  7. An immune-inspired swarm aggregation algorithm for self-healing swarm robotic systems.

    PubMed

    Timmis, J; Ismail, A R; Bjerknes, J D; Winfield, A F T

    2016-08-01

    Swarm robotics is concerned with the decentralised coordination of multiple robots having only limited communication and interaction abilities. Although fault tolerance and robustness to individual robot failures have often been used to justify the use of swarm robotic systems, recent studies have shown that swarm robotic systems are susceptible to certain types of failure. In this paper we propose an approach to self-healing swarm robotic systems and take inspiration from the process of granuloma formation, a process of containment and repair found in the immune system. We use a case study of a swarm performing team work where previous works have demonstrated that partially failed robots have the most detrimental effect on overall swarm behaviour. We have developed an immune inspired approach that permits the recovery from certain failure modes during operation of the swarm, overcoming issues that effect swarm behaviour associated with partially failed robots. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Observation of Prethermalization in Long-Range Interacting Spin Chains (Open Access, Author’s Manuscript)

    DTIC Science & Technology

    2016-08-03

    instance, quantum systems that are near-integrable usually fail to thermalize in an experimentally realistic time scale and, instead, relax to quasi ...However, it is possible to observe quasi -stationary states, often called prethermal, that emerge within an experimentally accessible time scale. Previous...generalized Gibbs ensemble (GGE) [10–13]. Here we experimentally study the relaxation dynamics of a chain of up to 22 spins evolving under a long-range

  9. Resonant Laser Ignition Study of HAN-HEHN Propellant Mixture (Preprint)

    DTIC Science & Technology

    2008-07-17

    results to larger samples can be predicted by the adaptation of modeling 4 formalism previously reported for solid propellant laser ignition (15-17...The inclusion of a chemical heat release term in the form of an Arrhenius expression within a heat conduction model can also give valuable...the face of the pressure transducer. In this case the BaF2 cell entrance window failed quietly at 30 µs following the initial shock sequence. The

  10. Failure analysis of stainless steel femur fixation plate.

    PubMed

    Hussain, P B; Mohammad, M

    2004-05-01

    Failure analysis was performed to investigate the failure of the femur fixation plate which was previously fixed on the femur of a girl. Radiography, metallography, fractography and mechanical testing were conducted in this study. The results show that the failure was due to the formation of notches on the femur plate. These notches act as stress raisers from where the cracks start to propagate. Finally fracture occurred on the femur plate and subsequently, the plate failed.

  11. Live birth after artificial oocyte activation using a ready-to-use ionophore: a prospective multicentre study.

    PubMed

    Ebner, Thomas; Montag, Markus; Montag, M; Van der Ven, K; Van der Ven, H; Ebner, T; Shebl, O; Oppelt, P; Hirchenhain, J; Krüssel, J; Maxrath, B; Gnoth, C; Friol, K; Tigges, J; Wünsch, E; Luckhaus, J; Beerkotte, A; Weiss, D; Grunwald, K; Struller, D; Etien, C

    2015-04-01

    Artificial oocyte activation has been proposed as a suitable means to overcome the problem of failed or impaired fertilization after intracytoplasmic sperm injection (ICSI). In a multicentre setting artificial oocyte activation was applied to 101 patients who were diagnosed with fertilization abnormalities (e.g. less than 50% fertilized oocytes) in a previous conventional ICSI cycle. Female gametes were activated for 15 min immediately after ICSI using a ready-to-use Ca(2+)-ionophore solution (A23187). Fertilization, pregnancy and live birth rates were compared with the preceding cycle without activation. The fertilization rate of 48% in the study cycles was significantly higher compared with the 25% in the control cycles (P < 0.001). Further splitting of the historical control group into failed (0%), low (1-30%) and moderate fertilization rate (31-50%) showed that all groups significantly benefitted (P < 0.001) in the ionophore cycle. Fewer patients had their embryo transfer cancelled compared with their previous treatments (1/101 versus 15/101). In total, 99% of the patients had an improved outcome with A23187 application resulting in a 28% live birth rate (35 babies). These data suggest that artificial oocyte activation using a ready-to-use compound is an efficient method. Copyright © 2014 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  12. Inward Leakage Variability between Respirator Fit Test Panels – Part I. Deterministic Approach

    PubMed Central

    Zhuang, Ziqing; Liu, Yuewei; Coffey, Christopher C.; Miller, Colleen; Szalajda, Jonathan

    2015-01-01

    Inter-panel variability has never been investigated. The objective of this study was to determine the variability between different anthropometric panels used to determine the inward leakage (IL) of N95 filtering facepiece respirators (FFRs) and elastomeric half-mask respirators (EHRs). A total of 144 subjects, who were both experienced and non-experienced N95 FFR users, were recruited. Five N95 FFRs and five N95 EHRs were randomly selected from among those models tested previously in our laboratory. The PortaCount Pro+ (without N95-Companion) was used to measure IL of the ambient particles with a detectable size range of 0.02 to 1 μm. The Occupational Safety and Health Administration standard fit test exercises were used for this study. IL test were performed for each subject using each of the 10 respirators. Each respirator/subject combination was tested in duplicate, resulting in a total 20 IL tests for each subject. Three 35-member panels were randomly selected without replacement from the 144 study subjects stratified by the National Institute for Occupational Safety and Health bivariate panel cell for conducting statistical analyses. The geometric mean (GM) IL values for all 10 studied respirators were not significantly different among the three randomly selected 35-member panels. Passing rate was not significantly different among the three panels for all respirators combined or by each model. This was true for all IL pass/fail levels of 1%, 2%, and 5%. Using 26 or more subjects to pass the IL test, all three panels had consistent passing/failing results for pass/fail levels of 1% and 5%. Some disagreement was observed for the 2% pass/fail level. Inter-panel variability exists, but it is small relative to the other sources of variation in fit testing data. The concern about inter-panel variability and other types of variability can be alleviated by properly selecting: pass/fail level (IL 1–5%); panel size (e.g., 25 or 35); and minimum number of subjects required to pass (e.g., 26 of 35 or 23 of 35). PMID:26011282

  13. Untrained Chimpanzees (Pan troglodytes schweinfurthii) Fail to Imitate Novel Actions

    PubMed Central

    Tennie, Claudio; Call, Josep; Tomasello, Michael

    2012-01-01

    Background Social learning research in apes has focused on social learning in the technical (problem solving) domain - an approach that confounds action and physical information. Successful subjects in such studies may have been able to perform target actions not as a result of imitation learning but because they had learnt some technical aspect, for example, copying the movements of an apparatus (i.e., different forms of emulation learning). Methods Here we present data on action copying by non-enculturated and untrained chimpanzees when physical information is removed from demonstrations. To date, only one such study (on gesture copying in a begging context) has been conducted – with negative results. Here we have improved this methodology and have also added non-begging test situations (a possible confound of the earlier study). Both familiar and novel actions were used as targets. Prior to testing, a trained conspecific demonstrator was rewarded for performing target actions in view of observers. All but one of the tested chimpanzees already failed to copy familiar actions. When retested with a novel target action, also the previously successful subject failed to copy – and he did so across several contexts. Conclusion Chimpanzees do not seem to copy novel actions, and only some ever copy familiar ones. Due to our having tested only non-enculturated and untrained chimpanzees, the performance of our test subjects speak more than most other studies of the general (dis-)ability of chimpanzees to copy actions, and especially novel actions. PMID:22905102

  14. Summary of the British Transplantation Society Guidelines for Management of the Failing Kidney Transplant.

    PubMed

    Andrews, Peter A

    2014-12-15

    The British Transplantation Society "Guideline for Transplantation Management of the Failing Kidney Transplant" was published in May 2014. This is the first national guideline in this field. In line with previous guidelines published by the British Transplantation Society, the guideline has used the GRADE system to rate the strength of evidence and recommendations.This article summarizes the Statements of Recommendation contained in the guideline, which provide a framework for the management of the failing kidney graft in the United Kingdom and may be of wide international interest. It is recommended that the full guideline document is consulted for details of the relevant references and evidence base. This may be accessed at: http://www.bts.org.uk/MBR/Clinical/Guidelines/Current/Member/Clinical/Current_Guidelines.aspx.

  15. Assessing Potential Energy Cost Savings from Increased Energy Code Compliance in Commercial Buildings

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

    Rosenberg, Michael I.; Hart, Philip R.; Athalye, Rahul A.

    The US Department of Energy’s most recent commercial energy code compliance evaluation efforts focused on determining a percent compliance rating for states to help them meet requirements under the American Recovery and Reinvestment Act (ARRA) of 2009. That approach included a checklist of code requirements, each of which was graded pass or fail. Percent compliance for any given building was simply the percent of individual requirements that passed. With its binary approach to compliance determination, the previous methodology failed to answer some important questions. In particular, how much energy cost could be saved by better compliance with the commercial energymore » code and what are the relative priorities of code requirements from an energy cost savings perspective? This paper explores an analytical approach and pilot study using a single building type and climate zone to answer those questions.« less

  16. Low calorie sweeteners: Evidence remains lacking for effects on human gut function.

    PubMed

    Bryant, Charlotte; Mclaughlin, John

    2016-10-01

    The importance of nutrient induced gut-brain signalling in the regulation of human food intake has become an increasing focus of research. Much of the caloric excess consumed comes from dietary sugars, but our knowledge about the mechanisms mediating the physiological and appetitive effects of sweet tastants in the human gut and gut-brain axis is far from complete. The comparative effects of natural sugars vs low calorie sweeteners are also poorly understood. Research in animal and cellular models has suggested a key functional role in gut endocrine cells for the sweet taste receptors previously well described in oral taste. However human studies to date have very consistently failed to show that activation of the sweet taste receptor by low calorie sweeteners placed in the human gut fails to replicate any of the effects on gastric motility, gut hormones or appetitive responses evoked by caloric sugars. Copyright © 2016. Published by Elsevier Inc.

  17. Study of Required Thrust Profile Determination of a Three Stages Small Launch Vehicle

    NASA Astrophysics Data System (ADS)

    Fariz, A.; Sasongko, R. A.; Poetro, R. E.

    2018-04-01

    The effect of solid rocket motor specifications, i.e. specific impulse and mass flow rate, and coast time on the thrust profile of three stages small launch vehicle is studied. Solid rocket motor specifications are collected from various small launch vehicle that had ever been in operation phase, and also from previous study. Comparison of orbital parameters shows that the radius of apocenter targeted can be approached using one combination of solid rocket motor specifications and appropriate coast time. However, the launch vehicle designed is failed to achieve the targeted orbit nor injecting the satellite to any orbit.

  18. Surgical criteria for femoroacetabular impingement syndrome: a scoping review.

    PubMed

    Peters, Scott; Laing, Alisha; Emerson, Courtney; Mutchler, Kelsey; Joyce, Thomas; Thorborg, Kristian; Hölmich, Per; Reiman, Michael

    2017-11-01

    The purpose of this review was to analyse and report criteria used for open and arthroscopic surgical treatment of femoroacetabular impingement syndrome (FAIS). A librarian-assisted computer search of Medline, CINAHL and Embase for studies related to criterion for FAIS surgery was used in this study. Inclusion criteria included studies with the primary purpose of surgery or surgical outcomes for treatment of FAIS with and without labral tear, and reporting criteria for FAIS surgery. Diagnostic imaging was a criterion for surgery in 92% of the included studies, with alpha angle the most frequently reported (68% of studies) criterion. Reporting of symptoms was a criterion for surgery in 75%, and special tests a criterion in 70% of studies. Range-of-motion limitations were only a required criterion in 30%, only 12% of studies required intra-articular injection and 44% of studies described previously failed treatment (non-surgical or physiotherapist-led rehabilitation) as a criterion for surgery. Only 56% of included studies utilised the combination of symptoms, clinical signs and diagnostic imaging combined for diagnosis of FAIS as suggested by the Warwick Agreement on FAIS meeting. Diagnostic imaging evidence of FAIS was the most commonly reported criterion for surgery. Only 56% of included studies utilised the combination of symptoms, clinical signs and diagnostic imaging for diagnosis of FAIS as suggested by the Warwick Agreement on FAIS meeting, and only 44% of studies had failed non-surgical treatment (and 18% a failed trial of physiotherapy) as a criterion for surgery. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. Intensification of Diabetes Therapy and Time Until A1C Goal Attainment Among Patients With Newly Diagnosed Type 2 Diabetes Who Fail Metformin Monotherapy Within a Large Integrated Health System.

    PubMed

    Pantalone, Kevin M; Wells, Brian J; Chagin, Kevin M; Ejzykowicz, Flavia; Yu, Changhong; Milinovich, Alex; Bauman, Janine M; Kattan, Michael W; Rajpathak, Swapnil; Zimmerman, Robert S

    2016-09-01

    "Clinical inertia" has been used to describe the delay in the intensification of type 2 diabetes treatment among patients with poor glycemic control. Previous studies may have exaggerated the prevalence of clinical inertia by failing to adequately monitor drug dose changes and nonmedication interventions. This project evaluated the intensification of diabetes therapy and hemoglobin A1c (A1C) goal attainment among patients with newly diagnosed type 2 diabetes when metformin monotherapy failed. The electronic health record at Cleveland Clinic was used to identify patients with newly diagnosed type 2 diabetes between 2005 and 2013 who failed to reach the A1C goal after 3 months of metformin monotherapy. A time-dependent survival analysis was used to compare the time until A1C goal attainment in patients who received early intensification of therapy (within 6 months of metformin failure) or late intensification. The analysis was performed for A1C goals of 7% (n = 1,168), 7.5% (n = 679), and 8% (n = 429). Treatment was intensified early in 62%, 69%, and 72% of patients when poor glycemic control was defined as an A1C >7%, >7.5%, and >8%, respectively. The probability of undergoing an early intensification was greater the higher the A1C category. Time until A1C goal attainment was shorter among patients who received early intensification regardless of the A1C goal (all P < 0.05). A substantial number of patients with newly diagnosed type 2 diabetes fail to undergo intensification of therapy within 6 months of metformin monotherapy failure. Early intervention in patients when metformin monotherapy failed resulted in more rapid attainment of A1C goals. © 2016 by the American Diabetes Association.

  20. Tonic or Phasic Stimulation of Dopaminergic Projections to Prefrontal Cortex Causes Mice to Maintain or Deviate from Previously Learned Behavioral Strategies

    PubMed Central

    Ellwood, Ian T.; Patel, Tosha; Wadia, Varun; Lee, Anthony T.; Liptak, Alayna T.

    2017-01-01

    Dopamine neurons in the ventral tegmental area (VTA) encode reward prediction errors and can drive reinforcement learning through their projections to striatum, but much less is known about their projections to prefrontal cortex (PFC). Here, we studied these projections and observed phasic VTA–PFC fiber photometry signals after the delivery of rewards. Next, we studied how optogenetic stimulation of these projections affects behavior using conditioned place preference and a task in which mice learn associations between cues and food rewards and then use those associations to make choices. Neither phasic nor tonic stimulation of dopaminergic VTA–PFC projections elicited place preference. Furthermore, substituting phasic VTA–PFC stimulation for food rewards was not sufficient to reinforce new cue–reward associations nor maintain previously learned ones. However, the same patterns of stimulation that failed to reinforce place preference or cue–reward associations were able to modify behavior in other ways. First, continuous tonic stimulation maintained previously learned cue–reward associations even after they ceased being valid. Second, delivering phasic stimulation either continuously or after choices not previously associated with reward induced mice to make choices that deviated from previously learned associations. In summary, despite the fact that dopaminergic VTA–PFC projections exhibit phasic increases in activity that are time locked to the delivery of rewards, phasic activation of these projections does not necessarily reinforce specific actions. Rather, dopaminergic VTA–PFC activity can control whether mice maintain or deviate from previously learned cue–reward associations. SIGNIFICANCE STATEMENT Dopaminergic inputs from ventral tegmental area (VTA) to striatum encode reward prediction errors and reinforce specific actions; however, it is currently unknown whether dopaminergic inputs to prefrontal cortex (PFC) play similar or distinct roles. Here, we used bulk Ca2+ imaging to show that unexpected rewards or reward-predicting cues elicit phasic increases in the activity of dopaminergic VTA–PFC fibers. However, in multiple behavioral paradigms, we failed to observe reinforcing effects after stimulation of these fibers. In these same experiments, we did find that tonic or phasic patterns of stimulation caused mice to maintain or deviate from previously learned cue–reward associations, respectively. Therefore, although they may exhibit similar patterns of activity, dopaminergic inputs to striatum and PFC can elicit divergent behavioral effects. PMID:28739583

  1. Outcomes of Ahmed glaucoma valve implantation in advanced primary congenital glaucoma with previous surgical failure.

    PubMed

    Huang, Jingjing; Lin, Jialiu; Wu, Ziqiang; Xu, Hongzhi; Zuo, Chengguo; Ge, Jian

    2015-01-01

    The purpose of this study was to evaluate the intermediate surgical results of Ahmed glaucoma valve (AGV) implantation in patients less than 7 years of age, with advanced primary congenital glaucoma who have failed previous surgeries. Consecutive patients with advanced primary congenital glaucoma that failed previous operations and had undergone subsequent AGV implantation were evaluated retrospectively. Surgical success was defined as 1) intraocular pressure (IOP) ≥6 and ≤21 mmHg; 2) IOP reduction of at least 30% relative to preoperative values; and 3) without the need for additional surgical intervention for IOP control, loss of light perception, or serious complications. Fourteen eyes of eleven patients were studied. Preoperatively, the average axial length was 27.71±1.52 (25.56-30.80) mm, corneal diameter was 14.71±1.07 (13.0-16.0) mm, cup-to-disc ratio was 0.95±0.04 (0.9-1.0), and IOP was 39.5±5.7 (30-55) mmHg. The mean follow-up time was 18.29±10.96 (5-44, median 18) months. There were significant reductions in IOPs and the number of glaucoma medications (P<0.001) postoperatively. The IOPs after operation were 11.3±3.4, 13.6±5.1, 16.3±2.7, and 16.1±2.6 mmHg at 1 month, 6 months, 12 months, and 18 months, respectively. Kaplan-Meier estimates of the cumulative probability of valve success were 85.7%, 71.4%, and 71.4% at 6, 12, and 18 months, respectively. Severe surgical complications, including erosion of tube, endophthalmitis, retinal detachment, choroidal detachment, and delayed suprachoroidal hemorrhage, occurred in 28.6% cases. AGV implantation remains a viable option for patients with advanced primary congenital glaucoma unresponsive to previous surgical intervention, despite a relatively high incidence of severe surgical complications.

  2. Outcomes of Ahmed glaucoma valve implantation in advanced primary congenital glaucoma with previous surgical failure

    PubMed Central

    Huang, Jingjing; Lin, Jialiu; Wu, Ziqiang; Xu, Hongzhi; Zuo, Chengguo; Ge, Jian

    2015-01-01

    Purpose The purpose of this study was to evaluate the intermediate surgical results of Ahmed glaucoma valve (AGV) implantation in patients less than 7 years of age, with advanced primary congenital glaucoma who have failed previous surgeries. Patients and methods Consecutive patients with advanced primary congenital glaucoma that failed previous operations and had undergone subsequent AGV implantation were evaluated retrospectively. Surgical success was defined as 1) intraocular pressure (IOP) ≥6 and ≤21 mmHg; 2) IOP reduction of at least 30% relative to preoperative values; and 3) without the need for additional surgical intervention for IOP control, loss of light perception, or serious complications. Results Fourteen eyes of eleven patients were studied. Preoperatively, the average axial length was 27.71±1.52 (25.56–30.80) mm, corneal diameter was 14.71±1.07 (13.0–16.0) mm, cup-to-disc ratio was 0.95±0.04 (0.9–1.0), and IOP was 39.5±5.7 (30–55) mmHg. The mean follow-up time was 18.29±10.96 (5–44, median 18) months. There were significant reductions in IOPs and the number of glaucoma medications (P<0.001) postoperatively. The IOPs after operation were 11.3±3.4, 13.6±5.1, 16.3±2.7, and 16.1±2.6 mmHg at 1 month, 6 months, 12 months, and 18 months, respectively. Kaplan–Meier estimates of the cumulative probability of valve success were 85.7%, 71.4%, and 71.4% at 6, 12, and 18 months, respectively. Severe surgical complications, including erosion of tube, endophthalmitis, retinal detachment, choroidal detachment, and delayed suprachoroidal hemorrhage, occurred in 28.6% cases. Conclusion AGV implantation remains a viable option for patients with advanced primary congenital glaucoma unresponsive to previous surgical intervention, despite a relatively high incidence of severe surgical complications. PMID:26082610

  3. Evaluation of a novel high-resolution mapping technology for ablation of recurrent scar-related atrial tachycardias.

    PubMed

    Anter, Elad; McElderry, Thomas H; Contreras-Valdes, Fernando M; Li, Jianqing; Tung, Patricia; Leshem, Eran; Haffajee, Charles I; Nakagawa, Hiroshi; Josephson, Mark E

    2016-10-01

    Rhythmia is a new technology capable of rapid and high-resolution mapping. However, its potential advantage over existing technologies in mapping complex scar-related atrial tachycardias (ATs) has not yet been evaluated. The purpose of this study was to examine the utility of Rhythmia for mapping scar-related ATs in patients who had failed previous ablation procedure(s). This multicenter study included 20 patients with recurrent ATs within 2 years after a previous ablation procedure (1.8 ± 0.7 per patient). In all cases, the ATs could not be adequately mapped during the index procedure because of scar with fractionated electrograms, precluding accurate time annotation, frequent change in the tachycardia in response to pacing, and/or degeneration into atrial fibrillation. These patients underwent repeat mapping and ablation procedure with Rhythmia. From a total of 28 inducible ATs, 24 were successfully mapped. Eighteen ATs (75%) terminated during radiofrequency ablation and 4 (16.6%) with catheter pressure or entrainment from the site of origin or isthmus. Two ATs that were mapped to the interatrial septum slowed but did not terminate with ablation. In 21 of 24 ATs the mechanism was macroreentry, while in 3 of 24 the mechanism was focal. Interestingly, in 5 patients with previously failed ablation of an allegedly "focal" tachycardia, high-resolution mapping demonstrated macroreentrant arrhythmia. The mean mapping time was 28.6 ± 17 minutes, and the mean radiofrequency ablation time to arrhythmia termination was 3.2 ± 2.6 minutes. During a mean follow-up of 7.5 ± 3.1 months, 15 of 20 patients (75%) were free of AT recurrences. The Rhythmia mapping system may be advantageous for mapping complex scar-related ATs. Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  4. Peginterferon alfa‐2a (40KD) plus ribavirin in chronic hepatitis C patients who failed previous interferon therapy

    PubMed Central

    Sherman, M; Yoshida, E M; Deschenes, M; Krajden, M; Bain, V G; Peltekian, K; Anderson, F; Kaita, K; Simonyi, S; Balshaw, R; Lee, S S

    2006-01-01

    Background The management of patients with chronic hepatitis C who have relapsed or failed to respond to interferon based therapies is an important issue facing hepatologists. Aims We evaluated the efficacy and safety of peginterferon alfa‐2a (40KD) plus ribavirin in this population by conducting a multicentre open label study. Patients Data from adults with detectable serum hepatitis C virus (HCV) RNA who had not responded or had relapsed after previous conventional interferon or conventional interferon/ribavirin combination therapy were analysed. Methods Patients were retreated with peginterferon alfa‐2a (40KD) 180 µg/week plus ribavirin 800 mg/day for 24 or 48 weeks at the investigators' discretion. The study was conceived before the optimal dose of ribavirin (1000/1200 mg/day) for patients with genotype 1 was known. The primary endpoint was sustained virological response (SVR), defined as undetectable HCV RNA (<50 IU/ml) after 24 weeks of follow up. The analysis was conducted by intention to treat. Results A total of 312 patients (212 non‐responders, 100 relapsers) were included. Of these, 28 patients were treated for 24 weeks and 284 for 48 weeks. Baseline characteristics between non‐responders and relapsers were similar although more non‐responders had genotype 1 infection (87% v 69%). Overall SVR rates were 23% (48/212) for non‐responders and 41% (41/100) for relapsers. When data were analysed by genotype, SVR rates were 24% (61/253) in genotype 1 and 47% (28/59) in genotype 2/3. Conclusions These results in a large patient cohort demonstrate that it is possible to cure a proportion of previous non‐responders and relapsers by retreating with peginterferon alfa‐2a (40KD) plus ribavirin. PMID:16709661

  5. Role of Gap Junctions in Early Brain Injury Following Subarachnoid Hemorrhage

    PubMed Central

    Ayer, Robert; Chen, Wanqiu; Sugawara, Takashi; Suzuki, Hidenori; Zhang, John H.

    2010-01-01

    Gap junction inhibition has been demonstrated to reverse the vascular contraction that follows experimental subarachnoid hemorrhage. This study hypothesizes that the use of established gap junction inhibitors: octonal and carbenoxolone, to interrupt cell to cell communication will provide neuroprotection against early brain injury after SAH. The filament perforation model of SAH was performed in male Sprague–Dawley rats weighing between 300 and 380g. Octanol (260.46mg or 781.38 mg/kg), carbenoxolone (100 mg/kg), or vehicles were given via intraperitoneal injection 1 hour after SAH. Neurologic deficits and cerebral apoptosis were assessed 24 and 72 hours after SAH. In addition, Western blot analysis was performed to confirm the in vivo inhibition of CNS gap junctions. The administration of octanol and carbenoxolone both failed to attenuate the neurological deficits induced by SAH, and they did not reduce neuronal apoptosis. Additionally, carbenoloxone increased post SAH mortality and exacerbated SAH induced apoptosis. Despites previous studies that show gap junction inhibitors reverse vasospasm following experimental SAH, they failed to improve clinical outcomes or provide neuroprotection in this study. PMID:20018179

  6. 76 FR 42139 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Evaluation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-18

    ... there variation by sex, age, race/ethnicity, unemployment insurance receipt, education level, previous... person shall generally be subject to penalty for failing to comply with a collection of information if...

  7. 40 CFR 1601.33 - Miscellaneous fee provisions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... has a history of prompt payment of FOIA fees. In the case of requesters with no history of payment... be incurred; or (ii) The requester has previously failed to pay a fee in a timely fashion, i.e...

  8. A dynamic magnetic tension force as the cause of failed solar eruptions

    DOE Data Explorer

    Myers, Clayton E. [Princeton Univ., NJ (United States). Dept. of Astrophysical Sciences; Princeton Plasma Physics Lab. (PPPL), Princeton, NJ (United States); ] (ORCID:0000000345398406); Yamada, Maasaki [Princeton Plasma Physics Lab. (PPPL), Princeton, NJ (United States)] (ORCID:0000000349961649); Ji, Hantao [Princeton Univ., NJ (United States). Dept. of Astrophysical Sciences; Princeton Plasma Physics Lab. (PPPL), Princeton, NJ (United States); Laboratory for Space Environment and Physical Sciences, Harbin Institute of Technology, Harbin, Heilongjiang 150001, China] (ORCID:0000000196009963); Yoo, Jongsoo [Princeton Plasma Physics Lab. (PPPL), Princeton, NJ (United States)] (ORCID:0000000338811995); Fox, William [Princeton Plasma Physics Lab. (PPPL), Princeton, NJ (United States)] (ORCID:000000016289858X); Jara-Almonte, Jonathan [Princeton Univ., NJ (United States). Dept. of Astrophysical Sciences; Princeton Plasma Physics Lab. (PPPL), Princeton, NJ (United States); ] (ORCID:0000000307606198); Savcheva, Antonia [Harvard†“ Smithsonian Center for Astrophysics, Cambridge, Massachusetts 02138, USA] (ORCID:000000025598046X); DeLuca, Edward E. [Harvard†“ Smithsonian Center for Astrophysics, Cambridge, Massachusetts 02138, USA] (ORCID:0000000174162895)

    2015-12-11

    Coronal mass ejections are solar eruptions driven by a sudden release of magnetic energy stored in the Sun’s corona. In many cases, this magnetic energy is stored in long-lived, arched structures called magnetic flux ropes. When a flux rope destabilizes, it can either erupt and produce a coronal mass ejection or fail and collapse back towards the Sun. The prevailing belief is that the outcome of a given event is determined by a magnetohydrodynamic force imbalance called the torus instability. This belief is challenged, however, by observations indicating that torus-unstable flux ropes sometimes fail to erupt. This contradiction has not yet been resolved because of a lack of coronal magnetic field measurements and the limitations of idealized numerical modelling. Here we report the results of a laboratory experiment that reveal a previously unknown eruption criterion below which torus-unstable flux ropes fail to erupt. We find that such ‘failed torus’ events occur when the guide magnetic field (that is, the ambient field that runs toroidally along the flux rope) is strong enough to prevent the flux rope from kinking. Under these conditions, the guide field interacts with electric currents in the flux rope to produce a dynamic toroidal field tension force that halts the eruption. This magnetic tension force is missing from existing eruption models, which is why such models cannot explain or predict failed torus events.

  9. Event-related fields evoked by vocal response inhibition: a comparison of younger and older adults.

    PubMed

    Castro-Meneses, Leidy J; Johnson, Blake W; Sowman, Paul F

    2016-06-01

    The current study examined event-related fields (ERFs) evoked by vocal response inhibition in a stimulus-selective stop-signal task. We compared inhibition-related ERFs across a younger and an older group of adults. Behavioural results revealed that stop-signal reaction times (RTs), go-RTs, ignore-stop RTs and failed stop RTs were longer in the older, relative to the younger group by 38, 123, 149 and 116 ms, respectively. The amplitude of the ERF M2 peak (approximately 200 ms after the stop signal) evoked on successful stop trials was larger compared to that evoked on both failed stop and ignore-stop trials. The M4 peak (approximately 450 ms after stop signal) was of larger amplitude in both successful and failed stops compared to ignore-stop trials. In the older group, the M2, M3 and M4 peaks were smaller in amplitude and peaked later in time (by 24, 50 and 76 ms, respectively). We demonstrate that vocal response inhibition-related ERFs exhibit a similar temporal evolution to those previously described for manual response inhibition: an early peak at 200 ms (i.e. M2) that differentiates successful from failed stopping, and a later peak (i.e. M4) that is consistent with a neural marker of response checking and error processing. Across groups, our data support a more general decline of stimulus processing speed with age.

  10. Pembrolizumab versus the standard of care for relapsed and refractory classical Hodgkin's lymphoma progressing after brentuximab vedotin: an indirect treatment comparison.

    PubMed

    Keeping, Sam; Wu, Elise; Chan, Keith; Mojebi, Ali; Ferrante, Shannon Allen; Balakumaran, Arun

    2018-05-15

    There is significant unmet need among patients with relapsed and refractory classical Hodgkin's lymphoma (RRcHL) who have failed multiple lines of therapy, including brentuximab vedotin (BV). Pembrolizumab, an immune checkpoint inhibitor, is one possible treatment solution for this population. The objective of this study was to compare progression-free survival (PFS) with standard of care (SOC) versus pembrolizumab in previously BV treated RRcHL patients. A systematic literature review identified one observational study (Cheah et al., 2016) of SOC that was suitable for comparison with KEYNOTE-087, the principal trial of pembrolizumab in this population. Both naïve and population-adjusted (using outcomes regression) pairwise indirect comparisons were conducted. The primary analysis included all patients who had failed BV, with a secondary analysis conducted including only those known to have failed BV that was part of definitive treatment. In the primary analysis, SOC was inferior to pembrolizumab in both the unadjusted comparison (HR 5.00 [95% confidence interval (CI) 3.56-7.01]) and the adjusted comparison (HR 6.35 [95% CI 4.04-9.98]). These HRs increased to 5.16 (95% CI 3.61-7.38) and 6.56 (95% CI 4.01-10.72), respectively, in the secondary analysis. Pembrolizumab offers a significant improvement in PFS compared to SOC in this population.

  11. Glyburide in gestational diabetes--prediction of treatment failure.

    PubMed

    Yogev, Yariv; Melamed, Nir; Chen, Rony; Nassie, Daniel; Pardo, Joseph; Hod, Moshe

    2011-06-01

    To identify factors predicting failure of glyburide treatment in women with gestational diabetes mellitus (GDM). A retrospective study of all women with GDM that were treated with glyburide in a single tertiary referral center. Patients were switched from glyburide to insulin if they failed to achieve glycemic goals, and were then classified as glyburide failure. Overall, 124 women with GDM treated with glyburide were included in the study, of which 31 (25%) failed to achieve glycemic control. Women in the failure group were characterized by a higher weight gain during pregnancy, higher rates of GDM on previous pregnancies, and a glucose challenge test (GCT) result. On multivariate logistic regression analysis, a GCT value of >200 mg/dl (OR = 7.1, 95% CI 2.8-27.6) and weight gain ≥ 12 kg (OR = 3.9, 95% CI 1.2-13.0) were the only significant and independent predictors of glyburide failure. Most women who were successfully treated with glyburide required a daily dose of 5 mg or less and the time required to achieve glycemic control in these cases was 12.4 ± 4.9 days (range 5-24 days). Of the women who failed to achieve glycemic control with gluburide, 26/31 were switched to insulin, of them only 12 (46%) achieved desired level of glycemic control. Most women with GDM achieved desired level of glycemic control under glyburide treatment.

  12. Resistance to the beneficial effects of exercise in type 2 diabetes: are some individuals programmed to fail?

    PubMed

    Stephens, Natalie A; Sparks, Lauren M

    2015-01-01

    Exercise benefits most, but not all, individuals with type 2 diabetes (T2D). The beneficial effects are well studied, but why some individuals do not respond favorably to exercise training is largely unexplored. It is critical to treatment and prevention strategies to identify individuals with T2D that have a blunted metabolic response to exercise and investigate the underlying mechanisms that might predict this "programmed response to fail." We carried out a systematic review of classic and contemporary primary reports on clinical human and animal exercise studies. We also referenced unpublished data from our previous studies, as well those of collaborators. Genetic and epigenetic components and their associations with the exercise response were also examined. As evidence of the exercise resistance premise, we and others found that supervised exercise training results in substantial response variations in glucose homeostasis, insulin sensitivity, and muscle mitochondrial density, wherein approximately 15-20% of individuals fail to improve their metabolic health with exercise. Classic genetic studies have shown that the extent of the exercise training response is largely heritable, whereas new evidence demonstrates that DNA hypomethylation is linked to the exercise response in skeletal muscle. DNA sequence variation and/or epigenetic modifications may, therefore, dictate the exercise training response. Studies dedicated to uncovering the mechanisms of exercise resistance will advance the field of exercise and T2D, allowing interventions to be targeted to those most likely to benefit and identify novel approaches to treat those who do not experience metabolic improvements after exercise training.

  13. Peroral endoscopic remyotomy for failed Heller myotomy: a prospective single-center study.

    PubMed

    Zhou, P H; Li, Q L; Yao, L Q; Xu, M D; Chen, W F; Cai, M Y; Hu, J W; Li, L; Zhang, Y Q; Zhong, Y S; Ma, L L; Qin, W Z; Cui, Z

    2013-01-01

    Recurrence/persistence of symptoms occurs in approximately 20 % of patients after Heller myotomy for achalasia. Controversy exists regarding the therapy for patients in whom Heller myotomy has failed. The aim of the current study was to evaluate the efficacy and feasibility of peroral endoscopic myotomy (POEM), a new endoscopic myotomy technique, for patients with failed Heller myotomy. A total of 12 patients with recurrence/persistence of symptoms after Heller myotomy, as diagnosed by established methods and an Eckardt score of ≥ 4, were prospectively included. The primary outcome was symptom relief during follow-up, defined as an Eckardt score of ≤ 3. Secondary outcomes were procedure-related adverse events, lower esophageal sphincter (LES) pressure on manometry, reflux symptoms, and medication use before and after POEM. All 12 patients underwent successful POEM after a mean of 11.9 years (range 2 - 38 years) from the time of the primary Heller myotomy. No serious complications related to POEM were encountered. During a mean follow-up period of 10.4 months (range 5 - 14 months), treatment success was achieved in 11/12 patients (91.7 %; mean score pre- vs. post-treatment 9.2 vs. 1.3; P < 0.001). Mean LES pressure was 29.4 mmHg pre-treatment and 13.5 mmHg post-treatment (P < 0.001). One patient developed mild reflux symptoms and required intermittent medication with proton pump inhibitors. POEM seems to be a promising new treatment for failed Heller myotomy resulting in short-term symptom relief in > 90 % of cases. Previous Heller myotomy may make subsequent endoscopic remyotomy more challenging, but does not prevent successful POEM. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Reverse distal femoral locking compression plate a salvage option in nonunion of proximal femoral fractures.

    PubMed

    Dumbre Patil, Sampat S; Karkamkar, Sachin S; Patil, Vaishali S Dumbre; Patil, Shailesh S; Ranaware, Abhijeet S

    2016-01-01

    When primary fixation of proximal femoral fractures with implants fails, revision osteosynthesis may be challenging. Tracts of previous implants and remaining insufficient bone stock in the proximal femur pose unique problems for the treatment. Intramedullary implants like proximal femoral nail (PFN) or surface implants like Dynamic Condylar Screw (DCS) are few of the described implants for revision surgery. There is no evidence in the literature to choose one implant over the other. We used the reverse distal femur locking compression plate (LCP) of the contralateral side in such cases undergoing revision surgery. This implant has multiple options of fixation in proximal femur and its curvature along the length matches the anterior bow of the femur. We aimed to evaluate the efficacy of this implant in salvage situations. Twenty patients of failed primary proximal femoral fractures who underwent revision surgery with reverse distal femoral locking plate from February 2009 to November 2012 were included in this retrospective study. There were 18 subtrochanteric fractures and two ipsilateral femoral neck and shaft fractures, which exhibited delayed union or nonunion. The study included 14 males and six females. The mean patient age was 43.6 years (range 22-65 years) and mean followup period was 52.1 months (range 27-72 months). Delayed union was considered when clinical and radiological signs of union failed to progress at the end of four months from initial surgery. All fractures exhibited union without any complications. Union was assessed clinically and radiologically. One case of ipsilateral femoral neck and shaft fracture required bone grafting at the second stage for delayed union of the femoral shaft fracture. Reverse distal femoral LCP of the contralateral side can be used as a salvage option for failed fixation of proximal femoral fractures exhibiting nonunion.

  15. Biceps tenodesis is a viable option for salvage of failed SLAP repair.

    PubMed

    Werner, Brian C; Pehlivan, Hakan C; Hart, Joseph M; Lyons, Matthew L; Gilmore, C Jan; Garrett, Cara B; Carson, Eric W; Diduch, David R; Miller, Mark D; Brockmeier, Stephen F

    2014-08-01

    Outcomes of arthroscopic superior labral anterior-posterior (SLAP) repairs have been well reported with generally favorable outcomes. Unfortunately, a percentage of patients remain dissatisfied or suffer further injury after SLAP repair and may seek additional treatment. The purpose of this study was to evaluate the surgical outcomes of biceps tenodesis for failed SLAP repairs. A retrospective review of all patients undergoing biceps tenodesis was completed. Inclusion criteria were previous SLAP repair and subsequent revision biceps tenodesis. Exclusion criteria were additional shoulder procedures including rotator cuff repair, instability procedures, and preoperative frozen shoulder. Objective outcomes were postoperative assessments with Constant score, American Shoulder and Elbow Surgeons score, Single Assessment Numeric Evaluation, Simple Shoulder Test, and Veterans RAND 36-Item Health Survey. Physical examination was conducted to determine postoperative range of motion and strength compared with the nonoperative shoulder. A cohort of 24 patients was identified, and of these, 17 patients (71%) completed the study at 2 years' follow-up. The average postoperative Constant score was 84.4; American Shoulder and Elbow Surgeons score, 75.5; Single Assessment Numeric Evaluation score, 73.1%; Simple Shoulder Test score, 9.2; and Veterans RAND 36-Item Health Survey score, 76.1. Postoperative range of motion of the operative shoulder returned to near that of the asymptomatic nonoperative shoulder. Workers' compensation status led to inferior results. Options for patients with a failed prior SLAP repair are limited. As a salvage operation for failed SLAP repair, biceps tenodesis serves the majority of patients well, with favorable outcomes by validated measures and excellent shoulder range of motion and elbow strength at 2 years' follow-up. Workers' compensation status may predispose patients to poorer outcomes. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  16. Retrieval and clinical analysis of distraction-based dual growing rod constructs for early-onset scoliosis.

    PubMed

    Hill, Genevieve; Nagaraja, Srinidhi; Akbarnia, Behrooz A; Pawelek, Jeff; Sponseller, Paul; Sturm, Peter; Emans, John; Bonangelino, Pablo; Cockrum, Joshua; Kane, William; Dreher, Maureen

    2017-10-01

    Growing rod constructs are an important contribution for treating patients with early-onset scoliosis. These devices experience high failure rates, including rod fractures. The objective of this study was to identify the failure mechanism of retrieved growing rods, and to identify differences between patients with failed and intact constructs. Growing rod patients who had implant removal and were previously enrolled in a multicenter registry were eligible for this study. Forty dual-rod constructs were retrieved from 36 patients across four centers, and 34 of those constructs met the inclusion criteria. Eighteen constructs failed due to rod fracture. Sixteen intact constructs were removed due to final fusion (n=7), implant exchange (n=5), infection (n=2), or implant prominence (n=2). Analyses of clinical registry data, radiographs, and retrievals were the outcome measures. Retrievals were analyzed with microscopic imaging (optical and scanning electron microscopy) for areas of mechanical failure, damage, and corrosion. Failure analyses were conducted on the fracture surfaces to identify failure mechanism(s). Statistical analyses were performed to determine significant differences between the failed and intact groups. The failed rods fractured due to bending fatigue under flexion motion. Construct configuration and loading dictate high bending stresses at three distinct locations along the construct: (1) mid-construct, (2) adjacent to the tandem connector, or (3) adjacent to the distal anchor foundation. In addition, high torques used to insert set screws may create an initiation point for fatigue. Syndromic scoliosis, prior rod fractures, increase in patient weight, and rigid constructs consisting of tandem connectors and multiple crosslinks were associated with failure. This is the first study to examine retrieved, failed growing rod implants across multiple centers. Our analysis found that rod fractures are due to bending fatigue, and that stress concentrations play an important role in rod fractures. Recommendations are made on surgical techniques, such as the use of torque-limiting wrenches or not exceeding the prescribed torques. Additional recommendations include frequent rod replacement in select patients during scheduled surgeries. Published by Elsevier Inc.

  17. Demographic processes limiting seedling recruitment in arid grassland restoration

    Treesearch

    Jeremy J. James; Tony J. Svejcar; Matthew J. Rinella

    2011-01-01

    Seeding is an important management tool in aridland restoration, but seeded species often fail to establish. Previous research has largely focused on the technical aspects of seeding with little effort directed at identifying demographic processes driving recruitment failures.

  18. Cold in-place recycle phase III, mix design.

    DOT National Transportation Integrated Search

    2014-10-01

    This projects purpose is to revise the UDOT accepted design methods for Cold In-Place Recycling so that they : better reflect field behavior and target the desirable attributes of the material. The previous design process failed to : adequately pr...

  19. 45 CFR 5.44 - Procedures for assessing and collecting fees.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... proceed with the search. (b) Advance payment. If you have failed to pay previous bills in a timely fashion... have a history of prompt payment. We may also, at our discretion, aggregate the charges for certain...

  20. Breastfeeding is positively associated with child intelligence even net of parental IQ.

    PubMed

    Kanazawa, Satoshi

    2015-12-01

    Some previous reviews conclude that breastfeeding is not significantly associated with increased intelligence in children once mother's IQ is statistically controlled. The conclusion may potentially have both theoretical and methodological problems. The National Child Development Study allows the examination of the effect of breastfeeding on intelligence in two consecutive generations of British children. The analysis of the first generation shows that the effect of breastfeeding on intelligence increases from Age 7 to 16. The analysis of the second generation shows that each month of breastfeeding, net of parental IQ and other potential confounds, is associated with an increase of .16 IQ points. Further analyses suggest that some previous studies may have failed to uncover the effect of breastfeeding on child intelligence because of their reliance on one IQ test. (c) 2015 APA, all rights reserved).

