[Pterygium surgery and fibrin glue: avoiding dehiscence].

PubMed

Pérez-Silguero, D; Díaz-Ginory, A; Santana-Rodríguez, C; Pérez-Silguero, M A

2014-01-01

The purpose of the study is to evaluate those cases of pterygium surgery with fibrin sealant that produced dehiscence of the graft, and then apply and evaluate the efficacy of a different surgical technique in an attempt eliminate this complication in previously identified cases of high risk. The first phase is a retrospective study of 42 cases of pterygium surgery. In the second phase, the variation in the surgical technique was prospectively used in 14 cases of pterygium surgery. Cases of recurrent pterygium, broad pterygium, and complicated surgery were identified as the groups with a risk of suffering dehiscence of the graft. With the variant applied surgery no dehiscence occurred when using the variation in surgical technique, with no added complications. Copyright © 2012 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

Conjunctival autograft for pterygium

PubMed Central

Clearfield, Elizabeth; Muthappan, Valliammai; Wang, Xue; Kuo, Irene C

2016-01-01

Background A pterygium is a fleshy, wing-shaped growth from the conjunctiva, crossing over the limbus onto the cornea. Prevalence ranges widely around the world. Evidence suggests that ultraviolet light is a major contributor in the formation of pterygia. Pterygia impair vision, limit eye movements, and can cause eye irritation, foreign body sensation, and dryness. In some susceptible patients, the pterygium can grow over the entire corneal surface, blocking the visual axis. Surgery is the only effective treatment for pterygium, though recurrences are common. With simple excision techniques (that is, excising the pterygium and leaving bare sclera), the risk of recurrence has been reported to be upwards of 80%. Pterygium excision combined with a tissue graft has a lower risk of recurrence. In conjunctival autograft surgery, conjunctival tissue from another part of the person’s eye along with limbal tissue is resected in one piece and used to cover the area from which the pterygium was excised. Another type of tissue graft surgery for pterygium is amniotic membrane graft, whereby a piece of donor amniotic membrane is fixed to the remaining limbus and bare sclera area after the pterygium has been excised. Objectives The objective of this review was to assess the safety and effectiveness of conjunctival autograft (with or without adjunctive therapy) compared with amniotic membrane graft (with or without adjunctive therapy) for pterygium. We also planned to determine whether use of MMC yielded better surgical results and to assess the direct and indirect comparative costs of these procedures. Search methods We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (Issue 10, 2015), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to November 2015), EMBASE (January 1980 to November 2015), PubMed (1948 to November 2015), Latin American and Caribbean Health Sciences Literature Database (LILACS) (1982 to November 2015), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com) (last searched 21 November 2014), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic search for trials. We last searched the electronic databases on 23 November 2015. Selection criteria We included in this review randomized controlled trials that had compared conjunctival autograft surgery (with or without adjunctive therapy) with amniotic membrane graft surgery (with or without adjunctive therapy) in people with primary or recurrent pterygium. Data collection and analysis Two review authors independently screened search results and assessed full-text reports from among the potentially eligible trials. Two review authors independently extracted data from the included trials and assessed the trial characteristics and risk of bias. The primary outcome was the risk of recurrence of pterygium at 3 months and 6 months after surgery. We combined results from individual studies in meta-analyses using random-effects models. Risk of recurrence of pterygium was reported using risk ratios to compare conjunctival autograft with amniotic membrane transplant. Main results We identified 20 studies that had analyzed a total of 1947 eyes of 1866 participants (individual studies ranged from 8 to 346 participants who were randomized). The studies were conducted in eight different countries: one in Brazil, three in China, three in Cuba, one in Egypt, two in Iran, two in Thailand, seven in Turkey, and one in Venezuela. Overall risk of bias was unclear, as many studies did not provide information on randomization methods or masking to prevent performance and detection bias. The risk ratio for recurrence of pterygium using conjunctival autograft versus amniotic membrane transplant was 0.87 (95% confidence interval (CI) 0.43 to 1.77) and 0.53 (95% CI 0.33 to 0.85) at 3 months and 6 months, respectively. These estimates include participants with primary and recurrent pterygia. We performed a subgroup analysis to compare participants with primary pterygia with participants with recurrent pterygia. For participants with primary pterygia, the risk ratio was 0.92 (95% CI 0.37 to 2.30) and 0.58 (95% CI 0.27 to 1.27) at 3 months and 6 months, respectively. We were only able to estimate the recurrence of pterygia at 6 months for participants with recurrent pterygia, and the risk ratio comparing conjunctival autograft with amniotic membrane transplant was 0.45 (95% CI 0.21 to 0.99). One included study was a doctoral thesis and did not use allocation concealment. When this study was excluded in a sensitivity analysis, the risk ratio for pterygium recurrence at 6 months’ follow-up was 0.43 (95% CI 0.30 to 0.62) for participants with primary and recurrent pterygium. One of the secondary outcomes, the proportion of participants with clinical improvement, was analyzed in only one study. This study reported clinical outcome as the risk of non-recurrence, which was seen in 93.8% of participants in the conjunctival limbal autograft group and 93.3% in the amniotic membrane transplant group at 3 months after surgery. We did not analyze data on the need for repeat surgery, vision-related quality of life, and direct and indirect costs of surgery due to an insufficient number of studies reporting these outcomes. Thirteen studies reported adverse events associated with conjunctival autograft surgery and amniotic membrane transplant surgery. Adverse events that occurred in more than one study were granuloma and pyogenic granuloma and increased intraocular pressure. None of the included studies reported that participants had developed induced astigmatism. Authors’ conclusions In association with pterygium excision, conjunctival autograft is associated with a lower risk of recurrence at six months’ after surgery than amniotic membrane transplant. Participants with recurrent pterygia in particular have a lower risk of recurrence when they receive conjunctival autograft surgery compared with amniotic membrane transplant. There are few studies comparing the two techniques with respect to visual acuity outcomes, and we identified no studies that reported on vision-related quality of life or direct or indirect costs. Comparison of these two procedures in such outcome measures bears further investigation. There were an insufficient number of studies that used adjunctive mitomycin C to estimate the effects on pterygium recurrence following conjunctival autograft or amniotic membrane transplant. PMID:26867004

Conjunctival autograft for pterygium.