  1. Depressive symptoms, antidepressant medication use, and insulin resistance: the PPP-Botnia Study.

    PubMed

    Pyykkönen, Antti-Jussi; Räikkönen, Katri; Tuomi, Tiinamaija; Eriksson, Johan G; Groop, Leif; Isomaa, Bo

    2011-12-01

    Although insulin resistance (IR) may underlie associations between depressive symptoms and diabetes, previous findings have been contradictory. We examined whether depressive symptoms associate with IR and insulin secretion, and, additionally, whether antidepressant medication use may modulate such associations. A total of 4,419 individuals underwent an oral glucose tolerance test (OGTT). Participants with previously or newly diagnosed diabetes are excluded from this sample. The homeostasis model assessment of IR (HOMA-IR) and corrected insulin response (CIR) were calculated. Depressive symptoms and antidepressant medication use were self-reported. After controlling for confounding factors, depressive symptoms were associated with higher fasting and 30-min insulin during the OGTT and higher HOMA-IR but not CIR. Antidepressant medication use failed to modify these associations. Depressive symptoms are associated with IR but not with changes in insulin response when corrected for IR in individuals without previously or newly diagnosed diabetes.

  2. OGLE-2014-SN-073 as a fallback accretion powered supernova

    NASA Astrophysics Data System (ADS)

    Moriya, Takashi J.; Terreran, Giacomo; Blinnikov, Sergei I.

    2018-03-01

    We investigate the possibility that the energetic Type II supernova OGLE-2014-SN-073 is powered by a fallback accretion following the failed explosion of a massive star. Taking massive hydrogen-rich supernova progenitor models, we estimate the fallback accretion rate and calculate the light-curve evolution of supernovae powered by the fallback accretion. We find that such fallback accretion powered models can reproduce the overall observational properties of OGLE-2014-SN-073. It may imply that some failed explosions could be observed as energetic supernovae like OGLE-2014-SN-073 instead of faint supernovae as previously proposed.

  3. VAGINAL BIRTH AFTER A PREVIOUS CAESAREAN SECTION: CURRENT TRENDS AND OUTLOOK IN GHANA.

    PubMed

    Seffah, J D; Adu-Bonsaffoh, K

    2014-01-01

    The optimal mode of subsequent delivery of women with prior caesarean birth remains a subject of intense research and debate in contemporary obstetric practice especially in low resource settings like West Africa where there are obvious systemic and management-related challenges associated with trial of scar. However, there is evidence that vaginal birth after caesarean section (VBAC) is safe in appropriately selected women in addition to adequate intrapartum monitoring and ready access to theatre when emergency CS is indicated. The primary objective of the study was to determine the current trends and performance of VBAC in Ghana after decades of practice of trial of labour after caesarean section (TOLAC) in the mist of inherent challenges in deciding the optimal mode of childbirth for women with a previous caesarean birth. The secondary objective was to relate evidence based practice of TOLAC to obstetric practice in low resource settings like Ghana and provide recommendations for improving maternal and newborn health among women with prior caesarean birth. This was a retrospective study of the records of patients who had had a prior caesarean delivery and who then proceeded to deliver the next babies at the Korle Bu Teaching Hospital (KBTH) between Jan 2010 and Dec 2014. The data on demography, antenatal care, labour and delivery and outcomes were collected from the Labour and Recovery wards and the Biostatistics unit of the Maternity unit of the Hospital. Excluded were women with a previous CS who had multiple pregnancies and those with incomplete notes as well as those whose delivery plans were not predetermined antenatally.. The data were analyzed using SPSS version 20. There were 53,581 deliveries during the study period. Vaginal delivery was obtained in 31,870 (59.5%) pregnancies and 21,711(40.5%) had CS. Also, 6261 (11.7%) had had a prior CS and 2472 (39.5%) of these were selected for TOLAC while 2119 (33.8) were scheduled for planned repeat CS. There was an inverse trend between the annual caesarean sections rates and the proportion of women with one previous CS scheduled for TOLAC. There was a statistically significant difference between women who had successful or failed VBAC regarding maternal age, parity, number of ANC visits, gestational age at delivery, birth weight, Apgar score at 1 min and Apgar score at 5 min. Birth weights of less than 1.5kg, and 3.5Kg or greater were associated significantly with higher incidence failed TOLAC and emergency repeat CS. However, birth weights ranging from 2.0 to 3.49kg were associated with significantly lower incidence of failed TOLAC and emergency repeat CS. Birth weight of 2.5-2.99kg was associated with the lowest incidence of failed TOLAC and repeat CS. . There is a significantly high vaginal birth after caesarian section (VBAC) success rate among carefully selected women undergoing trial of scar in Ghana although a decreasing trend towards trial of labor after caesarian section (TOLAC) and a rising CS rate were determined. TOLAC remains a viable option for child birth in low resource settings like West Africa even though there are specific clinical and management related challenges to overcome. Adequate patient education and counselling in addition to appropriate patient selection for TOLAC remains the cornerstone to achieving high VBAC success rate with minimal adverse outcomes in such settings.

  4. 24 CFR 15.110 - What fees will HUD charge?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... estimated fee is more than $250.00 or you have a history of failing to pay FOIA fees to HUD in a timely... consumer credit reporting agencies of your delinquency. (3) If you owe fees for previous FOIA responses...

  5. Performance and Symptom Validity Testing as a Function of Medical Board Evaluation in U.S. Military Service Members with a History of Mild Traumatic Brain Injury.

    PubMed

    Armistead-Jehle, Patrick; Cole, Wesley R; Stegman, Robert L

    2018-02-01

    The study was designed to replicate and extend pervious findings demonstrating the high rates of invalid neuropsychological testing in military service members (SMs) with a history of mild traumatic brain injury (mTBI) assessed in the context of a medical evaluation board (MEB). Two hundred thirty-one active duty SMs (61 of which were undergoing an MEB) underwent neuropsychological assessment. Performance validity (Word Memory Test) and symptom validity (MMPI-2-RF) test data were compared across those evaluated within disability (MEB) and clinical contexts. As with previous studies, there were significantly more individuals in an MEB context that failed performance (MEB = 57%, non-MEB = 31%) and symptom validity testing (MEB = 57%, non-MEB = 22%) and performance validity testing had a notable affect on cognitive test scores. Performance and symptom validity test failure rates did not vary as a function of the reason for disability evaluation when divided into behavioral versus physical health conditions. These data are consistent with past studies, and extends those studies by including symptom validity testing and investigating the effect of reason for MEB. This and previous studies demonstrate that more than 50% of SMs seen in the context of an MEB will fail performance validity tests and over-report on symptom validity measures. These results emphasize the importance of using both performance and symptom validity testing when evaluating SMs with a history of mTBI, especially if they are being seen for disability evaluations, in order to ensure the accuracy of cognitive and psychological test data. Published by Oxford University Press 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  6. Deep structure of Porcupine Basin and nature of the Porcupine Median Ridge from seismic refraction tomography

    NASA Astrophysics Data System (ADS)

    Watremez, L.; Chen, C.; Prada, M.; Minshull, T. A.; O'Reilly, B.; Reston, T. J.; Wagner, G.; Gaw, V.; Klaeschen, D.; Shannon, P.

    2015-12-01

    The Porcupine Basin is a narrow V-shaped failed rifted basin located offshore SW Ireland. It is of Permo-Triassic to Cenozoic age, with the main rifting phase in the Late Jurassic to Early Cretaceous. Porcupine Basin is a key study area to learn about the processes of continental extension and to understand the thermal history of this rifted basin. Previous studies show increasing stretching factors, from less than 1.5 to the North to more than 6 to the South. A ridge feature, the Porcupine Median Ridge, has been identified in the middle of the southernmost part of the basin. During the last three decades, this ridge has been successively interpreted as a volcanic structure, a diapir of partially serpentinized mantle, or a block of continental crust. Its nature still remains debated today. In this study, we use arrival times from refractions and wide-angle reflections in the sedimentary, crustal and mantle layers to image the crustal structure of the thinnest part of the basin, the geometry of the continental thinning from margin to margin, and the Porcupine Median Ridge. The final velocity model is then compared with coincident seismic reflection data. We show that (1) the basin is asymmetric, (2) P-wave velocities in the uppermost mantle are lower than expected for unaltered peridotites, implying upper-mantle serpentinisation, (3) the nature of Porcupine Median Ridge is probably volcanic, and (4) the amount of thinning is greater than shown in previous studies. We discuss the thermal implications of these results for the evolution of this rift system and the processes leading to the formation of failed rifts. This project is funded by the Irish Shelf Petroleum Studies Group (ISPSG) of the Irish Petroleum Infrastructure Programme Group 4.

  7. [Epidemiology of shoulder dystocia].

    PubMed

    Deneux-Tharaux, C; Delorme, P

    2015-12-01

    To synthetize the available evidence regarding the incidence and risk factors of shoulder dystocia (SD). Consultation of the Medline database, and of national guidelines. Shoulder dystocia is defined as a vaginal delivery that requires additional obstetric manoeuvres to deliver the foetus after the head has delivered and gentle traction has failed. With this definition, the incidence of SD in population-based studies is about 0.5-1% of vaginal deliveries. Many risk factors have been described but most associations are not independent, or have not been constantly found. The 2 characteristics consistently found as independent risk factors for SD in the literature are previous SD (incidence of SD of about 10% in parturients with previous SD) and foetal macrosomia. Maternal diabetes and obesity also are associated with a higher risk of SD (2 to 4 folds) but these associations may be completely explained by foetal macrosomia. However, even factors independently and constantly associated with SD do not allow a valid prediction of SD because they are not discriminant; 50 to 70% of SD cases occur in their absence, and the great majority of deliveries when they are present is not associated with SD. Shoulder dystocia is defined by the need for additional obstetric manoeuvres to deliver the foetus after the head has delivered and gentle traction has failed, and complicates 0.5-1% of vaginal deliveries. Its main risk factors are previous SD and macrosomia, but they are poorly predictive. SD remains a non-predictable obstetrics emergency. Knowledge of SD risk factors should increase the vigilance of clinicians in at-risk contexts. Copyright © 2015. Published by Elsevier Masson SAS.

  8. Screening for developmental problems at primary care level: a field programme in San Isidro, Argentina.

    PubMed

    Lejarraga, Horacio; Menendez, Ana Maria; Menzano, Enrique; Guerra, Lucìa; Biancato, Silvia; Pianelli, Patricia; Del Pino, Mariana; Fattore, Marìa José; Contreras, Maria M

    2008-03-01

    Information on prevalence and type of problems of psychomotor development (PPD) is necessary for implementation of specific care programmes at field level. With the purpose of obtaining this information, a screening test, the Prueba Nacional de Pesquisa (PRUNAPE) for PPD was implemented in three health centres in San Isidro, a city near Buenos Aires, attended by different socio-economic groups: centres A and B were located in the inner city, and C in a middle-class area. The test was administered by three previously trained paediatricians to 839 apparently healthy children aged 0-5 years. The failure rates were 24%, 19% and 16% in centres A, B and C respectively (20% in total). Out of the 170 children failing the test and referred to hospital for diagnosis and treatment, only 96 complied and went through a series of studies carried out by a previously prepared multidisciplinary team. With the exception of children who failed the Battelle test [classified as Global Developmental Delay (GDD)], final diagnoses were classified according to Diagnostic and Statistical Manual of Mental Disorders, 4th edition: GDD (60 children), pervasive developmental disorders (11), communication disorders (10), motor disorders (6, of whom 2 were with cerebral palsy), attention deficit disorders (5), attachment disorders (2), normal children (3). Co-morbidity was present in 22 affected children. Forty-three per cent of children failing the test did not attend hospital or did not complete studies because of major social and family problems, the family not living in the area, or the parents preferring to consult their own paediatrician. Health centres and children not selected in a randomised way, and a significant proportion of them not complying with the indication of hospital referral were major sources of bias, so that PPD prevalences, positive and negative predictive values should be interpreted with great caution. Further studies accounting for these sources of bias are needed to confirm the observed prevalence of PPD. Training of health personnel, at hospital and health centre level, priority settings, and operational research to evaluate effectiveness of treatments and care delivery systems at field level are necessary in Argentina for optimal use of limited healthcare resources.

  9. Effects of vedolizumab induction therapy for patients with Crohn's disease in whom tumor necrosis factor antagonist treatment failed.

    PubMed

    Sands, Bruce E; Feagan, Brian G; Rutgeerts, Paul; Colombel, Jean-Frédéric; Sandborn, William J; Sy, Richmond; D'Haens, Geert; Ben-Horin, Shomron; Xu, Jing; Rosario, Maria; Fox, Irving; Parikh, Asit; Milch, Catherine; Hanauer, Stephen

    2014-09-01

    There is an increasing need for new treatments for patients with Crohn's disease (CD) in whom previous therapy with tumor necrosis factor (TNF) antagonists has failed. We performed a placebo-controlled, phase 3, double-blind trial to evaluate the efficacy and safety of vedolizumab, an antibody against the integrin α4β7, as induction therapy. Patients with moderately to severely active CD (CD activity index [CDAI] score, 220-400 points) were assigned randomly to groups given vedolizumab (300 mg) or placebo intravenously at weeks 0, 2, and 6. The primary analysis involved 315 patients with previous TNF antagonist failure (ie, an inadequate response to, loss of response to, or intolerance of ≥1 TNF antagonists); we determined the proportion of patients in clinical remission (CDAI, ≤150 points) at week 6. Secondary analyses evaluated outcomes at weeks 6 and 10 in this population and in the overall population (N = 416), which included patients naive to TNF antagonist therapy (n = 101). Among patients who had experienced previous TNF antagonist failure, 15.2% of those given vedolizumab and 12.1% of those given placebo were in remission at week 6 (P = .433). At week 10, a higher proportion of this population given vedolizumab was in remission (26.6%) than those given placebo (12.1%) (nominal P = .001; relative risk, 2.2; 95% confidence interval, 1.3-3.6). A higher proportion of patients with previous TNF antagonist failure given vedolizumab also had a CDAI-100 response (≥100-point decrease in CDAI score from baseline) at week 6 than those given placebo (39.2% vs 22.3%; nominal P = .001; relative risk, 1.8; 95% confidence interval, 1.2-2.5). Adverse event results were similar among all groups. Vedolizumab was not more effective than placebo in inducing clinical remission at week 6 among patients with CD in whom previous treatment with TNF antagonists had failed. The therapeutic benefits of vedolizumab in these patients were detectable at week 10. ClinicalTrials.gov number: NCT01224171. Copyright © 2014 AGA Institute. Published by Elsevier Inc. All rights reserved.

  10. Revision Tibiotalocalcaneal Arthrodesis With a Pseudoelastic Intramedullary Nail.

    PubMed

    Latt, L Daniel; Smith, Kathryn Elizabeth; Dupont, Kenneth Michael

    2017-02-01

    Hindfoot (tibiotalocalcaneal or TTC) arthrodesis is commonly used to treat concomitant arthritis of the ankle and subtalar joints. Simultaneous fusion of both joints can be difficult to achieve especially in patients with impaired healing due to smoking, diabetes mellitus, or Charcot neuroarthropathy. Conventional intramedullary fixation devices allow for compression to be applied at the time of surgery, but this compression can be lost due to bone resorption or settling, leading to impaired healing. In contrast, the novel pseudoelastic intramedullary nail is designed to maintain compression at the arthrodesis sites throughout the healing process by the use of an internal pseudoelastic element. We present 2 cases of revision TTC arthrodesis using the pseudoelastic intramedullary nail. In the first case, an 80-year-old diabetic man with previous ankle and failed subtalar fusion with screws underwent revision TTC arthrodesis. In the second case, a 66-year-old man with Charcot neuroarthropathy and a failed TTC arthrodesis with a static intramedullary nail underwent revision tibiotalar arthrodesis. In both cases, computed tomography scan demonstrated successful union and patients were allowed full weight bearing by 3 months after surgery. These cases provide early evidence that sustained compression via an intramedullary nail can lead to rapid successful hindfoot fusion when standard approaches have failed. Therapeutic, Level IV: Case study.

  11. Modal smoothing for analysis of room reflections measured with spherical microphone and loudspeaker arrays.

    PubMed

    Morgenstern, Hai; Rafaely, Boaz

    2018-02-01

    Spatial analysis of room acoustics is an ongoing research topic. Microphone arrays have been employed for spatial analyses with an important objective being the estimation of the direction-of-arrival (DOA) of direct sound and early room reflections using room impulse responses (RIRs). An optimal method for DOA estimation is the multiple signal classification algorithm. When RIRs are considered, this method typically fails due to the correlation of room reflections, which leads to rank deficiency of the cross-spectrum matrix. Preprocessing methods for rank restoration, which may involve averaging over frequency, for example, have been proposed exclusively for spherical arrays. However, these methods fail in the case of reflections with equal time delays, which may arise in practice and could be of interest. In this paper, a method is proposed for systems that combine a spherical microphone array and a spherical loudspeaker array, referred to as multiple-input multiple-output systems. This method, referred to as modal smoothing, exploits the additional spatial diversity for rank restoration and succeeds where previous methods fail, as demonstrated in a simulation study. Finally, combining modal smoothing with a preprocessing method is proposed in order to increase the number of DOAs that can be estimated using low-order spherical loudspeaker arrays.

  12. SIDE-EFFECTS OF COMBINED RADIATION AND CHEMOTHERAPY IN THE TREATMENT OF MALIGNANT TUMORS

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

    Ottoman, R.E.; Langdon, E.A.; Rochlin, D.B.

    1963-12-01

    A study was made of the effects of 5-fluorouracil (FU) and x irradiation, separately and in combination, upon multiple metastatic tumors within individual patients. Fourteen cases satisfied the criteria for a controlled study. In 4, the effects of irradiation alone were greater than the combination, in 4 the effects were equal, and in 6 the effects of irradiation were less than those of combination therapy. This study failed to demonstrate a significant alteration in the tumor response by the addition of FU to x irradiation. Four instances of unusual reactions in previously irradiated skin were noted following FU administration. (auth)

  13. A dynamic magnetic tension force as the cause of failed solar eruptions

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

    Myers, Clayton E.; Yamada, Masaaki; Ji, Hantao

    Coronal mass ejections are solar eruptions driven by a sudden release of magnetic energy stored in the Sun's corona. In many cases, this magnetic energy is stored in long-lived, arched structures called magnetic flux ropes. When a flux rope destabilizes, it can either erupt and produce a coronal mass ejection or fail and collapse back towards the Sun. The prevailing belief is that the outcome of a given event is determined by a magnetohydrodynamic force imbalance called the torus instability. This belief is challenged, however, by observations indicating that torus-unstable flux ropes sometimes fail to erupt. This contradiction has notmore » yet been resolved because of a lack of coronal magnetic field measurements and the limitations of idealized numerical modelling. In this paper, we report the results of a laboratory experiment that reveal a previously unknown eruption criterion below which torus-unstable flux ropes fail to erupt. We find that such 'failed torus' events occur when the guide magnetic field (that is, the ambient field that runs toroidally along the flux rope) is strong enough to prevent the flux rope from kinking. Under these conditions, the guide field interacts with electric currents in the flux rope to produce a dynamic toroidal field tension force that halts the eruption. Lastly, this magnetic tension force is missing from existing eruption models, which is why such models cannot explain or predict failed torus events.« less

  14. A dynamic magnetic tension force as the cause of failed solar eruptions

    DOE PAGES

    Myers, Clayton E.; Yamada, Masaaki; Ji, Hantao; ...

    2015-12-23

    Coronal mass ejections are solar eruptions driven by a sudden release of magnetic energy stored in the Sun's corona. In many cases, this magnetic energy is stored in long-lived, arched structures called magnetic flux ropes. When a flux rope destabilizes, it can either erupt and produce a coronal mass ejection or fail and collapse back towards the Sun. The prevailing belief is that the outcome of a given event is determined by a magnetohydrodynamic force imbalance called the torus instability. This belief is challenged, however, by observations indicating that torus-unstable flux ropes sometimes fail to erupt. This contradiction has notmore » yet been resolved because of a lack of coronal magnetic field measurements and the limitations of idealized numerical modelling. In this paper, we report the results of a laboratory experiment that reveal a previously unknown eruption criterion below which torus-unstable flux ropes fail to erupt. We find that such 'failed torus' events occur when the guide magnetic field (that is, the ambient field that runs toroidally along the flux rope) is strong enough to prevent the flux rope from kinking. Under these conditions, the guide field interacts with electric currents in the flux rope to produce a dynamic toroidal field tension force that halts the eruption. Lastly, this magnetic tension force is missing from existing eruption models, which is why such models cannot explain or predict failed torus events.« less

  15. Poor methodological detail precludes experimental repeatability and hampers synthesis in ecology.

    PubMed

    Haddaway, Neal R; Verhoeven, Jos T A

    2015-10-01

    Despite the scientific method's central tenets of reproducibility (the ability to obtain similar results when repeated) and repeatability (the ability to replicate an experiment based on methods described), published ecological research continues to fail to provide sufficient methodological detail to allow either repeatability of verification. Recent systematic reviews highlight the problem, with one example demonstrating that an average of 13% of studies per year (±8.0 [SD]) failed to report sample sizes. The problem affects the ability to verify the accuracy of any analysis, to repeat methods used, and to assimilate the study findings into powerful and useful meta-analyses. The problem is common in a variety of ecological topics examined to date, and despite previous calls for improved reporting and metadata archiving, which could indirectly alleviate the problem, there is no indication of an improvement in reporting standards over time. Here, we call on authors, editors, and peer reviewers to consider repeatability as a top priority when evaluating research manuscripts, bearing in mind that legacy and integration into the evidence base can drastically improve the impact of individual research reports.

  16. Active Fail-Safe Micro-Array Flow Control for Advanced Embedded Propulsion Systems

    NASA Technical Reports Server (NTRS)

    Anderson, Bernhard H.; Mace, James L.; Mani, Mori

    2009-01-01

    The primary objective of this research effort was to develop and analytically demonstrate enhanced first generation active "fail-safe" hybrid flow-control techniques to simultaneously manage the boundary layer on the vehicle fore-body and to control the secondary flow generated within modern serpentine or embedded inlet S-duct configurations. The enhanced first-generation technique focused on both micro-vanes and micro-ramps highly-integrated with micro -jets to provide nonlinear augmentation for the "strength' or effectiveness of highly-integrated flow control systems. The study focused on the micro -jet mass flow ratio (Wjet/Waip) range from 0.10 to 0.30 percent and jet total pressure ratios (Pjet/Po) from 1.0 to 3.0. The engine bleed airflow range under study represents about a 10 fold decrease in micro -jet airflow than previously required. Therefore, by pre-conditioning, or injecting a very small amount of high-pressure jet flow into the vortex generated by the micro-vane and/or micro-ramp, active flow control is achieved and substantial augmentation of the controlling flow is realized.

  17. Evaluation of an updated version of the risk awareness and perception training program for young drivers.

    DOT National Transportation Integrated Search

    2017-03-01

    Previous research suggests newly licensed teen drivers often fail to anticipate where unexpected hazards might materialize. One : training program designed to address these apparent deficiencies in knowledge and skills that has shown promise in previ...

  18. 12 CFR 792.26 - Will I be asked to pay fees in advance?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... have no history of payment; or (b) You have previously failed to pay a fee charged in a timely fashion... and obtain satisfactory assurance of full payment where you have a history of prompt payment of FOIA...

  19. Descemet Membrane Endothelial Keratoplasty After Penetrating Keratoplasty: Features for Success.

    PubMed

    Einan-Lifshitz, Adi; Belkin, Avner; Sorkin, Nir; Mednick, Zale; Boutin, Tanguy; Gill, Ishrat; Karimi, Mohammad; Chan, Clara C; Rootman, David S

    2018-05-08

    To evaluate Descemet membrane endothelial keratoplasty (DMEK) in the setting of failed penetrating keratoplasty (PKP) and to identify factors associated with DMEK success and failure after PKP. A retrospective chart review of patients who underwent DMEK for failed PKP at Toronto Western Hospital, Canada, between 2014 and 2017 was performed. Demographic characteristics, number of previous transplants, intraoperative and postoperative complications, best spectacle-corrected visual acuity (BSCVA), and endothelial cell density were analyzed. Twenty-eight eyes were included in the study. Rebubbling intervention was performed in 12 eyes (43%) within the first postoperative weeks. Five eyes (18%) developed graft rejection episodes. Twelve eyes (43%) had to be regrafted after DMEK surgery and were deemed failures (because of persistent Descemet membrane detachment, rejection episode that led to secondary failure, and infection). BSCVA before DMEK was significantly worse in the eyes that failed than those that did not [1.97 ± 0.85 and 1.2 ± 0.56 logMAR, respectively, (P = 0.01)]. Rebubbling was required in 75% of eyes in the failure group compared with 19% in the success group (P = 0.002). Six of the 16 eyes (37.5%) in the success group underwent femtosecond laser-enabled DMEK, whereas this technique was not used in any of the eyes in the failure group (P = 0.017). DMEK is a viable option for cases of failed PKP. DMEK failure after PKP might be associated with lower visual acuity before DMEK surgery, higher number of rebubble interventions, and manual descemetorhexis rather than femtosecond laser-enabled DMEK.

  20. Boston type 1 keratoprosthesis for failed keratoplasty.

    PubMed

    Hager, Jonathan L; Phillips, David L; Goins, Kenneth M; Kitzmann, Anna S; Greiner, Mark A; Cohen, Alex W; Welder, Jeffrey D; Wagoner, Michael D

    2016-02-01

    The purpose of this study was to evaluate the outcomes of the Boston type 1 keratoprosthesis (Kpro-1) in eyes with failed keratoplasty. A retrospective review was performed of every patient treated with a Kpro-1 at a tertiary eye care center between January 1, 2008 and July 1, 2013. Eyes with a failed keratoplasty originally performed for corneal edema, trauma, or keratoconus were included in the statistical analysis. The main outcome measures were visual outcome, prosthesis retention, and postoperative complications. Twenty-four eyes met the inclusion criteria, including 13 eyes with corneal edema, 8 eyes with trauma, and 3 eyes with keratoconus. After a mean follow-up period of 28.9 months (range 7-63 months), the median best corrected visual acuity (BCVA) was 20/125. The BCVA was ≥ 20/40 in 4 (16.7 %) eyes, ≥ 20/70 in 9 (37.5 %) eyes, and ≥ 20/200 in 14 (58.3 %) eyes. Overall, the postoperative BCVA improved in 17 (70.9 %) eyes, was unchanged in 3 (12.5 %) eyes, and was worse in 4 (16.7 %) eyes. The initial Kpro-1 was retained in 22 (91.7 %) eyes, and was successfully repeated in the other 2 eyes. One or more serious prosthesis- or sight-threatening complications occurred in 8 (33.3 %) eyes. These included 1 case of wound dehiscence leading to prosthesis extrusion, 1 case of fungal keratitis leading to prosthesis extrusion, 4 cases of endophthalmitis, and 5 retinal detachments. The Boston Kpro-1 is associated with an excellent prognosis for prosthesis retention and satisfactory visual improvement in eyes with previous failed keratoplasty.

  1. Sustained virological response and baseline predictors in HIV-HCV coinfected patients retreated with pegylated interferon and ribavirin after failing a previous interferon-based therapy: systematic review and meta-analysis.

    PubMed

    Basso, Monica; Parisi, Saverio Giuseppe; Mengoli, Carlo; Gentilini, Valeria; Menegotto, Nicola; Monticelli, Jacopo; Nicolè, Stefano; Cruciani, Mario; Palù, Giorgio

    2013-01-01

    Published data on retreatment with pegylated interferon and ribavirin of previously failing HIV-HCV coinfected patients are sparse and limited to observational study. We aimed to evaluate efficacy and pretreatment predictors. Systematic review and meta-analysis of observational studies. The overall and genotype-related success rate was investigated. A direct comparison was performed between genotypes 1/4 and 2/3 by evaluating the sustained virological response (SVR) rate ratio (RR). The effect of study level variables on the effect size was investigated by meta-regression. Variables that were analyzed included age, gender, advanced hepatic fibrosis, pretreatment of HCV RNA and CD4, and successful antiretroviral treatment (ART). The available evidence was from 5 open-label, cohort studies (275 patients). The overall SVR rate was 0.280 (95% CI,0.171-0.425). The SVR rate in genotype 1/4 infections was 0.174 (95% CI, 0.129-0.230), and in genotype 2/3 infections it was 0.474 (95% CI, 0.286-0.670). The pooled RR comparing the SVR of genotype 1/4 to 2/3 was 0.369 (95% CI, 0.239-0.568), with a decreased probability of response for genotype 1/4 (P < .001). HIV RNA suppression had a significant effect on SVR (P = .005). The other covariates had no effect on the overall SVR rate. The overall SVR rate was 28%, consistent with the rate reported in the retreatment of mono-infected patients with the same schedule. A substantial relative reduction in the SVR rate of about one-third, when treating genotypes 1/4, was found, with a low SVR rate of 17%. Successful HIV suppression by ART predicted a higher rate of treatment success.

  2. Treating laryngopharyngeal reflux: Evaluation of an anti-reflux program with comparison to medications.

    PubMed

    Yang, Jin; Dehom, Salem; Sanders, Stephanie; Murry, Thomas; Krishna, Priya; Crawley, Brianna K

    To determine if an anti-reflux induction program relieves laryngopharyngeal reflux (LPR) symptoms more effectively than medication and behavioral changes alone. Retrospective study. Tertiary care academic center. A database was populated with patients treated for LPR. Patients were included in the study group if they completed a two-week anti-reflux program (diet, alkaline water, medications, behavioral modifications). Patients were included in the control group if they completed anti-reflux medications and behavioral modifications only. Patients completed the voice handicap index (VHI), reflux symptom index (RSI), cough severity index (CSI), dyspnea index (DI) and eating assessment tool (EAT-10) surveys and underwent laryngoscopy for examination and reflux finding score (RFS) quantification. Of 105 study group patients, 96 (91%) reported subjective improvement in their LPR symptoms after an average 32-day first follow-up and their RSI and CSI scores improved significantly. No significant differences were found in VHI, DI, or EAT-10 scores. Fifteen study patients who had previously failed adequate high-dose medication trials reported improvement and their CSI and EAT-10 scores improved significantly. Ninety-five percent of patients with a chief complaint of cough reported improvement and their CSI scores improved significantly from 12.3 to 8.2. Among 81 controls, only 39 (48%) patients reported improvement after an average 62-day first follow-up. Their RSI scores did not significantly change. The anti-reflux program yielded rapid and substantial results for a large cohort of patients with LPR. It compared favorably with medication and behavioral modification alone. It was effective in improving cough and treating patients who had previously failed medications alone. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. DoD Needs to Improve Oversight of the Afghan National Police Training/Mentoring and Logistics Support Contract

    DTIC Science & Technology

    2013-06-25

    test Waste Water Treatment Plant” because no testing kit was onsite. The COR additionally stated he identified failed equipment and the contractor...Officer ( PCO ) confirmed with the previous ACC-Rl PCO and neither recall ever making this statement. The previous PCO recalls discussing that a QASP...performance surveillance and have access to all contract documents. Adequate contract oversight is always a concern of the PCO , in part due to the

  4. Simulating Category Learning and Set Shifting Deficits in Patients Weight-Restored from Anorexia Nervosa

    DTIC Science & Technology

    2014-01-01

    Neuropsychology, in press     Simulating Category Learning and Set Shifting Deficits in Patients Weight-Restored from Anorexia Nervosa J...University   Objective: To examine set shifting in a group of women previously diagnosed with anorexia nervosa (AN) who are now weight-restored (AN-WR...participant fails to switch to the new rule but rather persists with the previously correct rule. Adult patients with Anorexia Nervosa (AN) are often impaired

  5. Self-consistent calculation of the Sommerfeld enhancement

    DOE PAGES

    Blum, Kfir; Sato, Ryosuke; Slatyer, Tracy R.

    2016-06-08

    A calculation of the Sommerfeld enhancement is presented and applied to the problem of s-wave non-relativistic dark matter annihilation. The difference from previous computations in the literature is that the effect of the underlying short-range scattering process is consistently included together with the long-range force in the effective QM Schrödinger problem. Our procedure satisfies partial-wave unitarity where previous calculations fail. We provide analytic results for some potentials of phenomenological relevance.

  6. Retrieval Practice Fails to Insulate Episodic Memories against Interference after Stroke.

    PubMed

    Pastötter, Bernhard; Eberle, Hanna; Aue, Ingo; Bäuml, Karl-Heinz T

    2017-01-01

    Recent work in cognitive psychology showed that retrieval practice of previously studied information can insulate this information against retroactive interference from subsequently studied other information in healthy individuals. The present study examined whether this beneficial effect of interference reduction is also present in patients with stroke. Twenty-two patients with stroke, 4.6 months post injury on average, and 22 healthy controls participated in the experiment. In each of two experimental sessions, participants first studied a list of items (list 1) and then underwent a practice phase in which the list 1 items were either restudied or retrieval practiced. Participants then either studied a second list of items (list 2) or fulfilled an unrelated distractor task. Recall of the two lists' items was assessed in a final criterion test. Results showed that, in healthy controls, additional study of list 2 items impaired final recall of list 1 items in the restudy condition but not in the retrieval practice condition. In contrast, in patients with stroke, list 2 learning impaired final list 1 recall in both conditions. The results indicate that retrieval practice insulated the tested information against retroactive interference in healthy controls, but failed to do so in patients with stroke. Possible implications of the findings for the understanding of long-term memory impairment after stroke are discussed.

  7. Low frequency of genotypic resistance in HIV-1-infected patients failing an atazanavir-containing regimen: a clinical cohort study.

    PubMed

    Dolling, David I; Dunn, David T; Sutherland, Katherine A; Pillay, Deenan; Mbisa, Jean L; Parry, Chris M; Post, Frank A; Sabin, Caroline A; Cane, Patricia A

    2013-10-01

    To determine protease mutations that develop at viral failure for protease inhibitor (PI)-naive patients on a regimen containing the PI atazanavir. Resistance tests on patients failing atazanavir, conducted as part of routine clinical care in a multicentre observational study, were randomly matched by subtype to resistance tests from PI-naive controls to account for natural polymorphisms. Mutations from the consensus B sequence across the protease region were analysed for association and defined using the IAS-USA 2011 classification list. Four hundred and five of 2528 (16%) patients failed therapy containing atazanavir as a first PI over a median (IQR) follow-up of 1.76 (0.84-3.15) years and 322 resistance tests were available for analysis. Recognized major atazanavir mutations were found in six atazanavir-experienced patients (P < 0.001), including I50L and N88S. The minor mutations most strongly associated with atazanavir experience were M36I, M46I, F53L, A71V, V82T and I85V (P < 0.05). Multiple novel mutations, I15S, L19T, K43T, L63P/V, K70Q, V77I and L89I/T/V, were also associated with atazanavir experience. Viral failure on atazanavir-containing regimens was not common and major resistance mutations were rare, suggesting that adherence may be a major contributor to viral failure. Novel mutations were described that have not been previously documented.

  8. Comparison of the orogenic displacement of sodium caseinate with the caseins from the air-water interface by nonionic surfactants.

    PubMed

    Woodward, N C; Gunning, A P; Mackie, A R; Wilde, P J; Morris, V J

    2009-06-16

    Displacement of sodium caseinate from the air-water interface by nonionic surfactants Tween 20 and Tween 60 was observed by atomic force microscopy (AFM). The interfacial structure was sampled by Langmuir-Blodgett deposition onto freshly cleaved mica substrates. Protein displacement occurred through an orogenic mechanism: it involved the nucleation and growth of surfactant domains within the protein network, followed by failure of the protein network. The surface pressure at which failure of the protein network occurred was essentially independent of the type of surfactant. The major component of sodium caseinate is beta-casein, and previous studies at the air-water interface have shown that beta-casein networks are weak, failing at surface pressures below that observed for sodium caseinate. The other components of sodium caseinate are alpha(s)- and kappa-caseins. Studies of the displacement of alpha(s)-caseins from air-water interfaces show that these proteins also form weak networks that fail at surface pressures below that observed for sodium caseinate. However, kappa-casein was found to form strong networks that resisted displacement and failed at surface pressures comparable to those observed for sodium caseinate. The AFM images of the displacement suggest that, despite kappa-casein being a minor component, it dominates the failure of sodium caseinate networks: alpha(s)-casein and beta-casein are preferentially desorbed at lower surface pressures, allowing the residual kappa-casein to control the breakdown of the sodium caseinate network at higher surface pressures.

  9. 44 CFR 6.83 - Prepayment of fees.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... (a) or (b). [52 FR 13679, Apr. 24, 1987] ... before continuing to process the request. (b) When a requester has previously failed to pay a fee charged... or a pending request from that requester. (c) When FEMA acts under § 5.44 (a) or (b), the...

  10. 44 CFR 6.83 - Prepayment of fees.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... (a) or (b). [52 FR 13679, Apr. 24, 1987] ... before continuing to process the request. (b) When a requester has previously failed to pay a fee charged... or a pending request from that requester. (c) When FEMA acts under § 5.44 (a) or (b), the...

  11. 44 CFR 6.83 - Prepayment of fees.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... (a) or (b). [52 FR 13679, Apr. 24, 1987] ... before continuing to process the request. (b) When a requester has previously failed to pay a fee charged... or a pending request from that requester. (c) When FEMA acts under § 5.44 (a) or (b), the...

  12. 44 CFR 6.83 - Prepayment of fees.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... (a) or (b). [52 FR 13679, Apr. 24, 1987] ... before continuing to process the request. (b) When a requester has previously failed to pay a fee charged... or a pending request from that requester. (c) When FEMA acts under § 5.44 (a) or (b), the...

  13. 44 CFR 6.83 - Prepayment of fees.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... (a) or (b). [52 FR 13679, Apr. 24, 1987] ... before continuing to process the request. (b) When a requester has previously failed to pay a fee charged... or a pending request from that requester. (c) When FEMA acts under § 5.44 (a) or (b), the...

  14. SMALL-SCALE HETEROGENEITY IN THE GEOCHEMISTRY OF SEAGRASS VEGETATED AND NON-VEGETATIVE SEDIMENTS: CAUSES AND CONSEQUENCES

    EPA Science Inventory

    In addition to nutrient and light availability, sedimentary biogeochemical processes can play an essential role in seagrass productivity. Previous investigations of the interactions between seagrasses and their underlying sediments have failed to clearly identify the spatio-tempo...

  15. Respecting the Evidence: The Achievement Crisis Remains Real.

    ERIC Educational Resources Information Center

    Stedman, Lawrence C.

    1996-01-01

    In their arguments that there is actually no crisis in American education and that students are achieving more than previous generations, David Berliner and Bruce Biddle have ignored or dismissed extensive data on student achievement that demonstrate the failings of the American system. (SLD)

  16. Molecular Genetic Studies of Bone Mechanical Strain and of Pedigrees with Very High Bone Density

    DTIC Science & Technology

    2010-11-01

    shear, such as 129J and AKR (reported previously), would also exhibit this same A G SNP at nucleotide 1075 of the Lepr. Our future work will address...no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control...CLASSIFICATION OF: “U” 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 362 19a. NAME OF RESPONSIBLE PERSON USAMRMC a . REPORT U b. ABSTRACT U c. THIS

  17. [Proprioceptive sensitivity and orofacial functions].

    PubMed

    Auriol, M; Coutand, A; Crinetz, V; Chomette, G; Doumit, A; Lucht, M

    1985-01-01

    Proprioceptive sensibility from stimulation of muscle, ligament articular and vestibular receptors plays a determining role in the regulation of tone, of the resting position of the mandible, of head posture and of the closure pathway of the mandible. Studies conducted on temporomandibular joints of fetuses and adult subjects failed to demonstrate the specialized corpuscles (a fact previously noted by Ramfjord) in the temporomaxillary joint capsule, described typically in other joints. In contrast, however, histology showed a particularly rich population of muscle receptors adjacent to this joint, this being only one of several particular characteristics.

  18. Aquatic Habitat Studies on the Lower Mississippi River, River Mile 480 to 530. Report 7. Management of Ecological Data in Large River Ecosystems.

    DTIC Science & Technology

    1982-02-01

    operational. Many times at the startup of a project, variable selection and research data formats are often tentative because of the unknown biological...previously. This flow of data is shown in Figure 1. ELPROGI also made quality control decisions; when a variable for a given observation failed a...a series MENT OF ECOLOGICAL DATA IN LARGE RIVER ECOSYSTEMS s. PERFORMING ONG. REPORT NUMBER 7. AUTNOlt.s) S. CONTRACT O GRANT N UNMSE-) Michael P

  19. Absence of cellular hypersensitivity to muscle and thymic antigens in myasthenia gravis.

    PubMed Central

    Behan, W M; Behan, P O; Simpson, J A

    1975-01-01

    Humoral antibodies to skeletal muscle and its components and to thymus have been demonstrated in the sera of patients with myasthenia gravis. A role for cellular hypersensitivity to similar antigens in the pathogenesis of the disease has been suggested by some reports of the presence of cellular immunity. A detailed immunological study using muscle and thymic antigens, including those prepared from the patients' own tissues, failed to confirm these findings. It is suggested that previous reports of cellular hypersensitivity represent the demonstration of an epiphenomenon. PMID:1206412

  20. Examining Impulse-Variability Theory and the Speed-Accuracy Trade-Off in Children's Overarm Throwing Performance.

    PubMed

    Molina, Sergio L; Stodden, David F

    2018-04-01

    This study examined variability in throwing speed and spatial error to test the prediction of an inverted-U function (i.e., impulse-variability [IV] theory) and the speed-accuracy trade-off. Forty-five 9- to 11-year-old children were instructed to throw at a specified percentage of maximum speed (45%, 65%, 85%, and 100%) and hit the wall target. Results indicated no statistically significant differences in variable error across the target conditions (p = .72), failing to support the inverted-U hypothesis. Spatial accuracy results indicated no statistically significant differences with mean radial error (p = .18), centroid radial error (p = .13), and bivariate variable error (p = .08) also failing to support the speed-accuracy trade-off in overarm throwing. As neither throwing performance variability nor accuracy changed across percentages of maximum speed in this sample of children as well as in a previous adult sample, current policy and practices of practitioners may need to be reevaluated.

  1. The endangered Florida pondweed (Potamogeton floridanus) is a hybrid: Why we need to understand biodiversity thoroughly.

    PubMed

    Kaplan, Zdeněk; Fehrer, Judith; Bambasová, Veronika; Hellquist, C Barre

    2018-01-01

    Thorough understanding of biodiversity is a fundamental prerequisite for biological research. A lack of taxonomic knowledge and species misidentifications are particularly critical for conservation. Here we present an example of Potamogeton floridanus, the Florida Pondweed, an endangered taxon endemic to a small area in the Florida panhandle, whose taxonomic status remained controversial for more than a century, and all previous attempts to elucidate its identity have failed. We applied molecular approaches to tackle the origin of the mysterious taxon and supplemented them with morphological and anatomical investigations of both historical herbarium collections and plants recently collected in the type area for a comprehensive taxonomic reassessment. Sequencing of two nuclear ribosomal markers and one chloroplast non-coding spacer resulted in the surprising discovery that P. floridanus is a hybrid of P. pulcher and P. oakesianus, with the former being the maternal parent. The hybrid colony is currently geographically isolated from the distribution range of P. oakesianus. We show that previous molecular analyses have failed to reveal its hybrid identity due to inadequate nuclear DNA sequence editing. This is an example how the uncritical use of automized sequence reads can hamper molecular species identifications and also affect phylogenetic tree construction and interpretation. This unique hybrid taxon, P. ×floridanus, adds another case study to the debate on hybrid protection; consequences for its conservation are discussed.

  2. The endangered Florida pondweed (Potamogeton floridanus) is a hybrid: Why we need to understand biodiversity thoroughly

    PubMed Central

    Fehrer, Judith; Bambasová, Veronika; Hellquist, C. Barre

    2018-01-01

    Thorough understanding of biodiversity is a fundamental prerequisite for biological research. A lack of taxonomic knowledge and species misidentifications are particularly critical for conservation. Here we present an example of Potamogeton floridanus, the Florida Pondweed, an endangered taxon endemic to a small area in the Florida panhandle, whose taxonomic status remained controversial for more than a century, and all previous attempts to elucidate its identity have failed. We applied molecular approaches to tackle the origin of the mysterious taxon and supplemented them with morphological and anatomical investigations of both historical herbarium collections and plants recently collected in the type area for a comprehensive taxonomic reassessment. Sequencing of two nuclear ribosomal markers and one chloroplast non-coding spacer resulted in the surprising discovery that P. floridanus is a hybrid of P. pulcher and P. oakesianus, with the former being the maternal parent. The hybrid colony is currently geographically isolated from the distribution range of P. oakesianus. We show that previous molecular analyses have failed to reveal its hybrid identity due to inadequate nuclear DNA sequence editing. This is an example how the uncritical use of automized sequence reads can hamper molecular species identifications and also affect phylogenetic tree construction and interpretation. This unique hybrid taxon, P. ×floridanus, adds another case study to the debate on hybrid protection; consequences for its conservation are discussed. PMID:29608584

  3. Role of Southern Ocean stratification in glacial atmospheric CO2 reduction

    NASA Astrophysics Data System (ADS)

    Kobayashi, H.; Oka, A.

    2014-12-01

    Paleoclimate proxy data at the glacial period shows high salinity of more than 37.0 psu in the deep South Atlantic. At the same time, data also indicate that the residence time of the water mass was more than 3000 years. These data implies that the stratification by salinity was stronger in the deep Southern Ocean (SO) in the Last Glacial Maximum (LGM). Previous studies using Ocean General Circulation Model (OGCM) fail to explain the low glacial atmospheric carbon dioxide (CO2) concentration at LGM. The reproducibility of salinity and water mass age is considered insufficient in these OGCMs, which may in turn affect the reproducibility of the atmospheric CO2concentration. In coarse-resolution OGCMs, The deep water is formed by unrealistic open-ocean deep convection in the SO. Considering these facts, we guessed previous studies using OGCM underestimated the salinity and water mass age at LGM. This study investigate the role of the enhanced stratification in the glacial SO on the variation of atmospheric CO2 concentration by using OGCM. In order to reproduce the recorded salinity of the deep water, relaxation of salinity toward value of recorded data is introduced in our OGCM simulations. It was found that deep water formation in East Antarctica is required for explaining the high salinity in the South Atlantic. In contrast, it is difficult to explain the glacial water mass age, even if we assume the situation vertical mixing is very weak in the SO. Contrary to previous estimate, the high salinity of the deep SO resulted in increase of Antarctic Bottom water (AABW) flow and decrease the residence time of carbon in the deep ocean, which increased atmospheric CO2 concentration. On the other hand, the weakening of the vertical mixing in the SO contributed to increase the vertical gradient of dissolved inorganic carbon (DIC), which decreased atmospheric CO2 concentration. Adding the contribution of the enhanced stratification in the glacial SO, we obtained larger reduction in atmospheric CO2 concentration than previous studies. However, we still fail to explain the full amplitude of recorded glacial reduction of atmospheric CO2 concentration. The carbonate compensation process, which is not incorporated in our simulations, might be required for further reduction in atmospheric CO2 concentration.

  4. Theory and Practice on Teacher Performance Evaluation

    ERIC Educational Resources Information Center

    Yonghong, Cai; Chongde, Lin

    2006-01-01

    Teacher performance evaluation plays a key role in educational personnel reform, so it has been an important yet difficult issue in educational reform. Previous evaluations on teachers failed to make strict distinction among the three dominant types of evaluation, namely, capability, achievement, and effectiveness. Moreover, teacher performance…

  5. NIH-supported trial drug shows benefit in children with previously treated cancers

    Cancer.gov

    Young patients with some types of advanced cancer, for whom standard treatment had failed, had their tumors disappear during treatment with a drug that both targets and blocks a protein associated with their disease. These findings are from a Phase I, mul

  6. 78 FR 57542 - Airworthiness Directives; The Boeing Company Airplanes

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-19

    ... cracked retract actuator fuse pins that could fail earlier than the previously determined safe life limit... 5 p.m., Monday through Friday, except Federal holidays. For service information identified in this proposed AD, contact Boeing Commercial Airplanes, Attention: Data & Services Management, P.O. Box 3707, MC...

  7. The Intravitreal Autologous Platelet Concentrate Injection as an Adjunct of Vitrectomy for the Treatment of Refractory Macular Holes

    ClinicalTrials.gov

    2014-03-06

    Macular Hole With High Myopia (Spherical Equivalent ≤ -6.0 Diopters) or,; Large Size Macular Hole (Diameter > 600 Microns) or; Recurred or Failed Macular Hole From Previous Surgery; or Chronic Macular Hole (Symptom Duration > 6 Months)

  8. Development and evaluation of a simplified superpave IDT testing system for implementation in mix design and control : final report, March 2008.

    DOT National Transportation Integrated Search

    2009-08-01

    Asphalt mixtures designed using modern conventional methods, whether Marshall or Superpave methodologies, fail to address the cracking performance of these mixtures. Research previously conducted at the University of Florida for the Florida Departmen...

  9. Analogical Transfer from a Simulated Physical System

    ERIC Educational Resources Information Center

    Day, Samuel B.; Goldstone, Robert L.

    2011-01-01

    Previous research has consistently found that spontaneous analogical transfer is strongly tied to concrete and contextual similarities between the cases. However, that work has largely failed to acknowledge that the relevant factor in transfer is the similarity between individuals' mental representations of the situations rather than the overt…

  10. Avascular Necrosis of Acetabulum: The Hidden Culprit of Resistant Deep Wound Infection and Failed Fixation of Fracture Acetabulum - A Case Report.

    PubMed

    K, Kandhari V; M, Desai M; S, Bava S; N, Wade R

    2015-01-01

    Chances of avascular necrosis of acetabulum are rare as it enjoys a rich blood supply. But cases of post - traumatic avascular necrosis of acetabulum following fracture of posterior column have been well documented. Importance of identifying and suspecting the avascular necrosis of acetabulum is essential in cases of failed fixation of fracture acetabulum, previously operated using extensile approach to acetabulum; either extended anterior ilio - femoral or tri - radiate approach. Such patients usually present with repeated deep bone infection or with early failure of fixation with aseptic loosening and migration of its components. We present a similar case. 40 years female presented with inadequately managed transverse fracture of left acetabulum done by anterior extended ilio-inguinal approach. The fixation failed. She presented 6 months later with painful hip. Cemented total hip replacement was performed with reconstruction of acetabulum by posterior column plating. Six months postoperatively patient presented with dislodgement of cup, pelvic discontinuity and sinus in the thigh. Two stage revision surgery was planned. First implant, removal; debridement and antibiotic spacer surgery was performed. At second stage of revision total hip replacement, patient had Paprosky grade IIIb defect in acetabulum. Spacer was removed through the posterior approach. Anterior approach was taken for anterior plating. Intra-operatively external iliac pulsations were found to be absent so procedure was abandoned after expert opinion. Postoperatively digital subtraction angiography demonstrated a chronic block in the external iliac artery and corona mortis was the only patent vascular channel providing vascular to the left lower limb. Thus, peripheral limb was stealing blood supply from the acetabulum to maintain perfusion. Patient was ultimately left with pelvic discontinuity, excision arthroplasty and pseudoarthrosis of the left hip. Avascular necrosis of acetabulum is a rare entity & often not recognized. One should be suspicious about diagnosis of avascular necrosis of acetabulum in select cases of failed acetabular fixation, previously operated via extensile anterior ilio - inguinal approach. Angiographic evaluation is essential in revision cases of failed acetabular fixation. Corona mortis (crown or circle of death) can sometimes act as a savior of limb.

  11. Progressive retry for software error recovery in distributed systems

    NASA Technical Reports Server (NTRS)

    Wang, Yi-Min; Huang, Yennun; Fuchs, W. K.

    1993-01-01

    In this paper, we describe a method of execution retry for bypassing software errors based on checkpointing, rollback, message reordering and replaying. We demonstrate how rollback techniques, previously developed for transient hardware failure recovery, can also be used to recover from software faults by exploiting message reordering to bypass software errors. Our approach intentionally increases the degree of nondeterminism and the scope of rollback when a previous retry fails. Examples from our experience with telecommunications software systems illustrate the benefits of the scheme.

  12. Presenting hydrothorax predicts failure of needle aspiration in primary spontaneous pneumothorax.

    PubMed

    Wu, Kwok Kei; Lui, Chun Tat; Ho, Chik Leung; Tsui, Kwok Leung; Fung, Hin Tat

    2016-06-01

    The objective was to evaluate if existence of hydrothorax in initial chest radiograph predicts treatment outcome in patients with primary spontaneous pneumothorax who received needle thoracostomy. This is a retrospective cohort study carried out from January 2011 to August 2014 in 1 public hospital in Hong Kong. All consecutive adult patients aged 18years or above who attended the emergency department with the diagnosis of primary spontaneous pneumothorax with needle aspiration performed as primary treatment were included. Age, smoking status, size of pneumothorax, previous history of pneumothorax, aspirated gas volume and presence of hydropneumothorax in initial radiograph were included in the analysis. The outcome was success or failure of the needle aspiration. Logistic regression was used to identify the predicting factors of failure of needle aspiration. There were a total of 127 patients included. Seventy-three patients (57.5%) were successfully treated with no recurrence upon discharge. Among 54 failure cases, 13 patients (10.2%) failed immediately after procedure as evident by chest radiograph and required second treatment. Forty-one patients (32.3%) failed upon subsequent chest radiographs. Multivariate logistic regression showed factors independently associated with the failure of needle aspiration, which included hydropneumothorax in the initial radiograph (odds ratio [OR]=4.47 [1.56i12.83], P=.005), previous history of pneumothorax (OR=3.92 [1.57-9.79], P=.003), and large size of pneumothorax defined as apex-to-cupola distance ≥5cm (OR=2.75 [1.21-6.26], P=.016). Hydropneumothorax, previous history of pneumothorax, and large size were independent predictors of failure of needle aspiration in treatment of primary spontaneous pneumothorax. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Rational action selection in 1½- to 3-year-olds following an extended training experience.

    PubMed

    Klossek, Ulrike M H; Dickinson, Anthony

    2012-02-01

    Previous studies failed to find evidence for rational action selection in children under 2 years of age. The current study investigated whether younger children required more training to encode the relevant causal relationships. Children between 1½ and 3 years of age were trained over two sessions to perform actions on a touch-sensitive screen to obtain video clips as outcomes. Subsequently, a visual habituation procedure was employed to devalue one of the training outcomes. As in previous studies, 2- and 3-year-olds chose actions associated with an expected valued outcome significantly more often during a subsequent choice test. Moreover, analysis of children's first responses in the post-devaluation test revealed evidence of rational action selection even in the youngest age group (18-23 months). Consistent with dual-process accounts of action control, the findings support the view that the ability to make rational action choices develops gradually. 2011 Elsevier Inc. All rights reserved.

  14. The Pneumonia Etiology Research for Child Health Project: A 21st Century Childhood Pneumonia Etiology Study

    PubMed Central

    O’Brien, Katherine L.; Deloria-Knoll, Maria; Murdoch, David R.; Feikin, Daniel R.; DeLuca, Andrea N.; Driscoll, Amanda J.; Baggett, Henry C.; Brooks, W. Abdullah; Howie, Stephen R. C.; Kotloff, Karen L.; Madhi, Shabir A.; Maloney, Susan A.; Sow, Samba; Thea, Donald M.; Scott, J. Anthony

    2012-01-01

    The Pneumonia Etiology Research for Child Health (PERCH) project is a 7-country, standardized, comprehensive evaluation of the etiologic agents causing severe pneumonia in children from developing countries. During previous etiology studies, between one-quarter and one-third of patients failed to yield an obvious etiology; PERCH will employ and evaluate previously unavailable innovative, more sensitive diagnostic techniques. Innovative and rigorous epidemiologic and analytic methods will be used to establish the causal association between presence of potential pathogens and pneumonia. By strategic selection of study sites that are broadly representative of regions with the greatest burden of childhood pneumonia, PERCH aims to provide data that reflect the epidemiologic situation in developing countries in 2015, using pneumococcal and Haemophilus influenzae type b vaccines. PERCH will also address differences in host, environmental, and/or geographic factors that might determine pneumonia etiology and, by preserving specimens, will generate a resource for future research and pathogen discovery. PMID:22403238

  15. The Pneumonia Etiology Research for Child Health Project: a 21st century childhood pneumonia etiology study.

    PubMed

    Levine, Orin S; O'Brien, Katherine L; Deloria-Knoll, Maria; Murdoch, David R; Feikin, Daniel R; DeLuca, Andrea N; Driscoll, Amanda J; Baggett, Henry C; Brooks, W Abdullah; Howie, Stephen R C; Kotloff, Karen L; Madhi, Shabir A; Maloney, Susan A; Sow, Samba; Thea, Donald M; Scott, J Anthony

    2012-04-01

    The Pneumonia Etiology Research for Child Health (PERCH) project is a 7-country, standardized, comprehensive evaluation of the etiologic agents causing severe pneumonia in children from developing countries. During previous etiology studies, between one-quarter and one-third of patients failed to yield an obvious etiology; PERCH will employ and evaluate previously unavailable innovative, more sensitive diagnostic techniques. Innovative and rigorous epidemiologic and analytic methods will be used to establish the causal association between presence of potential pathogens and pneumonia. By strategic selection of study sites that are broadly representative of regions with the greatest burden of childhood pneumonia, PERCH aims to provide data that reflect the epidemiologic situation in developing countries in 2015, using pneumococcal and Haemophilus influenzae type b vaccines. PERCH will also address differences in host, environmental, and/or geographic factors that might determine pneumonia etiology and, by preserving specimens, will generate a resource for future research and pathogen discovery.

  16. Erlotinib in African Americans with Advanced Non-Small Cell Lung Cancer: A Prospective Randomized Study with Genetic and Pharmacokinetic Analysis

    PubMed Central

    Phelps, Mitch A.; Stinchcombe, Thomas E.; Blachly, James S.; Zhao, Weiqiang; Schaaf, Larry J.; Starrett, Sherri L.; Wei, Lai; Poi, Ming; Wang, Danxin; Papp, Audrey; Aimiuwu, Josephine; Gao, Yue; Li, Junan; Otterson, Gregory A.; Hicks, William J.; Socinski, Mark A.; Villalona-Calero, Miguel A.

    2014-01-01

    Prospective studies focusing on EGFR inhibitors in African Americans with NSCLC have not been previously performed. In this phase II randomized study, 55 African Americans with NSCLC received erlotinib 150mg/day or a body weight adjusted dose with subsequent escalations to the maximum allowable, 200mg/day, to achieve rash. Erlotinib and OSI-420 exposures were lower compared to previous reports, consistent with CYP3A pharmacogenetics implying higher metabolic activity. Tumor genetics revealed only two EGFR mutations, EGFR amplification in 17/47 samples, 8 KRAS mutations and 5 EML4-ALK translocations. Although absence of rash was associated with shorter time to progression (TTP), disease control rate, TTP, and 1-year survival were not different between the two dose groups, indicating the dose-to-rash strategy failed to increase clinical benefit. Observed low incidence of toxicity and low erlotinib exposure suggest standardized and maximum allowable dosing may be suboptimal in African Americans. PMID:24781527

  17. Correction of Large Oro-antral Communications From Previously Failed Implant Treatment: Reconstruction of Hard and Soft Tissues.

    PubMed

    Petrungaro, Paul S; Gonzalez, Santiago; Villegas, Carlos

    2018-02-01

    As dental implants become more popular for the treatment of partial and total edentulism and treatment of "terminal dentitions," techniques for the management of the atrophic posterior maxillae continue to evolve. Although dental implants carry a high success rate long term, attention must be given to the growing numbers of revisions or retreatment of cases that have had previous dental implant treatment and/or advanced bone replacement procedures that, due to either poor patient compliance, iatrogenic error, or poor quality of the pre-existing alveolar and/or soft tissues, have led to large osseous defects, possibly with deficient soft-tissue volume. In the posterior maxillae, where the poorest quality of bone in the oral cavity exists, achieving regeneration of the alveolar bone and adequate volume of soft tissue remains a complex procedure. This is made even more difficult when dealing with loss of dental implants previously placed, aggressive bone reduction required in various implant procedures, and/or residual sinus infections precluding proper closure of the oral wound margins. The purpose of this article is to outline a technique for the total closure of large oro-antral communications, with underlying osseous defects greater than 15 mm in width and 30 mm in length, for which multiple previous attempts at closure had failed, to achieve not only the reconstruction of adequate volume and quality of soft tissues in the area of the previous fistula, but also total regeneration of the osseous structures in the area of the large void.

  18. Power Asymmetries and Punishment in a Prisoner's Dilemma with Variable Cooperative Investment.

    PubMed

    Bone, Jonathan E; Wallace, Brian; Bshary, Redouan; Raihani, Nichola J

    2016-01-01

    In many two-player games, players that invest in punishment finish with lower payoffs than those who abstain from punishing. These results question the effectiveness of punishment at promoting cooperation, especially when retaliation is possible. It has been suggested that these findings may stem from the unrealistic assumption that all players are equal in terms of power. However, a previous empirical study which incorporated power asymmetries into an iterated prisoner's dilemma (IPD) game failed to show that power asymmetries stabilize cooperation when punishment is possible. Instead, players cooperated in response to their partner cooperating, and punishment did not yield any additional increase in tendency to cooperate. Nevertheless, this previous study only allowed an all-or-nothing-rather than a variable-cooperation investment. It is possible that power asymmetries increase the effectiveness of punishment from strong players only when players are able to vary their investment in cooperation. We tested this hypothesis using a modified IPD game which allowed players to vary their investment in cooperation in response to being punished. As in the previous study, punishment from strong players did not increase cooperation under any circumstances. Thus, in two-player games with symmetric strategy sets, punishment does not appear to increase cooperation.

  19. Medical Therapy Versus Balloon Sinus Dilation in Adults With Chronic Rhinosinusitis (MERLOT): 12-Month Follow-up.

    PubMed

    Stolovitzky, J Pablo; Mehendale, Neelesh; Matheny, Keith E; Brown, William J; Rieder, Anthony A; Liepert, Douglas R; Tseng, Ewen; Gould, Andrew

    2018-05-21

    Background Chronic rhinosinusitis (CRS) is a devastating disease affecting nearly 30 million people in the United States. An interim analysis of data from the present study suggested that, in patients who had previously failed medical therapy, balloon sinus dilation (BSD) plus medical management (MM) provides a significant improvement in the quality of life (QOL) at 24 weeks postprocedure compared to MM alone. Objective The primary objective of this final analysis was to evaluate the durability of treatment effects through the 52-week follow-up. Methods Adults aged 19 and older with CRS who had failed MM elected either BSD plus MM or continued MM. Patients were evaluated at 2 (BSD arm only), 12, 24, and 52 weeks posttreatment. Balloon dilations were performed either as an office-based procedure under local anesthesia or in the operating room per physicians' and patients' discretion. The primary end point was change in patient-reported QOL as measured by Chronic Sinusitis Survey (CSS) total score from baseline to the 24-week follow-up. Secondary outcomes including changes in CSS, Rhinosinusitis Disability Index (RSDI), and Sino-Nasal Outcome Test (SNOT) total and subscores, sinus medication usage, missed days of work/school, number of medical care visits, and sinus infections from baseline to the 52-week follow-up are reported here within. Results BSD led to sustained greater improvements in self-reported QOL using the CSS and RSDI total scores with a trend toward improvement in the SNOT-20 total score from baseline to the 52-week follow-up compared to continued MM. There were no changes in medication usage apart from nasal steroid usage for which the MM cohort had an increase in usage. There were no device-related serious adverse events. Conclusion The current analysis highlights the safety, effectiveness, and durability of BSD in CRS patients aged 19 and older who had previously failed MM.

  20. Mechanism of valve failure and efficacy of reintervention through catheterization in patients with bioprosthetic valves in the pulmonary position

    PubMed Central

    Callahan, Ryan; Bergersen, Lisa; Baird, Christopher W; Porras, Diego; Esch, Jesse J; Lock, James E; Marshall, Audrey C

    2017-01-01

    Background: Surgical and transcatheter bioprosthetic valves (BPVs) in the pulmonary position in patients with congenital heart disease may ultimately fail and undergo transcatheter reintervention. Angiographic assessment of the mechanism of BPV failure has not been previously described. Aims: The aim of this study was to determine the mode of BPV failure (stenosis/regurgitation) requiring transcatheter reintervention and to describe the angiographic characteristics of the failed BPVs and report the types and efficacy of reinterventions. Materials and Methods: This is a retrospective single-center review of consecutive patients who previously underwent pulmonary BPV placement (surgical or transcatheter) and subsequently underwent percutaneous reintervention from 2005 to 2014. Results: Fifty-five patients with surgical (41) and transcutaneous pulmonary valve (TPV) (14) implantation of BPVs underwent 66 catheter reinterventions. The surgically implanted valves underwent fifty reinterventions for indications including 16 for stenosis, seven for regurgitation, and 27 for both, predominantly associated with leaflet immobility, calcification, and thickening. Among TPVs, pulmonary stenosis (PS) was the exclusive failure mode, mainly due to loss of stent integrity (10) and endocarditis (4). Following reintervention, there was a reduction of right ventricular outflow tract gradient from 43 ± 16 mmHg to 16 ± 10 mmHg (P < 0.001) and RVp/AO ratio from 0.8 ± 0.2 to 0.5 ± 0.2 (P < 0.001). Reintervention with TPV placement was performed in 45 (82%) patients (34 surgical, 11 transcatheter) with no significant postintervention regurgitation or paravalvular leak. Conclusion: Failing surgically implanted BPVs demonstrate leaflet calcification, thickness, and immobility leading to PS and/or regurgitation while the mechanism of TPV failure in the short- to mid-term is stenosis, mainly from loss of stent integrity. This can be effectively treated with a catheter-based approach, predominantly with the valve-in-valve technique. PMID:28163423

  1. Does spatial attention modulate the C1 component? The jury continues to deliberate.

    PubMed

    Baumgartner, Hannah M; Graulty, Christian J; Hillyard, Steven A; Pitts, Michael A

    The thoughful comments on our study (Baumgartner et al., this issue) that failed to replicate the C1 attention effect reported by a previous study roughly fall into three broad categories. First, the commentators identified specific differences between the two studies that may have contributed to the discrepant results. Second, they highlighted some of the theoretical and methodological problems that are encountered when trying to demonstrate attention effects on the initial evoked response in primary visual cortex. Third, they offered a number of proposals for optimizing experimental designs and analysis methods that may increase the likelihood of observing attention-related modulations of the C1. We consider each of these topics in turn.

  2. Orbital-Phase-Resolved Study of OAO 1657-415 in Spin-Up and Spin-Down

    NASA Technical Reports Server (NTRS)

    Chakrabarty, Deepto

    2003-01-01

    We observed the 38-s X-ray pulsar OAO 1657-415 in a series of daily snapshots spanning its 10-day binary orbit, on three different occasions corresponding to different accretion torque states. The goal was to see if the previously observed drastic variability in X-ray spectral properties showed a systematic pattern with respect to orbital phase or torque state. Our study failed to identify any systematic patterns, although considerably stochastic variability was observed. Overall, our results were inconclusive. We chose not to prepare a journal paper on this study, although the data were shared with several other groups interested in monitoring the properties of this source.

  3. Endoscopic spray cryotherapy for esophageal cancer: safety and efficacy

    PubMed Central

    Greenwald, Bruce D.; Dumot, John A.; Abrams, Julian A.; Lightdale, Charles J.; David, Donald S.; Nishioka, Norman S.; Yachimski, Patrick; Johnston, Mark H.; Shaheen, Nicholas J.; Zfass, Alvin M.; Smith, Jenny O.; Gill, Kanwar Rupinder S.; Burdick, J. Steven; Mallat, Damien; Wolfsen, Herbert C.

    2011-01-01

    Background Few options exist for patients with localized esophageal cancer ineligible for conventional therapies. Endoscopic spray cryotherapy with low-pressure liquid nitrogen has demonstrated efficacy in this setting in early studies. Objective To assess the safety and efficacy of cryotherapy in esophageal carcinoma. Design Multicenter, retrospective cohort study. Setting Ten academic and community medical centers between 2006 and 2009. Patients Subjects with esophageal carcinoma in whom conventional therapy failed and those who refused or were ineligible for conventional therapy. Interventions Cryotherapy with follow-up biopsies. Treatment was complete when tumor eradication was confirmed by biopsy or when treatment was halted because of tumor progression, patient preference, or comorbid condition. Main Outcome Measurements Complete eradication of luminal cancer and adverse events. Results Seventy-nine subjects (median age 76 years, 81% male, 94% with adenocarcinoma) were treated. Tumor stage included T1-60, T2-16, and T3/4-3. Mean tumor length was 4.0 cm (range 1–15 cm). Previous treatment including endoscopic resection, photodynamic therapy, esophagectomy, chemotherapy, and radiation therapy failed in 53 subjects (67%). Forty-nine completed treatment. Complete response of intraluminal disease was seen in 31 of 49 subjects (61.2%), including 18 of 24 (75%) with mucosal cancer. Mean (standard deviation) length of follow-up after treatment was 10.6 (8.4) months overall and 11.5 (2.8) months for T1 disease. No serious adverse events were reported. Benign stricture developed in 10 (13%), with esophageal narrowing from previous endoscopic resection, radiotherapy, or photodynamic therapy noted in 9 of 10 subjects. Limitations Retrospective study design, short follow-up. Conclusions Spray cryotherapy is safe and well tolerated for esophageal cancer. Short-term results suggest that it is effective in those who could not receive conventional treatment, especially for those with mucosal cancer. PMID:20363410

  4. Endoscopic spray cryotherapy for esophageal cancer: safety and efficacy.

    PubMed

    Greenwald, Bruce D; Dumot, John A; Abrams, Julian A; Lightdale, Charles J; David, Donald S; Nishioka, Norman S; Yachimski, Patrick; Johnston, Mark H; Shaheen, Nicholas J; Zfass, Alvin M; Smith, Jenny O; Gill, Kanwar Rupinder S; Burdick, J Steven; Mallat, Damien; Wolfsen, Herbert C

    2010-04-01

    Few options exist for patients with localized esophageal cancer ineligible for conventional therapies. Endoscopic spray cryotherapy with low-pressure liquid nitrogen has demonstrated efficacy in this setting in early studies. To assess the safety and efficacy of cryotherapy in esophageal carcinoma. Multicenter, retrospective cohort study. Ten academic and community medical centers between 2006 and 2009. Subjects with esophageal carcinoma in whom conventional therapy failed and those who refused or were ineligible for conventional therapy. Cryotherapy with follow-up biopsies. Treatment was complete when tumor eradication was confirmed by biopsy or when treatment was halted because of tumor progression, patient preference, or comorbid condition. Complete eradication of luminal cancer and adverse events. Seventy-nine subjects (median age 76 years, 81% male, 94% with adenocarcinoma) were treated. Tumor stage included T1-60, T2-16, and T3/4-3. Mean tumor length was 4.0 cm (range 1-15 cm). Previous treatment including endoscopic resection, photodynamic therapy, esophagectomy, chemotherapy, and radiation therapy failed in 53 subjects (67%). Forty-nine completed treatment. Complete response of intraluminal disease was seen in 31 of 49 subjects (61.2%), including 18 of 24 (75%) with mucosal cancer. Mean (standard deviation) length of follow-up after treatment was 10.6 (8.4) months overall and 11.5 (2.8) months for T1 disease. No serious adverse events were reported. Benign stricture developed in 10 (13%), with esophageal narrowing from previous endoscopic resection, radiotherapy, or photodynamic therapy noted in 9 of 10 subjects. Retrospective study design, short follow-up. Spray cryotherapy is safe and well tolerated for esophageal cancer. Short-term results suggest that it is effective in those who could not receive conventional treatment, especially for those with mucosal cancer. Copyright 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

  5. Intersession Telephone Contact with Individuals Diagnosed with Borderline Personality Disorder: Lessons from Dialectical Behavior Therapy

    ERIC Educational Resources Information Center

    Ben-Porath, Denise D.

    2004-01-01

    Therapists often struggle with managing intersession contact with clients diagnosed with borderline personality disorder, particularly when dangerous and life-threatening symptoms are communicated (Gunderson, 1996). Difficulties have arisen, in part, because previous phone contacts with this population have failed to recognize the importance of…

  6. Evaluating the Success of Strategic Change against Kotter's Eight Steps

    ERIC Educational Resources Information Center

    Spencer, Mark H.; Winn, Bradley A.

    2005-01-01

    New subscribers to the "Harvard Business Review" receive as a bonus with their first issue a compilation of fifteen classics, which appeared in previous "HBR" issues. One article, "Leading Change: Why Transformation Efforts Fail", by John P. Kotter, first appeared in the March-April 1995 issue and is often…

  7. Design Research Using Game Design as an Instructional Strategy

    ERIC Educational Resources Information Center

    Siko, Jason; Barbour, Michael

    2014-01-01

    Using Homemade PowerPoint games as an instructional strategy incorporates elements of game design and constructionism in the classroom using "Microsoft PowerPoint," which is ubiquitous in schools today. However, previous research examining the use of these games has failed to show statistical differences in performance. In the second…

  8. Unexpected Genome Variability at Multiple Loci Suggests Cacao Swollen Shoot Virus Comprises Multiple, Divergent Molecular Variants.

    USDA-ARS?s Scientific Manuscript database

    Cacao swollen shoot virus (CSSV) [Badnavirus, Caulimoviridae] causes swollen shoot disease of Theobroma cacao L. in West Africa. Since ~2000, various diagnostic tests have failed to detect CSSV in ~50-70% of symptomatic cacao plants, suggesting the possible emergence of new, previously uncharacteriz...

  9. Mechanical pulping with a sequential velocity refiner- a new concept

    Treesearch

    C.W. McMillin

    1978-01-01

    In previous research with refiner mechanical pulps, a theoretical stress analysis indicated that longitudinal tracheids of Pinus taeda L. fail while under torsional stress and unwind into ribbonlike elements that provide the coherence necessary for strength development. When macerated tracheids of loblolly pine were individually stressed in torsion...

  10. A Cross-Cultural Conflict Reexamined: Annette Akroyd and Keshub Chunder Sen.

    ERIC Educational Resources Information Center

    Scherer, M. A.

    1996-01-01

    Reexamines a well-known conflict between Unitarian reformer, Annette Akroyd, and Hindu liberal, Keshub Chunder Sen, over the administration of a private girls' school in 19th century India. Argues that previous interpretations stressing colonial ethnocentrism failed to take into account the complexity of the situation. (MJP)

  11. SCALE-UP IMPLEMENTATION OF A SUSTAINABLE, APPROPRIATE, AWARDS-WINNING, ARSENIC AND MICROBIAL REMOVAL FILTER IN RURAL NEPAL

    EPA Science Inventory

    In the rural Terai region of Nepal, about 5 million people are affected by arsenic and/or pathogens in their drinking water. Previous mitigation efforts failed in those areas because of the use of inappropriate technologies and unsustainable implementation strategy. Currentl...

  12. 49 CFR 655.41 - Pre-employment drug testing.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... employee takes a pre-employment drug test administered under this part with a verified negative result. An...) When a covered employee or applicant has previously failed or refused a pre-employment drug test...-employment drug test administered under this part with a verified negative result. (c) If a pre-employment...

  13. 49 CFR 655.41 - Pre-employment drug testing.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... employee takes a pre-employment drug test administered under this part with a verified negative result. An...) When a covered employee or applicant has previously failed or refused a pre-employment drug test...-employment drug test administered under this part with a verified negative result. (c) If a pre-employment...

  14. 49 CFR 655.41 - Pre-employment drug testing.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... employee takes a pre-employment drug test administered under this part with a verified negative result. An...) When a covered employee or applicant has previously failed or refused a pre-employment drug test...-employment drug test administered under this part with a verified negative result. (c) If a pre-employment...

  15. 49 CFR 655.41 - Pre-employment drug testing.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... employee takes a pre-employment drug test administered under this part with a verified negative result. An...) When a covered employee or applicant has previously failed or refused a pre-employment drug test...-employment drug test administered under this part with a verified negative result. (c) If a pre-employment...

  16. 49 CFR 655.41 - Pre-employment drug testing.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... employee takes a pre-employment drug test administered under this part with a verified negative result. An...) When a covered employee or applicant has previously failed or refused a pre-employment drug test...-employment drug test administered under this part with a verified negative result. (c) If a pre-employment...

  17. 42 CFR 417.458 - Recoupment of uncollected deductible and coinsurance amounts.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS... Medicare Contract § 417.458 Recoupment of uncollected deductible and coinsurance amounts. An HMO or CMP... previous contract period except in the following circumstances: (a) The HMO or CMP failed to collect the...

  18. To Lease or Not To Lease.

    ERIC Educational Resources Information Center

    Hamilton, William A.

    1998-01-01

    Thanks to previous bond issues, the Walled Lake (Michigan) Schools had a well-defined technology plan featuring staff development, student performance benchmarks, and rooms of outdated computers. After three bond issues failed, the district adopted leasing as an alternative. Their present three-year contract supplies 154 used computers and a…

  19. Biochemical and physiological consequences of the Apollo flight diet.

    NASA Technical Reports Server (NTRS)

    Hander, E. W.; Leach, C. S.; Fischer, C. L.; Rummel, J.; Rambaut, P.; Johnson, P. C.

    1971-01-01

    Six male subjects subsisting on a typical Apollo flight diet for five consecutive days were evaluated for changes in biochemical and physiological status. Laboratory examinations failed to demonstrate any significant changes of the kind previously attributed to weightlessness, such as in serum electrolytes, endocrine values, body fluid, or hematologic parameters.

  20. Second Label Learning in Bilingual and Monolingual Infants

    ERIC Educational Resources Information Center

    Kandhadai, Padmapriya; Hall, D. Geoffrey; Werker, Janet F.

    2017-01-01

    "Mutual exclusivity" is the assumption that each object has only one category label. Prior research suggests that bilingual infants, unlike monolingual infants, fail to adhere to this assumption to guide word learning. Yet previous work has not addressed whether bilingual infants systematically interpret a novel word for a familiar…

  1. 32 CFR 299.5 - Procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... has a history of prompt payment. A history of prompt payment means payment within 30 calendar days of... payment before processing is continued if the requester does not have a history of prompt payment. All.... (3) When a requester has previously failed to pay a fee charged within a timely fashion (i.e., within...

  2. Running on Empty? Finding the Time and Capacity to Lead Learning

    ERIC Educational Resources Information Center

    Hallinger, Philip; Murphy, Joseph F.

    2013-01-01

    In recent years, policy changes in American education have refocused a spotlight on principal instructional leadership. Although in previous eras the professional literature exhorted principals to "be instructional leaders," there were few sanctions if they failed to do so. In the current policy context, however, instructional leadership has…

  3. Context-specific attentional sampling: Intentional control as a pre-requisite for contextual control.

    PubMed

    Brosowsky, Nicholaus P; Crump, Matthew J C

    2016-08-01

    Recent work suggests that environmental cues associated with previous attentional control settings can rapidly and involuntarily adjust attentional priorities. The current study tests predictions from adaptive-learning and memory-based theories of contextual control about the role of intentions for setting attentional priorities. To extend the empirical boundaries of contextual control phenomena, and to determine whether theoretical principles of contextual control are generalizable we used a novel bi-dimensional stimulus sampling task. Subjects viewed briefly presented arrays of letters and colors presented above or below fixation, and identified specific stimuli according to a dimensional (letter or color) and positional cue. Location was predictive of the cued dimension, but not the position or identity. In contrast to previous findings, contextual control failed to develop through automatic, adaptive-learning processes. Instead, previous experience with intentionally changing attentional sampling priorities between different contexts was required for contextual control to develop. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Survival Prediction in Patients Undergoing Open-Heart Mitral Valve Operation After Previous Failed MitraClip Procedures.

    PubMed

    Geidel, Stephan; Wohlmuth, Peter; Schmoeckel, Michael

    2016-03-01

    The objective of this study was to analyze the results of open heart mitral valve operations for survival prediction in patients with previously unsuccessful MitraClip procedures. Thirty-three consecutive patients who underwent mitral valve surgery in our institution were studied. At a median of 41 days, they had previously undergone one to five futile MitraClip implantations. At the time of their operations, patients were 72.6 ± 10.3 years old, and the calculated risk, using the European System for Cardiac Operative Risk Evaluation (EuroSCORE) II, was a median of 26.5%. Individual outcomes were recorded, and all patients were monitored postoperatively. Thirty-day mortality was 9.1%, and the overall survival at 2.2 years was 60.6%. Seven cardiac-related and six noncardiac deaths occurred. Univariate survival regression models demonstrated a significant influence of the following variables on survival: EuroSCORE II (p = 0.0022), preoperative left ventricular end-diastolic dimension (p = 0.0052), left ventricular ejection fraction (p = 0.0249), coronary artery disease (p = 0.0385), and severe pulmonary hypertension (p = 0.0431). Survivors showed considerable improvements in their New York Heart Association class (p < 0.0001), left ventricular ejection fraction (p = 0.0080), grade of mitral regurgitation (p = 0.0350), and mitral valve area (p = 0.0486). Survival after mitral repair was not superior to survival after replacement. Indications for surgery after failed MitraClip procedures must be considered with the greatest of care. Variables predicting postoperative survival should be taken into account regarding the difficult decision as to whether to operate or not. Our data suggest that replacement of the pretreated mitral valve is probably the more reasonable concept rather than complex repairs. When the EuroSCORE II at the time of surgery exceeds 30%, conservative therapy is advisable. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  5. Re-re-treatment of hepatitis C virus: Eight patients who relapsed twice after direct-acting-antiviral drugs

    PubMed Central

    Hartman, Joshua; Bichoupan, Kian; Patel, Neal; Chekuri, Sweta; Harty, Alyson; Dieterich, Douglas; Perumalswami, Ponni; Branch, Andrea D

    2015-01-01

    AIM: To determine risk factors associated with hepatitis C virus (HCV) treatment failure after direct acting antivirals in patients with complex treatment histories. METHODS: All HCV mono-infected patients who received treatment at our institution were queried. Analysis was restricted to patients who previously failed treatment with boceprevir (BOC) or telaprevir (TVR) and started simeprevir (SMV) and sofosbuvir (SOF) ± ribavirin (RBV) between December 2013 and June 2014. Patients with human immunodeficiency virus (HIV)/HCV co-infection or patients who received a liver transplant in the past were excluded. Viral loads were recorded while on treatment and after treatment. Data collection continued until December, 31st 2014 when data analysis was initiated. Patients missing virologic outcomes data were not included in the analysis. Analysis of 35 patients who had virologic outcome data available resulted in eight patients who were viral load negative at the end of treatment with SMF/SOF but later relapsed. Data related to patient demographics, HCV infection, and treatment history was collected in order to identify risk factors shared among patients who failed treatment with SMF/SOF. RESULTS: Eight patients who were treated with the first generation HCV protease inhibitors BOC or TVR in combination with pegylated-interferon (PEG) and RBV who failed this triple therapy were subsequently re-treated with an off-label all-oral regimen of SMV and SOF for 12 wk, with RBV in seven cases. Treatment was initiated before the Food and Drug Administration approved a 24-wk SMV/SOF regimen for patients with liver cirrhosis. All eight patients had an end of treatment response, but later relapsed. Eight (100%) patients were male. Mean age was 56 (range, 49-64). Eight (100%) patients had previously failed PEG/RBV dual therapy at least once in addition to prior failure with triple therapy. Total number of times treated ranged from 3-6 (mean 3.8). Eight (100%) patients were male had liver cirrhosis as determined by Fibroscan or MRI. Seven (87.5%) patients had genotype 1a HCV. Seven (87.5%) patients had over 1 million IU/mL HCV RNA at the time of re-treatment. CONCLUSION: This study identifies factors associated with SMV/SOF treatment failure and provides evidence that twleve weeks of SMV/SOF/RBV is insufficient in cirrhotics with high-titer genotype 1a HCV. PMID:26604650

  6. Re-re-treatment of hepatitis C virus: Eight patients who relapsed twice after direct-acting-antiviral drugs.

    PubMed

    Hartman, Joshua; Bichoupan, Kian; Patel, Neal; Chekuri, Sweta; Harty, Alyson; Dieterich, Douglas; Perumalswami, Ponni; Branch, Andrea D

    2015-11-21

    To determine risk factors associated with hepatitis C virus (HCV) treatment failure after direct acting antivirals in patients with complex treatment histories. All HCV mono-infected patients who received treatment at our institution were queried. Analysis was restricted to patients who previously failed treatment with boceprevir (BOC) or telaprevir (TVR) and started simeprevir (SMV) and sofosbuvir (SOF) ± ribavirin (RBV) between December 2013 and June 2014. Patients with human immunodeficiency virus (HIV)/HCV co-infection or patients who received a liver transplant in the past were excluded. Viral loads were recorded while on treatment and after treatment. Data collection continued until December, 31(st) 2014 when data analysis was initiated. Patients missing virologic outcomes data were not included in the analysis. Analysis of 35 patients who had virologic outcome data available resulted in eight patients who were viral load negative at the end of treatment with SMF/SOF but later relapsed. Data related to patient demographics, HCV infection, and treatment history was collected in order to identify risk factors shared among patients who failed treatment with SMF/SOF. Eight patients who were treated with the first generation HCV protease inhibitors BOC or TVR in combination with pegylated-interferon (PEG) and RBV who failed this triple therapy were subsequently re-treated with an off-label all-oral regimen of SMV and SOF for 12 wk, with RBV in seven cases. Treatment was initiated before the Food and Drug Administration approved a 24-wk SMV/SOF regimen for patients with liver cirrhosis. All eight patients had an end of treatment response, but later relapsed. Eight (100%) patients were male. Mean age was 56 (range, 49-64). Eight (100%) patients had previously failed PEG/RBV dual therapy at least once in addition to prior failure with triple therapy. Total number of times treated ranged from 3-6 (mean 3.8). Eight (100%) patients were male had liver cirrhosis as determined by Fibroscan or MRI. Seven (87.5%) patients had genotype 1a HCV. Seven (87.5%) patients had over 1 million IU/mL HCV RNA at the time of re-treatment. This study identifies factors associated with SMV/SOF treatment failure and provides evidence that twleve weeks of SMV/SOF/RBV is insufficient in cirrhotics with high-titer genotype 1a HCV.

  7. Real-world Experience With a Decellularized Dehydrated Human Amniotic Membrane Allograft.

    PubMed

    Smiell, Janice M; Treadwell, Terry; Hahn, Helen D; Hermans, Michel H

    2015-06-01

    While randomized controlled trials (RCTs) are designed to evaluate efficacy and/or safety under controlled conditions, use of strict inclusion/ exclusion criteria are noted to exclude more than 50% of wound populations. Applicability of RCT outcomes to performance expectations in real-world wound populations raises questions about generalizing their results. The primary aim of this decellularized, dehydrated human amniotic membrane (DDHAM) Use Registry Study was to gain experience and observe outcomes with use of a DDHAM in uninfected, full-thickness, or partial-thickness wounds that, in the investigators' opinions, would benefit from such treatment. Investigators were instructed to provide usual care regarding visit and application frequencies, concomitant therapies, and change in wound-care regimens. The only exclusions were patients with actively infected wounds or known hypersensitivity to DDHAM. Fifteen sites with practicing wound care clinicians of various specialties participated in this review, enrolling chronic wounds including venous, diabetic, pressure, collagen vascular, and arterial ulcers-all of various severities, durations, sizes, and previous treatments. Twenty-eight ulcers studied had failed 32 previous treatments with advanced biologic therapies. A total of 244 wounds were observed in this study, however, this review is limited to the 179 chronic wounds in 165 patients that were enrolled at 15 of the 19 participating centers. The 4 centers that enrolled acute wounds only were excluded. Results from the analysis of this very heterogeneous population demonstrated that during the usual course of an average of 8 weeks of wound management, patients experienced factors that significantly affected wound closure. These factors included wound infections, noncompliance with prescribed treatments (eg, compression, off-loading, and wound care), re-injury of the wound, and systemic comorbidities. Nearly 50% of chronic wounds (including those that failed previous therapy with advanced biologics) with an average baseline area of 3.1 cm2 achieved complete closure within a median of 6.3 weeks without product-related adverse experiences. Despite the challenges of uncontrolled factors that affect healing, this registry study demonstrated the safety and clinical benefit of DDHAM to support wound closure across a variety of chronic wound types and patient conditions in real-world environments.