PubMed

Clearfield, Elizabeth; Muthappan, Valliammai; Wang, Xue; Kuo, Irene C

2016-02-11

A pterygium is a fleshy, wing-shaped growth from the conjunctiva, crossing over the limbus onto the cornea. Prevalence ranges widely around the world. Evidence suggests that ultraviolet light is a major contributor in the formation of pterygia. Pterygia impair vision, limit eye movements, and can cause eye irritation, foreign body sensation, and dryness. In some susceptible patients, the pterygium can grow over the entire corneal surface, blocking the visual axis.Surgery is the only effective treatment for pterygium, though recurrences are common. With simple excision techniques (that is, excising the pterygium and leaving bare sclera), the risk of recurrence has been reported to be upwards of 80%. Pterygium excision combined with a tissue graft has a lower risk of recurrence. In conjunctival autograft surgery, conjunctival tissue from another part of the person's eye along with limbal tissue is resected in one piece and used to cover the area from which the pterygium was excised. Another type of tissue graft surgery for pterygium is amniotic membrane graft, whereby a piece of donor amniotic membrane is fixed to the remaining limbus and bare sclera area after the pterygium has been excised. The objective of this review was to assess the safety and effectiveness of conjunctival autograft (with or without adjunctive therapy) compared with amniotic membrane graft (with or without adjunctive therapy) for pterygium. We also planned to determine whether use of MMC yielded better surgical results and to assess the direct and indirect comparative costs of these procedures. We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (Issue 10, 2015), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to November 2015), EMBASE (January 1980 to November 2015), PubMed (1948 to November 2015), Latin American and Caribbean Health Sciences Literature Database (LILACS) (1982 to November 2015), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com) (last searched 21 November 2014), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic search for trials. We last searched the electronic databases on 23 November 2015. We included in this review randomized controlled trials that had compared conjunctival autograft surgery (with or without adjunctive therapy) with amniotic membrane graft surgery (with or without adjunctive therapy) in people with primary or recurrent pterygium. Two review authors independently screened search results and assessed full-text reports from among the potentially eligible trials. Two review authors independently extracted data from the included trials and assessed the trial characteristics and risk of bias. The primary outcome was the risk of recurrence of pterygium at 3 months and 6 months after surgery. We combined results from individual studies in meta-analyses using random-effects models. Risk of recurrence of pterygium was reported using risk ratios to compare conjunctival autograft with amniotic membrane transplant. We identified 20 studies that had analyzed a total of 1947 eyes of 1866 participants (individual studies ranged from 8 to 346 participants who were randomized). The studies were conducted in eight different countries: one in Brazil, three in China, three in Cuba, one in Egypt, two in Iran, two in Thailand, seven in Turkey, and one in Venezuela. Overall risk of bias was unclear, as many studies did not provide information on randomization methods or masking to prevent performance and detection bias.The risk ratio for recurrence of pterygium using conjunctival autograft versus amniotic membrane transplant was 0.87 (95% confidence interval (CI) 0.43 to 1.77) and 0.53 (95% CI 0.33 to 0.85) at 3 months and 6 months, respectively. These estimates include participants with primary and recurrent pterygia. We performed a subgroup analysis to compare participants with primary pterygia with participants with recurrent pterygia. For participants with primary pterygia, the risk ratio was 0.92 (95% CI 0.37 to 2.30) and 0.58 (95% CI 0.27 to 1.27) at 3 months and 6 months, respectively. We were only able to estimate the recurrence of pterygia at 6 months for participants with recurrent pterygia, and the risk ratio comparing conjunctival autograft with amniotic membrane transplant was 0.45 (95% CI 0.21 to 0.99). One included study was a doctoral thesis and did not use allocation concealment. When this study was excluded in a sensitivity analysis, the risk ratio for pterygium recurrence at 6 months' follow-up was 0.43 (95% CI 0.30 to 0.62) for participants with primary and recurrent pterygium. One of the secondary outcomes, the proportion of participants with clinical improvement, was analyzed in only one study. This study reported clinical outcome as the risk of non-recurrence, which was seen in 93.8% of participants in the conjunctival limbal autograft group and 93.3% in the amniotic membrane transplant group at 3 months after surgery.We did not analyze data on the need for repeat surgery, vision-related quality of life, and direct and indirect costs of surgery due to an insufficient number of studies reporting these outcomes.Thirteen studies reported adverse events associated with conjunctival autograft surgery and amniotic membrane transplant surgery. Adverse events that occurred in more than one study were granuloma and pyogenic granuloma and increased intraocular pressure. None of the included studies reported that participants had developed induced astigmatism. In association with pterygium excision, conjunctival autograft is associated with a lower risk of recurrence at six months' after surgery than amniotic membrane transplant. Participants with recurrent pterygia in particular have a lower risk of recurrence when they receive conjunctival autograft surgery compared with amniotic membrane transplant. There are few studies comparing the two techniques with respect to visual acuity outcomes, and we identified no studies that reported on vision-related quality of life or direct or indirect costs. Comparison of these two procedures in such outcome measures bears further investigation. There were an insufficient number of studies that used adjunctive mitomycin C to estimate the effects on pterygium recurrence following conjunctival autograft or amniotic membrane transplant.

Effect of topical cyclopentolate on post-operative pain after pterygium surgery.

PubMed

Goktas, Sertan; Sakarya, Yasar; Ozcimen, Muammer; Sakarya, Rabia; Alpfidan, Ismail; Ivacık, Ismail Senol; Erdogan, Erkan

2017-11-01

The aim was to evaluate the effectiveness of topical cyclopentolate following pterygium surgery for post-operative ocular pain. All participants had nasal pterygium and underwent pterygium excision and conjunctival autografting with fibrin glue. Participants were randomised into two groups. Participants in group 1 received one per cent cyclopentolate eye drops and artificial tears upon completing surgery and were prescribed self-administered drops three times daily for three days, while participants in group 2 received a control (artificial tears) in a manner identical to group 1. Data were gathered regarding post-operative pain intensity experienced during each of the three days. Pain was graded from zero to 10 according to a visual analogue scale, in which zero signified no pain and 10 signified severe, unbearable pain. This study analysed data regarding 38 participants in group 1 and 40 participants in group 2. Results were defined as median with interquartile range (IQR); median of the pain scores at days one, two and three were as follows, respectively: 4 (IQR 2), 2.5 (IQR 1) and 2 (IQR 1.25) for group 1 and 5 (IQR 1), 3 (IQR 1.75) and 3 (IQR 1) for group 2. Pain scores were significantly lower for group 1 compared with group 2 at days one, two and three (p < 0.05). Topical cyclopentolate seems to be effective and well tolerated following pterygium surgery for post-operative ocular pain. © 2017 Optometry Australia.

Molecular effects of doxycycline treatment on pterygium as revealed by massive transcriptome sequencing.

PubMed

Larráyoz, Ignacio M; de Luis, Alberto; Rúa, Oscar; Velilla, Sara; Cabello, Juan; Martínez, Alfredo

2012-01-01

Pterygium is a lesion of the eye surface which involves cell proliferation, migration, angiogenesis, fibrosis, and extracellular matrix remodelling. Surgery is the only approved method to treat this disorder, but high recurrence rates are common. Recently, it has been shown in a mouse model that treatment with doxycycline resulted in reduction of the pterygium lesions. Here we study the mechanism(s) of action by which doxycycline achieves these results, using massive sequencing techniques. Surgically removed pterygia from 10 consecutive patients were set in short term culture and exposed to 0 (control), 50, 200, and 500 µg/ml doxycycline for 24 h, their mRNA was purified, reverse transcribed and sequenced through Illumina's massive sequencing protocols. Acquired data were subjected to quantile normalization and analyzed using cytoscape plugin software to explore the pathways involved. False discovery rate (FDR) methods were used to identify 332 genes which modified their expression in a dose-dependent manner upon exposure to doxycycline. The more represented cellular pathways included all mitochondrial genes, the endoplasmic reticulum stress response, integrins and extracellular matrix components, and growth factors. A high correlation was obtained when comparing ultrasequencing data with qRT-PCR and ELISA results. Doxycycline significantly modified the expression of important cellular pathways in pterygium cells, in a way which is consistent with the observed efficacy of this antibiotic to reduce pterygium lesions in a mouse model. Clinical trials are under way to demonstrate whether there is a benefit for human patients.

Visual outcome and efficacy of conjunctival autograft, harvested from the body of pterygium in pterygium excision.

PubMed

Bhandari, Vipul; Rao, Chandan Latha; Ganesh, Sri; Brar, Sheetal

2015-01-01

To evaluate the efficacy of conjunctival autograft after the pterygium excision with fibrin adhesive using conjunctiva over the pterygium. This prospective study included 25 eyes of 25 patients with a mean age of 40±10 years, who underwent the pterygium excision with conjunctival autograft derived from the body of the pterygium and attached using fibrin glue. The mean follow-up period was 6 months. On all postoperative visits, changes in uncorrected visual acuity, corrected distance visual acuity, astigmatism, complications, and the evidence of recurrence were recorded. At the end of mean follow-up, uncorrected visual acuity and corrected distance visual acuity improved by one or two lines in all eyes treated. Mean astigmatism reduced significantly from a preoperative value from 2.308D to 1.248D postoperatively (P<0.026). Minor postoperative complications such as congestion, chemosis, and subconjunctival hemorrhage were seen, which resolved with time. No major sight-threatening or graft-related complications were detected. There was no evidence of recurrence during a follow-up period of 6 months. Self-conjunctival autograft following the pterygium excision appears to be a feasible, safe, and effective alternative method for management of pterygium. It also preserves the superior conjunctiva for future surgeries. However, longer follow-up is required to study the long-term outcomes, especially the incidence of recurrence.