  8. Fishnet statistics for probabilistic strength and scaling of nacreous imbricated lamellar materials

    NASA Astrophysics Data System (ADS)

    Luo, Wen; Bažant, Zdeněk P.

    2017-12-01

    Similar to nacre (or brick masonry), imbricated (or staggered) lamellar structures are widely found in nature and man-made materials, and are of interest for biomimetics. They can achieve high defect insensitivity and fracture toughness, as demonstrated in previous studies. But the probability distribution with a realistic far-left tail is apparently unknown. Here, strictly for statistical purposes, the microstructure of nacre is approximated by a diagonally pulled fishnet with quasibrittle links representing the shear bonds between parallel lamellae (or platelets). The probability distribution of fishnet strength is calculated as a sum of a rapidly convergent series of the failure probabilities after the rupture of one, two, three, etc., links. Each of them represents a combination of joint probabilities and of additive probabilities of disjoint events, modified near the zone of failed links by the stress redistributions caused by previously failed links. Based on previous nano- and multi-scale studies at Northwestern, the strength distribution of each link, characterizing the interlamellar shear bond, is assumed to be a Gauss-Weibull graft, but with a deeper Weibull tail than in Type 1 failure of non-imbricated quasibrittle materials. The autocorrelation length is considered equal to the link length. The size of the zone of failed links at maximum load increases with the coefficient of variation (CoV) of link strength, and also with fishnet size. With an increasing width-to-length aspect ratio, a rectangular fishnet gradually transits from the weakest-link chain to the fiber bundle, as the limit cases. The fishnet strength at failure probability 10-6 grows with the width-to-length ratio. For a square fishnet boundary, the strength at 10-6 failure probability is about 11% higher, while at fixed load the failure probability is about 25-times higher than it is for the non-imbricated case. This is a major safety advantage of the fishnet architecture over particulate or fiber reinforced materials. There is also a strong size effect, partly similar to that of Type 1 while the curves of log-strength versus log-size for different sizes could cross each other. The predicted behavior is verified by about a million Monte Carlo simulations for each of many fishnet geometries, sizes and CoVs of link strength. In addition to the weakest-link or fiber bundle, the fishnet becomes the third analytically tractable statistical model of structural strength, and has the former two as limit cases.

  9. Outcome of Descemet stripping automated endothelial keratoplasty in eyes with an Ahmed glaucoma valve.

    PubMed

    Chiam, Patrick J; Cheeseman, Robert; Ho, Vivian W; Romano, Vito; Choudhary, Anshoo; Batterbury, Mark; Kaye, Stephen B; Willoughby, Colin E

    2017-05-01

    The purpose was to investigate the survival of Descemet stripping automated endothelial keratoplasty (DSAEK) in eyes with an Ahmed glaucoma valve (AGV). The study had a retrospective case-series of patients with an AGV in the anterior chamber undergoing a DSAEK. Included in the analysis were graft size, number of previous operations, post-operative glaucoma medications, post-operative intraocular pressure (IOP) control, graft size and donor factors (age, endothelial cell density, and post-mortem time). A generalised linear model with binary logistic regression was used to test for an effect on graft survival at 1 year and 1.5 years. Fourteen eyes from 13 patients were included. The survival rate of the first DSAEK at 6, 12, 18, 24 and 30-months was 85%, 71%, 50%, 36% and 30%, respectively. The mean duration to graft failure was 12.9 ± 6.2 months. Five of the seven failed first grafts went on to have a repeat DSAEK. The mean follow-up in this subgroup was 30.7 ± 18.4 months. The survival rate of second DSAEK at 6, 12, 18 and 24 months was 100% (5/5), 100% (5/5), 75% (3/4) and 67% (2/3). Only one second DSAEK failed in the duration of the study and went on to receive a third DSAEK which failed at 18-months. The mean IOP within the first year was significantly lower for grafts that survived at 1 and 1.5 years (17.4 mmHg, 16.9 mmHg) than for grafts that failed (19.4 mmHg, 19.4 mmHg) (p = 0.04, p = 0.009). DSAEK is a viable alternative to PK to restore visual function in eyes with an AGV sited in the anterior chamber. IOP is an important risk factor for graft failure.

  10. Evolutionary relatedness does not predict competition and co-occurrence in natural or experimental communities of green algae

    PubMed Central

    Alexandrou, Markos A.; Cardinale, Bradley J.; Hall, John D.; Delwiche, Charles F.; Fritschie, Keith; Narwani, Anita; Venail, Patrick A.; Bentlage, Bastian; Pankey, M. Sabrina; Oakley, Todd H.

    2015-01-01

    The competition-relatedness hypothesis (CRH) predicts that the strength of competition is the strongest among closely related species and decreases as species become less related. This hypothesis is based on the assumption that common ancestry causes close relatives to share biological traits that lead to greater ecological similarity. Although intuitively appealing, the extent to which phylogeny can predict competition and co-occurrence among species has only recently been rigorously tested, with mixed results. When studies have failed to support the CRH, critics have pointed out at least three limitations: (i) the use of data poor phylogenies that provide inaccurate estimates of species relatedness, (ii) the use of inappropriate statistical models that fail to detect relationships between relatedness and species interactions amidst nonlinearities and heteroskedastic variances, and (iii) overly simplified laboratory conditions that fail to allow eco-evolutionary relationships to emerge. Here, we address these limitations and find they do not explain why evolutionary relatedness fails to predict the strength of species interactions or probabilities of coexistence among freshwater green algae. First, we construct a new data-rich, transcriptome-based phylogeny of common freshwater green algae that are commonly cultured and used for laboratory experiments. Using this new phylogeny, we re-analyse ecological data from three previously published laboratory experiments. After accounting for the possibility of nonlinearities and heterogeneity of variances across levels of relatedness, we find no relationship between phylogenetic distance and ecological traits. In addition, we show that communities of North American green algae are randomly composed with respect to their evolutionary relationships in 99% of 1077 lakes spanning the continental United States. Together, these analyses result in one of the most comprehensive case studies of how evolutionary history influences species interactions and community assembly in both natural and experimental systems. Our results challenge the generality of the CRH and suggest it may be time to re-evaluate the validity and assumptions of this hypothesis. PMID:25473009

  11. Perineal anastomotic urethroplasty for posttraumatic urethral stricture with or without previous urethral manipulations: a review of 61 cases with long-term followup.

    PubMed

    Lumen, Nicolaas; Hoebeke, Piet; Troyer, Bart De; Ysebaert, Barbara; Oosterlinck, Willem

    2009-03-01

    We retrospectively analyzed cases of anastomotic urethroplasty for posttraumatic urethral strictures that were done at our center. Surgical and functional outcomes were evaluated. The impact of previous urethral manipulations was assessed. Between 1993 and 2006, 61 males were treated with anastomotic urethroplasty because of urethral trauma after pelvic fracture. Mean followup was 67 months (range 19 to 173). In 21 of the 61 cases (34.4%) urethral manipulation had been performed previously (secondary cases) but had failed. All patients were treated via the perineal approach. In 9 patients (14.8%) recurrence was reported. The recurrence rate was higher in patients who underwent former treatment than in primary patients (19% vs 12.5%). Posttraumatic impotence was reported by 20 patients (32.8%) but in 2 erectile function was restored after treatment. One patient had minor stress incontinence. In 2 secondary cases the rectum was injured during the procedure but could be repaired. Anastomotic urethroplasty via the perineal approach is an excellent treatment for posttraumatic urethral stricture. Results are good at long-term followup. Although statistical significance has not been attained, failures and complications seem to be higher in patients who have already undergone failed urethroplasty.

  12. Role of specific IgE and skin-prick testing in predicting food challenge results to baked egg.

    PubMed

    Cortot, Catherine F; Sheehan, William J; Permaul, Perdita; Friedlander, James L; Baxi, Sachin N; Gaffin, Jonathan M; Dioun, Anahita F; Hoffman, Elaine B; Schneider, Lynda C; Phipatanakul, Wanda

    2012-01-01

    Previous studies suggest that children with egg allergy may be able to tolerate baked egg. Reliable predictors of a successful baked egg challenge are not well established. We examined egg white-specific IgE levels, skin-prick test (SPT) results, and age as predictors of baked egg oral food challenge (OFC) outcomes. We conducted a retrospective chart review of children, aged 2-18 years, receiving an egg white-specific IgE level, SPT, and OFC to baked egg from 2008 to 2010. Fifty-two oral baked egg challenges were conducted. Of the 52 challenges, 83% (n = 43) passed and 17% (n = 9) failed, including 2 having anaphylaxis. Median SPT wheal size was 12 mm (range, 0-35 mm) for passed challenges and 17 mm (range, 10-30 mm) for failed challenges (p = 0.091). The negative predictive value for passing the OFC was 100% (9 of 9) if SPT wheal size was <10 mm. Median egg white-specific IgE was 2.02 kU/L (range, <0.35-13.00 kU/L) for passed challenges and 1.52 kU/L (range, 0.51-6.10 kU/L) for failed challenges (p = 0.660). Receiver operating characteristic (ROC) curve analysis for SPT revealed an area under the curve (AUC) of 0.64. ROC curve analysis for egg white-specific IgE revealed an AUC of 0.63. There was no significant difference in age between patients who failed and those who passed (median = 8.8 years versus 7.0 years; p = 0.721). Based on our sample, SPT, egg white-specific IgE and age are not good predictors of passing a baked egg challenge. However, there was a trend for more predictability with SPT wheal size.

  13. Biochemical effectiveness of allopurinol and allopurinol-probenecid in previously benzbromarone-treated gout patients.

    PubMed

    Reinders, Mattheus K; van Roon, Eric N; Houtman, Pieternella M; Brouwers, Jacobus R B J; Jansen, Tim L Th A

    2007-09-01

    In 2003, the uricosuric drug benzbromarone was withdrawn from the market. The first alternative drug of choice was the xanthine oxidase inhibitor allopurinol. The purpose was to (1) investigate the efficacy of allopurinol (standard dosage) compared with previous treatment with benzbromarone; and (2) investigate the combination therapy allopurinol-probenecid as an effective alternative treatment compared with previous benzbromarone treatment. A prospective, open study was carried out in a cohort of 51 gout patients who discontinued benzbromarone therapy because of market withdrawal. Patients were given 200-300 mg allopurinol (stage 1). When allopurinol failed to attain the target serum urate (sUr) levels

  14. Geomagnetic Polarity Epochs: Sierra Nevada II.

    PubMed

    Cox, A; Doell, R R; Dalrymple, G B

    1963-10-18

    Ten new determinations on volcanic extrusions in the Sierra Nevada with potassium-argon ages of 3.1 million years or less indicate that the remanent magnetizations fall into two groups, a normal group in which the remanent magnetization is directed downward and to the north, and a reversed group magnetized up and to the south. Thermomagnetic experiments and mineralogic studies fail to provide an explanation of the opposing polarities in terms of mineralogic control, but rather suggest that the remanent magnetization reflects reversals of the main dipole field of the earth. All available radiometric ages are consistent with this field-reversal hypothesis and indicate that the present normal polarity epoch (N1) as well as the previous reversed epoch (R1) are 0.9 to 1.0 million years long, whereas the previous normal epoch (N2) was at least 25 percent longer.

  15. Geomagnetic polarity epochs: Sierra Nevada II

    USGS Publications Warehouse

    Cox, A.; Doell, Richard R.; Brent, Dalrymple G.

    1963-01-01

    Ten new determinations on volcanic extrusions in the Sierra Nevada with potassium-argon ages of 3.1 million years or less indicate that the remanent magnetizations fall into two groups, a normal group in which the remanent magnetization is directed downward and to the north, and a reversed group magnetized up and to the south. Thermomagnetic experiments and mineralogic studies fail to provide an explanation of the opposing polarities in terms of mineralogic control, but rather suggest that the remanent magnetization reflects reversals of the main dipole field of the earth. All available radiometric ages are consistent with this field-reversal hypothesis and indicate that the present normal polarity epoch (N1) as well as the previous reversed epoch (R1) are 0.9 to 1.0 million years long, whereas the previous normal epoch (N2) was at least 25 percent longer.

  16. MLEP-Fail calibration for 1/8 inch thick cast plate of 17-4 steel.

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

    Corona, Edmundo

    The purpose of the work presented in this memo was to calibrate the Sierra material model Multilinear Elastic-Plastic Hardening Model with Failure (MLEP-Fail) for 1/8 inch thick cast plate of 17-4 steel. The calibration approach is essentially the same as that recently used in a previous memo using data from smooth and notched tensile specimens. The notched specimens were manufactured with three notch radii R = 1=8, 1/32 and 1/64 inches. The dimensions of the smooth and notched specimens are given in the prints in Appendix A. Two cast plates, Plate 3 and Plate 4, with nominally identical properties weremore » considered.« less

  17. Mitigating Thermal Runaway Risk in Lithium Ion Batteries

    NASA Technical Reports Server (NTRS)

    Darcy, Eric; Jeevarajan, Judy; Russell, Samuel

    2014-01-01

    The JSC/NESC team has successfully demonstrated Thermal Runaway (TR) risk reduction in a lithium ion battery for human space flight by developing and implementing verifiable design features which interrupt energy transfer between adjacent electrochemical cells. Conventional lithium ion (li-Ion) batteries can fail catastrophically as a result of a single cell going into thermal runaway. Thermal runaway results when an internal component fails to separate electrode materials leading to localized heating and complete combustion of the lithium ion cell. Previously, the greatest control to minimize the probability of cell failure was individual cell screening. Combining thermal runaway propagation mitigation design features with a comprehensive screening program reduces both the probability, and the severity, of a single cell failure.

  18. Association between GRB2/Sos and insulin receptor substrate 1 is not sufficient for activation of extracellular signal-regulated kinases by interleukin-4: implications for Ras activation by insulin.

    PubMed

    Pruett, W; Yuan, Y; Rose, E; Batzer, A G; Harada, N; Skolnik, E Y

    1995-03-01

    Insulin receptor substrate 1 (IRS-1) mediates the activation of a variety of signaling pathways by the insulin and insulin-like growth factor 1 receptors by serving as a docking protein for signaling molecules with SH2 domains. We and others have shown that in response to insulin stimulation IRS-1 binds GRB2/Sos and have proposed that this interaction is important in mediating Ras activation by the insulin receptor. Recently, it has been shown that the interleukin (IL)-4 receptor also phosphorylates IRS-1 and an IRS-1-related molecule, 4PS. Unlike insulin, however, IL-4 fails to activate Ras, extracellular signal-regulated kinases (ERKs), or mitogen-activated protein kinases. We have reconstituted the IL-4 receptor into an insulin-responsive L6 myoblast cell line and have shown that IRS-1 is tyrosine phosphorylated to similar degrees in response to insulin and IL-4 stimulation in this cell line. In agreement with previous findings, IL-4 failed to activate the ERKs in this cell line or to stimulate DNA synthesis, whereas the same responses were activated by insulin. Surprisingly, IL-4's failure to activate ERKs was not due to a failure to stimulate the association of tyrosine-phosphorylated IRS-1 with GRB2/Sos; the amounts of GRB2/Sos associated with IRS-1 were similar in insulin- and IL-4-stimulated cells. Moreover, the amounts of phosphatidylinositol 3-kinase activity associated with IRS-1 were similar in insulin- and IL-4-stimulated cells. In contrast to insulin, however, IL-4 failed to induce tyrosine phosphorylation of Shc or association of Shc with GRB2. Thus, ERK activation correlates with Shc tyrosine phosphorylation and formation of an Shc/GRB2 complex. Thus, ERK activation correlates with Shc tyrosine phosphorylation and formation of an Shc/GRB2 complex. Previous studies have indicated that activation of ERks in this cell line is dependent upon Ras since a dominant-negative Ras (Asn-17) blocks ERK activation by insulin. Our findings, taken in the context of previous work, suggest that binding of GRB2/Sos to Shc may be the predominant mechanism whereby insulin as well as cytokine receptors activate Ras.

  19. The effect of exogenous GM1 ganglioside on kindled-amygdaloid seizures.

    PubMed

    Albertson, T E; Walby, W F

    1987-01-01

    The effects of 12 daily doses of 30 mg/kg GM1 ganglioside i.p. on the acquisition of kindled-amygdaloid seizures in the rat was studied. No modification in the rate of kindling or the expression of the elicited seizures was noted during the acquisition phase. Further studies with additional fully amygdaloid kindled rats failed to show significant modification of suprathreshold or threshold elicited seizures after single 30-60 mg/kg i.p. doses of GM1 ganglioside. Despite previous studies which have shown antibodies to GM1 ganglioside to be convulsive, no anticonvulsant activity was demonstrated in this study with exogenous GM1 ganglioside using a battery of kindled-amygdaloid seizure tests in the rat.

  20. The TrialsTracker: Automated ongoing monitoring of failure to share clinical trial results by all major companies and research institutions.

    PubMed

    Powell-Smith, Anna; Goldacre, Ben

    2016-01-01

    Background : Failure to publish trial results is a prevalent ethical breach with a negative impact on patient care. Audit is an important tool for quality improvement. We set out to produce an online resource that automatically identifies the sponsors with the best and worst record for failing to share trial results. Methods: A tool was produced that identifies all completed trials from clinicaltrials.gov, searches for results in the clinicaltrials.gov registry and on PubMed, and presents summary statistics for each sponsor online. Results : The TrialsTracker tool is now available. Results are consistent with previous publication bias cohort studies using manual searches. The prevalence of missing studies is presented for various classes of sponsor. All code and data is shared. Discussion: We have designed, built, and launched an easily accessible online service, the TrialsTracker, that identifies sponsors who have failed in their duty to make results of clinical trials available, and which can be maintained at low cost. Sponsors who wish to improve their performance metrics in this tool can do so by publishing the results of their trials.

  1. The motor cost of telling lies: electrocortical signatures and personality foundations of spontaneous deception.

    PubMed

    Panasiti, Maria Serena; Pavone, Enea F; Mancini, Alessandra; Merla, Arcangelo; Grisoni, Luigi; Aglioti, Salvatore M

    2014-01-01

    Although universal, lying is generally considered immoral behavior. Most neuroscience studies on lying sanction or instruct deceptive behaviors and thus might fail to acknowledge the significance of lie-related moral conflicts. By combining electroencephalogram (EEG) recordings with a novel paradigm in which participants decided freely whether to deceive another person, we have generated indices of the cognitive (reaction times and stimulus-locked event-related components) and moral (readiness potential and its correlations with deception-related personality traits) cost of spontaneous deception. Our data fail to support the consensus that deception is cognitively more demanding than truth telling, suggesting that spontaneous deception, as opposed to lying out of requirement, might not mandate additional cognitive workload. Interestingly, lying was associated with decreased motor readiness, an event-related potential (ERP) component that is linked to motor preparation of self-determined actions and modulated when we face moral dilemmas. Notably, this reduction was less extensive in manipulative participants and greater in those who cared highly about their impression management. Our study expands on previous findings on deception by associating a cortical marker of reduced preparation to act with individual differences in moral cognition.

  2. Low frequency of genotypic resistance in HIV-1-infected patients failing an atazanavir-containing regimen: a clinical cohort study

    PubMed Central

    Dolling, David I.; Dunn, David T.; Sutherland, Katherine A.; Pillay, Deenan; Mbisa, Jean L.; Parry, Chris M.; Post, Frank A.; Sabin, Caroline A.; Cane, Patricia A.; Aitken, Celia; Asboe, David; Webster, Daniel; Cane, Patricia; Castro, Hannah; Dunn, David; Dolling, David; Chadwick, David; Churchill, Duncan; Clark, Duncan; Collins, Simon; Delpech, Valerie; Geretti, Anna Maria; Goldberg, David; Hale, Antony; Hué, Stéphane; Kaye, Steve; Kellam, Paul; Lazarus, Linda; Leigh-Brown, Andrew; Mackie, Nicola; Orkin, Chloe; Rice, Philip; Pillay, Deenan; Phillips, Andrew; Sabin, Caroline; Smit, Erasmus; Templeton, Kate; Tilston, Peter; Tong, William; Williams, Ian; Zhang, Hongyi; Zuckerman, Mark; Greatorex, Jane; Wildfire, Adrian; O'Shea, Siobhan; Mullen, Jane; Mbisa, Tamyo; Cox, Alison; Tandy, Richard; Hale, Tony; Fawcett, Tracy; Hopkins, Mark; Ashton, Lynn; Booth, Claire; Garcia-Diaz, Ana; Shepherd, Jill; Schmid, Matthias L.; Payne, Brendan; Hay, Phillip; Rice, Phillip; Paynter, Mary; Bibby, David; Kirk, Stuart; MacLean, Alasdair; Gunson, Rory; Coughlin, Kate; Fearnhill, Esther; Fradette, Lorraine; Porter, Kholoud; Ainsworth, Jonathan; Anderson, Jane; Babiker, Abdel; Fisher, Martin; Gazzard, Brian; Gilson, Richard; Gompels, Mark; Hill, Teresa; Johnson, Margaret; Kegg, Stephen; Leen, Clifford; Nelson, Mark; Palfreeman, Adrian; Post, Frank; Sachikonye, Memory; Schwenk, Achim; Walsh, John; Huntington, Susie; Jose, Sophie; Thornton, Alicia; Glabay, Adam; Orkin, C.; Garrett, N.; Lynch, J.; Hand, J.; de Souza, C.; Fisher, M.; Perry, N.; Tilbury, S.; Gazzard, B.; Nelson, M.; Waxman, M.; Asboe, D.; Mandalia, S.; Delpech, V.; Anderson, J.; Munshi, S.; Korat, H.; Welch, J.; Poulton, M.; MacDonald, C.; Gleisner, Z.; Campbell, L.; Gilson, R.; Brima, N.; Williams, I.; Schwenk, A.; Ainsworth, J.; Wood, C.; Miller, S.; Johnson, M.; Youle, M.; Lampe, F.; Smith, C.; Grabowska, H.; Chaloner, C.; Puradiredja, D.; Walsh, J.; Weber, J.; Ramzan, F.; Mackie, N.; Winston, A.; Leen, C.; Wilson, A.; Allan, S.; Palfreeman, A.; Moore, A.; Wakeman, K.

    2013-01-01

    Objectives To determine protease mutations that develop at viral failure for protease inhibitor (PI)-naive patients on a regimen containing the PI atazanavir. Methods Resistance tests on patients failing atazanavir, conducted as part of routine clinical care in a multicentre observational study, were randomly matched by subtype to resistance tests from PI-naive controls to account for natural polymorphisms. Mutations from the consensus B sequence across the protease region were analysed for association and defined using the IAS-USA 2011 classification list. Results Four hundred and five of 2528 (16%) patients failed therapy containing atazanavir as a first PI over a median (IQR) follow-up of 1.76 (0.84–3.15) years and 322 resistance tests were available for analysis. Recognized major atazanavir mutations were found in six atazanavir-experienced patients (P < 0.001), including I50L and N88S. The minor mutations most strongly associated with atazanavir experience were M36I, M46I, F53L, A71V, V82T and I85V (P < 0.05). Multiple novel mutations, I15S, L19T, K43T, L63P/V, K70Q, V77I and L89I/T/V, were also associated with atazanavir experience. Conclusions Viral failure on atazanavir-containing regimens was not common and major resistance mutations were rare, suggesting that adherence may be a major contributor to viral failure. Novel mutations were described that have not been previously documented. PMID:23711895

  3. Efficacy and safety of Apatinib in stage IV sarcomas: experience of a major sarcoma center in China.

    PubMed

    Li, Feng; Liao, Zhichao; Zhao, Jun; Zhao, Gang; Li, Xubin; Du, Xiaoling; Yang, Yun; Yang, Jilong

    2017-09-08

    This study was conducted to review the efficacy and safety of Apatinib in stage IV sarcoma patients who failed previous chemotherapy. The clinical information on 16 patients with stage IV sarcomas who failed in prior chemotherapy and subsequently received Apatinib treatment was collected. Apatinib was given 500mg/daily and 4 weeks as a cycle. All patients had at least one measurable extracranial tumor according to Response Evaluation Criteria In Solid Tumors 1.0 criteria. Progression free survival (PFS), overall survival (OS), objective response rate (ORR), disease control rate (DCR) and treatment-related adverse effects (AEs) were reviewed and evaluated. Patients was administered Apatinib for 0 to 9 cycles with the median of 3.2 cycles. Median follow-up time was 8.4 months (1 to 12 months). Ten of 16 patients received at least 1 complete cycle of Apatinib treatment were eligible for the efficacy analysis. The median PFS was 8.84 months. Two patients achieved partial response (PR) and 6 patients achieved stable disease (SD). Two patients were evaluated as progression disease (PD) and one patient died of disease progression. The ORR was 20.0% (2/10) and the DCR was 80.0% (8/10). The most common grade 3/4 treatment-related AEs were hypertension (18.7%), hand-foot syndrome (12.5%) and proteinuria (6.3%). No drug-related severe AEs occurred. CApatinib treatment in this exploratory study exhibited objective efficacy and manageable toxicity in stage IV sarcoma patients who failed in chemotherapy. This result supports future random controlled trial to further define Apatinib activity in stage IV sarcomas.

  4. Do gorillas (Gorilla gorilla) and orangutans (Pongo pygmaeus) fail to represent objects in the context of cohesion violations?

    PubMed

    Cacchione, Trix; Call, Josep

    2010-08-01

    Recent research suggests that witnessing events of fission (e.g., the splitting of a solid object) impairs human infants', human adults', and non-human primates' object representations. The present studies investigated the reactions of gorillas and orangutans to cohesion violation across different types of fission events implementing a behavioral paradigm previously used with human infants. Results suggest that fission events vary in their impact on representational abilities but do not destroy apes' representations of continuously existing objects. Copyright (c) 2010 Elsevier B.V. All rights reserved.

  5. Predicting on-road assessment pass and fail outcomes in older drivers with cognitive impairment using a battery of computerized sensory-motor and cognitive tests.

    PubMed

    Hoggarth, Petra A; Innes, Carrie R H; Dalrymple-Alford, John C; Jones, Richard D

    2013-12-01

    To generate a robust model of computerized sensory-motor and cognitive test performance to predict on-road driving assessment outcomes in older persons with diagnosed or suspected cognitive impairment. A logistic regression model classified pass–fail outcomes of a blinded on-road driving assessment. Generalizability of the model was tested using leave-one-out cross-validation. Three specialist clinics in New Zealand. Drivers (n=279; mean age 78.4, 65% male) with diagnosed or suspected dementia, mild cognitive impairment, unspecified cognitive impairment, or memory problems referred for a medical driving assessment. A computerized battery of sensory-motor and cognitive tests and an on-road medical driving assessment. One hundred fifty-five participants (55.5%) received an on-road fail score. Binary logistic regression correctly classified 75.6% of the sample into on-road pass and fail groups. The cross-validation indicated accuracy of the model of 72.0% with sensitivity for detecting on-road fails of 73.5%, specificity of 70.2%, positive predictive value of 75.5%, and negative predictive value of 68%. The off-road assessment prediction model resulted in a substantial number of people who were assessed as likely to fail despite passing an on-road assessment and vice versa. Thus, despite a large multicenter sample, the use of off-road tests previously found to be useful in other older populations, and a carefully constructed and tested prediction model, off-road measures have yet to be found that are sufficiently accurate to allow acceptable determination of on-road driving safety of cognitively impaired older drivers. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

  6. Identifying barriers to follow-up eye care for children after failed vision screening in a primary care setting.

    PubMed

    Su, Zhuo; Marvin, Elizabeth K; Wang, Bing Q; van Zyl, Tavé; Elia, Maxwell D; Garza, Esteban N; Salchow, Daniel J; Forster, Susan H

    2013-08-01

    To identify barriers to follow-up eye care in children who failed a visual acuity screening conducted by their primary care provider. Children aged 3-14 years who failed a visual acuity screening were identified. A phone survey with the parent of every child was conducted 4 months after the screening. Family demographics, parental awareness of childhood eye diseases and eye care for children, and barriers to follow-up eye care were assessed. Of 971 children sampled, 199 (20.5%) failed a visual acuity screening. The survey was completed by the parents of 58 children (29.1%), of whom 27 (46.6%) presented for follow-up examination. The most common reason for failure to follow-up was parental unawareness of screening results (29.3%). Follow-up rates were higher in children with previous eye examinations than in those without (81% versus 17%; P = 0.005) and in children who waited <2 months for a follow-up appointment than in those who had to wait longer (100% versus 63%; P = 0.024). Child's sex, ethnicity, and health insurance status, parent's marital, education and employment status, household income, and transportation access were not associated with statistically significant different follow-up rates. Parental unawareness of a failed visual acuity screening is an important barrier to obtaining follow-up. Strategies to improve follow-up rates after a failed visual acuity screening may include communicating the results clearly and consistently, providing education about the importance of timely follow-up, and offering logistic support for accessing eye appointments to families. Copyright © 2013 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

  7. The 20-min trial of the maintenance of wakefulness test is profoundly affected by motivation.

    PubMed

    Shreter, Roni; Peled, Ron; Pillar, Giora

    2006-12-01

    Assessment of the ability to maintain wakefulness, although very important both for research and for clinical purposes, is still equivocal. The current gold standard is considered the Maintenance of Wakefulness Test (MWT), although there are two different potential protocols to perform it and the normal reference range has been determined on selected populations. The effect of potential "penalty" on failing the test (i.e., presenting sleepiness) has not been seriously studied. We therefore planned this study to examine the effect of motivation on the MWT results in a potentially sleepy population. We hypothesized that with the knowledge that participants may lose their driving license if they fail the test, the results would indicate significantly less sleepiness than reported for other populations. Fifty-four consecutive subjects at high risk of sleepiness referred to the sleep laboratory for evaluation of their ability to maintain wakefulness were studied. All were referred by the National Council for Driving Safety, knowing that if they failed the test, their driving license would not be renewed. Referral reasons were previously diagnosed: obstructive sleep apnea (OSA; 43%), sleep-related accident (7%), or other causes to suspect sleepiness. All underwent a full-night polysomnography (PSG) followed by MWT, five trials of 20 min each (MWT20). Of the 54 participants, 13 were treated for OSA and 28 had untreated OSA, 21 of them had severe OSA (Respiratory Disturbance Index > 30/h). Seventy-four percent of the participants had a BMI >30 kg/m2. Only 5 of the participants fell asleep in any of the MWT trials (one to five trials), which could not be predicted by severity of OSA, age, BMI, or variables derived from the previous night PSG. Of the 21 patients with severe untreated OSA, only 1 patient fell asleep during the MWT20. We conclude that motivation profoundly affects the MWT results, raising the question what should be considered normal or abnormal when sleepy results may cause penalty or other practical implications. In addition, we believe that these results suggest that for renewal of driving license purposes, the MWT20 is insufficient. We speculate that MWT40, with tighter cutoff threshold, would be a more effective tool.

  8. 7 CFR 457.132 - Cranberry crop insurance provisions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    .... If you fail to notify us of any circumstance that may affect your yields from previous levels, we... considered acceptable by us; and (d) That are grown on vines that have completed four growing seasons after...: (i) A transfer of coverage and right to an indemnity, or a similar form approved by us, is completed...

  9. 7 CFR 457.132 - Cranberry crop insurance provisions.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    .... If you fail to notify us of any circumstance that may affect your yields from previous levels, we... considered acceptable by us; and (d) That are grown on vines that have completed four growing seasons after...: (i) A transfer of coverage and right to an indemnity, or a similar form approved by us, is completed...

  10. 7 CFR 457.132 - Cranberry crop insurance provisions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    .... If you fail to notify us of any circumstance that may affect your yields from previous levels, we... considered acceptable by us; and (d) That are grown on vines that have completed four growing seasons after...: (i) A transfer of coverage and right to an indemnity, or a similar form approved by us, is completed...

  11. 7 CFR 457.132 - Cranberry crop insurance provisions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    .... If you fail to notify us of any circumstance that may affect your yields from previous levels, we... considered acceptable by us; and (d) That are grown on vines that have completed four growing seasons after...: (i) A transfer of coverage and right to an indemnity, or a similar form approved by us, is completed...

  12. Procedural Justice, Distributive Justice: How Experiences with Downsizing Condition Their Impact on Organizational Commitment

    ERIC Educational Resources Information Center

    Clay-Warner, Jody; Hegtvedt, Karen A.; Roman, Paul

    2005-01-01

    Previous research demonstrates that both procedural justice and distributive justice are important predictors of work attitudes. This research, however, fails to examine conditions that affect the relative importance of each type of justice. Here we argue that prior experiences with regard to downsizing shape individuals' workplace schemas, which…

  13. Moral Reasoning in Gifted and Average I.Q. Third and Fourth Graders.

    ERIC Educational Resources Information Center

    Sager, Susan M.; Workman, Susan H.

    In an examination of the relationship between academic giftedness and the development of moral reasoning, six story pairs varying intentionality with either personal injury or property damage were group administered to 104 third and fourth graders, 52 of whom had been previously identified as gifted. Results failed to demonstrate any significant…

  14. Development and Assessment of a Molecular Structure and Properties Learning Progression

    ERIC Educational Resources Information Center

    Cooper, Melanie M.; Underwood, Sonia M.; Hilley, Caleb Z.; Klymkowsky, Michael W.

    2012-01-01

    Previously, we found that: (i) many students were unable to construct representations of simple molecular structures; (ii) a majority of students fail to make the important connection between these representations and macroscopic properties of the material; and (iii) they were unable to decode the information contained in such representations.…

  15. Self-Management Education for Rehabilitation Inpatients Suffering from Inflammatory Bowel Disease: A Cluster-Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Reusch, A.; Weiland, R.; Gerlich, C.; Dreger, K.; Derra, C.; Mainos, D.; Tuschhoff, T.; Berding, A.; Witte, C.; Kaltz, B.; Faller, H.

    2016-01-01

    Although inflammatory bowel disease (IBD) affects patients' psychological well-being, previous educational programs have failed to demonstrate effects on psychosocial outcomes and quality of life. Therefore, we developed a group-based psychoeducational program that combined provision of both medical information and psychological self-management…

  16. Three Insights About Change

    NASA Technical Reports Server (NTRS)

    Little, Terry

    2002-01-01

    Managers need to develop credibility, and need to base it upon new managerial accomplishments rather than previous ones. New and exciting jobs in management are challenging, but can lead to personal growth. Personnel who are afraid of potential negative consequences resulting from administrative changes are a hindrance to projects. An approval-seeking management style almost always fails.

  17. iss055e032444

    NASA Image and Video Library

    2018-04-25

    iss055e032444 (April 25, 2018) --- NASA astronaut Scott Tingle replaces a failed light bulb in a light to be used on a new external television camera group (ETVCG) that will be installed on an upcoming spacewalk. Parts from the old ETVCG, removed during a previous spacewalk, will be shipped back to Earth in Dragon for refurbishment.

  18. The Narrative Waltz: The Role of Flexibility in Writing Proficiency

    ERIC Educational Resources Information Center

    Allen, Laura K.; Snow, Erica L.; McNamara, Danielle S.

    2016-01-01

    A commonly held belief among educators, researchers, and students is that high-quality texts are easier to read than low-quality texts, as they contain more engaging narrative and story-like elements. Interestingly, these assumptions have typically failed to be supported by the literature on writing. Previous research suggests that higher quality…

  19. Rural Communities in an Advanced Industrial Society: Dilemmas and Opportunities.

    ERIC Educational Resources Information Center

    Blakely, Edward J.

    The major features previously used to define rural life now fail to describe much of rural America, as changes that place rural areas in the vanguard of American society are manifest in rural landscape, institutions, economic activity, and life. The principal policy thrusts of modernization and urbanization and the related theories of product…

  20. Development and Validation of a Scale Measuring Approaches to Work-Related Informal Learning

    ERIC Educational Resources Information Center

    Froehlich, Dominik E.; Beausaert, Simon; Segers, Mien

    2017-01-01

    Social approaches to work-related informal learning, such as proactive feedback-seeking, help-seeking and information-seeking, are important determinants of development in the workplace. Unfortunately, previous research has failed to clearly conceptualize these forms of learning and does not provide a validated and generally applicable measurement…

  1. Credit Recovery Programs. What Works Clearinghouse Intervention Report

    ERIC Educational Resources Information Center

    What Works Clearinghouse, 2015

    2015-01-01

    "Credit recovery programs" allow high school students to recover course credit, through in-school, online, or mixed modes, for classes they previously failed. The WWC reviewed the research on these programs and their impacts on middle school, junior high school, or high school students at risk of dropping out or who have already dropped…

  2. 48 CFR 52.212-4 - Contract Terms and Conditions-Commercial Items.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... issue a demand for payment to the Contractor upon finding a debt is due under the contract. (iii) Final... days; (B) The Contractor fails to liquidate a debt previously demanded by the Contracting Officer within the timeline specified in the demand for payment unless the amounts were not repaid because the...

  3. Back in the Game

    ERIC Educational Resources Information Center

    McCrea, Bridget

    2013-01-01

    In 2010, Attila J. Weninger was 61 and ready to retire. But he received a phone call. A recruitment firm hired by the Stevens Point (Wis.) Area Public School District called on Weninger to help the troubled district, which faced budget problems, vacancies in top cabinet positions, and two previously failed referendums. It was in sore need of new…

  4. Pacemaker failure resulting from radiation damage

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

    Quertermous, T.; Megahy, M.S.; Das Gupta, D.S.

    1983-07-01

    The authors present a case of radiation-induced pacemaker failure. After 2000 rad (20 Gy) of photon irradiation for metastatic bronchogenic carcinoma, the pulse generator circuitry failed, producing a runaway rhythm. This suggests that present pacemaker circuitry may be more susceptible to irradiation than previously believed, and that even modest radiation doses can induce life-threatening arrhythmias.

  5. Personality, Coping Style and Well-Being of Parents Rearing Children with Developmental Disabilities

    ERIC Educational Resources Information Center

    Glidden, L. M.; Billings, F. J.; Jobe, B. M.

    2006-01-01

    Background: Parents with children with developmental disabilities (DD) encounter a variety of stressors associated with rearing their children and must develop effective coping mechanisms in order to adapt successfully to these challenges. Previous research has failed to establish the role of parental individual differences in the reported use of…

  6. Connecticut's Children: Still at Risk. 1995 Data Update.

    ERIC Educational Resources Information Center

    Cunningham, Michelle Doucette

    This 1995 update to "Connecticut's Children: Still at Risk" is the second annual report examining how children in the state are faring. The title indicates that Connecticut's children are at tremendous risk of failing to become productive adults. The update does not repeat much of the general information from the previous year's…

  7. 40 CFR 86.1835-01 - Confirmatory certification testing.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... previously failed an emission standard; (ii) The test exhibits high emission levels determined by exceeding a...) The Administrator may require that any one or more of the test vehicles be submitted to the Agency, at such place or places as the Agency may designate, for the purposes of conducting emissions tests. The...

  8. Professors Can Be Friends of a Free Press Too.

    ERIC Educational Resources Information Center

    Ciofalo, Andrew

    A faculty adviser to the student newspaper at Loyola College, a small Catholic liberal arts college in Maryland, encountered difficulties concerning First Amendment rights. Previous efforts to establish guidelines for the student press by factions in the administration had failed, and the student newspaper has been able to solidify its First…

  9. 41 CFR 51-8.15 - Collection of fees and charges.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... charges. 51-8.15 Section 51-8.15 Public Contracts and Property Management Other Provisions Relating to... AVAILABILITY OF AGENCY MATERIALS § 51-8.15 Collection of fees and charges. (a) Except when prepayment is.... (c) In instances where a requester has previously failed to pay a fee, the Committee may require the...

  10. 41 CFR 51-8.15 - Collection of fees and charges.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... charges. 51-8.15 Section 51-8.15 Public Contracts and Property Management Other Provisions Relating to... AVAILABILITY OF AGENCY MATERIALS § 51-8.15 Collection of fees and charges. (a) Except when prepayment is.... (c) In instances where a requester has previously failed to pay a fee, the Committee may require the...

  11. 41 CFR 51-8.15 - Collection of fees and charges.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... charges. 51-8.15 Section 51-8.15 Public Contracts and Property Management Other Provisions Relating to... AVAILABILITY OF AGENCY MATERIALS § 51-8.15 Collection of fees and charges. (a) Except when prepayment is.... (c) In instances where a requester has previously failed to pay a fee, the Committee may require the...

  12. 41 CFR 51-8.15 - Collection of fees and charges.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... charges. 51-8.15 Section 51-8.15 Public Contracts and Property Management Other Provisions Relating to... AVAILABILITY OF AGENCY MATERIALS § 51-8.15 Collection of fees and charges. (a) Except when prepayment is.... (c) In instances where a requester has previously failed to pay a fee, the Committee may require the...

  13. 41 CFR 51-8.15 - Collection of fees and charges.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... charges. 51-8.15 Section 51-8.15 Public Contracts and Property Management Other Provisions Relating to... AVAILABILITY OF AGENCY MATERIALS § 51-8.15 Collection of fees and charges. (a) Except when prepayment is.... (c) In instances where a requester has previously failed to pay a fee, the Committee may require the...

  14. 34 CFR 5.62 - Advance payment of fees.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... anticipated cost and obtains satisfactory assurance of full payment if the requester has a history of prompt payment of FOIA fees; or (2) Requires an advance payment if the requester has no history of payment. (b) If a requester has previously failed to pay a fee in a timely fashion, the FOI Officer does not...

  15. 5 CFR 2604.504 - Miscellaneous fee provisions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... be required to provide satisfactory assurance of full payment where the requester has a history of... estimated charges in the case of requesters with no history of payment; or (2) A requester has previously failed to pay a fee charged in a timely fashion (i.e., within 30 days of the date of the billing). In...

  16. 11 CFR 4.9 - Fees.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Commission will notify the requestor of the likely cost and, where the requestor has a history of prompt... FOIA fee payment history, the Commission will require an advance payment of an amount up to the full estimated charges; or (2) A requestor has previously failed to pay a fee in a timely fashion (i.e., within...

  17. Measuring and Monitoring in the South African "Kha Ri Gude" Mass Literacy Campaign

    ERIC Educational Resources Information Center

    McKay, Veronica

    2015-01-01

    After many previous failed attempts to reach illiterate adults, the award-winning South African "Kha Ri Gude" mass literacy campaign, launched in 2008, undertook to ensure that learners seized the opportunity to learn--for many adults, this was a "last chance". Written from an insider perspective by the campaign's founding…

  18. Role of autologous non-vascularised intramedullary fibular strut graft in humeral shaft nonunions following failed plating.

    PubMed

    Kashayi-Chowdojirao, Sreekanth; Vallurupalli, Aashish; Chilakamarri, Vijay Krishna; Patnala, Chandrasekhar; Chodavarapu, Lalith Mohan; Kancherla, Nageswara Rao; Khazi Syed, Asif Hussain

    2017-11-01

    Non-union humeral shaft fractures are seen frequently in clinical practice at about 2-10% in conservative management and 30% in surgically operated patients. Osteosynthesis using dynamic compression plate (DCP), intramedullary nailing, locking compression plate (LCP), Ilizarov technique along with bone grafting have been reported previously. In cases of prior failed plate-screw osteosynthesis the resultant osteopenia, cortical defect, bone loss, scalloping around screws and metallosis, make the management of non-union more complicated. Fibular graft as an intramedullary strut is useful in these conditions by increasing screw purchase, union and mechanical stability. This study is a retrospective and prospective follow up of revision plating along with autologous non-vascularised intramedullary fibular strut graft (ANVFG) for humeral non-unions following failed plate osteosynthesis. Seventy eight cases of nonunion humeral shaft fractures were managed in our institute between 2008 and 2015. Of these, 57 cases were failed plate osteosynthesis, in which 15 cases were infected and 42 cases were noninfected. Out of the 78 cases, bone grafting was done in 55 cases. Fibular strut graft was used in 22 patients, of which 4 cases were of primary nonunion with osteoporotic bone. Applying the exclusion criteria of infection and inclusion criteria of failed plate osteosynthesis managed with revision plating using either LCP or DCP and ANVFG, 17 cases were studied. The mean age of the patients was 40.11 yrs (range: 26-57 yrs). The mean duration of non-union was 4.43 yrs (range: 0.5-14 yrs). The mean follow-up period was 33.41 months (range: 12-94 months). The average length of fibula was 10.7 cm (range: 6-15 cm). Main outcome measurements included bony union by radiographic assessment and pre- and postoperative functional evaluation using the DASH (Disabilities of the Arm, Shoulder and Hand) score. Results: Sixteen out of 17 fractures united following revision plating and fibular strut grafting. Average time taken for union was 3.5 months (range: 3-5 months). Complications included one each of implant failure with bending, transient radial nerve palsy and transient ulnar nerve palsy. No case had infection, graft site morbidity or peroneal nerve palsy. Functional assessment by DASH score improved from 59.14 (range: 43.6-73.21) preoperatively to 23.39 (range: 8.03-34.2) postoperatively (p = 0.0003). Conclusion: The results of our study indicate that revision plating along with ANVFG is a reliable option in humeral diaphyseal non-unions with failed plate-screw osteosynthesis providing adequate screw purchase, mechanical stability and high chances of union with good functional outcome.

  19. Perception of foreign cigarettes and their advertising in China: a study of college students from 12 universities.

    PubMed

    Zhu, S H; Li, D; Feng, B; Zhu, T; Anderson, C M

    1998-01-01

    To examine how deeply foreign cigarette advertising had penetrated the Chinese market when a new ban on cigarette advertising was enacted in February 1995. A survey using self-completion questionnaires administered in college classrooms from November 1994 to March 1995. Eight universities and four medical schools in three Chinese cities: Beijing, Wenzhou, and Hangzhou. 1896 college students who agreed to complete a written questionnaire. The mean age was 21.2 years; 39.5% of respondents were female. Four of the top eight cigarette brands most familiar to the respondents were foreign: Marlboro, 555, Kent, and Hilton. Advertisements for the foreign brands were much more likely to be seen than those for the domestic brands; those for Marlboro were reported most often (29.7%), followed by 555 (21.8%) and Kent (18.1%). Among smokers, Marlboro was the most preferred foreign brand, by 44.2%. The preference for Marlboro was also correlated with smokers having seen its advertisements. Most respondents, 71.8%, believed that cigarette advertising should be banned. The previous restrictions on cigarette advertising in China failed to prevent a large portion of the population from seeing and understanding the advertisements. Before the 1995 advertising ban took effect, strict limitations on imports of foreign cigarettes notwithstanding, certain highly advertised brands such as Marlboro achieved wide recognition and even consumer preference. Stricter restrictions are suggested as previous ones have failed to achieve their intended effects.

  20. Factors affecting the results of comprehensive pre-internship exam among medical students of Kermanshah University of Medical Sciences.

    PubMed

    Khazaei, Mohammad Rasool; Zarin, Afshin; Rezaei, Mansuor; Khazaei, Mozafar

    2018-06-01

    This study was aimed to evaluate the factors affecting the results of comprehensive pre-internship exam (CPIE) among medicals students of Kermanshah University of Medical Sciences. In this descriptive-analytical study, all students (n=240) participating in CPIE over a 3-year period (2012-2014) were selected. Data were gathered by a questionnaire, including the CPIE results and educational and demographic data. Spearman correlation coefficient, Mann-Whitney U-test, and analysis of variance were used to analyze the association of students' success with study variables. Also, regression analysis was applied to determine the role of independent variables in students' success. The frequency of the failed units in apprenticeship course was one of the most important risk factors associated with failure in CPIE. Average scores of pre-internship course were the most important factors of success in CPIE. The CPIE score had the highest direct relationship with grade point average (GPA) of apprenticeship course, total GPA of all three courses, GPAs of physiopathology and basic sciences courses, and score of comprehensive basic sciences examination, respectively. CPIE showed the highest inverse correlation with the number of failed units in apprenticeship course. The most important factors influencing this exam were failure in apprenticeship course and GPA of previous educational stages.

  1. The importance of scaling for detecting community patterns: success and failure in assemblages of introduced species

    USGS Publications Warehouse

    Allen, Craig R.; Angeler, David G.; Moulton, Michael P.; Holling, Crawford S.

    2015-01-01

    Community saturation can help to explain why biological invasions fail. However, previous research has documented inconsistent relationships between failed invasions (i.e., an invasive species colonizes but goes extinct) and the number of species present in the invaded community. We use data from bird communities of the Hawaiian island of Oahu, which supports a community of 38 successfully established introduced birds and where 37 species were introduced but went extinct (failed invasions). We develop a modified approach to evaluate the effects of community saturation on invasion failure. Our method accounts (1) for the number of species present (NSP) when the species goes extinct rather than during its introduction; and (2) scaling patterns in bird body mass distributions that accounts for the hierarchical organization of ecosystems and the fact that interaction strength amongst species varies with scale. We found that when using NSP at the time of extinction, NSP was higher for failed introductions as compared to successful introductions, supporting the idea that increasing species richness and putative community saturation mediate invasion resistance. Accounting for scale-specific patterns in body size distributions further improved the relationship between NSP and introduction failure. Results show that a better understanding of invasion outcomes can be obtained when scale-specific community structure is accounted for in the analysis.

  2. A geographical assessment of vegetation carbon stocks and greenhouse gas emissions on potential microalgae-based biofuel facilities in the United States.

    PubMed

    Quiroz Arita, Carlos; Yilmaz, Özge; Barlak, Semin; Catton, Kimberly B; Quinn, Jason C; Bradley, Thomas H

    2016-12-01

    The microalgae biofuels life cycle assessments (LCA) present in the literature have excluded the effects of direct land use change (DLUC) from facility construction under the assumption that DLUC effects are negligible. This study seeks to model the greenhouse gas (GHG) emissions of microalgae biofuels including DLUC by quantifying the CO 2 equivalence of carbon released to the atmosphere through the construction of microalgae facilities. The locations and types of biomass and Soil Organic Carbon that are disturbed through microalgae cultivation facility construction are quantified using geographical models of microalgae productivity potential including consideration of land availability. The results of this study demonstrate that previous LCA of microalgae to biofuel processes have overestimated GHG benefits of microalgae-based biofuels production by failing to include the effect of DLUC. Previous estimations of microalgae biofuel production potential have correspondingly overestimated the volume of biofuels that can be produced in compliance with U.S. environmental goals. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Association Reactions at Low Pressure: 5. The CH(sub 3)+/HCN System. A Final Word?

    NASA Technical Reports Server (NTRS)

    Anicich, V.; Sen, A.; Huntress, W.; McEwan, M.

    1994-01-01

    The reaction of the methyl cation with hydrogen cyanide is revisited. We have confidence that we have resolved a long standing apparent contradiction of experimental results. A literature history is presented along with one new experiment and a reexamination of an old experiment. In this present work it is shown that all of the previous studies had made consistent observations. Yet, each of the previous studies failed to observe all of the information present. The methyl cation does react with HCN by radiative association, a fact which had been in doubt. The product ions formed in the two-body and three-body processes react differently with HCN. The collisionally stabilized association product formed by a three-body mechanism does not react with HCN and is readily detected in the experiments. The radiatively stabilized association product, formed by a slow two-body reaction, is not detected because it reacts with HCN by a fast proton transfer reaction forming the protonated HCN ion.

  4. Neutralizing antibody fails to impact the course of Ebola virus infection in monkeys.

    PubMed

    Oswald, Wendelien B; Geisbert, Thomas W; Davis, Kelly J; Geisbert, Joan B; Sullivan, Nancy J; Jahrling, Peter B; Parren, Paul W H I; Burton, Dennis R

    2007-01-01

    Prophylaxis with high doses of neutralizing antibody typically offers protection against challenge with viruses producing acute infections. In this study, we have investigated the ability of the neutralizing human monoclonal antibody, KZ52, to protect against Ebola virus in rhesus macaques. This antibody was previously shown to fully protect guinea pigs from infection. Four rhesus macaques were given 50 mg/kg of neutralizing human monoclonal antibody KZ52 intravenously 1 d before challenge with 1,000 plaque-forming units of Ebola virus, followed by a second dose of 50 mg/kg antibody 4 d after challenge. A control animal was exposed to virus in the absence of antibody treatment. Passive transfer of the neutralizing human monoclonal antibody not only failed to protect macaques against challenge with Ebola virus but also had a minimal effect on the explosive viral replication following infection. We show that the inability of antibody to impact infection was not due to neutralization escape. It appears that Ebola virus has a mechanism of infection propagation in vivo in macaques that is uniquely insensitive even to high concentrations of neutralizing antibody.

  5. A comparison of sea surface salinity in the equatorial Pacific Ocean during the 1997-1998, 2012-2013, and 2014-2015 ENSO events

    NASA Astrophysics Data System (ADS)

    Corbett, Caroline M.; Subrahmanyam, Bulusu; Giese, Benjamin S.

    2017-11-01

    Sea surface salinity (SSS) variability during the 1997-1998 El Niño event and the failed 2012-2013 and 2014-2015 El Niño events is explored using a combination of observations and ocean reanalyses. Previously, studies have mainly focused on the sea surface temperature (SST) and sea surface height (SSH) variability. This analysis utilizes salinity data from Argo and the Simple Ocean Data Assimilation (SODA) reanalysis to examine the SSS variability. Advective processes and evaporation minus precipitation (E-P) variability is understood to influence SSS variability. Using surface wind, surface current, evaporation, and precipitation data, we analyze the causes for the observed SSS variability during each event. Barrier layer thickness and upper level salt content are also examined in connection to subsurface salinity variability. Both advective processes and E-P variability are important during the generation and onset of a successful El Niño, while a lack of one or both of these processes leads to a failed ENSO event.

  6. Relations of children's proactive and reactive assertiveness to peer acceptance: moderating effects of social interest.

    PubMed

    Lee, Han-Jong

    2014-06-01

    Previous studies on the social outcome of assertiveness reported mixed findings, failing to support the assumption that assertiveness promotes peer acceptance. In an attempt to provide explanations for the inconsistencies in prior findings, this study proposed making a distinction between proactive and reactive assertiveness and examined the moderating effects of social interest. A total of 441 fifth and sixth graders (232 boys, 209 girls; M age = 10.6 yr., SD = 0.6) participated in the study. Results indicated that proactive assertiveness was positively related to peer acceptance regardless of social interest. By contrast, reactive assertiveness was positively related to peer acceptance but only when social interest is high. When social interest is low, it was negatively associated with peer acceptance.

  7. Failed surrogate conceptions: social and ethical aspects of preconception disruptions during commercial surrogacy in India.

    PubMed

    Mitra, Sayani; Schicktanz, Silke

    2016-09-19

    During a commercial surrogacy arrangement, the event of embryo transfer can be seen as the formal starting point of the arrangement. However, it is common for surrogates to undergo a failed attempt at pregnancy conception or missed conception after an embryo transfer. This paper attempts to argue that such failed attempts can be understood as a loss. It aims to reconstruct the experiences of loss and grief of the surrogates and the intended parents as a consequence of their collective failure to conceive a surrogate pregnancy. Drawing on a qualitative study conducted over a period of eight months between 2014 and 2015 at two fertility clinics in Delhi and two in Kolkata, India, this paper examines the experiences of the surrogates and the intended parents when faced with missed conceptions or failed conceptions during a surrogacy arrangement. We argue that while the surrogate grieves the non-arrival of a 'good news' as an uncertain loss, the intended parents experience yet another, failure in addition to the losses they might have incurred during their previous fertility treatments. The body of the surrogate becomes a site of 'a lost opportunity'. The surrogate embodies a loss in her quest to achieve social mobility and the intended parents experience a disembodied pregnancy loss. This very emotional experience stands in stark contrast to the conceptualisation of such failed attempts as non-events within the discourse of the surrogacy industry. The experience of loss of the intended parents is recognised but their grief is given no space. We argue that such ambiguity around the nature of losses resulting out of a missed or failed conception during surrogacy is an outcome of lack of interpersonal relationship between the surrogate and the intended parents. Since commercial surrogacy is a relational process, the only way in which the experiences of losses and failures of the actors at the preconception stage can be better addressed is through developing close sharing and understanding between each other through an ethics of care. Therefore, to nurture caring relationships, surrogacy needs to be understood as a moral commitment by -the surrogates and intended parents. To enable such a commitment, there is a need to reconsider the pre-defined and legally regulated professional duty of the doctors, agents and agencies. It cannot be a one-sided commitment, but has to have elements of mutuality.

  8. Perceptions of Suicide Stigma.

    PubMed

    Frey, Laura M; Hans, Jason D; Cerel, Julie

    2016-03-01

    Previous research has failed to examine perceptions of stigma experienced by individuals with a history of suicidal behavior, and few studies have examined how stigma is experienced based on whether it was perceived from treatment providers or social network members. This study examined stigma experienced by individuals with previous suicidal behavior from both treatment providers and individuals in one's social and family networks. Individuals (n = 156) with a lifetime history of suicidal behavior were recruited through the American Association of Suicidology listserv. Respondents reported the highest rates of perceived stigma with a close family member (57.1%) and emergency department personnel (56.6%). Results indicated that individuals with previous suicidal behavior were more likely to experience stigma from non-mental health providers and social network members than from mental health providers. A hierarchical regression model including both source and type of stigma accounted for more variance (R(2) = .14) in depression symptomology than a model (R(2) = .06) with only type of stigma. Prevalence of stigma perceived from social network members was the best predictor of depression symptom severity. These findings highlight the need for future research on how social network members react to suicide disclosure and potential interventions for improving interactions following disclosure.

  9. Risk factors for Wilms tumor. Report from the National Wilms Tumor Study.

    PubMed

    Olshan, A F; Breslow, N E; Falletta, J M; Grufferman, S; Pendergrass, T; Robison, L L; Waskerwitz, M; Woods, W G; Vietti, T J; Hammond, G D

    1993-08-01

    Previous epidemiologic studies have indicated that several factors may be associated with an increased risk of Wilms tumor including paternal occupational exposures, maternal exposure during pregnancy to cigarettes, coffee or tea, oral contraceptives, hormonal pregnancy tests, hair-coloring products, maternal hypertension, vaginal infection during pregnancy, and higher birth weight of the child. The current study examines the nonoccupational risk factors using questionnaire data from a large national collaborative clinical trial. Parents of 200 children registered with the National Wilms Tumor Study and 233 matched controls, identified using telephone random-digit dialing, completed a self-administered questionnaire about a variety of risk factors. As opposed to some previous studies, no association was found for mother's smoking during pregnancy (10+ cigarettes per day; odds ratio [OR] = 0.73; 95% confidence interval [CI] = 0.40-1.34), maternal consumption of coffee or tea during pregnancy (4+ cups per day; OR = 1.31; CI = 0.57-3.01), or hypertension during pregnancy (OR = 0.96; CI = 0.45-2.06). In addition, no association was found in this study for hormone exposure during pregnancy, hair dye use, vaginal infection during pregnancy, or high birth weight. A previously unreported association with a history of household insect extermination was found (OR = 2.16; CI = 1.24-3.75). In general, the study failed to confirm most of the previously reported maternal risk factors for Wilms tumor. Understanding the possible role of paternal exposures may be the best objective for further research on potential risk factors for Wilms tumor.

  10. Genome-wide association study of ancestry-specific TB risk in the South African Coloured population

    PubMed Central

    Chimusa, Emile R.; Zaitlen, Noah; Daya, Michelle; Möller, Marlo; van Helden, Paul D.; Mulder, Nicola J.; Price, Alkes L.; Hoal, Eileen G.

    2014-01-01

    The worldwide burden of tuberculosis (TB) remains an enormous problem, and is particularly severe in the admixed South African Coloured (SAC) population residing in the Western Cape. Despite evidence from twin studies suggesting a strong genetic component to TB resistance, only a few loci have been identified to date. In this work, we conduct a genome-wide association study (GWAS), meta-analysis and trans-ethnic fine mapping to attempt the replication of previously identified TB susceptibility loci. Our GWAS results confirm the WT1 chr11 susceptibility locus (rs2057178: odds ratio = 0.62, P = 2.71e−06) previously identified by Thye et al., but fail to replicate previously identified polymorphisms in the TLR8 gene and locus 18q11.2. Our study demonstrates that the genetic contribution to TB risk varies between continental populations, and illustrates the value of including admixed populations in studies of TB risk and other complex phenotypes. Our evaluation of local ancestry based on the real and simulated data demonstrates that case-only admixture mapping is currently impractical in multi-way admixed populations, such as the SAC, due to spurious deviations in average local ancestry generated by current local ancestry inference methods. This study provides insights into identifying disease genes and ancestry-specific disease risk in multi-way admixed populations. PMID:24057671

  11. Vedolizumab as a rescue therapy for patients with medically refractory Crohn's disease.

    PubMed

    Crowell, K T; Tinsley, A; Williams, E D; Coates, M D; Bobb, A; Koltun, W A; Messaris, E

    2018-04-19

    Vedolizumab, a monoclonal antibody resulting in gut-selective anti-inflammatory activity, was approved by the US Food and Drug Administration in 2014 for use in patients with Crohn's disease (CD). The aim of this study was to investigate the efficacy of vedolizumab as a rescue therapy when other medical therapies have failed. A retrospective review was performed on consecutive patients with CD receiving vedolizumab at the Penn State Hershey IBD Center between May 2014 and March 2016. These patients were unresponsive or intolerant to tumour necrosis factor (TNF) antagonist therapy, and previously would have been candidates for surgery. Outcomes included surgical intervention, clinical response and endoscopic improvement. A total of 48 patients with medically refractory CD receiving vedolizumab were included. The median length of follow-up was 69 weeks (range 15-113 weeks). A majority (81%) of patients previously failed at least two TNF antagonists, and 77% had prior surgery for CD. Surgical intervention was required in 21 (44%) patients and 13 (27%) patients required intra-abdominal operations. At the conclusion of the study, 23 (48%) patients reported continued improvement of symptoms, and 22 of 37 (59%) patients undergoing endoscopy showed improvement. Patients with the inflammatory CD phenotype were more likely to improve clinically and avoid surgery. Vedolizumab alone or in combination with immunomodulators or steroids may be used as a rescue therapy in patients with medically refractory CD and may decrease the rate of surgical intervention. Patients with the inflammatory CD phenotype had the best clinical response and decreased need for surgery, suggesting that vedolizumab is most effective in the inflammatory phenotype. Colorectal Disease © 2018 The Association of Coloproctology of Great Britain and Ireland.

  12. Endoscopic variceal ligation for primary prophylaxis of esophageal variceal hemorrhage in pre-liver transplant patients.

    PubMed

    Lim, Eu Jin; Gow, Paul J; Angus, Peter W

    2009-11-01

    Endoscopic variceal ligation (EVL) is widely used to prevent esophageal variceal bleeding in patients with advanced cirrhosis. However, the safety and efficacy of EVL in this setting have not been clearly established. This study included 300 adult patients with cirrhosis on our liver transplant waitlist who underwent upper gastrointestinal endoscopy. Esophageal varices deemed to be at high risk of bleeding were banded until eradication or transplantation. A retrospective review of patient notes and endoscopy databases was undertaken, and the number of banding episodes, complications, and patient outcomes were recorded. Forty-two of 300 patients presented with or had previous variceal bleeding prior to referral and were excluded from the analysis. Of the remaining 258 patients, 101 underwent a total of 259 banding episodes (2.6 per patient) with a median follow-up post-banding of 18.4 months per patient (a total of 150 patient years). Failed prophylaxis occurred in 2 patients (2%), and there were 3 episodes (1.2%) of acute hematemesis from band-induced ulceration. One patient (1%) had mild esophageal stricturing post-banding without dysphagia. Four of 36 patients (11%) previously found to have moderately sized or larger varices that were not banded presented with hematemesis due to variceal bleeding and were subsequently banded. None of the patients that received banding died because of bleeding or failed to receive a transplant as a result of banding complications. This study shows that in liver transplant candidates, EVL is highly effective in preventing first variceal bleed. Although banding carries a small risk of band-induced bleeding, this rate is low in comparison with the predicted rate of variceal bleeding in this population.

  13. Pegylated interferon de novo-induce autoimmune haemolytic anaemia in chronic hepatitis C patient.

    PubMed

    Said, Ashraf; Elbahrawy, Ashraf; Alfiomy, Mohamed; Abdellah, Mohamed; Shahat, Khaled; Salah, Mohamed; Mostafa, Sadek; Elwassief, Ahmed; Aboelfotoh, Attef; Abdelhafeez, Hafez; El-Sherif, Assem

    2011-08-11

    A 55-year-old Egyptian woman with chronic hepatitis C undergoing treatment with pegylated interferon (Peg-IFN) alfa-2a plus ribavirin was referred to our hospital on November 2010 with prolonged easy fatigability and an attack of syncope; she had no prior history of autoimmune disorders or allergy. Laboratory investigations documented the presence of Peg-IFN induced autoimmune haemolytic anaemia and autoimmune thyroiditis. Intravenous γ globulin (IVGG) failed to correct the autoimmune process; on the other hand steroid therapy dramatically corrected both haematological and thyroid values, and step down the immune process. Our report indicated that Peg-IFN de novo-induce autoimmune haemolysis, documenting a previous report. IVGG failed to step down the immune process in our case.

  14. Pegylated interferon de novo-induce autoimmune haemolytic anaemia in chronic hepatitis C patient

    PubMed Central

    Said, Ashraf; Elbahrawy, Ashraf; Alfiomy, Mohamed; Abdellah, Mohamed; Shahat, Khaled; Salah, Mohamed; Mostafa, Sadek; Elwassief, Ahmed; Aboelfotoh, Attef; Abdelhafeez, Hafez; El-Sherif, Assem

    2011-01-01

    A 55-year-old Egyptian woman with chronic hepatitis C undergoing treatment with pegylated interferon (Peg-IFN) alfa-2a plus ribavirin was referred to our hospital on November 2010 with prolonged easy fatigability and an attack of syncope; she had no prior history of autoimmune disorders or allergy. Laboratory investigations documented the presence of Peg-IFN induced autoimmune haemolytic anaemia and autoimmune thyroiditis. Intravenous γ globulin (IVGG) failed to correct the autoimmune process; on the other hand steroid therapy dramatically corrected both haematological and thyroid values, and step down the immune process. Our report indicated that Peg-IFN de novo-induce autoimmune haemolysis, documenting a previous report. IVGG failed to step down the immune process in our case. PMID:22688484

  15. Resolution of hypothyroidism after correction of somatovisceral reflex dysfunction by refusion of the cervical spine.

    PubMed

    Berkowitz, Murray R

    2015-01-01

    Psychosis is a rare initial presentation of new-onset hypothyroidism. The author describes the case of a 29-year-old woman who presented with psychosis caused by hypothyroidism, or myxedema madness. Although the patient's psychosis resolved after standard monotherapy using levothyroxine sodium, her hypothyroidism persisted. Imaging of the patient's cervical spine showed that previous C5-C6 and C6-C7 fusions had failed. The failed fusions were corrected, and the patient's hypothyroidism resolved, suggesting that the somatovisceral reflex was the cause of the patient's hypothyroidism. Although somatovisceral reflex dysfunctions are rare, physicians should consider them as potential underlying causes of their patients' presenting medical conditions. © 2015 The American Osteopathic Association.

  16. Improvement program for polycarbonate capacitors. [hermetically sealed, and ac wound

    NASA Technical Reports Server (NTRS)

    Bailey, R. R.; Waterman, K. D.

    1973-01-01

    Hermetically sealed, wound, AC, polycarbonate capacitors incorporating design improvements recommended in a previous study were designed and built. A 5000 hour, 400 Hz ac life test was conducted using 384 of these capacitors to verify the adequacy of the design improvements. The improvements incorporated in the capacitors designed for this program eliminated the major cause of failure found in the preceding work, termination failure. A failure cause not present in the previous test became significant in this test with capacitors built from one lot of polycarbonate film. The samples from this lot accounted for 25 percent of the total test complement. Analyses of failed samples showed that the film had an excessive solvent content. This solvent problem was found in 37 of the total 46 failures which occurred in this test. The other nine were random failures resulting from causes such as seal leaks, foreign particles, and possibly wrinkles.

  17. Accurate guide wire of lag screw placement in the intertrochanteric fractures: a technical note.

    PubMed

    Li, Jiang; Wang, Liao; Li, Xiaodong; Feng, Kai; Tang, Jian; Wang, Xiaoqing

    2017-09-01

    Cephalomedullary fixations are commonly used in the treatment of intertrochanteric fractures. In clinical practice, one of the difficulties is when we exit the guide wire in a wrong position of femoral neck and insert near the hole again, the guide wire often flow into the previous track. This study develops a surgical technique to direct the guide wire to slip away the previous track and slip into a right position. When guide wire is exited to the cortex of femoral, we let the wire in and out at the cortical layer for several times to enlarge the entry hole. After that, electric drill is inverted, rubbed and entered slowly at a right angle. When guide wire encountered new resistance, the electric drill is turned back instantly. This technique can help trauma and orthopedic surgeons to obtain precision placement of the lag screw after the first try is failed.

  18. Early-warning signals of critical transition: Effect of extrinsic noise

    NASA Astrophysics Data System (ADS)

    Qin, Shanshan; Tang, Chao

    2018-03-01

    Complex dynamical systems often have tipping points and exhibit catastrophic regime shift. Despite the notorious difficulty of predicting such transitions, accumulating studies have suggested the existence of generic early-warning signals (EWSs) preceding upcoming transitions. However, previous theories and models were based on the effect of the intrinsic noise (IN) when a system is approaching a critical point, and did not consider the pervasive environmental fluctuations or the extrinsic noise (EN). Here, we extend previous theory to investigate how the interplay of EN and IN affects EWSs. Stochastic simulations of model systems subject to both IN and EN have verified our theory and demonstrated that EN can dramatically alter and diminish the EWS. This effect is stronger with increasing amplitude and correlation time scale of the EN. In the presence of EN, the EWS can fail to predict or even give a false alarm of critical transitions.

  19. Are blood group isoantigens lost from malignant prostatic epithelium? Immunohistochemical support for the preservation of the H isoantigen.

    PubMed Central

    Vowden, P.; Lowe, A. D.; Lennox, E. S.; Bleehen, N. M.

    1986-01-01

    Previous studies while demonstrating the presence of blood group isoantigens on normal prostatic epithelium have failed to identify such antigens on malignant prostatic tissue. Using a series of blood group specific monoclonal antibodies directed towards the A, B, H and Y antigens we have reinvestigated blood group isoantigen expression in both benign prostatic hypertrophy and prostatic adenocarcinoma. Results obtained from areas of benign prostatic hypertrophy are in broad agreement with those published however though we were unable to detect either A or B blood group isoantigens Type 2H and Y isoantigens were identified in 10 of the 12 tumours. These findings, while differing from previously reported results, lend support to the suggested connection between ontogenesis, oncogenesis and blood group isoantigen expression and also support the proposed link between Type 2 structures and malignant transformation. Images Figure 1 Figure 2 PMID:2421753

  20. Statistical Mechanics Model of Solids with Defects

    NASA Astrophysics Data System (ADS)

    Kaufman, M.; Walters, P. A.; Ferrante, J.

    1997-03-01

    Previously(M.Kaufman, J.Ferrante,NASA Tech. Memor.,1996), we examined the phase diagram for the failure of a solid under isotropic expansion and compression as a function of stress and temperature with the "springs" modelled by the universal binding energy relation (UBER)(J.H.Rose, J.R.Smith, F.Guinea, J.Ferrante, Phys.Rev.B29, 2963 (1984)). In the previous calculation we assumed that the "springs" failed independently and that the strain is uniform. In the present work, we have extended this statistical model of mechanical failure by allowing for correlations between "springs" and for thermal fluctuations in strains. The springs are now modelled in the harmonic approximation with a failure threshold energy E0, as an intermediate step in future studies to reinclude the full non-linear dependence of the UBER for modelling the interactions. We use the Migdal-Kadanoff renormalization-group method to determine the phase diagram of the model and to compute the free energy.

  1. Growth and Morphology of Phase Separating Supercritical Fluids

    NASA Technical Reports Server (NTRS)

    Hegseth, John; Beysens, Daniel; Perrot, Francoise; Nikolayev, Vadim; Garrabos, Yves

    1996-01-01

    The scientific objective is to study the relation between the morphology and the growth kinetics of domains during phase separation. We know from previous experiments performed near the critical point of pure fluids and binary liquids that there are two simple growth laws at late times. The 'fast' growth appears when the volumes of the phases are nearly equal and the droplet pattern is interconnected. In this case the size of the droplets grows linearly in time. The 'slow' growth appears when the pattern of droplets embedded in the majority phase is disconnected. In this case the size of the droplets increases in proportion to time to the power 1/3. The volume fraction of the minority phase is a good candidate to determine this change of behavior. All previous attempts to vary the volume fraction in a single experimental cell have failed because of the extreme experimental difficulties.

  2. The whole-genome landscape of medulloblastoma subtypes

    PubMed Central

    Northcott, Paul A.; Buchhalter, Ivo; Morrissy, A. Sorana; Hovestadt, Volker; Weischenfeldt, Joachim; Ehrenberger, Tobias; Groebner, Susanne; Segura-Wang, Maia; Zichner, Thomas; Rudneva, Vasilisa; Warnatz, Hans-Jörg; Sidiropoulos, Nikos; Phillips, Aaron H.; Schumacher, Steven; Kleinheinz, Kortine; Waszak, Sebastian M.; Erkek, Serap; Jones, David T.W.; Worst, Barbara C.; Kool, Marcel; Zapatka, Marc; Jäger, Natalie; Chavez, Lukas; Hutter, Barbara; Bieg, Matthias; Paramasivam, Nagarajan; Heinold, Michael; Gu, Zuguang; Ishaque, Naveed; Jäger-Schmidt, Christina; Imbusch, Charles D.; Jugold, Alke; Hübschmann, Daniel; Risch, Thomas; Amstislavskiy, Vyacheslav; Gonzalez, Francisco German Rodriguez; Weber, Ursula D.; Wolf, Stephan; Robinson, Giles W.; Zhou, Xin; Wu, Gang; Finkelstein, David; Liu, Yanling; Cavalli, Florence M.G.; Luu, Betty; Ramaswamy, Vijay; Wu, Xiaochong; Koster, Jan; Ryzhova, Marina; Cho, Yoon-Jae; Pomeroy, Scott L.; Herold-Mende, Christel; Schuhmann, Martin; Ebinger, Martin; Liau, Linda M.; Mora, Jaume; McLendon, Roger E.; Jabado, Nada; Kumabe, Toshihiro; Chuah, Eric; Ma, Yussanne; Moore, Richard A.; Mungall, Andrew J.; Mungall, Karen L.; Thiessen, Nina; Tse, Kane; Wong, Tina; Jones, Steven J.M.; Witt, Olaf; Milde, Till; Von Deimling, Andreas; Capper, David; Korshunov, Andrey; Yaspo, Marie-Laure; Kriwacki, Richard; Gajjar, Amar; Zhang, Jinghui; Beroukhim, Rameen; Fraenkel, Ernest; Korbel, Jan O.; Brors, Benedikt; Schlesner, Matthias; Eils, Roland; Marra, Marco A.; Pfister, Stefan M.; Taylor, Michael D.; Lichter, Peter

    2018-01-01

    Summary Current therapies for medulloblastoma (MB), a highly malignant childhood brain tumor, impose debilitating effects on the developing child, warranting deployment of molecularly targeted treatments with reduced toxicities. Prior studies failed to disclose the full spectrum of driver genes and molecular processes operative in MB subgroups. Herein, we detail the somatic landscape across 491 sequenced MBs and molecular heterogeneity amongst 1,256 epigenetically analyzed cases, identifying subgroup-specific driver alterations including previously unappreciated actionable targets. Driver mutations explained the majority of Group 3 and Group 4 patients, remarkably enhancing previous knowledge. Novel molecular subtypes were differentially enriched for specific driver events, including hotspot in-frame insertions targeting KBTBD4 and ‘enhancer hijacking’ driving PRDM6 activation. Thus, application of integrative genomics to an unprecedented cohort of clinical samples derived from a single childhood cancer entity disclosed a series of new cancer genes and biologically relevant subtype diversity that represent attractive therapeutic targets for treating MB patients. PMID:28726821

  3. The role of past interactions in great apes' communication about absent entities.

    PubMed

    Bohn, Manuel; Call, Josep; Tomasello, Michael

    2016-11-01

    Recent evidence suggests that great apes can use the former location of an entity to communicate about it. In this study we built on these findings to investigate the social-cognitive foundations of great apes' communicative abilities. We tested whether great apes (n = 35) would adjust their requests for absent entities to previous interactions they had with their interlocutor. We manipulated the apes' experience with respect to the interlocutor's knowledge about the previous content of the now-empty location as well as their experience with the interlocutor's competence to provide additional food items. We found that apes adjusted their requests to both of these aspects but failed to integrate them with one another. These results demonstrate a surprising amount of flexibility in great apes' communicative abilities while at the same time suggesting some important limitations in their social communicative skills. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  4. Immunohistochemistry of the lymphoid tissues of the tammar wallaby, Macropus eugenii

    PubMed Central

    Old, Julie M; Deane, Elizabeth M

    2002-01-01

    The lymphoid tissues of the metatherian mammal, the adult tammar wallaby, Macropus eugenii, were investigated using immunohistochemical techniques. Five cross-reactive antibodies previously shown to recognize surface markers in marsupial tissues and five previously untested antibodies were used. The distribution of T-cells in the tissue beds of spleen, lymph node, thymus, gut-associated lymphoid tissue (GALT) and bronchus-associated lymphoid tissue (BALT) was documented using antibodies to CD3 and CD5. Similarly, B-cells were identified in the same tissues using anti-CD79b. Antibodies to CD8, CD31, CD79a and CD68 failed to recognize cells in these tissue beds. In general the pattern of cellular distribution identified using these antibodies was similar to that observed in other marsupial and eutherian lymphoid tissues. This study provides further information on the commonality of lymphoid tissue structure in the two major groups of extant mammals, metatherians and eutherians. PMID:12363276

  5. Dramatic response to high-dose icotinib in a lung adenocarcinoma patient after erlotinib failure.

    PubMed

    Guan, Yin; Zhao, Hong; Meng, Jing; Yan, Xiang; Jiao, ShunChang

    2014-02-01

    Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) retreatment is rarely administered for non-small cell lung cancer (NSCLC) patients who did not respond to previous TKI treatment. A high dose of TKI may overcome resistance to the standard dose of TKI and have different effectiveness toward cancer compared with the standard dose of TKI. This manuscript describes a dramatic and durable response to high-dose icotinib in a NSCLC patient who did not respond to a previous standard dose of erlotinib. The treatment extended the life of the patient for one additional year. A higher dose of icotinib deserves further study not only for patients whose therapy failed with the standard dose of TKI but also for newly diagnosed NSCLC patients with a sensitive mutation. Serial mutation testing during disease development is necessary for analysis and evaluation of EGFR TKI treatment. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  6. Novel therapies for the treatment of pertussis disease

    PubMed Central

    Scanlon, Karen M.; Skerry, Ciaran; Carbonetti, Nicholas. H.

    2015-01-01

    Whooping cough, or pertussis, incidence has reached levels not seen since the 1950s. Previous studies have shown that antibiotics fail to improve the course of disease unless diagnosed early. Early diagnosis is complicated by the non-diagnostic presentation of disease early in infection. This review focuses on previous attempts at developing novel host-directed therapies for the treatment of pertussis. In addition, two novel approaches from our group are discussed. Manipulation of the signaling pathway of sphingosine-1-phosphate, a lipid involved in many immune processes, has shown great promise, but is in its infancy. Pendrin, a host epithelial anion exchanger upregulated in the airways with B. pertussis infection, appears to drive mucus production and dysregulation of airway surface liquid pH and salinity. In addition to detailing these potential new therapeutic targets, the need for greater focus on the neonatal model of disease is highlighted. PMID:26394802

  7. Power Asymmetries and Punishment in a Prisoner’s Dilemma with Variable Cooperative Investment

    PubMed Central

    Bone, Jonathan E.; Wallace, Brian; Bshary, Redouan; Raihani, Nichola J.

    2016-01-01

    In many two-player games, players that invest in punishment finish with lower payoffs than those who abstain from punishing. These results question the effectiveness of punishment at promoting cooperation, especially when retaliation is possible. It has been suggested that these findings may stem from the unrealistic assumption that all players are equal in terms of power. However, a previous empirical study which incorporated power asymmetries into an iterated prisoner's dilemma (IPD) game failed to show that power asymmetries stabilize cooperation when punishment is possible. Instead, players cooperated in response to their partner cooperating, and punishment did not yield any additional increase in tendency to cooperate. Nevertheless, this previous study only allowed an all-or-nothing–rather than a variable–cooperation investment. It is possible that power asymmetries increase the effectiveness of punishment from strong players only when players are able to vary their investment in cooperation. We tested this hypothesis using a modified IPD game which allowed players to vary their investment in cooperation in response to being punished. As in the previous study, punishment from strong players did not increase cooperation under any circumstances. Thus, in two-player games with symmetric strategy sets, punishment does not appear to increase cooperation. PMID:27191958

  8. Recall versus familiarity when recall fails for words and scenes: The differential roles of the hippocampus, perirhinal cortex, and category-specific cortical regions☆

    PubMed Central

    Ryals, Anthony J.; Cleary, Anne M.; Seger, Carol A.

    2013-01-01

    This fMRI study examined recall and familiarity for words and scenes using the novel recognition without cued recall (RWCR) paradigm. Subjects performed a cued recall task in which half of the test cues resembled studied items (and thus were familiar) and half did not. Subjects also judged the familiarity of the cue itself. RWCR is the finding that, among cues for which recall fails, subjects generally rate cues that resemble studied items as more familiar than cues that do not. For words, left and right hippocampal activity increased when recall succeeded relative to when it failed. When recall failed, right hippocampal activity was decreased for familiar relative to unfamiliar cues. In contrast, right Prc activity increased for familiar cues for which recall failed relative to both familiar cues for which recall succeeded and to unfamiliar cues. For scenes, left hippocampal activity increased when recall succeeded relative to when it failed but did not differentiate familiar from unfamiliar cues when recall failed. In contrast, right Prc activity increased for familiar relative to unfamiliar cues when recall failed. Category-specific cortical regions showed effects unique to their respective stimulus types: The visual word form area (VWFA) showed effects for recall vs. familiarity specific to words, and the parahippocampal place area (PPA) showed effects for recall vs. familiarity specific to scenes. In both cases, these effects were such that there was increased activity occurring during recall relative to when recall failed, and decreased activity occurring for familiar relative to unfamiliar cues when recall failed. PMID:23142268

  9. Wide abdominal rectus plication abdominoplasty for the treatment of chronic intractable low back pain.

    PubMed

    Oneal, Robert M; Mulka, Joseph P; Shapiro, Paul; Hing, David; Cavaliere, Christi

    2011-01-01

    A previous report demonstrated that the wide abdominal rectus plication abdominoplasty is an effective treatment modality in select patients with low back pain who failed to achieve relief with conservative therapy. The authors studied eight female patients who presented with chronic low back pain and marked lower abdominal wall muscular laxity. All had failed to respond to conservative management for their chronic back pain. They all underwent wide abdominal rectus plication abdominoplasty. Patient selection and details of the procedure are discussed. There were no significant complications in this series, and all the patients had prompt and prolonged alleviation of their back pain. Length of follow-up ranged from 2 to 11 years. Changes in the biomechanics of the lower abdominal musculature as a result of the wide abdominal rectus plication abdominoplasty are discussed in the context of increasing spinal stability, leading to an alleviation of chronic low back pain. An argument is made that this abdominoplasty procedure produces a spine-stabilizing effect by (1) tightening the muscles of the lateral abdominal complex and thus increasing intraabdominal pressure and (2) increasing the efficiency of these muscles so that their effectiveness as spine stabilizers is increased. Even though this is a small series, the fact that all the patients sustained long-term alleviation of their preoperative chronic back pain suggests that the wide abdominal rectus plication abdominoplasty should be considered as an option for patients with weak lower abdominal muscles and intractable low back pain who have failed conservative management.

  10. Confirmatory Factor Analysis of the Trinity Inventory of Precursors to Suicide (TIPS) and Its Relationship to Hopelessness and Depression

    ERIC Educational Resources Information Center

    Smyth, Caroline L.; MacLachlan, Malcolm

    2005-01-01

    Numerous existing measures assess attitudes toward suicide yet fail to account for contextual factors. The Trinity Inventory of Precursors to Suicide (TIPS) is presented as an alternative, with implications for the development of prevention programs. Having previously reported exploratory analysis of the TIPS; confirmatory factor analysis and…

  11. Dynamic torsional unwinding of southern pine tracheids as observed in the scanning electron microscope

    Treesearch

    C.W. McMillin

    1974-01-01

    In previous research on the process for making groundwood in a double-disk refiner, a theoretical stress analysis indicated that tracheids of Pinus taeda L. may fail while under torsional stress and unwind into ribbonlike elements. Such elements provide the coherence necessary for strength development in these pulps. Depending upon their physical...

  12. 75 FR 31734 - Airworthiness Directives; GROB-WERKE (Type Certificate Previously Held by BURKHART GROB Luft- und...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-04

    ... manufacturer has received a report of a failed canopy jettison test, during a regular maintenance check. The... jettison test, during a regular maintenance check. The investigation revealed that a cable shroud of the... Information Grob Aircraft AG has issued Service Bulletin No. MSB1078-164, dated July 21, 2009. The actions...

  13. Physical Education, Lifelong Participation and "the Couch Potato Society"

    ERIC Educational Resources Information Center

    Green, Ken

    2004-01-01

    In a previous paper (Green, 2002), it was argued that official and semi-official rhetoric related to school sport and PE in recent years has failed to consider adequately, or often acknowledge, trends in sport and physical activity and lifestyle developments among young people and adults. This sequel focuses attention upon the significance of the…

  14. Examining the Perceived Value of Integration of Earned Value Management with Risk Management-Based Performance Measurement Baseline

    ERIC Educational Resources Information Center

    Shah, Akhtar H.

    2014-01-01

    Many projects fail despite the use of evidence-based project management practices such as Performance Measurement Baseline (PMB), Earned Value Management (EVM) and Risk Management (RM). Although previous researchers have found that integrated project management techniques could be more valuable than the same techniques used by themselves, these…

  15. A Developmental Perspective on the Role of Motor Skill Competence in Physical Activity: An Emergent Relationship

    ERIC Educational Resources Information Center

    Stodden, David F.; Goodway, Jacqueline D.; Langendorfer, Stephen J.; Roberton, Mary Ann; Rudisill, Mary E.; Garcia, Clersida; Garcia, Luis E.

    2008-01-01

    Although significant attention has been paid to promoting the importance of physical activity in children, adolescents, and adults, we do not currently understand how to promote sustained physical activity levels throughout the lifespan. We contend that previous research has failed to consider the dynamic and synergistic role that motor skill…

  16. 75 FR 12466 - Airworthiness Directives; GROB-WERKE (Type Certificate Previously Held by BURKHART GROB Luft- und...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-16

    ... failed canopy jettison test, during a regular maintenance check. The investigation revealed that a cable... received by the closing date and may amend this proposed AD because of those comments. We will post all... provide. We will also post a report summarizing each substantive verbal contact we receive about this...

  17. 76 FR 2605 - Airworthiness Directives; Rolls-Royce plc RB211-Trent 800 Series Turbofan Engines

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-14

    ... blade root lubrication coating system may be reduced dependant on the extent of previous running with... Trent 895 powered Boeing 777-200 aircraft experienced release of a low pressure (LP) compressor blade which failed due to fatigue cracking in the root section of the blade. The released blade (undercut root...