Genetics Home Reference: popliteal pterygium syndrome

MedlinePlus

... Additional Information & Resources MedlinePlus (1 link) Health Topic: Cleft Lip and Palate Genetic and Rare Diseases Information Center (1 link) ... InfoSearch: Popliteal pterygium syndrome March of Dimes: Cleft Lip and Cleft Palate Orphanet: Popliteal pterygium syndrome Patient Support and Advocacy ...

Comparison of gene expression profiles in primary and immortalized human pterygium fibroblast cells.

PubMed

Hou, Aihua; Voorhoeve, P Mathijs; Lan, Wanwen; Tin, Minqi; Tong, Louis

2013-11-01

Pterygium is a fibrovascular growth on the ocular surface with corneal tissue destruction, matrix degradation and varying extents of chronic inflammation. To facilitate investigation of pterygium etiology, we immortalized pterygium fibroblast cells and profiled their global transcript levels compared to primary cultured cells. Fibroblast cells were cultured from surgically excised pterygium tissue using the explant method and propagated to passage number 2-4. We hypothesized that intervention with 3 critical molecular intermediates may be necessary to propage these cells. Primary fibroblast cells were immortalized sequentially by a retroviral construct containing the human telomerase reverse transcriptase gene and another retroviral expression vector expressing p53/p16 shRNAs. Primary and immortalized fibroblast cells were evaluated for differences in global gene transcript levels using an Agilent Genechip microarray. Light microscopic morphology of immortalized cells was similar to primary pterygium fibroblast at passage 2-4. Telomerase reverse transcriptase was expressed, and p53 and p16 levels were reduced in immortalized pterygium fibroblast cells. There were 3308 significantly dysregulated genes showing at least 2 fold changes in transcript levels between immortalized and primary cultured cells (2005 genes were up-regulated and 1303 genes were down-regulated). Overall, 13.58% (95% CI: 13.08-14.10) of transcripts in immortalized cells were differentially expressed by at least 2 folds compared to primary cells. Pterygium primary fibroblast cells were successfully immortalized to at least passage 11. Although a variety of genes are differentially expressed between immortalized and primary cells, only genes related to cell cycle are significantly changed, suggesting that the immortalized cells may be used as an in vitro model for pterygium pathology. © 2013 Elsevier Inc. All rights reserved.

Mitomycin C in pterygium treatment

PubMed Central

Martins, Thiago Gonçalves dos Santos; Costa, Ana Luiza Fontes de Azevedo; Alves, Milton Ruiz; Chammas, Roger; Schor, Paulo

2016-01-01

Pterygium is a benign lesion usually growing from the nasal side of the conjunctiva onto the cornea. Most cases of pterygium does not cause problem or requires specific treatment. The exact cause of pterygium is not clear yet, but some factors are pointed as causes, being the most important the long-term ultraviolet ray exposure. Pterygium surgery is usually considered when there are symptoms that do not respond to conservative treatment. Recurrence is the main complication of the surgery, and much has been done to avoid it. Mitomycin C (MMC) has been used as a fibroblast proliferation inhibitor during the surgery to reduce the chance of recurrence of the pterygium. This review describes the use of MMC as an adjunctive, the optimal dosage, the duration of administration of MMC and possible complications, when used during, after and before the surgery. Most studies suggest that increased exposure (dose or duration) of MMC is associated with a lower recurrence, but with higher risks of complications. PMID:27158622

Detection of human papillomavirus in pterygium and conjunctival papilloma by hybrid capture II and PCR assays.

PubMed

Takamura, Y; Kubo, E; Tsuzuki, S; Akagi, Y

2008-11-01

To elucidate the putative role of human papillomavirus (HPV) infection in pterygium and conjunctival papilloma. Hybrid capture II (HC-II) and polymerase chain reaction (PCR) assays were performed to detect HPV in pterygium (42 samples obtained from 40 patients) and conjunctival papilloma (8 samples from 6 patients). The amount of HPV DNA was evaluated by measurement of relative light units (RLUs) on a luminometer. All papilloma samples were positive for HPV DNA by PCR and HC-II. The RLU values for specimens of recurrent and re-recurrent papilloma were markedly higher than those for specimens of primary lesions. HPV was detected by PCR in 2 of 42 (4.8%) beta-globin-positive pterygium specimens, whereas HC-II showed that HPV was negative in all pterygium samples. Our results support the hypothesis that HPV DNA is associated with the pathogenesis of conjunctival papilloma, but not pterygium. RLU measurement by HC-II may serve as a marker for evaluating the activity of HPV in conjunctival tumours.

Ethnic Variations in Pterygium in a Rural Population in Southwestern China: The Yunnan Minority Eye Studies.

PubMed

Zhong, Hua; Chen, Qin; Li, Jun; Shen, Wei; Sheng, Xun; Niu, Zhiqiang; Zhou, Hua; Wei, Tao; Yuan, Yuansheng; Pan, Chen-Wei

2016-01-01

To determine the prevalence and associations of pterygium in a multiethnic adult population in rural China and to examine potential ethnic differences Methods: A total of 6418 adults (2133 ethnic Bai, 2130 ethnic Yi, and 2155 ethnic Han) aged 50 years or older participated in the study. Anterior segment examination was performed without pupil dilation using a slit lamp. Pterygium was defined as a raised fleshy triangular fibrovascular tissue growth of the conjunctiva encroaching onto a clear cornea. Pterygium was least prevalent among adults of Yi ethnicity (29.5%) compared with Bai (39.0%, p < 0.001) or Han (39.5%, p < 0.001) ethnicities. Those of Bai ethnicity were most likely to be affected by severe pterygium (7.5%), while Yi were least likely to be affected (3.8%). Multivariate analysis revealed that increasing age (odds ratio, OR, 1.017), female sex (OR 1.53), lower educational level (OR 1.25), higher blood pressure levels (OR 1.002), and greater time spent outdoors per day (OR 1.09) were significantly associated with a higher prevalence of pterygium, while Yi ethnicity (OR 0.65, comparing Yi with Han) and wearing brimmed hats outdoors (OR 0.82) were protective factors. Ethnicity was significantly associated with prevalence of pterygium. Our findings may be applicable to many other countries located within the "pterygium belt" for health resource allocation among different ethnic groups.

Minimally Invasive Pterygium Surgery: Sutureless Excision with Amniotic Membrane and Hydrogel Sealant.

PubMed

Bondalapati, Sailaja; Ambati, Balamurali

2016-01-01

To describe a novel technique for sutureless pterygium surgery using ReSure(®) tissue sealant. In this retrospective observational case series, we describe a modified procedure for pterygium excision followed by amniotic membrane transplant (AMT) adhered to the corneal and conjunctival defects using ReSure tissue sealant. Nine eyes of seven patients (age range: 28-80 years, 4 females and 3 males) underwent pterygium removal with AMT followed by adherence of tissue to the conjunctival edges with ReSure. No issues with transplant dislocation or failure and no intra- or postoperative complications were noted. No recurrences were noted during the follow-up period. ReSure may be considered as a potential sealant to adhere AMT to defective corneal and conjunctival tissues in sutureless pterygium surgery.

Detection of increase in corneal irregularity due to pterygium using Fourier series harmonic analyses with multiple diameters.

PubMed

Minami, Keiichiro; Miyata, Kazunori; Otani, Atsushi; Tokunaga, Tadatoshi; Tokuda, Shouta; Amano, Shiro

2018-05-01

To determine steep increase of corneal irregularity induced by advancement of pterygium. A total of 456 eyes from 456 consecutive patients with primary pterygia were examined for corneal topography and advancement of pterygium with respect to the corneal diameter. Corneal irregularity induced by the pterygium advancement was evaluated by Fourier harmonic analyses of the topographic data that were modified for a series of analysis diameters from 1 mm to 6 mm. Incidences of steep increases in the asymmetry or higher-order irregularity components (inflection points) were determined by using segmented regression analysis for each analysis diameter. The pterygium advancement ranged from 2% to 57%, with a mean of 22.0%. Both components showed steep increases from the inflection points. The inflection points in the higher-order irregularity component altered with the analysis diameter (14.0%-30.6%), while there was no alternation in the asymmetry components (35.5%-36.8%). For the former component, the values at the inflection points were obtained in a range of 0.16 to 0.25 D. The Fourier harmonic analyses for a series of analysis diameters revealed that the higher-order irregularity component increased with the pterygium advancement. The analysis results confirmed the precedence of corneal irregularity due to pterygium advancement.

Topical anesthesia with benoxinate 0.4% for pterygium surgery.

PubMed

Frucht-Pery, J

1997-03-01

Anesthesia during pterygium surgery is usually achieved with injections of anesthetic medications. This study evaluated the efficacy of topical anesthesia with benoxinate hydrochloride 0.4% for pterygium surgery. One hundred fifty consecutive patients who had primary or recurrent pterygium underwent surgical excision of the lesion. Before the surgical procedure began, each eye that was operated on received 1 drop of benoxinate hydrochloride 0.4% solution every 1 minute for 10 minutes. The pain sensation was tested with 0.12 forceps. The pterygium was dissected, and 1 or 2 conjunctival sutures were placed, leaving bare sclera. Drops of benoxinate hydrochloride 0.4% were added every 5 minutes during the operation. The average pterygium excision time in this study was 25 minutes. Of the 150 patients studied, only 3 required intraoperative injection of lignocaine 1%. In 2 cases, subconjunctival injection was performed, and in 1 case, retrobulbar injection was required to complete the procedure. Of the remaining 147 patients, 115 had discomfort or mild pain and asked for more anesthetics once or twice during the procedure. Postoperatively, the wounds epithelialized within 7 to 14 days in all patients, except for 2 who had postoperative dellen and 2 who received mitomycin-C postoperatively. Topical administration of benoxinate hydrochloride 0.4% provides useful anesthesia for pterygium surgery.

Prevalence of pterygium in Iran: a systematic review and meta-analysis study

PubMed Central

Yasemi, Masoud; Bamdad, Shahram; Sarokhani, Diana; Sarokhani, Mandana; Sayemiri, Kourosh

2017-01-01

Background and aim Pterygium is one of the most prevalent pathologies involving the cornea, which can lead to various vision signs and even reduction in eyesight. No accurate estimate has been reported about the prevalence of pterygium in Iran. Hence, this study aimed to determine the pterygium prevalence in Iran by meta-analysis method. Methods Searching for data of the last eleven years (from 2004 to 2015) was conducted using the keywords of pterygium, eye, and Iran in International and domestic indexing services and databases including Iranmedex, Scientific Information Database (SID), Magiran, Irandoc, Medlib, IranPsych, Science Direct, Web of Science (Thomson Reuters), PubMed, and Scopus. The data were analyzed using the meta-analysis method (the random effects model). The disharmony of the studies was investigated using the I2 index. The data were analyzed by STATA Ver.11 software. Results In 5 studies conducted in Iran, with a sample size of 10,838 people between 2004 and 2015, the extent of the prevalence was estimated to be 11% (95% CI: 3 to 18%). Also, the prevalence of pterygium in women and men was 18% and 13%, respectively. Conclusion According to the published reports from Iran and its comparison with other points in the world, the prevalence of pterygium in Iran is high, especially among women. PMID:29560142

The influence of pterygium morphology on fibrin glue conjunctival autografting pterygium surgery.

PubMed

Sandra, Sekelj; Zeljka, Janjetovic; Zeljka, Vukovic Arar; Kristian, Samardzic; Ivana, Aric

2014-02-01

To evaluate the influence of pterygium morphology on the efficacy and safety of fibrin glue in pterygium surgery with conjunctival autografting. A prospective case series. During a period of 15 months, 45 patients (51 eyes) were recruited from the General Hospital for pterygium surgery. Seven eyes (13.73 %) were operated on for a recurrent pterygium. Autologous conjunctiva was harvested from the superior bulbar conjunctiva and fixed with fibrin glue. The pterygia were preoperatively divided into atrophic/grade 1 (n = 18; 35.29 %), intermediate/grade 2 (n = 22; 43.14 %) or fleshy/grade 3 (n = 11; 21.57 %) according to clinical morphology. Patients were evaluated for intraoperative and postoperative complications and recurrence rates. The success rate was defined by no pterygium recurrences. Patients with 2-year follow-ups were included in this study. Fifty-one patients (21 females/30 males) with a mean age of 60-65 years (range 24-87 years) took part in the study. All patients completed the study. No intraoperative complications were noted. Postsurgical complications included graft edema (n = 4; 7.8 %), graft hyperemia (n = 2; 3.8 %), and graft dislocation (n = 3; 5.9 %); these complications were transient. One graft unfastened completely (2 %) and five pterygium recurrences occurred (n = 5; 9.8 %). The overall success rate was 90 % after 2 years. In grade I group there were no recurrences, in grade 2 group there were two recurrences, and in grade 3 group there were three recurrences. There were significantly more recurrences in grade 3 group than in grade 2 group. There were more recurrences in both groups than in group 1 (60 vs 40 vs 0 % of all recurrences, p ≤ 0.05). The use of fibrin glue is a safe, easy and effective technique for attaching the conjunctival autograft in pterygium surgery. The morphology of pterygium influences recurrence rates, without significance for intraoperative and postoperative complications.

Pterygium recurrence after excision with conjunctival autograft: a comparison of fibrin tissue adhesive to absorbable sutures.

PubMed

Farid, Marjan; Pirnazar, Jonathan Ramin

2009-01-01

To evaluate the rate of recurrence after pterygium excision with conjunctival autograft (CAG) using Tisseel fibrin tissue adhesive versus absorbable sutures. Forty-seven eyes of 42 patients who had undergone primary pterygium excision surgery with CAG were retrospectively reviewed. The study group, CAG adhered using Tisseel tissue adhesive (n = 27), were compared with the control group, CAG adhered using absorbable sutures (n = 20). Postoperative courses were followed for 22-36 months after surgery. Rates of recurrence were compared using logistic regression. Recurrence was defined as regrowth of fibrovascular tissue 1 mm past the corneoscleral limbus. The recurrence rate in the Tisseel group was 3.7% compared with 20% in the sutured group (P = 0.035). Recurrence rate in the Tisseel group was comparable to previously reported rates for CAG with sutures in the literature. There was a significant inverse relationship between age and rate of recurrence overall (P = 0.025). There was no difference in time to recurrence between the groups -- with an average time to recurrence of 3.13 months. In a predominantly Southern California population where there is an overall higher rate of pterygium recurrence, Tisseel tissue adhesive may improve surgical outcomes with equal to or lower long-term recurrence rates than previously reported.

Comparative Study of Different {beta}-Radiation Doses for Preventing Pterygium Recurrence

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

Yamada, Takayuki, E-mail: tyamada-oph@umin.ac.jp; Mochizuki, Hideki; Ue, Takahiro

Purpose: To compare the pterygium recurrence rates after treatment with two different {beta}-radiation doses. Methods and Materials: A total of 84 patients with a mean age of 63.0 {+-} 10.3 years (men, 48 eyes, and women, 47 eyes) and initially treated with {beta}-radiation after pterygium excision were recruited. The mean follow-up period was 49.9 {+-} 51.3 months. The patients were assigned to two dose groups: a high-dose (40 Gy) or a low-dose (20 Gy) group. The statistical significance of differences in patient age, pterygium size, and interval between surgery and radiotherapy were analyzed in the 20-Gy group using the Coxmore » proportional hazard model at p < .05. Results: The high- and low-dose groups included 28 and 67 eyes, respectively. Pterygia recurred in 11 eyes, all in the low-dose group. The interval between surgery and radiotherapy was not a significant predictor of recurrence. Smaller pterygia had a lower risk of recurrence than pterygia that had encroached the pupillary area (pterygium located within one-third of the corneal radius from the limbus, corrected hazard ratio [HR], 0.069; 95% confidence interval [CI], 0.006-0.766; p = .030; pterygium extending beyond one-third of the corneal radius, corrected HR, 0.188; 95% CI, 0.018-0.696; p = 0.019; and pterygium reaching the pupillary area, corrected HR, 0.184; 95% CI, 0.036-0.929; p = .040). Older age was marginally significant as a negative predictor of recurrence (HR, 0.943; 95% CI, 0.887-1.003; p = .061). No scleromalacia developed during the follow-up period. Conclusions: {beta}-Radiation at 40 Gy was more efficacious than at 20 Gy in preventing pterygium recurrence without scleromalacia development, particularly for large-size pterygia and those in young patients.« less

The nuclear-factor kappaB pathway is activated in pterygium.