  18. Specificity of Putative Psychosocial Risk Factors for Psychiatric Disorders in Children and Adolescents

    ERIC Educational Resources Information Center

    Shanahan, Lilly; Copeland, William; Costello, E. Jane; Angold, Adrian

    2008-01-01

    Background: Most psychosocial risk factors appear to have general rather than specific patterns of association with common childhood and adolescence disorders. However, previous research has typically failed to 1) control for comorbidity among disorders, 2) include a wide range of risk factors, and 3) examine sex by developmental stage effects on…

  19. Attentional Shifts between Audition and Vision in Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Occelli, Valeria; Esposito, Gianluca; Venuti, Paola; Arduino, Giuseppe Maurizio; Zampini, Massimiliano

    2013-01-01

    Previous evidence on neurotypical adults shows that the presentation of a stimulus allocates the attention to its modality, resulting in faster responses to a subsequent target presented in the same (vs. different) modality. People with Autism Spectrum Disorders (ASDs) often fail to detect a (visual or auditory) target in a stream of stimuli after…

  20. Big Boys and Little Girls: Gender, Acculturation, and Weight among Young Children of Immigrants

    ERIC Educational Resources Information Center

    Van Hook, Jennifer; Baker, Elizabeth

    2010-01-01

    Previous research fails to find a consistent association between obesity and acculturation for children. We theorize that social isolation shelters children of immigrants from the U.S. "obesiogenic" environment, but this protective effect is offset by immigrant parents' limited capacity to identify and manage this health risk in the United States.…

  1. Matching University Graduates' Competences with Employers' Needs in Taiwan

    ERIC Educational Resources Information Center

    Ho, Hsuan-Fu

    2015-01-01

    The dramatic expansion of the number of higher educational institutions in Taiwan has contributed a great deal to the growing unemployment rate of university graduates. Given the accumulated number of students who graduated in previous years and failed to find a job, the pressure of finding a job is growing each year. On the other hand, however,…

  2. Unpacking Resistance to Change within-School Reform Programmes with a Social Justice Orientation

    ERIC Educational Resources Information Center

    Hynds, Anne

    2010-01-01

    Previous research in the area of resistance has inadequately described opposition to change within-school reform initiatives with a social justice orientation. A lack of attention to, and agreement on, the nature and causes of resistance may explain why so many equity-minded educational reforms fail to be sustained. This article highlights various…

  3. Mechanism-Based Causal Reasoning in Young Children

    ERIC Educational Resources Information Center

    Buchanan, David W.; Sobel, David M.

    2011-01-01

    The hypothesis that children develop an understanding of causal mechanisms was tested across 3 experiments. In Experiment 1 (N = 48), preschoolers had to choose as efficacious either a cause that had worked in the past, but was now disconnected from its effect, or a cause that had failed to work previously, but was now connected. Four-year-olds…

  4. Commercial Insurance vs Community-Based Health Plans: Time for a Policy Option With Clinical Emphasis to Address the Cost Spiral

    ERIC Educational Resources Information Center

    Amundson, Bruce

    2005-01-01

    The nation continues its ceaseless struggle with the spiraling cost of health care. Previous efforts (regulation, competition, voluntary action) have included almost every strategy except clinical. Insurers have largely failed in their cost-containment efforts. There is a strong emerging body of literature that demonstrates the relationship…

  5. When Honesty is the Expected Policy: Utilizing Peer Relations in Classroom Management

    ERIC Educational Resources Information Center

    Rudebock, Richard D.

    2005-01-01

    In this article, a teacher shares his experience at handling student cheating in his small business management class at a private Christian liberal arts university and recommends the steps he had taken to other teachers who encountered similar situations. Shocked by the failing scores from two students who had done well on previous quizzes, the…

  6. 29 CFR 4901.33 - Payment of fees.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...: (i) Where the requester has a history of prompt payment of fees under this part, the PBGC will notify... requester has no history of payment for requests made pursuant to FOIA and this part, the PBGC may require... requester has previously failed to pay a fee charged in a timely fashion (i.e., within 30 days of the date...

  7. 10 CFR 1004.9 - Fees for providing records.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... full payment where the requester has a history of prompt payment of FOIA fees, or require an advance payment of an amount up to the full estimated charges in the case of requesters with no history of payment. (ii) A requester has previously failed to pay a fee in a timely fashion (i.e., within 30 days of the...

  8. 5 CFR 2502.14 - Miscellaneous fee provisions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... obtain satisfactory assurance of full payment where the requestor has a history of prompt payment of FOIA... requestors with no history of payment; or (2) A requestor has previously failed to pay a fee charged in a timely fashion (i.e., within thirty days of the date of the billing). OA may require the requestor to pay...

  9. 11 CFR 9405.11 - Miscellaneous fee provisions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... where the requester has a history of prompt payment of FOIA fees or require an advance payment of an amount up to the full estimated charges in the case of requesters with no history of payment; or (2) A requester has previously failed to pay a fee charged in a timely fashion (i.e., within 30 days of the date...

  10. 14 CFR 1206.704 - Advance payments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... where the requester has a history of prompt payment of FOIA fees, or require an advance payment of an amount up to the full estimated charges in the case of requesters with no history of payment; or (2) A requester has previously failed to pay a fee in a timely fashion (within 30 days of billing), then NASA may...

  11. 36 CFR 404.9 - Miscellaneous fee provisions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... likely cost and obtain satisfactory assurance of full payment where the requester has a history of prompt... case of requesters with no history of payment; or (2) A requester has previously failed to pay a fee charged in a timely fashion (i.e., within 30 days of the date of the billing). Then, ABMC may require the...

  12. 24 CFR 2002.15 - Advance payments.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... where the requester has a history of prompt payment of FOIA fees, or require an advance payment of an amount up to the full estimated charges in the case of requesters with no history of payment; or (2) Where a requester has previously failed to pay a fee charged in a timely fashion (i.e., within 30 days...

  13. Magnetic perturbation inspection of inner bearing races

    NASA Technical Reports Server (NTRS)

    Barton, J. R.; Lankford, J.

    1972-01-01

    Approximately 100 inner race bearings were inspected nondestructively prior to endurance testing. Two of the bearings which failed during testing spalled at the sites of subsurface inclusions previously detected by using magnetic field perturbation. At other sites initially judged to be suspect, subsurface inclusion-nucleated cracking was observed. Inspection records and metallurgical sectioning results are presented and discussed.

  14. Medial versus anterior open reduction for developmental hip dislocation in age-matched patients.

    PubMed

    Hoellwarth, Jason S; Kim, Young-Jo; Millis, Michael B; Kasser, James R; Zurakowski, David; Matheney, Travis H

    2015-01-01

    The difference between medial (MAOR) and anterior (AAOR) approaches for open reduction of developmental hip dysplasia in terms of risk for avascular necrosis (AVN) and need for further corrective surgery (FCS, femoral and/or acetabular osteotomy) is unclear. This study compared age-matched cohorts undergoing either MAOR or AAOR in terms of these 2 primary outcomes. Prognostic impact of presence of ossific nucleus at time of open reduction was also investigated. Institutional review board approval was obtained. Nineteen hips (14 patients) managed by MAOR were matched with 19 hips (18 patients) managed by AAOR based on age at operation (mean 6.0; range, 1.4 to 14.9 mo). Patients with neuromuscular conditions and known connective tissue disorders were excluded. Primary outcomes assessed at minimum 2 years' follow-up included radiographic evidence of AVN (Kalamchi and MacEwen) or requiring FCS. MAOR and AAOR cohorts were similar regarding age at open reduction, sex, laterality, and follow-up duration. One hip in each group had AVN before open reduction thus were excluded from AVN analysis. At minimum 2 years postoperatively (mean 6.2; range, 1.8 to 11.7 y), 4/18 (22%) MAOR and 5/18 (28%) AAOR met the same criteria for AVN (P=1.0). No predictors of AVN could be identified by regression analysis. Presence of an ossific nucleus preoperatively was not a protective factor from AVN (P=0.27). FCS was required in 4/19 (21%) MAOR and 7/19 (37%) AAOR hips (P=0.48). However, 7/12 (54%) hips failing closed reduction required FCS compared with 4/26 (16%) hips without prior failed closed reduction (P=0.024). Cox regression analysis showed that patients who failed closed reduction had an annual risk of requiring FCS approximately 6 times that of patients without a history of failed closed reduction (hazard ratio=6.1; 95% CI, 1.5-24.4; P=0.009), independent of surgical approach (P=0.55) or length of follow-up (P=0.78). In this study of age-matched patients undergoing either MAOR or AAOR, we found no association between surgical approach and risk of AVN or FCS. In addition, we identified no protective benefit of a preoperative ossific nucleus in terms of development of AVN. However, failing closed reduction was associated with a 6-fold increased annual risk of requiring FCS. To the best of our knowledge, this is the first study comparing these 2 surgical techniques in an age-matched manner. It further corroborates previous studies stating that there may be no difference in risk of AVN based on surgical approach or presence of ossific nucleus preoperatively. Level III-retrospective comparative study.

  15. Cognitive Reflection and the Diligent Worker: An Experimental Study of Millennials

    PubMed Central

    Corgnet, Brice; Hernán Gonzalez, Roberto; Mateo, Ricardo

    2015-01-01

    Recent studies have shown that despite crucially needing the creative talent of millennials (people born after 1980) organizations have been reluctant to hire young workers because of their supposed lack of diligence. We propose to help resolve this dilemma by studying the determinants of task performance and shirking behaviors of millennials in a laboratory work environment. We find that cognitive ability is a good predictor of task performance in line with previous literature. In contrast with previous research, personality traits do not consistently predict either task performance or shirking behaviors. Shirking behaviors, as measured by the time participants spent browsing the internet for non-work purposes (Cyberloafing), were only explained by the performance on the Cognitive Reflection Test (CRT). This finding echoes recent research in cognitive psychology according to which conventional measures of cognitive ability only assess a narrow concept of rational thinking (the algorithmic mind) that fails to capture individuals’ capacity to reflect and control their impulses. Our findings suggest that hiring diligent millennials relies on the use of novel cognitive measures such as CRT in lieu of standard personality and intelligence tests. PMID:26545244

  16. Cognitive Reflection and the Diligent Worker: An Experimental Study of Millennials.

    PubMed

    Corgnet, Brice; Hernán Gonzalez, Roberto; Mateo, Ricardo

    2015-01-01

    Recent studies have shown that despite crucially needing the creative talent of millennials (people born after 1980) organizations have been reluctant to hire young workers because of their supposed lack of diligence. We propose to help resolve this dilemma by studying the determinants of task performance and shirking behaviors of millennials in a laboratory work environment. We find that cognitive ability is a good predictor of task performance in line with previous literature. In contrast with previous research, personality traits do not consistently predict either task performance or shirking behaviors. Shirking behaviors, as measured by the time participants spent browsing the internet for non-work purposes (Cyberloafing), were only explained by the performance on the Cognitive Reflection Test (CRT). This finding echoes recent research in cognitive psychology according to which conventional measures of cognitive ability only assess a narrow concept of rational thinking (the algorithmic mind) that fails to capture individuals' capacity to reflect and control their impulses. Our findings suggest that hiring diligent millennials relies on the use of novel cognitive measures such as CRT in lieu of standard personality and intelligence tests.

  17. Exploring the issue of failure to fail in a nursing program.

    PubMed

    Larocque, Sylvie; Luhanga, Florence Loyce

    2013-05-18

    A study using a qualitative descriptive design was undertaken to explore the issue of "failure to fail" in a nursing program. Individual in-depth interviews were conducted with nursing university faculty members, preceptors, and faculty advisors (n=13). Content analysis was used to analyze the data. Results indicate that: (a) failing a student is a difficult process; (b) both academic and emotional support are required for students and preceptors and faculty advisors; (c) there are consequences for programs, faculty, and students when a student has failed a placement; (d) at times, personal, professional, and structural reasons exist for failing to fail a student; and (e) the reputation of the professional program can be diminished as a result of failing to fail a student. Recommendations for improving assessment, evaluation, and intervention with a failing student include documentation, communication, and support. These findings have implications for improving the quality of clinical experiences.

  18. A brief overview of channel monitoring in land management: Five case studies. Case study #1

    Treesearch

    Leslie Reid

    1999-01-01

    Yesterday we heard about some successful monitoring programs,but today I would like to share some findings from a study I did, which was basically a post-mortem of failed monitoring programs.There were about 30 projects,and I wanted to know why did they fail,and were there patterns of why they failed.The projects ranged from university studies,land management,and...

  19. Acquisition of MDMA self-administration: pharmacokinetic factors and MDMA-induced serotonin release.

    PubMed

    Bradbury, Sarah; Bird, Judith; Colussi-Mas, Joyce; Mueller, Melanie; Ricaurte, George; Schenk, Susan

    2014-09-01

    The current study aimed to elucidate the role of pharmacokinetic (PK) parameters and neurotransmitter efflux in explaining variability in (±) 3, 4-methylenedioxymethamphetamine (MDMA) self-administration in rats. PK profiles of MDMA and its major metabolites were determined after the administration of 1.0 mg/kg MDMA (iv) prior to, and following, the acquisition of MDMA self-administration. Synaptic levels of 5-hydroxytryptamine (5HT) and dopamine (DA) in the nucleus accumbens were measured following administration of MDMA (1.0 and 3.0 mg/kg, iv) using in vivo microdialysis and compared for rats that acquired or failed to acquire MDMA self-administration. Effects of the 5HT neurotoxin, 5,7 dihydroxytryptamine (5, 7-DHT), on the acquisition of MDMA and cocaine self-administration were also determined. In keeping with previous findings, approximately 50% of rats failed to meet a criterion for acquisition of MDMA self-administration. The PK profiles of MDMA and its metabolites did not differ between rats that acquired or failed to acquire MDMA self-administration. MDMA produced more overflow of 5HT than DA. The MDMA-induced 5HT overflow was lower in rats that acquired MDMA self-administration compared with those that did not acquire self-administration. In contrast, MDMA-induced DA overflow was comparable for the two groups. Prior 5,7-DHT lesions reduced tissue levels of 5HT and markedly increased the percentage of rats that acquired MDMA self-administration and also decreased the latency to acquisition of cocaine self-administration. These data suggest that 5HT limits the initial sensitivity to the positively reinforcing effects of MDMA and delays the acquisition of reliable self-administration. © 2013 Society for the Study of Addiction.

  20. Dental implants in patients with ectodermal dysplasia: A systematic review.

    PubMed

    Chrcanovic, Bruno Ramos

    2018-05-21

    This study sought to assess the clinical outcome and survival rate of oral implants placed in individuals with ectodermal dysplasia (ED), based on previously published studies. An electronic search without time restrictions was undertaken in 5 databases (PubMed/Medline, Web of Science, ScienceDirect, J-Stage, Lilacs). Descriptive statistics, Kaplan Meier estimator and implant failure probability were calculated. 90 publications were included, reporting 228 ED patients that received 1472 implants (1392 conventional, 47 zygomatic, 33 mini-implants). Mean age of the patients was 20.2 ± 6.8 years (2-56). Patients had a mean of 3.2 ± 2.5 maxillary and 2.1 ± 2.6 mandibular permanent teeth (min-max, 0-14). Patients received a mean of 8.2 ± 3.8 implants (1-20). Most implants were placed in the third decade of life, 24.6% of the implants were placed in children (0-17 years of age). 1391 implants had information on follow-up (72 failures, 5.2%). The 20-year CSR was 84.6%. The probability of failure was 4.5% (95%CI 3.5%-5.6%, p < 0.001). Additional treatments performed were Le Fort I (99 implants, 20 patients, 3.5% failed), grafting (497 implants, 77 patients, 5.2% failed), distraction osteogenesis (79 implants, 16 patients, 10.1% failed). Mean follow-up was 42.9 ± 41.9 months (min-max, 2-240). Dental implants placed in ED patients, either infants or adults, present a high survival rate (20-year CSR 84.6%). Copyright © 2018 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  1. Hepatotoxicity associated with 6-methyl mercaptopurine formation during azathioprine and 6-mercaptopurine therapy does not occur on the short-term during 6-thioguanine therapy in IBD treatment.

    PubMed

    van Asseldonk, Dirk P; Seinen, Margien L; de Boer, Nanne K H; van Bodegraven, Ad A; Mulder, Chris J

    2012-02-01

    High concentrations of methylated thiopurine metabolites, such as 6-methyl mercaptopurine, are associated with hepatotoxicity during administration of the conventional thiopurines azathioprine or 6-mercaptopurine in IBD patients. Metabolization of the non-conventional thiopurine 6-thioguanine does not generate 6-methyl mercaptopurine. Hence, the aim of our study was to evaluate hepatotoxicity during 6-thioguanine in IBD patients who previously failed conventional thiopurines due to 6-methyl mercaptopurine associated hepatotoxicity. A retrospective single center intercept cohort study was performed of IBD patients using 6-thioguanine between January 2006 and July 2010 after failing conventional thiopurine therapy due to 6-methyl mercaptopurine associated hepatotoxicity. The primary outcome was the occurrence of 6-thioguanine induced hepatotoxicity, scaled according to the Common Terminology Criteria for Adverse Events. Nineteen patients were included. Median duration of 6-thioguanine therapy (median daily dosage 21 mg (9-24)) was 23 weeks (6-96). Hepatotoxicity did not reoccur in 15 out of 19, whereas grade 1 toxicity persisted in 4 patients (p<0.001). Median aspartate aminotransferase and alanine aminotransferase concentrations decreased from 34 U/l (20-59) and 64 U/l (15-175) to 23 U/l (18-40; p=0.003) and 20 U/l (14-48; p=0.019), respectively. Hepatotoxicity does not reoccur during 6-thioguanine treatment in most IBD patients who failed conventional thiopurines due to 6-methyl mercaptopurine associated hepatotoxicity. Hence, at least at short-term, 6-thioguanine appears a justifiable alternative thiopurine for these IBD patients. Copyright © 2011 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

  2. Salvage reconstruction of failed interposition arthroplasty at the base of the thumb.

    PubMed

    Braun, Richard M; Rechnic, Mark; Shah, Kalpit N

    2012-12-01

    We present an operative procedure designed to revise a failed arthroplasty at the base of the thumb. This report describes a reliable operation that corrects residual instability and malignment which results in thumbs that are weak and painful despite a previous procedure. The operation has also been used as a primary procedure for arthritis of the trapeziometacarpal joint where instability and subluxation was a major component of the problem requiring joint reconstruction. The unique features of this procedure include a reinforced double-thickness tendon graft, a unique tendon anchor, and a fascia lata allograft spacer. Significant functional improvement is anticipated when joint reconstruction provides increased proximal stability. Pinch and grip measurements improve. Pain scores also diminish after the operation. Hand function and patient satisfaction can be substantially improved with revision arthroplasty when the initial operation has failed to provide a thumb that is mobile, stable, and pain free. The technical features of the procedure address reduction of malignment, restoring of anatomic balance, and secure fixation of the proximal apex of the thumb metacarpal which restores thumb reduction position and digital balance.

  3. Redescription of Chimaera ogilbyi (Chimaeriformes; Chimaeridae) from the Indo-Australian region.

    PubMed

    Finucci, Brittany; White, William T; Kemper, Jenny M; Naylor, Gavin J P

    2018-01-24

    An integrated taxonomic approach, combining both morphological and molecular data, was adopted to investigate the Hydrolagus lemures-ogilbyi group in the Indo-Australian region. Single mitochondrial markers (CO1 and NADH2) provided evidence supporting the separation of four distinct species in this group. However, detailed morphological data collected from specimens from across their range failed to find any consistent differences, and many features previously considered to be diagnostic were found to be variable. Nuclear DNA data also failed to support the differences found with the single mitochondrial markers and, together with the morphological data, supported the hypothesis that only a single species in this group is present in the Indo-Australian region. In addition, the results failed to support the current generic placement of this group in Hydrolagus, suggesting they belong to the genus Chimaera with doubt over the validity of Hydrolagus as a valid genus. The oldest available name for this group is Chimaera ogilbyi and a redescription is provided. This species occurs throughout Australia, eastern Indonesia (Java, Bali, and Lombok) and northern Papua New Guinea.

  4. Prediction of particulate loading in exhaust from fabric filter baghouses with one or more failed bags.

    PubMed

    Qin, Wenjun; Dekermenjian, Manuel; Martin, Richard J

    2006-08-01

    Loss of filtration efficiency in a fabric filter baghouse is typically caused by bag failure, in one form or another. The degree of such failure can be as minor as a pinhole leak or as major as a fully involved baghouse fire. In some cases, local air pollution regulations or federal hazardous waste laws may require estimation of the total quantity of particulate matter released to the environment as a result of such failures. In this paper, a technique is presented for computing the dust loading in the baghouse exhaust when one or more bags have failed. The algorithm developed is shown to be an improvement over a previously published result, which requires empirical knowledge of the variation in baghouse pressure differential with bag failures. An example calculation is presented for a baghouse equipped with 200 bags. The prediction shows that a small percentage of failed bags can cause a relatively large proportion of the gas flow to bypass the active bags, which, in turn, leads to high outlet dust loading and low overall collection efficiency from the baghouse.

  5. Color Perception in Pediatric Patient Room Design: American versus Korean Pediatric Patients.

    PubMed

    Phillip Park, Jin Gyu; Park, Changbae

    2013-01-01

    This study simultaneously addresses the issues of the scarcity of information about pediatric patient color preferences, conflicting findings about the impact of culture on color preferences, and limitations of previous research instruments. Effects of culture and gender on color preferences were investigated using American and Korean pediatric patients. Much of the existing research in environmental design has focused on environments for healthy children and adults, but those findings cannot be confidently applied to environments for pediatric patients. In previous studies, the impact of culture on color preferences has been suggested, though the effects appear to vary. Moreover, the results of previous studies were typically based on perceptions of small color chips, which are different from seeing a color on wall surfaces. Previous studies also failed to control for confounding variables such as color attributes and light sources. Instead of using color chips, this study used physical model simulation to investigate environmental color preferences in real contexts. Cultural difference was found in white. Other than white, no significant cultural difference was found. Gender differences were found across both of the groups. Korean pediatric patients showed significantly higher preference scores for white than Americans did. Other than white, both groups reported blue and green as their most preferred colors; white was the least preferred. Both groups reported similar gender effects. Overall, male patients reported significantly lower preference scores for red and purple than female patients did. These results can help healthcare providers and professionals better understand appropriate colors for pediatric populations. Evidence-based design, healing environment, patients, pediatric, satisfaction.

  6. The effects of message framing, involvement, and nicotine dependence on anti-smoking public service announcements.

    PubMed

    Jung, Wan S; Villegas, Jorge

    2011-01-01

    Anti-smoking Public Service Announcements (PSAs) typically emphasize the negative consequences of failing to quit smoking (negative frame), as opposed to emphasizing the benefits of quitting (positive frame). However, stressing the benefits of quitting sometimes produces better communication outcomes. Previous research on message framing has tried to identify factors affecting the impact of positive framing and negative framing. Data were collected on 188 undergraduates attending a southeastern university in the United States who were assigned randomly to view either positive or negative messages. Our study found that involvement and nicotine dependence moderated the impact of framed smoking-cessation messages on attitude toward the ad.

  7. Mechanisms of Biliary Plastic Stent Occlusion and Efforts at Prevention

    PubMed Central

    Kwon, Chang-Il; Lehman, Glen A.

    2016-01-01

    Biliary stenting via endoscopic retrograde cholangiopancreatography has greatly improved the quality of patient care over the last 30 years. Plastic stent occlusion limits the life span of such stents. Attempts to improve plastic stent patency duration have mostly failed. Metal stents (self-expandable metal stents [SEMSs]) have therefore replaced plastic stents, especially for malignant biliary strictures. SEMS are at least 10 times more expensive than plastic stents. In this focused review, we will discuss basic mechanisms of plastic stent occlusion, along with a systematic summary of previous efforts and related studies to improve stent patency and potential new techniques to overcome existing limitations. PMID:27000422

  8. Second-line therapy with levofloxacin after failure of treatment to eradicate helicobacter pylori infection: time trends in a Spanish Multicenter Study of 1000 patients.

    PubMed

    Gisbert, Javier P; Pérez-Aisa, Angeles; Bermejo, Fernando; Castro-Fernández, Manuel; Almela, Pedro; Barrio, Jesús; Cosme, Angel; Modolell, Inés; Bory, Felipe; Fernández-Bermejo, Miguel; Rodrigo, Luis; Ortuño, Jesús; Sánchez-Pobre, Pilar; Khorrami, Sam; Franco, Alejandro; Tomas, Albert; Guerra, Iván; Lamas, Eloisa; Ponce, Julio; Calvet, Xavier

    2013-02-01

    Second-line bismuth-containing quadruple therapy is complex and frequently induces adverse effects. A triple rescue regimen containing levofloxacin is a potential alternative; however, resistance to quinolones is rapidly increasing. To evaluate the efficacy and tolerability of a second-line triple-regimen-containing levofloxacin in patients whose Helicobacter pylori eradication treatment failed and to assess whether the efficacy of the regimen decreases with time. Prospective multicenter study. In whom treatment with a regimen comprising a proton-pump inhibitor, clarithromycin, and amoxicillin had failed. Levofloxacin (500 mg bid), amoxicillin (1 g bid), and omeprazole (20 mg bid) for 10 days. Eradication was confirmed using the C-urea breath test 4 to 8 weeks after therapy. Compliance/tolerance: Compliance was determined through questioning and recovery of empty medication envelopes. Incidence of adverse effects was evaluated by means of a questionnaire. The study sample comprised 1000 consecutive patients (mean age, 49 ± 15 y, 42% men, 33% peptic ulcer) of whom 97% took all medications correctly. Per-protocol and intention-to-treat eradication rates were 75.1% (95% confidence interval, 72%-78%) and 73.8% (95% confidence interval, 71%-77%). Efficacy (intention-to-treat) was 76% in the year 2006, 68% in 2007, 70% in 2008, 76% in 2009, 74% in 2010, and 81% in 2011. In the multivariate analysis, none of the studied variables (including diagnosis and year of treatment) were associated with success of eradication. Adverse effects were reported in 20% of patients, most commonly nausea (7.9%), metallic taste (3.9%), myalgia (3.1%), and abdominal pain (2.9%). Ten-day levofloxacin-containing therapy is an encouraging second-line strategy, providing a safe and simple alternative to quadruple therapy in patients whose previous standard triple therapy has failed. The efficacy of this regimen remains stable with time.

  9. Recall versus familiarity when recall fails for words and scenes: the differential roles of the hippocampus, perirhinal cortex, and category-specific cortical regions.

    PubMed

    Ryals, Anthony J; Cleary, Anne M; Seger, Carol A

    2013-01-25

    This fMRI study examined recall and familiarity for words and scenes using the novel recognition without cued recall (RWCR) paradigm. Subjects performed a cued recall task in which half of the test cues resembled studied items (and thus were familiar) and half did not. Subjects also judged the familiarity of the cue itself. RWCR is the finding that, among cues for which recall fails, subjects generally rate cues that resemble studied items as more familiar than cues that do not. For words, left and right hippocampal activity increased when recall succeeded relative to when it failed. When recall failed, right hippocampal activity was decreased for familiar relative to unfamiliar cues. In contrast, right Prc activity increased for familiar cues for which recall failed relative to both familiar cues for which recall succeeded and to unfamiliar cues. For scenes, left hippocampal activity increased when recall succeeded relative to when it failed but did not differentiate familiar from unfamiliar cues when recall failed. In contrast, right Prc activity increased for familiar relative to unfamiliar cues when recall failed. Category-specific cortical regions showed effects unique to their respective stimulus types: The visual word form area (VWFA) showed effects for recall vs. familiarity specific to words, and the parahippocampal place area (PPA) showed effects for recall vs. familiarity specific to scenes. In both cases, these effects were such that there was increased activity occurring during recall relative to when recall failed, and decreased activity occurring for familiar relative to unfamiliar cues when recall failed. Copyright © 2012 Elsevier B.V. All rights reserved.

  10. Lumbar Disc Replacement for Junctional Decompensation After Fusion Surgery: Clinical and Radiological Outcome at an Average Follow-Up of 33 Months

    PubMed Central

    Sliwa, Karen; Weinberg, Ian R.; Sweet, Barry MBE; de Villiers, Malan; Candy, Geoffrey P.

    2007-01-01

    Background Failed fusion surgery remains difficult to treat. Few published data on disc replacement surgery after failed fusion procedures exist. Our objective was to evaluate outcomes of junctional lumbar disc replacement after previous fusion surgery and to correlate outcome with radiological changes to parameters of sagittal balance. Methods Out of a single-center prospective registry of 290 patients with 404 lumbar disc replacements, 27 patients had had a previous lumbar fusion operation on 1 to 4 lumbar segments and had completed a mean follow- up of 33 months (range: 18–56). We correlated the clinical outcome measures (patient satisfaction, 10-point pain score, and Oswestry Disability Index [ODI] score) to parameters of spinal sagittal alignment (sacral tilt, pelvic tilt, pelvic incidence, and lumbar lordosis). Results Postoperative hospital stay averaged 3.3 days (range: 2–8). Previously-employed patients went back to their jobs with a mean of 32 days (range: 21–42) after the procedure. At the latest follow-up, 1 of the patients considered the outcome to be poor, 3 fair, 8 good, and 15 excellent. Twenty-four patients “would undergo the operation again.” Average pain score decreased from 9.1 ± 1.0 (SD) to 3.2 ± 2.1 (P < .01). Average ODI decreased from 50.2 ± 9.9 preoperatively to 21.7 ± 14.2 (P ≤ .01). We found the change in pelvic tilt to be an independent predictor of better clinical outcome by multivariate analysis (P < .05). Conclusions In patients with junctional failure adjacent to a previous posterolateral fusion, disc replacement at the junctional level(s), compared with osteotomy and fusion surgery, offers the advantage of maintaining segmental mobility and correcting the flat-back deformity through a single approach with less operative time and blood loss. Early- to intermediate-term results are promising. The influence of changes in spinal sagittal alignment on clinical outcome needs to be addressed in future research. Clinical Relevance This is the first study on “junctional disc replacement patients” correlating clinical outcome to changes in spinal/pelvic alignment. PMID:25802584

  11. HIV-2 integrase polymorphisms and longitudinal genotypic analysis of HIV-2 infected patients failing a raltegravir-containing regimen.

    PubMed

    Cavaco-Silva, Joana; Abecasis, Ana; Miranda, Ana Cláudia; Poças, José; Narciso, Jorge; Águas, Maria João; Maltez, Fernando; Almeida, Isabel; Germano, Isabel; Diniz, António; Gonçalves, Maria de Fátima; Gomes, Perpétua; Cunha, Celso; Camacho, Ricardo Jorge

    2014-01-01

    To characterize the HIV-2 integrase gene polymorphisms and the pathways to resistance of HIV-2 patients failing a raltegravir-containing regimen, we studied 63 integrase strand transfer inhibitors (INSTI)-naïve patients, and 10 heavily pretreated patients exhibiting virological failure while receiving a salvage raltegravir-containing regimen. All patients were infected by HIV-2 group A. 61.4% of the integrase residues were conserved, including the catalytic motif residues. No INSTI-major resistance mutations were detected in the virus population from naïve patients, but two amino acids that are secondary resistance mutations to INSTIs in HIV-1 were observed. The 10 raltegravir-experienced patients exhibited resistance mutations via three main genetic pathways: N155H, Q148R, and eventually E92Q - T97A. The 155 pathway was preferentially used (7/10 patients). Other mutations associated to raltegravir resistance in HIV-1 were also observed in our HIV-2 population (V151I and D232N), along with several novel mutations previously unreported. Data retrieved from this study should help build a more robust HIV-2-specific algorithm for the genotypic interpretation of raltegravir resistance, and contribute to improve the clinical monitoring of HIV-2-infected patients.

  12. Particle size and morphology of UHMWPE wear debris in failed total knee arthroplasties--a comparison between mobile bearing and fixed bearing knees.

    PubMed

    Huang, Chun-Hsiung; Ho, Fang-Yuan; Ma, Hon-Ming; Yang, Chan-Tsung; Liau, Jiann-Jong; Kao, Hung-Chan; Young, Tai-Horng; Cheng, Cheng-Kung

    2002-09-01

    Osteolysis induced by ultrahigh molecular weight polyethylene wear debris has been recognized as the major cause of long-term failure in total joint arthroplasties. In a previous study, the prevalence of intraoperatively identified osteolysis during primary revision surgery was much higher in mobile bearing knee replacements (47%) than in fixed bearing knee replacements (13%). We postulated that mobile bearing knee implants tend to produce smaller sized particles. In our current study, we compared the particle size and morphology of polyethylene wear debris between failed mobile bearing and fixed bearing knees. Tissue specimens from interfacial and lytic regions were extracted during revision surgery of 10 mobile bearing knees (all of the low contact stress (LCS) design) and 17 fixed bearing knees (10 of the porous-coated anatomic (PCA) and 7 of the Miller/Galante design). Polyethylene particles were isolated from the tissue specimens and examined using both scanning electron microscopy and light-scattering analyses. The LCS mobile bearing knees produced smaller particulate debris (mean equivalent spherical diameter: 0.58 microm in LCS, 1.17 microm in PCA and 5.23 microm in M/G) and more granular debris (mean value: 93% in LCS, 77% in PCA and 15% in M/G).

  13. HIV-2 Integrase Polymorphisms and Longitudinal Genotypic Analysis of HIV-2 Infected Patients Failing a Raltegravir-Containing Regimen

    PubMed Central

    Cavaco-Silva, Joana; Abecasis, Ana; Miranda, Ana Cláudia; Poças, José; Narciso, Jorge; Águas, Maria João; Maltez, Fernando; Almeida, Isabel; Germano, Isabel; Diniz, António; Gonçalves, Maria de Fátima; Gomes, Perpétua; Cunha, Celso; Camacho, Ricardo Jorge

    2014-01-01

    To characterize the HIV-2 integrase gene polymorphisms and the pathways to resistance of HIV-2 patients failing a raltegravir-containing regimen, we studied 63 integrase strand transfer inhibitors (INSTI)-naïve patients, and 10 heavily pretreated patients exhibiting virological failure while receiving a salvage raltegravir-containing regimen. All patients were infected by HIV-2 group A. 61.4% of the integrase residues were conserved, including the catalytic motif residues. No INSTI-major resistance mutations were detected in the virus population from naïve patients, but two amino acids that are secondary resistance mutations to INSTIs in HIV-1 were observed. The 10 raltegravir-experienced patients exhibited resistance mutations via three main genetic pathways: N155H, Q148R, and eventually E92Q - T97A. The 155 pathway was preferentially used (7/10 patients). Other mutations associated to raltegravir resistance in HIV-1 were also observed in our HIV-2 population (V151I and D232N), along with several novel mutations previously unreported. Data retrieved from this study should help build a more robust HIV-2-specific algorithm for the genotypic interpretation of raltegravir resistance, and contribute to improve the clinical monitoring of HIV-2-infected patients. PMID:24681625

  14. Oral aniracetam treatment in C57BL/6J mice without pre-existing cognitive dysfunction reveals no changes in learning, memory, anxiety or stereotypy

    PubMed Central

    Reynolds, Conner D.; Jefferson, Taylor S.; Volquardsen, Meagan; Pandian, Ashvini; Smith, Gregory D.; Holley, Andrew J.; Lugo, Joaquin N.

    2017-01-01

    Background: The piracetam analog, aniracetam, has recently received attention for its cognition enhancing potential, with minimal reported side effects.  Previous studies report the drug to be effective in both human and non-human models with pre-existing cognitive dysfunction, but few studies have evaluated its efficacy in healthy subjects. A previous study performed in our laboratory found no cognitive enhancing effects of oral aniracetam administration 1-hour prior to behavioral testing in naïve C57BL/6J mice. Methods: The current study aims to further evaluate this drug by administration of aniracetam 30 minutes prior to testing in order to optimize any cognitive enhancing effects. In this study, all naïve C57BL/6J mice were tested in tasks of delayed fear conditioning, novel object recognition, rotarod, open field, elevated plus maze, and marble burying. Results: Across all tasks, animals in the treatment group failed to show enhanced learning when compared to controls. Conclusions: These results provide further evidence suggesting that aniracetam conveys no therapeutic benefit to subjects without pre-existing cognitive dysfunction. PMID:29946420

  15. Winter movements of four fish species near a thermal plume in northern Minnesota

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

    Ross, M.J.; Winter, J.D.

    1981-01-01

    Four fish species were studied during the winter of 1975 to compare their winter movements near the thermal plume of a power plant. Seventeen yellow perch (Perca flavescens), six northern pike (Esox lucius), three walleyes (Stizostedion vitreum), and two largemouth bass (Micropterus salmoides) were equipped with radio frequency transmitters. The spatial distributions differed among species. Only the largemouth bass confined their movements to heated water areas. The yellow perch, which was of particular interest, do not seem to be attracted to warm winter waters, and thus locate themselves in the peripheral areas of the discharge bay and fail to reproduce.more » This finding is contrary to those of previous studies.« less

  16. Three-Dimensional Printing: An Aid to Epidural Access for Neuromodulation.

    PubMed

    Taverner, Murray G; Monagle, John P

    2017-08-01

    The case report details to use of three-dimensional (3D) printing as an aid to neuromodulation. A patient is described in whom previous attempts at spinal neuromodulation had failed due to lack of epidural or intrathecal access, and the use of a 3D printed model allowed for improved planning and ultimately, success. Successful spinal cord stimulation was achieved with the plan developed by access to a 3D model of the patient's spine. Neuromodulation techniques can provide the optimal analgesic techniques for individual patients. At times these can fail due to lack of access to the site for intervention, in this case epidural access. 3D printing may provide additional information to improve the likelihood of access when anatomy is distorted and standard approaches prove difficult. © 2017 International Neuromodulation Society.

  17. [Factors associated with reported vaccination coverage in early infancy: results of a telephone survey].

    PubMed

    Nebot, M; Muñoz, E; Figueres, M; Rovira, G; Robert, M; Minguell, D

    2001-01-01

    Barcelona's Continuing Immunization Plan affords the possibility Of monitoring the immunization coverage of the population by means of the voluntary family postal notification system. Prior studies have revealed that some families fail to provide notification while being correctly vaccinated, which can lead to actual coverage being underestimated. The objectives of this study are to estimate the early childhood immunization coverage of the population and to ascertain the factors associated with failure to provide notification of immunization. A phone survey was conducted on a sample of 500 children regarding whom there was no record of any notification of the first three childhood vaccine doses (diphtheria, tetanus, whooping cough and oral polio), in addition to a sample of 500 children who were on record as having been immunized. To estimate the actual immunization coverage, all children were considered to have been properly immunized when their family members did provide notification. As regards those who failed to reply, it was considered in the worst of cases that these were cases of children who had not be immunized. In the best of cases scenario, a coverage similar to those of the responses was assumed. The response to the questionnaire was higher among those who had previously provided notification of immunization by way of the postal notification system (79.1%) than among those who had failed to provide notification of immunization (67%). The leading factors associated with failure to report immunization status were the size of the families, the use of private health care services and the place of birth of the parents. Solely six (6) cases of those who had failed to report immunization admitted to not having immunized their children, totaling 1.9% of the responses. The immunization coverage of the population in question would total 99.7% in the best of cases and 93.7% in the worst of cases scenario. Immunization coverage of the population in question is quite high. The results underline the importance of promoting immunization notification among health care professionals, especially in the private sector.

  18. When power does not corrupt: superior individuation processes among powerful perceivers.

    PubMed

    Overbeck, J R; Park, B

    2001-10-01

    To examine whether powerful people fail to individuate the less powerful, the authors assigned participants to either a high-power or low-power role for a computer E-mail role play. In 3 studies, participants in the high-power role made decisions and determined the outcomes of interactions; low-power role players had no power and relied on high-power targets for outcome decisions. Studies I and 2 found that high-power perceivers better individuated low-power targets. Study 3 demonstrated that high-power role players' superior judgment can be impaired by including a task that directs their responsibility toward organizational rather than interpersonal concerns. In all, results suggest that the effect of power on social judgment may be more complex and multifaceted than has previously been acknowledged.

  19. Array heterogeneity prevents catastrophic forgetting in infants

    PubMed Central

    Zosh, Jennifer M.; Feigenson, Lisa

    2015-01-01

    Working memory is limited in adults and infants. But unlike adults, infants whose working memory capacity is exceeded often fail in a particularly striking way: they do not represent any of the presented objects, rather than simply remembering as many objects as they can and ignoring anything further (Feigenson & Carey 2003, 2005). Here we explored the nature of this “catastrophic forgetting,” asking whether stimuli themselves modulate the way in which infants’ memory fails. We showed 13-month old infants object arrays that either were within or that exceeded working memory capacity—but, unlike previous experiments, presented objects with contrasting features. Although previous studies have repeatedly documented infants’ failure to represent four identical hidden objects, in Experiments 1 and 2 we found that infants who saw four contrasting objects hidden, and then retrieved just two of the four, successfully continued searching for the missing objects. Perceptual contrast between objects sufficed to drive this success; infants succeeded regardless of whether the different objects were contrastively labeled, and regardless of whether the objects were semantically familiar or completely novel. In Experiment 3 we explored the nature of this surprising success, asking whether array heterogeneity actually expanded infants’ working memory capacity or rather prevented catastrophic forgetting. We found that infants successfully continued searching after seeing four contrasting objects hidden and retrieving two of them, but not after retrieving three of them. This suggests that, like adults, infants were able to remember up to, but not beyond, the limits of their working memory capacity when representing heterogeneous arrays. PMID:25543889

  20. Perception of foreign cigarettes and their advertising in China: a study of college students from 12 universities

    PubMed Central

    Zhu, S.; Li, D.; Feng, B.; Zhu, T.; Anderson, C.

    1998-01-01

    OBJECTIVE—To examine how deeply foreign cigarette advertising had penetrated the Chinese market when a new ban on cigarette advertising was enacted in February 1995.
DESIGN—A survey using self-completion questionnaires administered in college classrooms from November 1994 to March 1995.
SETTINGS—Eight universities and four medical schools in three Chinese cities: Beijing, Wenzhou, and Hangzhou.
SUBJECTS—1896 college students who agreed to complete a written questionnaire. The mean age was 21.2 years; 39.5% of respondents were female.
RESULTS—Four of the top eight cigarette brands most familiar to the respondents were foreign: Marlboro, 555, Kent, and Hilton. Advertisements for the foreign brands were much more likely to be seen than those for the domestic brands; those for Marlboro were reported most often (29.7%), followed by 555 (21.8%) and Kent (18.1%). Among smokers, Marlboro was the most preferred foreign brand, by 44.2%. The preference for Marlboro was also correlated with smokers having seen its advertisements. Most respondents, 71.8%, believed that cigarette advertising should be banned.
CONCLUSIONS—The previous restrictions on cigarette advertising in China failed to prevent a large portion of the population from seeing and understanding the advertisements. Before the 1995 advertising ban took effect, strict limitations on imports of foreign cigarettes notwithstanding, certain highly advertised brands such as Marlboro achieved wide recognition and even consumer preference. Stricter restrictions are suggested as previous ones have failed to achieve their intended effects.