PubMed

Siak, Jay Jyh Kuen; Ng, See Liang; Seet, Li-Fong; Beuerman, Roger W; Tong, Louis

2011-01-05

Pterygium is a prevalent ocular surface disease with unknown pathogenesis. The authors investigated the role of nuclear factor kappa B (NF-κB) transcription factors in pterygium. Surgically excised primary pterygia were studied compared with uninvolved conjunctiva tissues. NF-κB activation was evaluated using Western blot analysis, ELISA, and DNA-binding assays. Primary pterygium fibroblasts were treated with TNF-α (20 ng/mL), and NF-κB activation was evaluated using immunocytochemistry, Western blot analysis, phospho-IκBα ELISA, and DNA-binding assays. TNF-α stimulation of NF-κB target genes RelB, NFKB2, RANTES, MCP-1, ENA-78, MMP-1, MMP-2, and MMP-3 in pterygium fibroblasts was compared with that in primary tenon fibroblasts by real-time PCR. Phosphorylation of IκBα (Ser32) was increased in pterygia tissues compared with uninvolved conjunctiva tissues, as determined by Western blot analysis and ELISA. IκBα expression was decreased, whereas nuclear RelA and p50 DNA-binding capacities were increased. Within 30 minutes of treatment with TNF-α, pterygium fibroblasts showed increased IκBα phosphorylation and nuclear translocation of RelA and p50. Treatment with TNF-α beyond 12 hours resulted in increased nuclear expression of RelB, p100, and p52. Furthermore, the upregulation of RANTES, MCP-1, ENA-78, MMP-1, MMP-2, and MMP-3 expression was more pronounced in TNF-α-treated pterygium fibroblasts than in tenon fibroblasts. The NF-κB pathway is shown for the first time to be activated in pterygia tissues compared with normal conjunctiva tissues. Stimulation by the inflammatory cytokine TNF-α can activate both canonical and noncanonical NF-κB pathways in pterygium fibroblasts with concomitant upregulation of NF-κB target genes.

Long-term results and prognostic factors of fractionated strontium-90 eye applicator for pterygium.

PubMed

Viani, Gustavo Arruda; Stefano, Eduardo Jose; De Fendi, Ligia Issa; Fonseca, Ellen Carrara

2008-11-15

To evaluate the long-term safety, effectiveness, and prognostic factors of fractionated postoperative beta-irradiation. Between 1993 and 2005, 623 patients with 737 pterygium lesions were treated with a strontium-90 eye applicator after surgical excision. The median follow-up period was 60 months (range, 6.7-139.5). Of the 737 lesions, 644 were primary and 93 were recurrences after surgical removal alone. Fractionated radiotherapy (RT) to a total dose of 35 Gy in five to seven fractions was used. A total of 73 local pterygium recurrences (9.9%) were noted. Of the recurrent cases, 80% were noted within 3 years after treatment. The 5- and 10-year probability of local control was 90% and 88%, respectively. The multivariate analysis for all cases demonstrated that gender, age, total radiation dose, recurrent pterygia, and interval between surgery and RT affected the overall local control rate. Late toxicities that might have been associated with strontium-90 RT included scleromalacia (scleral thinning) in nine eyes, adhesion of the eyelids in eight, cataracts in six, and scleral ulcer in five eyes. Fractionated strontium-90 RT to a total dose of approximately 35 Gy in five to seven fractions results in a similar local control rate as higher doses in other series, with an acceptable complication rate.

Serratia marcescens endophthalmitis after pterygium surgery: a case report.

PubMed

Yi, Myeong Yeon; Chung, Jin Kwon; Choi, Kyung Seek

2017-11-02

To report a case of Serratia marcescens endophthalmitis after pterygium surgery using the bare sclera technique with mitomycin C (MMC). A 69-year-old male patient underwent pterygium excision surgery using the bare sclera technique and 0.02% MMC. The patient presented with decreased visual acuity and pain from the day after the operation. Trans pars plana vitrectomy was performed and intravitreal antibiotics were administered. Cultures from the aqueous humor and intraocular lens were all positive for S. marcescens, which was sensitive to an empiric antibiotic regimen. The best corrected distant visual acuity, 1 month after treatment, was a finger count/50 cm, but the retinal layer structure and the vasculature were relatively well preserved. This is the first reported case of S. marcescens endophthalmitis after pterygium surgery. Endophthalmitis caused by S. marcescens has a devastating visual prognosis and may show a high clinical risk-benefit ratio for the application of MMC in pterygium surgery.

Dose-Effect Relationships for Recurrence of Keloid and Pterygium After Surgery and Radiotherapy

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

Kal, Henk B.; Veen, Ronald E.; Juergenliemk-Schulz, Ina M.

2009-05-01

Purpose: To show radiation dose-response relationships for recurrence of keloid and pterygium after radiotherapy following surgery. Methods and Materials: Using PubMed, we performed a retrospective review of articles reporting incidences and/or dose-response relationships for recurrence of keloid and pterygium after radiotherapy following surgery. The irradiation regimens identified were normalized by use of the linear-quadratic model; biologically effective doses (BEDs) were calculated. Results: For keloid recurrence after radiotherapy following keloid removal, with either teletherapy or brachytherapy, the recurrence rate after having delivered a BED greater than 30 Gy is less than 10%. For pterygium recurrence after bare sclera surgery and {supmore » 90}Sr {beta}-irradiation, a BED of about 30 Gy seems to be sufficient also to reduce the recurrence rate to less than 10%. Conclusions: Most of the doses in the radiotherapy schemes used for prevention of keloid recurrence after surgery are too low. In contrast, the doses applied in most regimens to prevent pterygium recurrence are too high. A scheme with a BED of 30 to 40 Gy seems to be sufficient to prevent recurrences of keloid as well as pterygium.« less

Conjunctival autografting combined with low-dose mitomycin C for prevention of primary pterygium recurrence.

PubMed

Frucht-Pery, Joseph; Raiskup, Frederic; Ilsar, Michael; Landau, David; Orucov, Faik; Solomon, Abraham

2006-06-01

To compare the clinical outcome of pterygium surgery combining intraoperative mitomycin C (MMC) with a free conjunctival autograft, with three other methods of pterygium surgery, including intraoperative MMC alone, conjunctival autograft alone, and bare sclera without adjunctive treatment. Interventional, randomized and in part nonrandomized, prospective, comparative study. setting: A university medical center department of ophthalmology. One hundred and twenty patients underwent pterygium excision surgery. These patients were divided into four treatment groups. In group 1 (30 patients), MMC, 0.2 mg/ml, was applied for three minutes. In group 2 (30 patients), conjunctival autografting was performed. Group 3 (30 patients) received sodium chloride 0.9% only, and group 4 (30 patients) underwent conjunctival autografting combined with one minute application of MMC, 0.2 mg/ml. Recurrence rates and complications. Pterygium recurred in two patients (6.6%) in group 1, in four patients (13.3%) in group 2, in 14 patients (46.6%) in group 3, and in none of the patients in group 4. chi(2) analysis revealed a significantly lower recurrence rate in group 4 compared with group 2 (P = .038) and with group 3 (P < .0001). Epithelialization of the wounds was complete within 14 days of surgery. No complications were demonstrated in any of the study groups except for one case of minor melting of the flap in group 4. This study indicates that pterygium excision with a free conjunctival autograft combined with intraoperative low-dose MMC is a safe and effective technique in pterygium surgery.

Optimal size of pterygium excision for limbal conjunctival autograft using fibrin glue in primary pterygia.

PubMed

Hwang, Ho Sik; Cho, Kyong Jin; Rand, Gabriel; Chuck, Roy S; Kwon, Ji Won

2018-06-07

In our study we describe a method that optimizes size of excision and autografting for primary pterygia along with the use of intraoperative MMC and fibrin glue. Our objective is to propose a simple, optimizedpterygium surgical technique with excellent aesthetic outcomes and low rates of recurrence and otheradverse events. Retrospective chart review of 78 consecutive patients with stage III primary pterygia who underwent an optimal excision technique by three experienced surgeons. The technique consisted of removal of the pterygium head, excision of the pterygium body and Tenon's layer limited in proportion to the length of the head, application of intraoperative mitomycin C to the defect, harvest of superior bulbar limbal conjunctival graft, adherence of graft with fibrin glue. Outcomes included operative time, follow up period, pterygium recurrence, occurrences of incorrectly sized grafts, and other complications. All patients were followed up for more than a year. Of the 78 patients, there were 2 cases of pterygium recurrence (2.6%). There was one case of wound dehiscence secondary to small-sized donor conjunctivaand one case of over-sized donor conjunctiva, neither of which required surgical correction. There were no toxic complications associated with the use of mitomycin C. Correlating the excision of the pterygium body and underlying Tenon's layer to the length of the pterygium head, along with the use intraoperative mitomycin C, limbal conjunctival autografting, and fibrin adhesionresulted in excellent outcomes with a low rate of recurrence for primary pterygia.

Efficacy of preoperative injection versus intraoperative application of mitomycin in recurrent pterygium surgery

PubMed Central

Zaky, Khaled S; Khalifa, Yasser M

2012-01-01

Purpose: To determine the efficacy of preoperative subconjunctival injection of mitomycin C a day before surgery in the management of recurrent pterygium. Materials and Methods: Randomized comparative case series. Fifty eyes with recurrent pterygium were randomly divided into two groups; the mitomycin injection group (25 eyes) and the mitomycin application group (25 eyes). The mitomycin injection group underwent preoperative subconjunctival injection of mitomycin C in low dose (0.1 ml of 0.15 mg/ml) a day before bare sclera pterygium excision surgery. The mitomycin application group underwent bare sclera pterygium excision with topical application of mitomycin C (same concentration). Results: At one year of follow-up, 24 of 25 eyes (96%) in the mitomycin injection group and 23 of 25 (92%) eyes in the mitomycin application group were free of recurrence. The difference was statistically insignificant. As regards postoperative complications, delayed epithelization (more than two weeks) occurred in two eyes (8%) in the mitomycin injection group and in one eye (4%) in the mitomycin application group. Scleral thinning was reported in one eye (4%) in the mitomycin application group which resolved within three weeks after surgery, no other serious postoperative complications were reported. Conclusion: Preoperative subconjunctival injection of mitomycin C in low dose (0.1 ml of 0.15 mg/ml) a day before pterygium surgery is a simple and effective modality for management of recurrent pterygium. It has the advantage of low recurrence and complications’ rate. PMID:22824595

A Prospective Study of Pterygium Excision and Conjunctival Autograft With Human Fibrin Tissue Adhesive: Effects on Vision, Refraction, and Corneal Topography.

PubMed

Misra, Stuti; Craig, Jennifer P; McGhee, Charles N J; Patel, Dipika V

2014-01-01

This study aimed to investigate changes in visual acuity, corneal parameters, and topographic parameters after pterygium surgery. A prospective observational study was conducted. Twenty eyes of 20 participants undergoing pterygium excision with conjunctival autograft secured using human fibrin tissue adhesive were included in the study. All the participants were assessed preoperatively and 1 and 3 months postoperatively. The parameters included subjective refraction, visual acuity, and pterygium size (pterygium horizontal corneal length [PHCL]) and corneal tomography by Pentacam rotating Scheimpflug tomographer (OCULUS Optikgeräte GmbH, Wetzlar, Germany). The astigmatic changes were calculated using vector analysis. The mean age of participants was 49.3 ± 12.1 years. Mean PHCL was 2.68 ± 0.30 mm. The mean best corrected visual acuity preoperatively was 6/7.5, improving significantly to 6/6 at 1 month (P = 0.001) with this improvement remaining stable at 3 months postoperatively (P = 0.34). There was no significant change in subjective astigmatism, however, mean topographic astigmatism decreased significantly at 1 month (4.36 diopter, P < 0.01) and remained unchanged at 3 months (P < 0.01). Greater PHCL was associated with greater changes in corneal astigmatism. Significant improvements and early stabilization of visual acuity and topographic astigmatism confirm the optical benefits of pterygium excision. These data also suggest a significant advantage of performing pterygium before rather than simultaneously with or after cataract surgery by enabling the most accurate biometry.

[Exposure of normal Tenon's capsule fibroblasts from pterygium to 5-fluorouracil and mitomycin C].

PubMed

Viveiros, Magda Massae Hata; Schellini, Silvana Artioli; Candeias, João; Padovani, Carlos Roberto

2007-01-01

To evaluate the fibroblast proliferation activity of normal Tenon's capsule from primary and recurrent patients with pterygium. A randomized prospective study was performed with 41 normal Tenon's capsule fragments from 21 primary and 20 recurrent patients with pterygium. The sample was collected from the inferior cul-de-sac. Proliferation rate from fibroblasts were evaluated after mitomycin C and 5-fluorouracil exposition. Data were submitted to statistical analysis. Of the 41 cultivated normal Tenon's capsules, only 1 from primary and 2 from recurrent pterygium patients proliferated. After antimitotic exposition, the proliferation rate was similar with both drugs. Mitomycin and 5-fluorouracil promote similar inhibition regarding proliferation of normal Tenon's fibroblast cultures.

Prevalence of pterygium and cataract in indigenous populations of the Brazilian Amazon rain forest.

PubMed

Paula, J S; Thorn, F; Cruz, A A V

2006-05-01

To compare the prevalence of pterygium and cataract in four indigenous populations of the Brazilian Amazonian rain forest (Arawak, Tukano, Maku, and Yanomami) with different ethnic and social behaviour backgrounds. A cross-sectional pterygium and cataract survey was performed in 624 adult Indians of the Brazilian rain forest belonging to four different ethnic groups. The Indians were classified according to their social behaviour in two groups: Arawak and Tukano (group 1) and Maku and Yanomami (group 2). Slit-lamp biomicroscopy was employed to examine the entire sample. All subjects were classified as 1 or 0 according to the presence or absence pterygium and cataract. Sex and age were also recorded. chi(2)-tests revealed that the prevalence of pterygium and cataract differed significantly between groups 1 and 2. For pterygia: 36.6% (97/265) and 5.0% (18/359), respectively (chi(2)=101.2, P<0.0001), and for cataracts: 24.5% (65/265) and 13.7% (49/359) respectively (chi(2)=12.09, P=0.0005). Gender was not associated with pterygium (P=0.1326) and cataract (P=0.2263) in both groups. Elderly subjects showed a significantly higher prevalence of cataract (P<0.0001). The prevalence of pterygia did not increase with age (P=0.8079) in both groups. Indians of group 1 have higher prevalence of pterygia and cataract than Indians of group 2. Social behaviour, especially the rate of sun exposure, appears to be the main factor for the different rates of pterygium and cataract displayed by these indigenous people of the Brazilian rain forest.

Prevalence of Pterygia in Hawaii: Examining Cumulative Surfing Hours as a Risk Factor.