Keywords: China; advertising; brand preferences PMID:9789931

  1. Control of asgE Expression during Growth and Development of Myxococcus xanthus

    PubMed Central

    Garza, Anthony G.; Harris, Baruch Z.; Greenberg, Brandon M.; Singer, Mitchell

    2000-01-01

    One of the earliest events in the Myxococcus xanthus developmental cycle is production of an extracellular cell density signal called A-signal (or A-factor). Previously, we showed that cells carrying an insertion in the asgE gene fail to produce normal levels of this cell-cell signal. In this study we found that expression of asgE is growth phase regulated and developmentally regulated. Several lines of evidence indicate that asgE is cotranscribed with an upstream gene during development. Using primer extension analyses, we identified two 5′ ends for this developmental transcript. The DNA sequence upstream of one 5′ end has similarity to the promoter regions of several genes that are A-signal dependent, whereas sequences located upstream of the second 5′ end show similarity to promoter elements identified for genes that are C-signal dependent. Consistent with this result is our finding that mutants failing to produce A-signal or C-signal are defective for developmental expression of asgE. In contrast to developing cells, the large majority of the asgE transcript found in vegetative cells appears to be monocistronic. This finding suggests that asgE uses different promoters for expression during vegetative growth and development. Growth phase regulation of asgE is abolished in a relA mutant, indicating that this vegetative promoter is induced by starvation. The data presented here, in combination with our previous results, indicate that the level of AsgE in vegetative cells is sufficient for this protein to carry out its function during development. PMID:11073904

  2. Evaluation of success after second Ahmed glaucoma valve implantation.

    PubMed

    Nilforushan, Naveed; Yadgari, Maryam; Jazayeri, Anis Alsadat; Karimi, Nasser

    2016-03-01

    To evaluate the outcome of the second Ahmed glaucoma valve (AGV) surgery in eyes with failed previous AGV surgery. Retrospective case series. Following chart review, 36 eyes of 34 patients with second AGV implantation were enrolled in this study. The primary outcome measure was surgical success defined in terms of intraocular pressure (IOP) control using two criteria: Success was defined as IOP ≤21 mmHg (criterion 1) and IOP ≤16 mmHg (criterion 2), with at least 20% reduction in IOP, either with no medication (complete success) or with no more than two medications (qualified success). Kaplan-Meier survival analysis was used to determine the probability of surgical success. The average age of the patients was 32.7 years (range 4-65), and the mean duration of follow-up was 21.4 months (range 6-96). Preoperatively, the mean IOP was 26.94 mmHg (standard deviation [SD] 7.03), and the patients were using 2.8 glaucoma medications on average (SD 0.9). The mean IOP decreased significantly to 13.28 mmHg (SD 3.59) at the last postoperative visit (P = 0.00) while the patients needed even fewer glaucoma medications on average (1.4 ± 1.1, P = 0.00). Surgical success of second glaucoma drainage devices (Kaplan-Meier analysis), according to criterion 1, at 6, 12, 18, and 42 months was 94%, 85%, 80%, and 53% respectively, and according to criterion 2, was 94%, 85%, 75%, and 45%, respectively. Repeated AGV implantation seems to be a safe modality of treatment with acceptable success rate in cases with failed previous AGV surgery.

  3. The Interviewer in the Respondent's Shoes: What Can We Learn from the Way Interviewers Answer Survey Questions?

    ERIC Educational Resources Information Center

    Wuyts, Celine; Loosveldt, Geert

    2017-01-01

    Previous research shows that interviewers to some extent fail to expend the effort that is needed to collect high-quality survey data. We extend the idea of interviewer satisficing to a related task, in which the interviewers themselves answer survey questions. We hypothesize that interviewers who self-administer the questionnaire in a careless…

  4. Lightweight Low Frequency Loudspeaker for Active Noise Control

    DTIC Science & Technology

    2001-03-02

    5 The present invention relates to diaphragms for acoustic speakers or transducers, and more specifically, to diaphragms coupled to lightweight...monomorphs and bimorphs. These actuators can deliver reasonable displacement, but in previous configurations when coupled to conventional diaphragms...in air they have failed to produce the combination of force and displacement needed at low frequencies. 15 Polymer speakers have been successful in

  5. At-Risk High School Students Recovering Course Credits Online: What We Know and Need to Know

    ERIC Educational Resources Information Center

    Viano, Samantha L.

    2018-01-01

    The majority of American high school students enrolling in online education are doing so in credit recovery courses. These are online courses specifically for students who previously failed a face-to-face version of the course. Despite the popularity of credit recovery courses, the literature on online learning largely ignores credit recovery…

  6. Credit Recovery in a Virtual School: Affordances of Online Learning for the At-Risk Student

    ERIC Educational Resources Information Center

    Oliver, Kevin; Kellogg, Shaun

    2015-01-01

    This paper summarizes evaluation findings about a high school credit recovery (CR) program as solicited by a statesponsored virtual school in the United States. Student and teacher surveys explained why CR students failed previous instances of face-to-face courses and defined how the online CR model helped these learners overcome both internal…

  7. School's Out: Pathways for Young People with Intellectual Disabilities from Out-of-Area Residential Schools or Colleges

    ERIC Educational Resources Information Center

    Heslop, P.; Abbott, D.

    2007-01-01

    Background: Previous research, and official guidance, has suggested that planning for the transition between children's and adults' services is failing young people with intellectual disabilities and their families in the UK. Youngsters placed away from home in residential schools or colleges are likely to be at even greater risk of poor…

  8. 76 FR 24798 - Airworthiness Directives; Rolls-Royce plc (RR) RB211-Trent 875-17, RB211-Trent 877-17, RB211...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-03

    ... blade root lubrication coating system may be reduced dependant on the extent of previous running with... Trent 895 powered Boeing 777-200 aircraft experienced release of a low pressure (LP) compressor blade which failed due to fatigue cracking in the root section of the blade. The released blade (undercut root...

  9. Scombroid poisoning: prompt resolution of symptoms with cimetidine.

    PubMed

    Blakesley, M L

    1983-02-01

    Ingestion of tainted fish of the tuna class may result in the toxic erythema and histamine overload of scombroid poisoning. We report four cases in which prompt resolution of symptoms was achieved by administration of intravenous cimetidine, with minimal side effects. A search of the literature failed to locate previous reports of the efficacy of cimetidine in the treatment of this syndrome.

  10. Isotretinoin revisited: pluripotent effects on human sebaceous gland cells.

    PubMed

    Zouboulis, Christos C

    2006-10-01

    Nelson et al. confirmed the previously described antiproliferative effect of isotretinoin on human sebocytes. They attributed a portion of this decrease to cell cycle arrest and detected sebocyte apoptosis, which was not recapitulated by alitretinoin or tretinoin. These events were specific to sebocytes, as isotretinoin failed to induce apoptosis in keratinocytes. Isotretinoin-induced apoptosis was shown to be an RAR-independent mechanism.

  11. Word, Thought, and Deed: The Role of Object Categories in Children's Inductive Inferences and Exploratory Play

    ERIC Educational Resources Information Center

    Schulz, Laura E.; Standing, Holly R.; Bonawitz, Elizabeth B.

    2008-01-01

    Previous research (e.g., S. A. Gelman & E. M. Markman, 1986; A. Gopnik & D. M. Sobel, 2000) suggests that children can use category labels to make inductive inferences about nonobvious causal properties of objects. However, such inductive generalizations can fail to predict objects' causal properties when (a) the property being projected varies…

  12. Paradigm Shift: Implementing "MEGA," a New Tool Proposed to Define and Assess Sexually Abusive Dynamics in Youth Ages 19 and Under

    ERIC Educational Resources Information Center

    Rasmussen, Lucinda A.; Miccio-Fonseca, L. C.

    2007-01-01

    Previous definitions of sexually abusive behavior in children and adolescents were deficient in failing to (1) highlight salient neuropsychological elements and antisocial behaviors that may contribute to a youth's functioning; (2) discriminate among possible types of coercion (e.g., manipulation, threats, physical force, and use of weapons); and…

  13. Response of transplanted aspen to irrigation and weeding on a Colorado reclaimed surface coal mine

    Treesearch

    Robert C. Musselman; Wayne D. Shepperd; Frederick W. Smith; Lance A. Asherin; Brian W. Gee

    2012-01-01

    Successful re-establishment of aspen (Populus tremuloides Michx.) on surface-mined lands in the western United States is problematic because the species generally regenerates vegetatively by sprouting from parent roots in the soil; however, topsoil is removed in the mining process. Previous attempts to plant aspen on reclaimed mine sites have failed because...

  14. Development of a new flux splitting scheme

    NASA Technical Reports Server (NTRS)

    Liou, Meng-Sing; Steffen, Christopher J., Jr.

    1991-01-01

    The use of a new splitting scheme, the advection upstream splitting method, for model aerodynamic problems where Van Leer and Roe schemes had failed previously is discussed. The present scheme is based on splitting in which the convective and pressure terms are separated and treated differently depending on the underlying physical conditions. The present method is found to be both simple and accurate.

  15. Development of a new flux splitting scheme

    NASA Technical Reports Server (NTRS)

    Liou, Meng-Sing; Steffen, Christopher J., Jr.

    1991-01-01

    The successful use of a novel splitting scheme, the advection upstream splitting method, for model aerodynamic problems where Van Leer and Roe schemes had failed previously is discussed. The present scheme is based on splitting in which the convective and pressure terms are separated and treated differently depending on the underlying physical conditions. The present method is found to be both simple and accurate.

  16. School Performance, Status Relations, and the Structure of Sentiment: Bringing the Teacher Back In. Report No. 9.

    ERIC Educational Resources Information Center

    Alexander, Karl L.; And Others

    Previous research has failed to support the widely held assumption that the academic difficulties experienced by many minority and low socioeconomic status youth are due to their "outsider" standing vis-a-vis the middle class culture thought to govern the social relations of schooling. This analysis suggests that this proposition errs in…

  17. [Austrian Low Countries, Europe's animal health pioneer, 1769-1776].

    PubMed

    Vallat, F

    2006-12-01

    Two previously unpublished manuscripts reveal how innovative the Austrian Low Countries were when they introduced an animal health policy to control rinderpest in 1769. The policy was novel in that it replaced the slaughter of individual sick animals with herd slaughter. Unfortunately, a number of neighbouring countries failed to emulate this sure-fire method of controlling rinderpest, among them France.

  18. 20 CFR 200.4 - Availability of information to public.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... requester has a history of prompt payment of FOIA fees, or require an advance payment of an amount up to the full estimated charges in the case of requesters with no history of payment; or (B) A requester has previously failed to pay a fee charged in a timely fashion (i.e., within 30 days of the date of the billing...

  19. The Effects of a History-Based Instructional Material on the Students' Understanding of Field Lines

    ERIC Educational Resources Information Center

    Pocovi, M. Cecilia

    2007-01-01

    Many students in physics courses fail to achieve a desired conceptual change because they assign an incorrect ontology to the to-be-learned concept. This situation has been detected in previous research for the case of field lines: many college students assign material properties to the lines and describe them, for example, as tubes that contain…

  20. Learned helplessness in the rat: effect of response topography in a within-subject design.

    PubMed

    dos Santos, Cristiano Valerio; Gehm, Tauane; Hunziker, Maria Helena Leite

    2011-02-01

    Three experiments investigated learned helplessness in rats manipulating response topography within-subject and different intervals between treatment and tests among groups. In Experiment 1, rats previously exposed to inescapable shocks were tested under an escape contingency where either jumping or nose poking was required to terminate shocks; tests were run either 1, 14 or 28 days after treatment. Most rats failed to jump, as expected, but learned to nose poke, regardless of the interval between treatment and tests and order of testing. The same results were observed in male and female rats from a different laboratory (Experiment 2) and despite increased exposure to the escape contingencies using a within-subject design (Experiment 3). Furthermore, no evidence of helplessness reversal was observed, since animals failed to jump even after having learned to nose-poke in a previous test session. These results are not consistent with a learned helplessness hypothesis, which claims that shock (un)controllability is the key variable responsible for the effect. They are nonetheless consistent with the view that inescapable shocks enhance control by irrelevant features of the relationship between the environment and behavior. Copyright © 2010 Elsevier B.V. All rights reserved.

  1. The effectiveness of retreatment with peginterferon alfa and ribavirin in patients with chronic viral hepatitis C genotype 2 and 3: a prospective cohort study in Brazil.

    PubMed

    Artico, Simara; Amaral, Karine Medeiros; Gonçalves, Candice Beatriz Treter; Picon, Paulo Dornelles

    2012-12-27

    More than 50% of patients infected with chronic hepatitis C virus (HCV) do not respond to treatment with conventional interferon (IFN) combined with ribavirin (RBV). The aim of our study was to evaluate the effectiveness of retreatment with peginterferon alfa-2a or 2b (PEG-IFN 2a or 2b) concomitantly with RBV in patients with HCV genotype 2 and 3, which were non-responders or relapsers to initial treatment with IFN / RBV and to identify possible predictors of sustained virological response (SVR). From September 2003 to March 2009 a cohort of 216 patients who had previously failed therapy with a regimen of standard interferon and ribavirin, were followed in a specialized service implemented in the Brazilian Unified Health System, Rio Grande do Sul. All patients were retreated with PEG-IFN 2a or 2b per week, associated with RBV, through oral route, with doses determined according to weight (1,000 mg if weight ≤ 75 Kg and 1,250 mg if ≥ 75 Kg) per day for 48 weeks. The HCV-RNA was tested by Polymerase Chain Reaction (PCR). Virological Response (VR) within 48 weeks and SVR in the 72 weeks was considered for evaluation of treatment efficacy. Analyses were performed in patients who received at least one dose of PEG-IFN. The SVR rate for non-responders to previous treatment was 34.4% and for relapsers was 50% (p = 0.031). As predictive factors that contribute to improve SVR, were identified the age (p = 0.005), to be relapsers to previous treatment (p = 0.023) and present liver biopsy examination Metavir F0-F2 (p = 0.004). In assessing the safety profile, 51 patients (23.6%) discontinued treatment prematurely. This alternative retreatment for patients who have failed prior therapies for anti-HCV, has demonstrated promising SVR rate, provided that it includes a careful selection of patients with predictors of response and adverse events monitored.

  2. The effectiveness of retreatment with peginterferon alfa and ribavirin in patients with chronic viral hepatitis C genotype 2 and 3: a prospective cohort study in Brazil

    PubMed Central

    2012-01-01

    Background More than 50% of patients infected with chronic hepatitis C virus (HCV) do not respond to treatment with conventional interferon (IFN) combined with ribavirin (RBV). The aim of our study was to evaluate the effectiveness of retreatment with peginterferon alfa-2a or 2b (PEG-IFN 2a or 2b) concomitantly with RBV in patients with HCV genotype 2 and 3, which were non-responders or relapsers to initial treatment with IFN / RBV and to identify possible predictors of sustained virological response (SVR). Methods From September 2003 to March 2009 a cohort of 216 patients who had previously failed therapy with a regimen of standard interferon and ribavirin, were followed in a specialized service implemented in the Brazilian Unified Health System, Rio Grande do Sul. All patients were retreated with PEG-IFN 2a or 2b per week, associated with RBV, through oral route, with doses determined according to weight (1,000 mg if weight ≤ 75 Kg and 1,250 mg if ≥ 75 Kg) per day for 48 weeks. The HCV-RNA was tested by Polymerase Chain Reaction (PCR). Virological Response (VR) within 48 weeks and SVR in the 72 weeks was considered for evaluation of treatment efficacy. Analyses were performed in patients who received at least one dose of PEG-IFN. Results The SVR rate for non-responders to previous treatment was 34.4% and for relapsers was 50% (p = 0.031). As predictive factors that contribute to improve SVR, were identified the age (p = 0.005), to be relapsers to previous treatment (p = 0.023) and present liver biopsy examination Metavir F0-F2 (p = 0.004). In assessing the safety profile, 51 patients (23.6%) discontinued treatment prematurely. Conclusions This alternative retreatment for patients who have failed prior therapies for anti-HCV, has demonstrated promising SVR rate, provided that it includes a careful selection of patients with predictors of response and adverse events monitored. PMID:23270376

  3. Definition of Failed Induction of Labor and Its Predictive Factors: Two Unsolved Issues of an Everyday Clinical Situation.

    PubMed

    Baños, Núria; Migliorelli, Federico; Posadas, Eduardo; Ferreri, Janisse; Palacio, Montse

    2015-01-01

    The objectives of this review were to identify the predictive factors of induction of labor (IOL) failure or success as well as to highlight the current heterogeneity regarding the definition and diagnosis of failed IOL. Only studies in which the main or secondary outcome was failed IOL, defined as not entering the active phase of labor after 24 h of prostaglandin administration ± 12 h of oxytocin infusion, were included in the review. The data collected were: study design, definition of failed IOL, induction method, IOL indications, failed IOL rate, cesarean section because of failed IOL and predictors of failed IOL. The database search detected 507 publications. The main reason for exclusion was that the primary or secondary outcomes were not the predetermined definition of failed IOL (not achieving active phase of labor). Finally, 7 studies were eligible. The main predictive factors identified in the review were cervical status, evaluated by the Bishop score or cervical length. Failed IOL should be defined as the inability to achieve the active phase of labor, considering that the definition of IOL is to enter the active phase of labor. A universal definition of failed IOL is an essential requisite to analyze and obtain solid results and conclusions on this issue. An important finding of this review is that only 7 of all the studies reviewed assessed achieving the active phase of labor as a primary or secondary IOL outcome. Another conclusion is that cervical status remains the most important predictor of IOL outcome, although the value of the parameters explored up to now is limited. To find or develop predictive tools to identify those women exposed to IOL who may not reach the active phase of labor is crucial to minimize the risks and costs associated with IOL failure while opening a great opportunity for investigation. Therefore, other predictive tools should be studied in order to improve IOL outcome in terms of health and economic burden. © 2015 S. Karger AG, Basel.

  4. Role of specific IgE and skin-prick testing in predicting food challenge results to baked egg

    PubMed Central

    Cortot, Catherine F.; Sheehan, William J.; Permaul, Perdita; Friedlander, James L.; Baxi, Sachin N.; Gaffin, Jonathan M.; Dioun, Anahita F.; Hoffman, Elaine B.; Schneider, Lynda C.

    2012-01-01

    Previous studies suggest that children with egg allergy may be able to tolerate baked egg. Reliable predictors of a successful baked egg challenge are not well established. We examined egg white–specific IgE levels, skin-prick test (SPT) results, and age as predictors of baked egg oral food challenge (OFC) outcomes. We conducted a retrospective chart review of children, aged 2–18 years, receiving an egg white–specific IgE level, SPT, and OFC to baked egg from 2008 to 2010. Fifty-two oral baked egg challenges were conducted. Of the 52 challenges, 83% (n = 43) passed and 17% (n = 9) failed, including 2 having anaphylaxis. Median SPT wheal size was 12 mm (range, 0–35 mm) for passed challenges and 17 mm (range, 10–30 mm) for failed challenges (p = 0.091). The negative predictive value for passing the OFC was 100% (9 of 9) if SPT wheal size was <10 mm. Median egg white–specific IgE was 2.02 kU/L (range, <0.35–13.00 kU/L) for passed challenges and 1.52 kU/L (range, 0.51–6.10 kU/L) for failed challenges (p = 0.660). Receiver operating characteristic (ROC) curve analysis for SPT revealed an area under the curve (AUC) of 0.64. ROC curve analysis for egg white–specific IgE revealed an AUC of 0.63. There was no significant difference in age between patients who failed and those who passed (median = 8.8 years versus 7.0 years; p = 0.721). Based on our sample, SPT, egg white–specific IgE and age are not good predictors of passing a baked egg challenge. However, there was a trend for more predictability with SPT wheal size. PMID:22584194

  5. Histopathology, Immunohistochemistry, and Electron Microscopic features of a Dacryocystorhinostomy Ostium Cicatrix.

    PubMed

    Ali, Mohammad Javed; Mishra, Dilip Kumar; Baig, Farhana; Naik, Milind N

    2016-01-01

    The aim of this study is to report the histopathological, Immunohistochemical, and ultrastructural features of a dacryocystorhinostomy ostium cicatrix. A prospective histopathological study was performed in a tertiary eye care setting. Scarred nasal mucosal tissues obtained during endoscopic revisions of 10 previously failed dacryocystorhinostomies secondary to complete cicatricial closure of the ostia were studied. The tissue specimens were analyzed using hematoxylin and eosin, periodic acid-Schiff staining. Special stains used include Masson's trichrome and Alizarin red. Immunohistochemistry was performed using vimentin, smooth muscle actin, CD3, CD5, and CD20. Specimens were processed for ultrastructural analysis as per standard protocols for transmission electron microscopy. The respiratory epithelial regeneration was noted to be complete. Irregular laying of deeply eosinophilic and hyalinized collagen with intervening fibroblasts was noted. Focal areas of new bone formation were seen within the cicatricial tissue with osteocytes and ongoing osteoblastic rimming. The infiltrates were mixture of both T and B lymphocytes and were positive for CD3, CD5, and CD20 immunostaining. Electron microscopy showed disorganized collagen fibrils with numerous fibroblasts and mononuclear inflammatory infiltrate. Amorphous bony osteoid within a fibrillar background with metabolically active osteoblasts showed a vesicular cytoplasm, hyperplastic proliferating mitochondria, large Golgi apparatus, and dense endoplasmic reticulum. There is new bone formation within the dense connective tissues of a dacryocystorhinostomy cicatrix. This study may provide useful inputs for further basic science studies aimed at better understanding of wound healing in failed dacryocystorhinostomy.

  6. Clinical outcome of head and neck cancer patients: a comparison between ENT patients referred via the 2 weeks wait pathway and alternative routes in the UK health system.

    PubMed

    Wong, B Y Winson; Fischer, S; Cruickshank, H E

    2017-01-01

    2 weeks wait (2ww) referral was intended to improve cancer outcomes in the UK. However, a previous study found that 2ww failed to detect early stage head and neck cancer. There is no current study to examine the survival outcome of head and neck cancer patients diagnosed on 2ww and non-2ww pathways. The aim of this study is to compare the outcome of cancer patients diagnosed on these pathways. We performed a retrospective review of head and neck cancer patients diagnosed between 2009 and 2013 in the ENT Department at Mid-Yorkshire NHS Hospitals Trust. Gender, age, disease staging, treatment modalities, route of referrals along with survival data were documented. Survival analysis was performed for 2ww and non-2ww cancer patients. There were 4123 patients referred on 2ww during the study period. 147 patients were diagnosed with cancers on 2ww and 89 patients were diagnosed on non-2ww. There were no statistical differences in clinical staging (p = 0.416) and overall survival (p = 0.376) between 2ww and non-2ww patients. This study failed to demonstrate a better overall survival in head and neck cancer patients diagnosed on 2ww pathway within the ENT cohort. Current referral system needs to be refined to improve the survival outcome in head and neck cancer patients.

  7. What shall I do now? State-dependent variations of life-history traits with aging in Wandering Albatrosses.

    PubMed

    Pardo, Deborah; Barbraud, Christophe; Weimerskirch, Henri

    2014-02-01

    Allocation decisions depend on an organism's condition which can change with age. Two opposite changes in life-history traits are predicted in the presence of senescence: either an increase in breeding performance in late age associated with terminal investment or a decrease due to either life-history trade-offs between current breeding and future survival or decreased efficiency at old age. Age variation in several life-history traits has been detected in a number of species, and demographic performances of individuals in a given year are influenced by their reproductive state the previous year. Few studies have, however, examined state-dependent variation in life-history traits with aging, and they focused mainly on a dichotomy of successful versus failed breeding and non-breeding birds. Using a 50-year dataset on the long-lived quasi-biennial breeding wandering albatross, we investigated variations in life-history traits with aging according to a gradient of states corresponding to potential costs of reproduction the previous year (in ascending order): non-breeding birds staying at sea or present at breeding grounds, breeding birds that failed early, late or were successful. We used multistate models to study survival and decompose reproduction into four components (probabilities of return, breeding, hatching, and fledging), while accounting for imperfect detection. Our results suggest the possible existence of two strategies in the population: strict biennial breeders that exhibited almost no reproductive senescence and quasi-biennial breeders that showed an increased breeding frequency with a strong and moderate senescence on hatching and fledging probabilities, respectively. The patterns observed on survival were contrary to our predictions, suggesting an influence of individual quality rather than trade-offs between reproduction and survival at late ages. This work represents a step further into understanding the evolutionary ecology of senescence and its relationship with costs of reproduction at the population level. It paves the way for individual-based studies that could show the importance of intra-population heterogeneity in those processes.

  8. Challenges in the repair of large abdominal wall hernias in Nigeria: review of available options in resource limited environments.

    PubMed

    Ezeome, E R; Nwajiobi, C E

    2010-06-01

    To evaluate the challenges and outcome of management of large abdominal wall hernias in a resource limited environment and highlight the options available to surgeons in similar conditions. A review of prospectively collected data on large abdominal wall hernias managed between 2003 and 2009. University of Nigeria Teaching Hospital, Enugu, Nigeria and surrounding hospitals. Patients with hernias more than 4 cm in their largest diameter, patients with closely sited multiple hernias or failed previous repairs and in whom the surgeon considers direct repair inappropriate. Demographics of patients with large hernias, methods of hernia repair, recurrences, early and late complications following the repair. There were 41 patients, comprising 28 females and 13 males with ages 14 - 73 years. Most (53.7%) were incisional hernias. Gynecological surgeries (66.7%) were the most common initiating surgeries. Fifteen of the patients (36.6%) have had failed previous repairs, 41.5% were obese, five patients presented with intestinal obstruction. Thirty nine of the hernias were repaired with prolene mesh, one with composite mesh and one by danning technique. Most of the patients had extra peritoneal mesh placement. Three patients needed ventilator support. After a mean follow up of 18.6 months, there was a single failed repair. Two post op deaths were related to respiratory distress. There were 12 wound infection and 8 superficial wound dehiscence, all of which except one resolved with dressing. One reoperation was done following mesh infection and extrusion. Large abdominal wall hernia repair in resource limited environments present several challenges with wound infection and respiratory distress being the most notable. Surgeons who embark on it in these environments must be prepared t o secure the proper tissue replacement materials and have adequate ventilation support.

  9. Rolled Tendon Allograft Interposition Arthroplasty for Salvage Surgery of the Hallux Metatarsophalangeal Joint.

    PubMed

    Thomas, Danielle; Thordarson, David

    2018-04-01

    Hallux rigidus is a common osteoarthritic disease of the first metatarsophalangeal joint (MTPJ). Few salvage treatment options exist that preserve motion for patients who have failed an initial procedure and who are not amenable to fusion, typically patients who are active or who would like to wear high heels. Allograft tendon interpositional arthroplasty is an unconventional salvage treatment option that may preserve motion and prevent bone loss. A retrospective chart review is reported of 19 patients who failed previous procedures and refused fusion who underwent allograft tendon interpositional arthroplasty of the hallux MTPJ by a single surgeon between 2012 and 2015. Outcomes included the American Orthopaedic Foot & Ankle Society (AOFAS) hallux metatarsophalangeal-interphalangeal scale assessment as well as measurement of apparent joint space on anterior to posterior and lateral views. The cumulative average AOFAS score for all patients was 68.5 preoperatively and 74.1 postoperatively. The average AOFAS pain subscore was 24.7 preoperatively and 26.8 postoperatively (SD = 7.7 and 13.8, respectively). Radiographically, patients had an increase in apparent joint space from pre- to postoperatively, most notable on the lateral view (0.6 to 4.7 mm; SD = 0.7 and 3.2 mm). Five patients required a second operative procedure, for an overall 26% reoperation rate. One patient underwent hallux MTPJ fusion after the interpositional arthroplasty. An additional 4 patients (21%) had symptoms requiring a steroid injection, and another 3 patients (16%) were recommended to undergo a revision procedure based on their symptoms. Rolled allograft tendon interposition arthroplasty performed poorly as a salvage strategy for failed previous hallux MTPJ surgery for hallux rigidus because of a high rate of complication and minimal benefits. The senior author has abandoned the technique. Level IV, retrospective case series.

  10. The Advanced Glaucoma Intervention Study (AGIS): 5. Encapsulated bleb after initial trabeculectomy.

    PubMed

    Schwartz, A L; Van Veldhuisen, P C; Gaasterland, D E; Ederer, F; Sullivan, E K; Cyrlin, M N

    1999-01-01

    To compare the incidence of encapsulated bleb after trabeculectomy in eyes with and without previous argon laser trabeculoplasty and to assess other risk factors for encapsulated bleb development. After medical treatment failure, eyes enrolled in the Advanced Glaucoma Intervention Study (AGIS) were randomly assigned to sequences of interventions starting with either argon laser trabeculoplasty or trabeculectomy. In the present study we compared the clinical course for 1 year after trabeculectomy in 119 eyes with failed argon laser trabeculoplasty with that of 379 eyes without previous argon laser trabeculoplasty. Data on bleb encapsulation were collected at the time that the encapsulation was diagnosed, and 3 and 6 months later. Of multiple factors examined in the AGIS data for the risk of developing encapsulated bleb, only male gender and high school graduation without further formal education were statistically significant. Encapsulation occurred in 18.5% of eyes with previous argon laser trabeculoplasty failure and 14.5% of eyes without previous argon laser trabeculoplasty (unadjusted relative risk, 1.27; 95% confidence limits = 0.81, 2.00; P = .23). After adjusting for age, gender, educational achievement, prescribed systemic beta-blockers, diabetes, visual field score, and years since glaucoma diagnosis, this difference remains statistically not significant. Four weeks after trabeculectomy, mean intraocular pressure was 7.5 mm Hg higher in eyes with (22.5 mm Hg) than without (15.0 mm Hg) encapsulated bleb; at 1 year after trabeculectomy and the resumption of medical therapy when needed, this excess was reduced to 1.4 mm Hg. This study, as did two previous studies, found male gender to be a risk factor for bleb encapsulation. Four studies, including the present study, have reported a higher rate of encapsulation in eyes with previous argon laser trabeculoplasty; in two of the studies, one of which was the present study, the rate was not statistically significantly higher; in the other two studies the rate was significantly higher. The 4-week postoperative mean intraocular pressure was higher in eyes with than without encapsulated bleb; with the resumption of medical treatment the two means converged after 1 year.

  11. Depletion of CD8 Memory T Cells for Induction of Tolerance of a Previously Transplanted Kidney Allograft

    PubMed Central

    Koyama, I.; Nadazdin, O.; Boskovic, S.; Ochiai, T.; Smith, R. N.; Sykes, M.; Sogawa, H.; Murakami, T.; Strom, T. B.; Colvin, R. B.; Sachs, D. H.; Benichou, G.; Cosimi, A. B.; Kawai, T.

    2013-01-01

    Heterologous immunologic memory has been considered a potent barrier to tolerance induction in primates. Induction of such tolerance for a previously transplanted organ may be more difficult, because specific memory cells can be induced and activated by a transplanted organ. In the current study, we attempted to induce tolerance to a previously transplanted kidney allograft in nonhuman primates. The conditioning regimen consisted of low dose total body irradiation, thymic irradiation, antithymocyte globulin, and anti- CD154 antibody followed by a brief course of a calcineurin inhibitor. This regimen had been shown to induce mixed chimerism and allograft tolerance when kidney transplantation (KTx) and donor bone marrow transplantation (DBMT) were simultaneously performed. However, the same regimen failed to induce mixed chimerism when delayed DBMT was performed after KTx. We found that significant levels of memory T cells remained after conditioning, despite effective depletion of naïve T cells. By adding humanized anti-CD8 monoclonal antibody (cM-T807), CD8 memory T cells were effectively depleted and these recipients successfully achieved mixed chimerism and tolerance. The current studies provide ‘proof of principle’ that the mixed chimerism approach can induce renal allograft tolerance, even late after organ transplantation if memory T-cell function is adequately controlled. PMID:17286617

  12. Vision, Training Hours, and Road Testing Results in Bioptic Drivers

    PubMed Central

    Dougherty, Bradley E.; Flom, Roanne E.; Bullimore, Mark A.; Raasch, Thomas W.

    2015-01-01

    Purpose Bioptic telescopic spectacles (BTS) can be used by people with central visual acuity that does not meet the state standards to obtain an unrestricted driver’s license. The purpose of this study was to examine the relationships among visual and demographic factors, training hours, and the results of road testing for bioptic drivers. Methods A retrospective study of patients who received an initial daylight bioptic examination at the Ohio State University and subsequently received a bioptic license was conducted. Data were collected on vision including visual acuity, contrast sensitivity, and visual field. Hours of driver training and results of Highway Patrol road testing were extracted from records. Relationships among vision, training hours, and road testing were analyzed. Results Ninety-seven patients who completed a vision examination between 2004 and 2008 and received daylight licensure with BTS were included. Results of the first Highway Patrol road test were available for 74 patients. The median interquartile range (IQR) hours of training prior to road testing was 21±17 hours, (range of 9 to 75 hours). Candidates without previous licensure were younger (p< 0.001) and had more documented training (p< 0.001). Lack of previous licensure and more training were significantly associated with having failed a portion of the Highway Patrol test and points deducted on the road test. Conclusions New bioptic drivers without previous non-bioptic driving experience required more training and performed more poorly on road testing for licensure than those who had previous non-bioptic licensure. No visual factor was predictive of road testing results after adjustment for previous experience. The hours of training received remained predictive of road testing outcome even with adjustment for previous experience. These results suggest that previous experience and trainer assessments should be investigated as potential predictors of road safety in bioptic drivers in future studies. PMID:25946098

  13. Development and destruction of the first state funded anti-smoking campaign in the USA.

    PubMed

    Tsoukalas, T H; Glantz, S A

    2003-06-01

    Minnesota was the first state in the USA to implement a large state funded tobacco control programme (in 1985). Despite evidence of effectiveness, it was dismantled in 1993. To describe and analyse how and why these events transpired and identify lessons for tobacco control advocates facing similar challenges in the 21st century. Case study based on previously secret tobacco industry documents, news reports, research reports, official documents, and interviews with health advocates and state government officials. Unable to defeat funding for this campaign in 1985, the tobacco industry organised groups which eliminated it later. Despite the programme's documented effectiveness, it was dismantled based on claims of fiscal crisis. These claims were not true; the real debate was what to do with the state's surplus. Health advocates failed to challenge the claim of fiscal crisis or mobilise public support for the programme. Simply quoting evidence that a tobacco control programme is effective does not ensure its continuing survival. Claims of fiscal crisis are an effective cover for tobacco industry efforts to dismantle successful programmes, particularly if health advocates accept these claims and fail to mobilise political pressure to defend the programme.

  14. Detecting changes in real-world objects: The relationship between visual long-term memory and change blindness.

    PubMed

    Brady, Timothy F; Konkle, Talia; Oliva, Aude; Alvarez, George A

    2009-01-01

    A large body of literature has shown that observers often fail to notice significant changes in visual scenes, even when these changes happen right in front of their eyes. For instance, people often fail to notice if their conversation partner is switched to another person, or if large background objects suddenly disappear.1,2 These 'change blindness' studies have led to the inference that the amount of information we remember about each item in a visual scene may be quite low.1 However, in recent work we have demonstrated that long-term memory is capable of storing a massive number of visual objects with significant detail about each item.3 In the present paper we attempt to reconcile these findings by demonstrating that observers do not experience 'change blindness' with the real world objects used in our previous experiment if they are given sufficient time to encode each item. The results reported here suggest that one of the major causes of change blindness for real-world objects is a lack of encoding time or attention to each object (see also refs. 4 and 5).

  15. Enhanced Two-Factor Authentication and Key Agreement Using Dynamic Identities in Wireless Sensor Networks.

    PubMed

    Chang, I-Pin; Lee, Tian-Fu; Lin, Tsung-Hung; Liu, Chuan-Ming

    2015-11-30

    Key agreements that use only password authentication are convenient in communication networks, but these key agreement schemes often fail to resist possible attacks, and therefore provide poor security compared with some other authentication schemes. To increase security, many authentication and key agreement schemes use smartcard authentication in addition to passwords. Thus, two-factor authentication and key agreement schemes using smartcards and passwords are widely adopted in many applications. Vaidya et al. recently presented a two-factor authentication and key agreement scheme for wireless sensor networks (WSNs). Kim et al. observed that the Vaidya et al. scheme fails to resist gateway node bypassing and user impersonation attacks, and then proposed an improved scheme for WSNs. This study analyzes the weaknesses of the two-factor authentication and key agreement scheme of Kim et al., which include vulnerability to impersonation attacks, lost smartcard attacks and man-in-the-middle attacks, violation of session key security, and failure to protect user privacy. An efficient and secure authentication and key agreement scheme for WSNs based on the scheme of Kim et al. is then proposed. The proposed scheme not only solves the weaknesses of previous approaches, but also increases security requirements while maintaining low computational cost.

  16. Decreased measles antibody response after measles-mumps-rubella vaccine in infants with colds.

    PubMed

    Krober, M S; Stracener, C E; Bass, J W

    1991-04-24

    We examined the possibility that the common cold or afebrile upper respiratory tract infection might interfere with successful immunization in children who receive standard measles-mumps-rubella vaccine. Infants 15 to 18 months of age presenting at our well-child clinics for routine examination and immunizations were divided into two groups. Those infants with a history and physical findings of upper respiratory tract infection were compared with healthy control group infants who did not have upper respiratory tract infections, and who did not have a history of upper respiratory tract infection symptoms within the previous month. Both groups were studied for their serologic response to measles-mumps-rubella vaccination. Prevaccination serum samples were obtained prior to vaccine administration and postvaccination serum samples were obtained 6 to 8 weeks later. Measles antibody was measured in these serum samples by an indirect fluorescein-tagged antibody test. Ten (21%) of 47 infants with colds failed to develop measles antibody, while only one (2%) of 51 well infants failed to develop antibody. We conclude that infants with colds have a significant seroconversion failure rate associated with measles vaccine administration and that this may be the cause of some primary measles vaccine failures.

  17. Development and destruction of the first state funded anti-smoking campaign in the USA

    PubMed Central

    Tsoukalas, T; Glantz, S

    2003-01-01

    Background: Minnesota was the first state in the USA to implement a large state funded tobacco control programme (in 1985). Despite evidence of effectiveness, it was dismantled in 1993. Objective: To describe and analyse how and why these events transpired and identify lessons for tobacco control advocates facing similar challenges in the 21st century. Design: Case study based on previously secret tobacco industry documents, news reports, research reports, official documents, and interviews with health advocates and state government officials. Results: Unable to defeat funding for this campaign in 1985, the tobacco industry organised groups which eliminated it later. Despite the programme's documented effectiveness, it was dismantled based on claims of fiscal crisis. These claims were not true; the real debate was what to do with the state's surplus. Health advocates failed to challenge the claim of fiscal crisis or mobilise public support for the programme. Conclusions: Simply quoting evidence that a tobacco control programme is effective does not ensure its continuing survival. Claims of fiscal crisis are an effective cover for tobacco industry efforts to dismantle successful programmes, particularly if health advocates accept these claims and fail to mobilise political pressure to defend the programme. PMID:12773734

  18. Treatment of Diabetes and Long-Term Survival After Insulin and Glucokinase Gene Therapy

    PubMed Central

    Callejas, David; Mann, Christopher J.; Ayuso, Eduard; Lage, Ricardo; Grifoll, Iris; Roca, Carles; Andaluz, Anna; Ruiz-de Gopegui, Rafael; Montané, Joel; Muñoz, Sergio; Ferre, Tura; Haurigot, Virginia; Zhou, Shangzhen; Ruberte, Jesús; Mingozzi, Federico; High, Katherine A.; Garcia, Felix; Bosch, Fatima

    2013-01-01

    Diabetes is associated with severe secondary complications, largely caused by poor glycemic control. Treatment with exogenous insulin fails to prevent these complications completely, leading to significant morbidity and mortality. We previously demonstrated that it is possible to generate a “glucose sensor” in skeletal muscle through coexpression of glucokinase and insulin, increasing glucose uptake and correcting hyperglycemia in diabetic mice. Here, we demonstrate long-term efficacy of this approach in a large animal model of diabetes. A one-time intramuscular administration of adeno-associated viral vectors of serotype 1 encoding for glucokinase and insulin in diabetic dogs resulted in normalization of fasting glycemia, accelerated disposal of glucose after oral challenge, and no episodes of hypoglycemia during exercise for >4 years after gene transfer. This was associated with recovery of body weight, reduced glycosylated plasma proteins levels, and long-term survival without secondary complications. Conversely, exogenous insulin or gene transfer for insulin or glucokinase alone failed to achieve complete correction of diabetes, indicating that the synergistic action of insulin and glucokinase is needed for full therapeutic effect. This study provides the first proof-of-concept in a large animal model for a gene transfer approach to treat diabetes. PMID:23378612

  19. Stent-over-sponge (SOS): a novel technique complementing endosponge therapy for foregut leaks and perforations.

    PubMed

    Valli, Piero V; Mertens, Joachim C; Kröger, Arne; Gubler, Christoph; Gutschow, Christian; Schneider, Paul M; Bauerfeind, Peter

    2018-02-01

     Endoluminal vacuum therapy (EVT) has evolved as a promising option for endoscopic treatment of foregut wall injuries in addition to the classic closure techniques using clips or stents. To improve vacuum force and maintain esophageal passage, we combined endosponge treatment with a partially covered self-expandable metal stent (stent-over-sponge; SOS).  Twelve patients with infected upper gastrointestinal wall defects were treated with the SOS technique.  Indications for SOS were anastomotic leakage after surgery (n = 11) and chronic foregut fistula (n = 1). SOS treatment was used as a first-line treatment in seven patients with a success rate of 71.4 % (5/7) and as a second-line treatment after failed previous EVT treatment in five patients (success rate 80 %; 4/5). Overall, SOS treatment was successful in 75 % of patients (9/12). No severe adverse events occurred. CONCLUSION : SOS is an effective method to treat severely infected foregut wall defects in patients where EVT has failed, and also as a first-line treatment. Comparative prospective studies are needed to confirm our preliminary results. © Georg Thieme Verlag KG Stuttgart · New York.

  20. Free-style puzzle flap: the concept of recycling a perforator flap.

    PubMed

    Feng, Kuan-Ming; Hsieh, Ching-Hua; Jeng, Seng-Feng

    2013-02-01

    Theoretically, a flap can be supplied by any perforator based on the angiosome theory. In this study, the technique of free-style perforator flap dissection was used to harvest a pedicled or free skin flap from a previous free flap for a second difficult reconstruction. The authors call this a free-style puzzle flap. For the past 3 years, the authors treated 13 patients in whom 12 pedicled free-style puzzle flaps were harvested from previous redundant free flaps and recycled to reconstruct soft-tissue defects at various anatomical locations. One free-style free puzzle flap was harvested from a previous anterolateral thigh flap for buccal cancer to reconstruct a foot defect. Total flap survival was attained in 12 of 13 flaps. One transferred flap failed completely. This patient had received postoperative radiotherapy after the initial cancer ablation and free anterolateral thigh flap reconstruction. Another free flap was used to close and reconstruct the wound. All the donor sites could be closed primarily. The free-style puzzle flap, harvested from a previous redundant free flap and used as a perforator flap to reconstruct a new defect, has proven to be versatile and reliable. When indicated, it is an alternative donor site for further reconstruction of soft-tissue defects.

  1. Clinical Value of Mercaptopurine After Failing Azathioprine Therapy in Patients With Inflammatory Bowel Disease.

    PubMed

    Meijer, Berrie; Seinen, Margien L; Leijte, Niek N W; Mulder, Chris J J; van Bodegraven, Adriaan A; de Boer, Nanne K H

    2016-08-01

    Thiopurines have been widely accepted as immunosuppressive therapy in inflammatory bowel disease. However, many patients have to discontinue thiopurines due to intolerance or ineffectiveness. A therapeutically beneficial effect of switching from azathioprine (AZA) to mercaptopurine (MP) after developing adverse events (AEs) has been reported. The authors assessed the clinical value of MP therapy after AZA discontinuation due to intolerance and, secondary, due to ineffectiveness. In this retrospective single-center study, the authors analyzed data from patients in whom AZA therapy had failed and who were subsequently treated with MP. Thirty-eight patients initiated MP therapy after intolerance to AZA. Intolerance reoccurred in 22 (58%) patients and the remaining 16 (42%) tolerated MP. In 18 out of 48 patients (38%), the AEs that led to discontinuation of MP were similar to those of AZA. A longer duration of prior AZA use was more common in patients who were subsequently tolerant for MP (5.3 versus 1.2 months; P = 0.04). Twenty-two patients discontinued AZA due to ineffectiveness. Eight (36%) patients had clinical benefit from a switch to MP. Six out of these 8 (75%) patients used allopurinol alongside MP, due to ineffectiveness based on a skewed thiopurine metabolism. Patients were more likely to have clinical benefit if the interval between both thiopurines was longer (4.4 versus 0.01 months; P < 0.05). The authors showed that a noteworthy number of patients benefitted therapeutically from a switch from AZA to MP when failing due to intolerance or ineffectiveness; however, the percentage was lower than previously reported in literature.