PubMed

Lin, Alexander D; Miles, Ku'ulei; Brinks, Mitchel V

2016-08-01

To examine the association between surfing and pterygium prevalence in Hawaii. A convenience sampling was performed at four beaches on the island of Oahu, Hawaii. A total of 169 individuals were interviewed and underwent penlight examination to assess grade and extent of pterygium. Of 169 participants aged 18-80 years, 88 non-surfers, 41 occasional surfers, 15 recreational surfers and 25 surfing enthusiasts were identified based on their lifetime surfing hours. Overall, 19 participants were found to have pterygia (28 pterygia total) including two non-surfers (2.3%), five occasional surfers (12.2%), three recreational surfers (20.0%), and nine enthusiast surfers (36.0%). Variables associated with pterygium prevalence were lifetime surfing hours (p < 0.0001), outdoor occupation (p = 0.04), Hawaiian residence (p = 0.009), and Hawaiian/Pacific Islander ethnicity (p = 0.002). Multiple logistic regression with the outcome of pterygium was performed, along with multiple linear regression for the continuous outcomes of corneal extent, chord length, and apex-visual axis gap, with lifetime surfing hours as the primary explanatory variable. After adjustment for confounders, a significant linear relationship was observed between chord length and lifetime surfing hours (p = 0.01). Surfing was associated with an increased pterygium prevalence and trend towards an association with increased pterygium severity. Increased risk of exposure to wind, particle irritation, and ultraviolet (UV) radiation while surfing may contribute to pterygium development. Implications for public health include promoting UV protective eyewear during surfing, in addition to raising awareness about the association of pterygia and the sport of surfing.

Fibrin adhesive is better than sutures in pterygium surgery.

PubMed

Ratnalingam, Vanitha; Eu, Andrew Lim Keat; Ng, Gim Leong; Taharin, Rohana; John, Elizabeth

2010-05-01

To evaluate the recurrence rate, surgical time, and postoperative pain between conjunctival autografting with sutures and with fibrin adhesive in pterygium surgery. A prospective, randomized, double-blind, clinical trial on the benefits of using fibrin adhesive in place of sutures in pterygium surgery. One hundred seventy-five eyes with primary pterygium were randomized to undergo pterygium surgery with conjunctival autograft transplantation using either fibrin adhesive or sutures. One hundred thirty-seven eyes of 113 patients that were operated on by a single surgeon (V.R.) completed the 1-year follow-up. Sixty-eight eyes were operated with fibrin adhesive and 69 eyes with sutures. Patients were followed up at 1 day, 1 week, 1 month, 6 months, and 1 year after surgery. Pterygium recurrence and postoperative pain was graded by an independent observer (A.L.) masked to the method of treatment. Surgical time was measured with a stopwatch. All patients were followed up for 1 year. There were 3 recurrences (4.41%) in the fibrin adhesive group and 11 recurrences (15.9%) in the suture group. The mean duration required to complete surgery in the fibrin adhesive group was 16.93 +/- 2.85 minutes, whereas that of the suture group was 29.84 +/- 5.65 minutes, which was statistically significant (P < 0.001). The immediate postoperative pain score and week 1 postoperative pain score were significantly lower in the fibrin adhesive group (P < 0.05). No major complications were observed in either group. The use of fibrin adhesive in primary pterygium surgery with conjunctival autografts reduces the recurrence rate, surgical time, and postoperative pain when compared with sutures.

Long-Term Results and Prognostic Factors of Fractionated Strontium-90 Eye Applicator for Pterygium

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

Arruda Viani, Gustavo; Stefano, Eduardo Jose; Fendi, Ligia Issa de

2008-11-15

Purpose: To evaluate the long-term safety, effectiveness, and prognostic factors of fractionated postoperative {beta}-irradiation. Methods and Materials: Between 1993 and 2005, 623 patients with 737 pterygium lesions were treated with a strontium-90 eye applicator after surgical excision. The median follow-up period was 60 months (range, 6.7-139.5). Of the 737 lesions, 644 were primary and 93 were recurrences after surgical removal alone. Fractionated radiotherapy (RT) to a total dose of 35 Gy in five to seven fractions was used. Results: A total of 73 local pterygium recurrences (9.9%) were noted. Of the recurrent cases, 80% were noted within 3 years aftermore » treatment. The 5- and 10-year probability of local control was 90% and 88%, respectively. The multivariate analysis for all cases demonstrated that gender, age, total radiation dose, recurrent pterygia, and interval between surgery and RT affected the overall local control rate. Late toxicities that might have been associated with strontium-90 RT included scleromalacia (scleral thinning) in nine eyes, adhesion of the eyelids in eight, cataracts in six, and scleral ulcer in five eyes. Conclusion: Fractionated strontium-90 RT to a total dose of approximately 35 Gy in five to seven fractions results in a similar local control rate as higher doses in other series, with an acceptable complication rate.« less

Primary Pterygium in a 7-Year-Old Boy: A Report of a Rare Case and Dilemma of its Management

PubMed Central

Noor, Raja Azmi Mohd

2003-01-01

Primary pterygium in children is uncommon but is associated with severe visual problems. Astigmatism is the main visual problem caused by pterygium. Significant amounts of astigmatism occur long before a pterygium encroaches the visual axis. Early surgical intervention is safe and effective. It is associated with significant visual improvement in outcome. This is a case report on seven-year-old Malay boy who presented with a growth over nasal aspect of the right eye of 1 year duration. His right eye visual acuity is affected up to 6/12. The dilemma pased to early surgical interview is the high rate of recurrancean the young age group. This problem is highlighted in this case report. PMID:23386804

Primary pterygium in a 7-year-old boy: a report of a rare case and dilemma of its management.

PubMed

Noor, Raja Azmi Mohd

2003-07-01

Primary pterygium in children is uncommon but is associated with severe visual problems. Astigmatism is the main visual problem caused by pterygium. Significant amounts of astigmatism occur long before a pterygium encroaches the visual axis. Early surgical intervention is safe and effective. It is associated with significant visual improvement in outcome. This is a case report on seven-year-old Malay boy who presented with a growth over nasal aspect of the right eye of 1 year duration. His right eye visual acuity is affected up to 6/12. The dilemma pased to early surgical interview is the high rate of recurrancean the young age group. This problem is highlighted in this case report.

Winglets of the eye: dominant transmission of early adult pterygium of the conjunctiva.

PubMed Central

Hecht, F; Shoptaugh, M G

1990-01-01

A pterygium, a wing-like thickening, of the bulbar conjunctiva is of environmental interest because it can occur on prolonged exposure to wind and weather. We describe a family with pterygium in two generations without a history of unusual exposure to the elements. There were six females and five males (including a set of male twins) with seven bilateral and four unilateral pterygia. The onset was unique in being in early adulthood, from the late teens through the twenties. This new genetic form can be distinguished by the age of onset from congenital and mid-adult pterygia, which are inherited as autosomal dominant traits. Irrespective of age, the treatment of conjunctival pterygium is surgical excision. PMID:2359104

Fibrin glue versus sutures for conjunctival autografting in primary pterygium surgery.