  2. Carbachol-mediated pigment granule dispersion in retinal pigment epithelium requires Ca2+ and calcineurin.

    PubMed

    Johnson, Adam S; García, Dana M

    2007-12-19

    Inside bluegill (Lepomis macrochirus) retinal pigment epithelial cells, pigment granules move in response to extracellular signals. During the process of aggregation, pigment motility is directed toward the cell nucleus; in dispersion, pigment is directed away from the nucleus and into long apical processes. A number of different chemicals have been found to initiate dispersion, and carbachol (an acetylcholine analog) is one example. Previous research indicates that the carbachol-receptor interaction activates a Gq-mediated pathway which is commonly linked to Ca2+ mobilization. The purpose of the present study was to test for involvement of calcium and to probe calcium-dependent mediators to reveal their role in carbachol-mediated dispersion. Carbachol-induced pigment granule dispersion was blocked by the calcium chelator BAPTA. In contrast, the calcium channel antagonist verapamil, and incubation in Ca2+-free medium failed to block carbachol-induced dispersion. The calcineurin inhibitor cypermethrin blocked carbachol-induced dispersion; whereas, two protein kinase C inhibitors (staurosporine and bisindolylmaleimide II) failed to block carbachol-induced dispersion, and the protein kinase C activator phorbol 12-myristate 13-acetate failed to elicit dispersion. A rise in intracellular calcium is necessary for carbachol-induced dispersion; however, the Ca2+ requirement is not dependent on extracellular sources, implying that intracellular stores are sufficient to enable pigment granule dispersion to occur. Calcineurin is a likely Ca2+-dependent mediator involved in the signal cascade. Although the pathway leads to the generation of diacylglycerol and calcium (both required for the activation of certain PKC isoforms), our evidence does not support a significant role for PKC.

  3. Carbachol-mediated pigment granule dispersion in retinal pigment epithelium requires Ca2+ and calcineurin

    PubMed Central

    Johnson, Adam S; García, Dana M

    2007-01-01

    Background Inside bluegill (Lepomis macrochirus) retinal pigment epithelial cells, pigment granules move in response to extracellular signals. During the process of aggregation, pigment motility is directed toward the cell nucleus; in dispersion, pigment is directed away from the nucleus and into long apical processes. A number of different chemicals have been found to initiate dispersion, and carbachol (an acetylcholine analog) is one example. Previous research indicates that the carbachol-receptor interaction activates a Gq-mediated pathway which is commonly linked to Ca2+ mobilization. The purpose of the present study was to test for involvement of calcium and to probe calcium-dependent mediators to reveal their role in carbachol-mediated dispersion. Results Carbachol-induced pigment granule dispersion was blocked by the calcium chelator BAPTA. In contrast, the calcium channel antagonist verapamil, and incubation in Ca2+-free medium failed to block carbachol-induced dispersion. The calcineurin inhibitor cypermethrin blocked carbachol-induced dispersion; whereas, two protein kinase C inhibitors (staurosporine and bisindolylmaleimide II) failed to block carbachol-induced dispersion, and the protein kinase C activator phorbol 12-myristate 13-acetate failed to elicit dispersion. Conclusion A rise in intracellular calcium is necessary for carbachol-induced dispersion; however, the Ca2+ requirement is not dependent on extracellular sources, implying that intracellular stores are sufficient to enable pigment granule dispersion to occur. Calcineurin is a likely Ca2+-dependent mediator involved in the signal cascade. Although the pathway leads to the generation of diacylglycerol and calcium (both required for the activation of certain PKC isoforms), our evidence does not support a significant role for PKC. PMID:18093324

  4. Does compliance with amblyopia management improve following supervised occlusion treatment?

    PubMed

    El-Ghrably, I A; Longville, D; Gnanaraj, L

    2007-01-01

    To demonstrate improvement in compliance following supervised occlusion therapy for amblyopia in children who had failed to respond to outpatient treatment. Retrospective review of the visual outcome of 30 children who were admitted to an ophthalmology ward for 1-day intensive supervised occlusion. These children had documented poor compliance and previously failed to respond to the outpatient occlusion treatment. During their stay a trained ophthalmology nurse educated parents regarding amblyopia and the benefits of occlusion therapy. Visual acuity (VA) of the amblyopic and fellow eyes was recorded on admission, discharge, and at each subsequent visit. The compliance was recorded from parent's history and also indirectly by noticing improvement in vision. The mean supervised occlusion was 7.4 hours (range 4-12 hours). The compliance with occlusion therapy improved in 23 children (77%) after discharge. The mean duration of occlusion after discharge improved to 4 hours (range 1-12 hours). The mean follow-up was 18 months (range 4-24 months). Though there was no dramatic improvement in VA at discharge there was a statistically significant improvement in VA between admission and last recorded VA (p<0.0001). Of the 23 children who were compliant with occlusion following discharge, 21 (91%) gained at least one line of acuity in their amblyopic eye on the last assessment of their VA and five of them achieved 6/12. Of the seven children who did not comply with occlusion following discharge, only one patient gained one line improvement in his amblyopic eye. This study shows that supervised occlusion treatment and parental education was effective in children who had initially failed traditional outpatient treatment.

  5. Effectiveness of Non-nucleoside Reverse-Transcriptase Inhibitor-Based Antiretroviral Therapy in Women Previously Exposed to a Single Intrapartum Dose of Nevirapine: A Multi-country, Prospective Cohort Study

    PubMed Central

    Stringer, Jeffrey S. A.; McConnell, Michelle S.; Kiarie, James; Bolu, Omotayo; Anekthananon, Thanomsak; Jariyasethpong, Tavatchai; Potter, Dara; Mutsotso, Winnie; Borkowf, Craig B.; Mbori-Ngacha, Dorothy; Muiruri, Peter; Ong'ech, John Odero; Zulu, Isaac; Njobvu, Lungowe; Jetsawang, Bongkoch; Pathak, Sonal; Bulterys, Marc; Shaffer, Nathan; Weidle, Paul J.

    2010-01-01

    Background Intrapartum and neonatal single-dose nevirapine (NVP) reduces the risk of mother-to-child HIV transmission but also induces viral resistance to non-nucleoside reverse transcriptase inhibitor (NNRTI) drugs. This drug resistance largely fades over time. We hypothesized that women with a prior single-dose NVP exposure would have no more than a 10% higher cumulative prevalence of failure of their NNRTI-containing antiretroviral therapy (ART) over the first 48 wk of therapy than would women without a prior exposure. Methods and Findings We enrolled 355 NVP-exposed and 523 NVP-unexposed women at two sites in Zambia, one site in Kenya, and two sites in Thailand into a prospective, non-inferiority cohort study and followed them for 48 wk on ART. Those who died, discontinued NNRTI-containing ART, or had a plasma viral load ≥400 copies/ml at either the 24 wk or 48 wk study visits and confirmed on repeat testing were characterized as having failed therapy. Overall, 114 of 355 NVP-exposed women (32.1%) and 132 of 523 NVP-unexposed women (25.2%) met criteria for treatment failure. The difference in failure rates between the exposure groups was 6.9% (95% confidence interval [CI] 0.8%–13.0%). The failure rates of women stratified by our predefined exposure interval categories were as follows: 47 of 116 women in whom less than 6 mo elapsed between exposure and starting ART failed therapy (40%; p<0.001 compared to unexposed women); 25 of 67 women in whom 7–12 mo elapsed between exposure and starting ART failed therapy (37%; p = 0.04 compared to unexposed women); and 42 of 172 women in whom more than 12 mo elapsed between exposure and starting ART failed therapy (24%; p = 0.82 compared to unexposed women). Locally weighted regression analysis also indicated a clear inverse relationship between virologic failure and the exposure interval. Conclusions Prior exposure to single-dose NVP was associated with an increased risk of treatment failure; however, this risk seems largely confined to women with a more recent exposure. Women requiring ART within 12 mo of NVP exposure should not be prescribed an NNRTI-containing regimen as first-line therapy. Please see later in the article for the Editors' Summary PMID:20169113

  6. Scientific and regulatory reasons for delay and denial of FDA approval of initial applications for new drugs, 2000-2012.

    PubMed

    Sacks, Leonard V; Shamsuddin, Hala H; Yasinskaya, Yuliya I; Bouri, Khaled; Lanthier, Michael L; Sherman, Rachel E

    Some new drug applications fail because of inadequate drug performance and others are not approved because the information submitted to the US Food and Drug Administration (FDA) is unsatisfactory to make that determination. Resubmission of failed applications is costly, delaying marketing approval and the availability of new drugs to patients. To identify the reasons that FDA marketing approval for new drugs was delayed or denied. A retrospective review of FDA documents and extraction of data were performed. We examined all drug applications first submitted to the FDA between 2000 and 2012 for new molecular entities (NMEs), which are active ingredients never before marketed in the United States in any form. Using FDA correspondence and reviews, we investigated the reasons NMEs failed to obtain FDA approval. Reasons for delayed FDA approval or nonapproval of NME applications. Of the 302 identified NME applications, 151 (50%) were approved when first submitted and 222 (73.5%) were ultimately approved. Seventy-one applications required 1 or more resubmissions before approval, with a median delay to approval of 435 days following the first unsuccessful submission. Of the unsuccessful first-time applications, 24 (15.9%) included uncertainties related to dose selection, 20 (13.2%) choice of study end points that failed to adequately reflect a clinically meaningful effect, 20 (13.2%) inconsistent results when different end points were tested, 17 (11.3%) inconsistent results when different trials or study sites were compared, and 20 (13.2%) poor efficacy when compared with the standard of care. The frequency of safety deficiencies was similar among never-approved drugs compared with those with delayed approval (43 of 80 never approved [53.8%] vs 37 of 71 eventually approved [52.1%]; difference, 1.7% [95% CI, -14.86% to 18.05%]; P = .87). However, efficacy deficiencies were significantly more frequent among the never-approved drugs than among those with delayed approvals (61 of 80 never approved [76.3%] vs 28 of 71 eventually approved [39.4%]; difference, 36.9% [95% CI, 20.25% to 50.86%]; P < .001). Several potentially preventable deficiencies, including failure to select optimal drug doses and suitable study end points, accounted for significant delays in the approval of new drugs. Understanding the reasons for previous failures is helpful to improve the efficiency of clinical development for new drugs.

  7. Systems Engineering Technical Leadership Development Program

    DTIC Science & Technology

    2012-02-01

    leading others in creative problem solving, complexity, and why projects fail . These topics were additionally supported by case studies designed to...Your Core Values Dominick Wed 12:30-1:30 Lunch Wed 1:30-2:45 Case Study: Why Projects Fail Pennotti Wed 2:45-3:00 Break Wed 3:00-4:30 Project...Case Study: When Good Wasn’t Good Enough 11. Technical Value-5: Group Project: AR2D2 RFP 12. Customer Expectation-1: Lecture: Why Systems Fail

  8. Hexagonal comb cells of honeybees are not produced via a liquid equilibrium process

    NASA Astrophysics Data System (ADS)

    Bauer, Daniel; Bienefeld, Kaspar

    2013-01-01

    The nests of European honeybees ( Apis mellifera) are organised into wax combs that contain many cells with a hexagonal structure. Many previous studies on comb-building behaviour have been made in order to understand how bees produce this geometrical structure; however, it still remains a mystery. Direct construction of hexagons by bees was suggested previously, while a recent hypothesis postulated the self-organised construction of hexagonal comb cell arrays; however, infrared and thermographic video observations of comb building in the present study failed to support the self-organisation hypothesis because bees were shown to be engaged in direct construction. Bees used their antennae, mandibles and legs in a regular sequence to manipulate the wax, while some bees supported their work by actively warming the wax. During the construction of hexagonal cells, the wax temperature was between 33.6 and 37.6 °C. This is well below 40 °C, i.e. the temperature at which wax is assumed to exist in the liquid equilibrium that is essential for self-organised building.

  9. Turning semicircular canal function on its head: dinosaurs and a novel vestibular analysis.

    PubMed

    Georgi, Justin A; Sipla, Justin S; Forster, Catherine A

    2013-01-01

    Previous investigations have correlated vestibular function to locomotion in vertebrates by scaling semicircular duct radius of curvature to body mass. However, this method fails to discriminate bipedal from quadrupedal non-avian dinosaurs. Because they exhibit a broad range of relative head sizes, we use dinosaurs to test the hypothesis that semicircular ducts scale more closely with head size. Comparing the area enclosed by each semicircular canal to estimated body mass and to two different measures of head size, skull length and estimated head mass, reveals significant patterns that corroborate a connection between physical parameters of the head and semicircular canal morphology. Head mass more strongly correlates with anterior semicircular canal size than does body mass and statistically separates bipedal from quadrupedal taxa, with bipeds exhibiting relatively larger canals. This morphologic dichotomy likely reflects adaptations of the vestibular system to stability demands associated with terrestrial locomotion on two, versus four, feet. This new method has implications for reinterpreting previous studies and informing future studies on the connection between locomotion type and vestibular function.

  10. Turning Semicircular Canal Function on Its Head: Dinosaurs and a Novel Vestibular Analysis

    PubMed Central

    Georgi, Justin A.; Sipla, Justin S.; Forster, Catherine A.

    2013-01-01

    Previous investigations have correlated vestibular function to locomotion in vertebrates by scaling semicircular duct radius of curvature to body mass. However, this method fails to discriminate bipedal from quadrupedal non-avian dinosaurs. Because they exhibit a broad range of relative head sizes, we use dinosaurs to test the hypothesis that semicircular ducts scale more closely with head size. Comparing the area enclosed by each semicircular canal to estimated body mass and to two different measures of head size, skull length and estimated head mass, reveals significant patterns that corroborate a connection between physical parameters of the head and semicircular canal morphology. Head mass more strongly correlates with anterior semicircular canal size than does body mass and statistically separates bipedal from quadrupedal taxa, with bipeds exhibiting relatively larger canals. This morphologic dichotomy likely reflects adaptations of the vestibular system to stability demands associated with terrestrial locomotion on two, versus four, feet. This new method has implications for reinterpreting previous studies and informing future studies on the connection between locomotion type and vestibular function. PMID:23516495

  11. Pituitary-adrenal hormones and testosterone across the menstrual cycle in women with premenstrual syndrome and controls.

    PubMed

    Bloch, M; Schmidt, P J; Su, T P; Tobin, M B; Rubinow, D R

    1998-06-15

    Premenstrual syndrome (PMS) is a cyclic mood disorder, widely believed, yet not conclusively shown, to be of endocrine etiology. This study examines basal levels of several hormones reported, albeit inconsistently, to differ in women with PMS compared with controls. Subjects (10 PMS patients and 10 controls) had their blood drawn for one full menstrual cycle. Subjects' mood and behavioral symptoms were assessed by daily self-ratings and objective ratings. Plasma was assayed for total and free testosterone (T), beta-endorphin (beta-EP), adrenocorticotropic hormone (ACTH), and cortisol. No differences were observed between the PMS and control groups for beta-EP, ACTH, or cortisol. PMS subjects had significantly lower total and free T plasma levels with a blunting of the normal periovulatory peak, a finding that may be epiphenomenal to age. This study does not confirm previous reports of abnormalities in plasma levels of either ACTH or beta-EP in women with PMS; it also fails to replicate a previous observation of high free T levels in women with PMS. These results are not supportive of a primary endocrine abnormality in PMS patients.

  12. Association reactions at low pressure. 5: The CH3(+)/HCN system. A final word?

    NASA Technical Reports Server (NTRS)

    Anicich, Vincent G.; Sen, Atish D.; Huntress, Wesley, Jr.; McEwan, Murray J.

    1995-01-01

    The reaction of the methyl cation with hydrogen cyanide is revisited. We have confidence that we have resolved a long standing apparent contradiction of experimental results. A literature history is presented along with one new experiment and a re-examination of an old experiment. In this present work it is shown that all of the previous studies had made consistent observations. Yet, each of the previous studies failed to observe all of the information present. The methyl cation does react with HCN by radiative association, a fact which had been in doubt. The product ions formed in the two-body and three-body processes react differently with HCN. The collisionally stabilized association product formed by a three-body mechanism, does not react with HCN and is readily detected in the experiments. The radiatively stabilized association product, formed by a slow two-body reaction, is not detected because it reacts with HCN by a fast proton transfer reaction forming the protonated HCN ion. Previous studies either 'lost' this product in the extremely large protonated HCN signal that is always present when HCN is used, or discounted it for various reasons. We have been able to show by ion cyclotron resonance (ICR) techniques (both FT-ICR and tandem ICR-dempster-ICR) that the radiative association product does react with the HCN to form the protonated HCN ion.

  13. Radiofrequency denervation of the hip joint for pain management: case report and literature review.

    PubMed

    Gupta, Gaurav; Radhakrishna, Mohan; Etheridge, Paul; Besemann, Markus; Finlayson, Robert J

    2014-01-01

    A 55-year-old male presented with severe pain and functional limitations as a result of left hip osteoarthritis. He had failed multiple treatments while waiting for a hip arthroplasty, including physical therapy, medications, and various intra-articular injections. Thermal radiofrequency lesioning of the obturator and femoral articular branches to the hip joint was offered in the interim. To our knowledge, this is the first report to describe an inferior-lateral approach for lesioning the obturator branch, the clinical application of successive lesions to increase denervation area, and outcomes in a patient receiving a second treatment with previously good results. To discuss relevant and technical factors for this specific case, we reviewed previous literature on hip joint radiofrequency and critically evaluated previous anatomic studies in the context of radiofrequency. The first treatment provided significant benefit for a period of 6 months. A second treatment was employed providing only mild to moderate benefit until his joint replacement surgery 4 months later. Literature review revealed studies of low quality secondary to small sample sizes, patient selection methodology, inclusion of patients with heterogenous etiologies for pain, variable needle placement techniques, and lack of measurement of functional outcomes. Case report and low quality studies in existing literature. Hip joint radiofrequency denervation is a promising avenue for adjunctive treatment of hip pain. Further cadaveric studies are required to clarify a multitude of technical parameters. Once these are well defined, future clinical studies should consider pain, functional, and economic outcomes in their design.

  14. Current Trends in Technology Education and Vocational Training in the Former Republics of the Soviet Union.

    ERIC Educational Resources Information Center

    Bannatyne, Mark W. McK.

    The schools of the new republics in the former Soviet Union have begun to address the issue of reforms of technical and vocational education in order to train a technologically literate society that can meet the demands of the next century. Previously, Soviet schools failed to offer industrial arts and home economics on a universal scale. This…

  15. FACTORS IN PREDICTING ARMY AVIATOR PERFORMANCE: BIRTH ORDER AND PARTICIPATION IN DANGEROUS SPORTS AND ACTIVITIES,

    DTIC Science & Technology

    Activities Inventory of 395 aviation warrant officer trainees, to test for birth - order effect by comparing first- and second-borns from the same-size...second-born trainees did not differ on measures of exposure to dangerous sports and activities or confidence. Neither pass-fail from flight training nor previous college attendance showed a birth - order effect. (Author)

  16. Lake States Pulpwood Production Hampered by Adverse Weather and Labor Shortage, 1965

    Treesearch

    Arthur G. Horn

    1966-01-01

    Demand for Lake States pulpwood gained strength in 1965, but production failed to rise. Adverse weather during part of the year and a general shortage of woods labor were deterrents to a larger harvest. The total pulpwood cut was 3,636,000 cords in 1965, representing very little change over the level of the 2 previous years. The tempo of pulpwood activities started...

  17. Inversion Effects in the Perception of the Moving Human Form: A Comparison of Adolescents with Autism Spectrum Disorder and Typically Developing Adolescents

    ERIC Educational Resources Information Center

    Cleary, Laura; Looney, Kathy; Brady, Nuala; Fitzgerald, Michael

    2014-01-01

    The "body inversion effect" refers to superior recognition of upright than inverted images of the human body and indicates typical configural processing. Previous research by Reed et al. using static images of the human body shows that people with autism fail to demonstrate this effect. Using a novel task in which adults, adolescents…

  18. Recurrent epileptic Wernicke aphasia.

    PubMed

    Sahaya, Kinshuk; Dhand, Upinder K; Goyal, Munish K; Soni, Chetan R; Sahota, Pradeep K

    2010-04-15

    We report a patient with recurrent epileptic Wernicke aphasia who prior to this presentation, had been misdiagnosed as transient ischemic attacks for several years. This case report emphasizes the consideration of epileptic nature of aphasia when a clear alternate etiology is unavailable, even when EEG fails to show a clear ictal pattern. We also present a brief discussion of previously reported ictal aphasias. Copyright 2010 Elsevier B.V. All rights reserved.

  19. Getting it Right: The Art of Strategy and Operational Warfare

    DTIC Science & Technology

    2008-01-01

    level strategic guidance. This latest revision reduces doctrinal clutter, and its crisp prose is a welcome stylistic improvement over previous...elements of power as “instruments,” joint doc- trine fails to make the cognitive discrimination necessary to deal with the challenges we face and...military, and economic elemental categories. This confusion creates a cognitive disso- nance within joint doctrine that remains unre- solved, seeing

  20. Determinants of Baccalaureate Degree Completion and Time-to-Degree for High School Graduates in 1992

    ERIC Educational Resources Information Center

    Lee, Giljae

    2010-01-01

    U.S. colleges and universities are failing to graduate a greater number of students than in previous decades, although there has been more than a 25 percent increase in the number of students enrolling in colleges after high school graduation for the last three decades. Nevertheless, the 6-year graduation rate has been lingering around 66 percent…

  1. Children's difficulty with true belief tasks: Competence deficit or performance problem?

    PubMed

    Oktay-Gür, Nese; Rakoczy, Hannes

    2017-09-01

    According to the standard picture of explicit theory of mind (ToM) development, children begin to (explicitly) ascribe beliefs to others and themselves from around age 4. The empirical basis of this picture comes from numerous studies consistently showing that children master verbal false belief (FB) tasks from around age 4 while children much younger have no difficulty in mastering structurally analogous true belief (TB) tasks. The standard picture, though, has come under serious attack from recent studies using TB tasks with wider age ranges. These studies have found that, paradoxically, children begin to fail TB tasks once they master FB tasks. Such findings cast doubt on the standard picture and suggest, instead, that FB tasks may be solved by much simpler strategies than proper belief reasoning. In the present study, we tested for the development of FB and TB performance in comprehensive and systematic ways. In particular, we tested the competing predictions of competence accounts (according to which TB failure reflects lack of conceptual competence) versus performance limitation accounts (according to which the standard picture is true yet children from around age 4 fail TB tasks due to performance factors). Studies 1 and 2 showed that performance in a variety of novel TB tasks showed a clear U-shaped curve, with children until age 3 and from age 10 performing competently and children in between failing, with strong negative correlations between TB and FB. Crucially, these patterns were found for various kinds of TB tasks, including those for which existing competence limitation accounts would not even predict any difficulty. Study 3, therefore, directly tested performance limitation accounts in terms of pragmatic and related factors and found that these patterns (failure in TB and negative TB-FB correlations) disappear once the relevant performance factors have been removed from the TB tasks. Taken together, these findings suggest that previous TB findings constitute false negatives, clearly speak for performance limitation accounts and thus corroborate the standard picture of the development of explicit theory of mind. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Infants use relative numerical group size to infer social dominance

    PubMed Central

    Pun, Anthea; Birch, Susan A. J.; Baron, Andrew Scott

    2016-01-01

    Detecting dominance relationships, within and across species, provides a clear fitness advantage because this ability helps individuals assess their potential risk of injury before engaging in a competition. Previous research has demonstrated that 10- to 13-mo-old infants can represent the dominance relationship between two agents in terms of their physical size (larger agent = more dominant), whereas younger infants fail to do so. It is unclear whether infants younger than 10 mo fail to represent dominance relationships in general, or whether they lack sensitivity to physical size as a cue to dominance. Two studies explored whether infants, like many species across the animal kingdom, use numerical group size to assess dominance relationships and whether this capacity emerges before their sensitivity to physical size. A third study ruled out an alternative explanation for our findings. Across these studies, we report that infants 6–12 mo of age use numerical group size to infer dominance relationships. Specifically, preverbal infants expect an agent from a numerically larger group to win in a right-of-way competition against an agent from a numerically smaller group. In addition, this is, to our knowledge, the first study to demonstrate that infants 6–9 mo of age are capable of understanding social dominance relations. These results demonstrate that infants’ understanding of social dominance relations may be based on evolutionarily relevant cues and reveal infants’ early sensitivity to an important adaptive function of social groups. PMID:26884199

  3. The Objective Borderline Method (OBM): A Probability-Based Model for Setting up an Objective Pass/Fail Cut-Off Score in Medical Programme Assessments

    ERIC Educational Resources Information Center

    Shulruf, Boaz; Turner, Rolf; Poole, Phillippa; Wilkinson, Tim

    2013-01-01

    The decision to pass or fail a medical student is a "high stakes" one. The aim of this study is to introduce and demonstrate the feasibility and practicality of a new objective standard-setting method for determining the pass/fail cut-off score from borderline grades. Three methods for setting up pass/fail cut-off scores were compared: the…

  4. Conditioned Stimuli’s Role in Relapse: Pre-Clinical Research on Pavlovian Instrumental Transfer

    PubMed Central

    Lamb, R.J.; Schindler, W.; Pinkston, Jonathan W.

    2016-01-01

    Rationale and Objective Pavlovian learning is central to many theories of addiction. In these theories, stimuli paired with drug ingestion become Conditioned Stimuli (CS) and subsequently elicit drug-seeking and -taking. However in most relevant studies, Pavlovian and instrumental learning are confounded. This confound may be avoided in Pavlovian-Instrumental-Transfer (PIT) procedures. In PIT, Pavlovian and instrumental learning are established separately, and then combined. In order to better understand the role of CSs in addiction, we review the relevant studies using PIT. Findings We identified seven articles examining PIT effects of ethanol- or cocaine-paired CSs. Under at least one condition six of these articles reported CS-elicited increases in responding previously maintained by drug. However, the only study using the optimal control condition failed to find a CS-elicited increase. Two studies examining CS specificity found the CS also increased responding maintained by a different reinforcer. Two studies examined if CSs elicit increases in actual drug-taking. Both failed to find CS-elicited increases, i.e., no study shows CS-elicited increases in actual drug-taking. Further, CS-elicited increases in extinguished responding are short-lived. Conclusions These findings are not entirely consistent with Pavlovian learning playing a central role in addiction. However, design issues can explain most of these inconsistencies. Studies without these design issues are needed. Additionally, existing theories hypothesize drug-paired CSs increase drug-taking by increasing motivation, by eliciting conditioned responses that make drug-seeking more probable, or by a combination of these. Work distinguishing between these mechanisms would also be useful. PMID:26800688

  5. Robotic trans-abdominal transplant nephrectomy for a failed renal allograft.

    PubMed

    Mulloy, M R; Tan, M; Wolf, J H; D'Annunzio, S H; Pollinger, H S

    2014-12-01

    Minimally invasive surgery for removal of a failed renal allograft has not previously been reported. Herein, we report the first robotic trans-abdominal transplant nephrectomy (TN). A 34-year-old male with Alport's syndrome lost function of his deceased donor allograft after 12 years and presented with fever, pain over his allograft and hematuria. The operation was performed intra-abdominally using the Da Vinci Robotic Surgical System with four trocars. The total operative time was 235 min and the estimated blood loss was less than 25 cm(3). There were no peri-operative complications observed and the patient was discharged to home less than 24 h postoperatively. The utilization of robotic technology facilitated the successful performance of a minimally invasive, trans-abdominal TN. © Copyright 2014 The American Society of Transplantation and the American Society of Transplant Surgeons.

  6. Sensor failure detection for jet engines

    NASA Technical Reports Server (NTRS)

    Beattie, E. C.; Laprad, R. F.; Akhter, M. M.; Rock, S. M.

    1983-01-01

    Revisions to the advanced sensor failure detection, isolation, and accommodation (DIA) algorithm, developed under the sensor failure detection system program were studied to eliminate the steady state errors due to estimation filter biases. Three algorithm revisions were formulated and one revision for detailed evaluation was chosen. The selected version modifies the DIA algorithm to feedback the actual sensor outputs to the integral portion of the control for the nofailure case. In case of a failure, the estimates of the failed sensor output is fed back to the integral portion. The estimator outputs are fed back to the linear regulator portion of the control all the time. The revised algorithm is evaluated and compared to the baseline algorithm developed previously.

  7. Age differences in the psychological consequences of Hurricane Hugo.

    PubMed

    Thompson, M P; Norris, F H; Hanacek, B

    1993-12-01

    At 12, 18, and 24 months after Hurricane Hugo, 831 adults were interviewed regarding their disaster-related stressors and present psychological state. The study's purposes were to assess whether age influenced one's vulnerability to postdisaster stress and to evaluate four different perspectives on disaster recovery that have been previously used to explain age differences. Regression analyses demonstrated that disaster exposure had substantial and pervasive psychological effects. The analyses also revealed a curvilinear interaction between disaster exposure and age. Younger people exhibited the most distress in the absence of disaster, but middle-aged people did so in its presence. Differential exposure, resources, and inoculation all failed to explain these differences, however, the burden perspective had considerable explanatory power.

  8. Happy but still focused: failures to find evidence for a mood-induced widening of visual attention.

    PubMed

    Bruyneel, Lynn; van Steenbergen, Henk; Hommel, Bernhard; Band, Guido P H; De Raedt, Rudi; Koster, Ernst H W

    2013-05-01

    In models of affect and cognition, it is held that positive affect broadens the scope of attention. Consistent with this claim, previous research has indeed suggested that positive affect is associated with impaired selective attention as evidenced by increased interference of spatially distant distractors. However, several recent findings cast doubt on the reliability of this observation. In the present study, we examined whether selective attention in a visual flanker task is influenced by positive mood induction. Across three experiments, positive affect consistently failed to exert any impact on selective attention. The implications of this null-finding for theoretical models of affect and cognition are discussed.

  9. ATP Synthase, a Target for Dementia and Aging?

    PubMed

    Larrick, James W; Larrick, Jasmine W; Mendelsohn, Andrew R

    2018-02-01

    Advancing age is the biggest risk factor for development for the major life-threatening diseases in industrialized nations accounting for >90% of deaths. Alzheimer's dementia (AD) is among the most devastating. Currently approved therapies fail to slow progression of the disease, providing only modest improvements in memory. Recently reported work describes mechanistic studies of J147, a promising therapeutic molecule previously shown to rescue the severe cognitive deficits exhibited by aged, transgenic AD mice. Apparently, J147 targets the mitochondrial alpha-F1-ATP synthase (ATP5A). Modest inhibition of the ATP synthase modulates intracellular calcium to activate AMP-activated protein kinase to inhibit mammalian target of rapamycin, a known mechanism of lifespan extension from worms to mammals.

  10. Eden-Hybinette and Pectoralis Major Transfer for Recurrent Shoulder Instability Due to Failed Latarjet and Chronic Subscapularis Rupture.

    PubMed

    Li, Xinning; Cusano, Antonio; Eichinger, Josef

    2017-01-01

    Shoulder dislocations are a common injury, with anterior shoulder dislocation among male patients being the most common presentation. A patient with recurrent shoulder instability, anterior-superior escape, and chronic subscapularis tendon rupture following multiple shoulder stabilization surgeries presents the surgeon with a complex and challenging case. This report describes a 40-year-old man with an extensive left shoulder history that included a failed Latarjet procedure, an irreparable, chronic subscapularis tear with grade 4 Goutallier fatty infiltration, and associated anterior-superior escape. Given his marked dysfunction, weakness, pain, and recurrent instability in the absence of glenohumeral arthritis, he underwent an open Eden-Hybinette procedure (iliac crest autograft), a pectoralis major transfer, and an anterior capsule repair. The patient returned to his previous work activities without limitations. To the authors' knowledge, this is the first report describing a combination of anterior glenoid bone grafting with a full pectoralis major muscle transfer for a patient with chronic subscapularis rupture and anterior-superior escape after a failed Latarjet procedure with minimum glenoid bone loss. Furthermore, the authors provide a biomechanical rationale for the reconstruction used for this problem. [Orthopedics. 2017; 40(1):e182-e187.]. Copyright 2016, SLACK Incorporated.

  11. Prediction of particulate loading in exhaust from fabric filter baghouses with one or more failed bags

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

    Wenjun Qin; Manuel Dekermenjian; Richard J. Martin

    2006-08-15

    Loss of filtration efficiency in a fabric filter baghouse is typically caused by bag failure, in one form or another. The degree of such failure can be as minor as a pinhole leak or as major as a fully involved baghouse fire. In some cases, local air pollution regulations or federal hazardous waste laws may require estimation of the total quantity of particulate matter released to the environment as a result of such failures. In this paper, a technique is presented for computing the dust loading in the baghouse exhaust when one or more bags have failed. The algorithm developedmore » is shown to be an improvement over a previously published result, which requires empirical knowledge of the variation in baghouse pressure differential with bag failures. An example calculation is presented for a baghouse equipped with 200 bags. The prediction shows that a small percentage of failed bags can cause a relatively large proportion of the gas flow to bypass the active bags, which, in turn, leads to high outlet dust loading and low overall collection efficiency from the baghouse. 10 refs., 5 figs., 3 tabs.« less

  12. Evidence of weak conscious experiences in the exclusion task

    PubMed Central

    Sandberg, Kristian; Del Pin, Simon H.; Bibby, Bo M.; Overgaard, Morten

    2014-01-01

    Exclusion tasks have been proposed as objective measures of unconscious perception as they do not depend upon subjective ratings. In exclusion tasks, participants have to complete a task without using a previously presented prime. Use of the prime is taken as evidence for unconscious processing in the absence of awareness, yet it may also simply indicate that participants have weak experiences but fail to realize that these affect the response or fail to counter the effect on the response. Here, we tested this claim by allowing participants to rate their experience of a masked prime on the perceptual awareness scale (PAS) after the exclusion task. Results showed that the prime was used almost as often when participants reported having seen a “weak glimpse” of the prime as when they claimed to have “no experience” of the prime, thus suggesting participants frequently have weak (possibly contentless) experiences of the stimulus when failing to exclude. This indicates that the criteria for report of awareness is lower (i.e., more liberal) than that for exclusion and that failure to exclude should not be taken as evidence of complete absence of awareness. PMID:25295024

  13. Modeling thermal and irradiation-induced swelling effects on the integrity of Ti 3 SiC 2 /SiC joints

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

    Nguyen, Ba Nghiep; Henager, Charles H.; Kurtz, Richard J.

    Previously, results for CVD-SiC joints created using solid state displacement reactions to form a dual-phase SiC/MAX phase irradiated at 800°C and 5 dpa indicated some extent of cracking in the joint and along the CVD-SiC/joint interface. This paper elucidates the origin of cracking by thermomechanical modeling combined with irradiation-induced swelling effects using a continuum damage approach with support of micromechanical modeling. Three irradiation temperatures (400°C, 500°C and 800°C) are considered assuming experimental irradiation doses in a range leading to saturation swelling in SiC. The analyses indicate that a SiC/MAX joint heated to 400°C fails during irradiation-induced swelling at this temperaturemore » while it experiences some damage after being heated to 500°C and irradiated at the same temperature. However, it fails during cooling from 500°C to room temperature. The joint experiences minor damage when heated to and irradiated at 800°C but does not fail after cooling. The prediction agrees with the experimental findings available for this case.« less

  14. Pictorial essay: Role of ultrasound in failed carpal tunnel decompression.

    PubMed

    Botchu, Rajesh; Khan, Aman; Jeyapalan, Kanagaratnam

    2012-01-01

    USG has been used for the diagnosis of carpal tunnel syndrome. Scarring and incomplete decompression are the main causes for persistence or recurrence of symptoms. We performed a retrospective study to assess the role of ultrasound in failed carpal tunnel decompression. Of 422 USG studies of the wrist performed at our center over the last 5 years, 14 were for failed carpal tunnel decompression. Scarring was noted in three patients, incomplete decompression in two patients, synovitis in one patient, and an anomalous muscle belly in one patient. No abnormality was detected in seven patients. We present a pictorial review of USG findings in failed carpal tunnel decompression.

  15. Pictorial essay: Role of ultrasound in failed carpal tunnel decompression

    PubMed Central

    Botchu, Rajesh; Khan, Aman; Jeyapalan, Kanagaratnam

    2012-01-01

    USG has been used for the diagnosis of carpal tunnel syndrome. Scarring and incomplete decompression are the main causes for persistence or recurrence of symptoms. We performed a retrospective study to assess the role of ultrasound in failed carpal tunnel decompression. Of 422 USG studies of the wrist performed at our center over the last 5 years, 14 were for failed carpal tunnel decompression. Scarring was noted in three patients, incomplete decompression in two patients, synovitis in one patient, and an anomalous muscle belly in one patient. No abnormality was detected in seven patients. We present a pictorial review of USG findings in failed carpal tunnel decompression. PMID:22623813

  16. Accessory atrioventricular pathways refractory to catheter ablation: role of percutaneous epicardial approach.

    PubMed

    Scanavacca, Maurício Ibrahim; Sternick, Eduardo Back; Pisani, Cristiano; Lara, Sissy; Hardy, Carina; d'Ávila, André; Correa, Frederico Soares; Darrieux, Francisco; Hachul, Denise; Marcial, Miguel Barbero; Sosa, Eduardo A

    2015-02-01

    Epicardial mapping and ablation of accessory pathways through a subxiphoid approach can be an alternative when endocardial or epicardial transvenous mapping has failed. We reviewed acute and long-term follow-up of 21 patients (14 males) referred for percutaneous epicardial accessory pathway ablation. There was a median of 2 previous failed procedures. All patients were highly symptomatic, 8 had atrial fibrillation (3 with cardiac arrest) and 13 had frequent symptomatic episodes of atrioventricular reentrant tachycardia. Six patients (28.5%) had a successful epicardial ablation. Five patients (23.8%) underwent a successful repeated endocardial mapping, and ablation after epicardial mapping yielded no early activation site. Epicardial mapping was helpful in guiding endocardial ablation in 2 patients (9.5%), showing that the earliest activation was simultaneous at the epicardium and endocardium. Four patients (19%) underwent successful open-chest surgery after failing epicardial/endocardial ablation. Two patients (9.5%) remained controlled under antiarrhythmic drugs after unsuccessful endocardial/epicardial ablation. Two patients had a coronary sinus diverticulum and one a right atrium to right ventricle diverticulum. Three patients acquired postablation coronary sinus stenosis. There was no major complication related to pericardial access. Percutaneous epicardial approach is an alternative when conventional endocardial or transvenous epicardial ablation fails in the elimination of the accessory pathway. A new attempt by endocardial approach was successful in a significant number of patients. Open-chest surgery may be required in symptomatic cases refractory to endocardial-epicardial approach. © 2014 American Heart Association, Inc.

  17. Relationship Between Lean Production and Operational Performance in the Manufacturing Industry

    NASA Astrophysics Data System (ADS)

    Rasi, Raja Zuraidah R. M.; Syamsyul Rakiman, Umol; Ahmad, Md Fauzi Bin

    2015-05-01

    Nowadays, more and more manufacturing firms have started to implement lean production system in their operations. Lean production viewed as one of the mechanism to maintain the organisation's position and to compete globally. However, many fail to apply the lean concepts successfully in their operations. Based on previous studies, implementation of lean production in the manufacturing industry is more focused on the relationship between Lean and Operational Performance of one dimension only. Therefore, this study attempted to examine the relationship between Lean Production (LP) and Operational Performance in 4 dimensions which are quality, delivery, cost and flexibility. This study employed quantitative study using questionnaires. Data was collected from 50 manufacturing industries. The data was analysed using Statistical Package for Social Science (SPSS) 22.0. This study is hoped to shed new understanding on the concept of Lean Production (LP) in regards of Operational Performance covering the 4 dimensions.

  18. Results of an ultrastructural study comparing stria vascularis with organ of Corti in guinea pigs treated with kanamycin.

    PubMed

    Gratacap, B; Charachon, R; Stoebner, P

    1985-01-01

    Ultrastructural study of ototoxicity is well documented with two points of interest: organ of Corti for aminoglycosides and stria vascularis for loop diuretics. As a previous study suggested initial lesions of stria vascularis, an attempt of comparison and of chronological study was made between the organ of Corti and stria vascularis lesions by kanamycin intoxication. The method was devised by J. M. ARAN, with electrophysiological control. We failed to find in the stria vascularis a radial or longitudinal pattern of lesions. We could not discern a chronological injury between the organ of Corti and stria vascularis because both were damaged even in the less deafened animals. Nevertheless, two facts were clarified: hair cell lesions are lysosomial as for the kidney lesions, while stria vascularis lesions are mitochondrial, melanine granulations play a part in drug metabolism (increased number, secretory aspect) and deserve further study.

  19. Factors affecting the decision to replace failed implants: a retrospective study.

    PubMed

    Mardinger, Ofer; Oubaid, Saheer; Manor, Yifat; Nissan, Joseph; Chaushu, Gavriel

    2008-12-01

    The purpose of the present study was to explore the major factors that can affect the decision to replace failed implants. A retrospective cohort study was conducted on 194 patients who presented following dental implant failure during a 6-year period (2000 to 2006). The collected data included patient characteristics, failed implant characteristics, the anatomic status of the alveolar ridge after failure, and factors affecting the decision to avoid reimplantation. The study group included patients in whom the failed dental implants were replaced, whereas there was no reimplantation in the control group. Seventy-four patients (135 implants) made up the control group, and 120 patients (157 implants) made up the study group. The mean patient age was higher and the medical status was worse in the control group. The number of failed implants per patient was higher in the control group. The time between the diagnosis of failure and removal and between implant placement and removal were greater in the control group. The chances of a patient with minor bone loss undergoing reimplantation was 20 times greater (odds ratio, 20.4) than a patient with severe bone loss. The main patient-related reasons for avoiding reimplantation were the additional costs (27%), fear of additional pain (17.7%), and fear of a second failure (16.2%). The removal of a failing implant as soon as it is diagnosed as hopeless will improve the chances for reimplantation.

  20. Association Testing of Previously Reported Variants in a Large Case-Control Meta-analysis of Diabetic Nephropathy

    PubMed Central

    Williams, Winfred W.; Salem, Rany M.; McKnight, Amy Jayne; Sandholm, Niina; Forsblom, Carol; Taylor, Andrew; Guiducci, Candace; McAteer, Jarred B.; McKay, Gareth J.; Isakova, Tamara; Brennan, Eoin P.; Sadlier, Denise M.; Palmer, Cameron; Söderlund, Jenny; Fagerholm, Emma; Harjutsalo, Valma; Lithovius, Raija; Gordin, Daniel; Hietala, Kustaa; Kytö, Janne; Parkkonen, Maija; Rosengård-Bärlund, Milla; Thorn, Lena; Syreeni, Anna; Tolonen, Nina; Saraheimo, Markku; Wadén, Johan; Pitkäniemi, Janne; Sarti, Cinzia; Tuomilehto, Jaakko; Tryggvason, Karl; Österholm, Anne-May; He, Bing; Bain, Steve; Martin, Finian; Godson, Catherine; Hirschhorn, Joel N.; Maxwell, Alexander P.; Groop, Per-Henrik; Florez, Jose C.

    2012-01-01

    We formed the GEnetics of Nephropathy–an International Effort (GENIE) consortium to examine previously reported genetic associations with diabetic nephropathy (DN) in type 1 diabetes. GENIE consists of 6,366 similarly ascertained participants of European ancestry with type 1 diabetes, with and without DN, from the All Ireland-Warren 3-Genetics of Kidneys in Diabetes U.K. and Republic of Ireland (U.K.-R.O.I.) collection and the Finnish Diabetic Nephropathy Study (FinnDiane), combined with reanalyzed data from the Genetics of Kidneys in Diabetes U.S. Study (U.S. GoKinD). We found little evidence for the association of the EPO promoter polymorphism, rs161740, with the combined phenotype of proliferative retinopathy and end-stage renal disease in U.K.-R.O.I. (odds ratio [OR] 1.14, P = 0.19) or FinnDiane (OR 1.06, P = 0.60). However, a fixed-effects meta-analysis that included the previously reported cohorts retained a genome-wide significant association with that phenotype (OR 1.31, P = 2 × 10−9). An expanded investigation of the ELMO1 locus and genetic regions reported to be associated with DN in the U.S. GoKinD yielded only nominal statistical significance for these loci. Finally, top candidates identified in a recent meta-analysis failed to reach genome-wide significance. In conclusion, we were unable to replicate most of the previously reported genetic associations for DN, and significance for the EPO promoter association was attenuated. PMID:22721967

Top