PubMed

Romano, Vito; Cruciani, Mario; Conti, Luigi; Fontana, Luigi

2016-12-02

Pterygium, a growth of the conjunctiva over the cornea, is a progressive disease leading in advanced stages to visual impairment, restriction of ocular motility, chronic inflammation and cosmetic concerns. Surgical removal is the treatment of choice, but recurrence can be a problem. Currently the best surgical option in terms of recurrence is conjunctival autograft. To date the most common surgical methods of attaching conjunctival autografts to the sclera are through suturing or fibrin glue. Each method presents its own advantages and disadvantages. Sutures require considerable skill from the surgeon and can be associated with a prolonged operation time, postoperative discomfort and suture-related complications, whereas fibrin glue may give a decreased operation time, improve postoperative comfort and avoid suture-related problems. To assess the effectiveness of fibrin glue compared to sutures in conjunctival autografting for the surgical treatment of pterygium. We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 9), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to October 2016), Embase (January 1980 to October 2016), the ISRCTN registry (www.isrctn.com/editAdvancedSearch), ClinicalTrials.gov (www.clinicaltrials.gov), and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 14 October 2016. We included randomised controlled trials (RCTs) in any setting where fibrin glue was compared with sutures to treat people with pterygium. Two review authors independently screened the search results, assessed trial quality, and extracted data using standard methodological procedures expected by Cochrane. Our primary outcome was recurrence of pterygium defined as any re-growth of tissue from the area of excision across the limbus onto the cornea. The secondary outcomes were surgical time and complication rate. We graded the certainty of the evidence using GRADE. We included 14 RCTs conducted in Brazil, China, Egypt, India, Malaysia, New Zealand, Philippines, Saudi Arabia, Sweden and Turkey. The trials were published between 2004 and 2016, and were assessed as a mixture of unclear and low risk of bias with three studies at high risk of attrition bias. Only adults were enrolled in these studies.Using fibrin glue for the conjunctival autograft may result in less recurrence of pterygium compared with using sutures (risk ratio (RR) 0.47, 95% CI 0.27 to 0.82, 762 eyes, 12 RCTs; low-certainty evidence). If pterygium recurs after approximately 10 in every 100 surgeries with sutures, then using fibrin glue may result in approximately 5 fewer cases of recurrence in every 100 surgeries (95% CI 2 fewer to 7 fewer cases). Using fibrin glue may lead to more complications compared with sutures (RR 1.92; 95% CI 1.22 to 3.02, 11 RCTs, 673 eyes, low-certainty evidence). The most common complications reported were: graft dehiscence, graft retraction and granuloma. On average using fibrin glue may mean that surgery is quicker compared with suturing (mean difference (MD) -17.01 minutes 95% CI -20.56 to -13.46), 9 RCTs, 614 eyes, low-certainty evidence). The meta-analyses, conducted on people with pterygium in a hospital or outpatient setting, show fibrin glue may result in less recurrence and may take less time than sutures for fixing the conjunctival graft in place during pterygium surgery. There was low-certainty evidence to suggest a higher proportion of complications in the fibrin glue group.

Population-based assessment of prevalence and risk factors for pterygium in the South Indian state of Andhra Pradesh: the Andhra Pradesh Eye Disease Study.

PubMed

Marmamula, Srinivas; Khanna, Rohit C; Rao, Gullapalli N

2013-08-09

To describe the prevalence and risk factors for pterygium in a population-based sample of individuals aged 30 years and older in South Indian state of Andhra Pradesh. A cross-sectional study was conducted in one urban and three rural locations in which 10,293 subjects were examined. All the subjects underwent comprehensive eye examination and a detailed interview by trained professionals. Pterygium was defined as fleshy fibro vascular growth, crossing the limbus, and typically seen on the nasal conjunctiva in either eye. Data were analyzed for 5586 subjects who were aged 30 years and older at the time of participation. The mean age of the participants was 47.5 years (SD 13 years; range 30-102 years). In total, 46.4% were male, 56.7% had no education, 52.2% of them were involved in outdoor occupations, and 25% belonged to urban area. The prevalence of pterygium was 11.7% (95% confidence interval [CI]: 10.9-12.6). The multiple logistic regression analysis revealed significantly higher odds of pterygium among older age groups, rural residents (odds ratio [OR]: 1.8; 95% CI: 1.4-2.4; P > 0.01), and those involved in outdoor occupations (OR: 1.8; 95% CI: 1.5-2.2, P < 0.001). Education had a protective effect (OR: 0.6; 95% CI: 0.5-0.7; P < 0.001). Pterygium is common in the South Indian state of Andhra Pradesh. Exposure to sunlight is a significant modifiable risk factor. Protecting the eyes from sunlight may decrease the risk of pterygium. However, the important public health challenge is to encourage the use of this protection as a routine in developing countries such as India.

Conjunctivolimbal Autograft Using a Fibrin Adhesive in Pterygium Surgery

PubMed Central

Kim, Hyun Ho; Mun, Hong Jae; Lee, Kyoo Won; Shin, Jae Pil

2008-01-01

Purpose To evaluate the efficacy and safety of fibrin bioadhesive in conjunctivolimbal autograft surgery for primary pterygium. Methods Thirty-six eyes in 34 patients were reviewed with nasal primary pterygium who were treated with pterygium excision with superior conjunctivolimbal transplantation with fibrin bioadhesive. Surgical durations were recorded and the patients were followed up on the first day after surgery and then at 1, 2, 4, 8 and 12 weeks postoperatively. The graft-recipient site attachments were examined and subjective symptoms of patients were recorded at every follow-up examinations. Results The mean patient age was 57.9±10.1 (ranging from 33 to 83) years. The mean follow-up period was 22.05±5.78 weeks. The mean surgery time was 18.04±5.65 minutes. The subjective symptoms (pain, foreign body sensation, tearing and discomfort) disappeared in 23 of 36 eyes (64%) in one week after surgery, and all discomforts subsided within two weeks after surgery in all patients. The conjunctivolimbal autograft was correctly positioned and fixed in 34 of 36 eyes (94.4%) throughout the follow-up period. Graft dehiscence was seen in two eyes (5.6%), one eye was treated with remedial sutures, and the other eye showed a spontaneous healing without remedial sutures. Transient graft edema occurred in four eyes (11.2%) but subsided spontaneously within a month. There were no cases of pterygium regrowth or complications due to the fibrin bioadhesive. Conclusions The use of fibrin bioadhesive in conjunctivolimbal autograft surgery in primary pterygium simplifies surgical techniques, shorten surgical duration, and produce less postoperative subjective symptoms. Therefore, the fibrin bioadhesive is a safe and effective tool to attach conjunctivolimbal autograft in primary pterygium surgery. PMID:18784440

[Expression of embryonic markers in pterygium derived mesenchymal cells].

PubMed

Pascual, G; Montes, M A; Pérez-Rico, C; Pérez-Kohler, B; Bellón, J M; Buján, J

2010-12-01

Destruction of the limbal epithelium barrier is the most important mechanism of pterygium formation (conjunctiva proliferation, encroaching onto the cornea). It is thought to arise from activated and proliferating limbal epithelial stem cells. The objective of this study is to evaluate the presence of undifferentiated mesenchymal cells (stem cells) in cultured cells extracted from human pterygium. Cells from 6 human pterygium were isolated by explantation and placed in cultures with amniomax medium. Once the monolayer was reached the cells were seeded onto 24 well microplates. The cells were studied in the second sub-culture. The immunohistochemical expression of different embryonic stem cell markers, OCT3/4 and CD9, was analysed. The differentiated phenotypes were characterised with the monoclonal antibodies anti-CD31, α-actin and vimentin. All the cell populations obtained from pterygium showed vimentin expression. Less than 1% of the cells were positive for CD31 and α-actin markers. The majority of the cell population was positive for OCT3/4 and CD9. The cell population obtained from pterygium expressed mesenchymal cell phenotype and embryonic markers, such us OCT3/4 and CD9. This undifferentiated population could be involved in the large recurrence rate of this type of tissue after surgery. Copyright © 2010 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

Amniotic membrane transplantation with conjunctival autograft for recurrent pterygium.

PubMed

Shimazaki, Jun; Kosaka, Koichi; Shimmura, Shigeto; Tsubota, Kazuo

2003-01-01

To study the effect of amniotic membrane transplantation (AMT) combined with either limbal autograft transplantation (LAT) or conjunctival autograft transplantation (CAT) in recurrent pterygium. Retrospective, noncomparative, interventional case series. Twenty-seven eyes of 27 patients with recurrent pterygium. The mean number of prior surgeries was 3.1 (range, 1-10). Fifteen eyes each had restriction of ocular movement and symblepharon before surgery. Patients were treated by AMT with either LAT (n = 15) or CAT (n = 12). Recurrence of pterygium, improvement in ocular movement, and symblepharon formation. Twenty-three (85.2%) of 27 eyes showed no recurrence with a mean observation period of 67.0 weeks. Fourteen eyes (93.3%) each showed improvement in ocular movement restriction and symblepharon after AMT. In four eyes that developed recurrence, three had LAT and one had CAT combined with AMT, suggesting that there was no difference in surgical outcome between LAT and CAT. AMT with CAT is a safe and effective method for recurrent pterygium, especially that associated with ocular movement restriction and symblepharon. Considering the potential adverse effects associated with limbal excision, AMT plus CAT may be preferred over AMT plus LAT.

Continuous fetal head flexion as a marker for prenatal diagnosis of lethal multiple pterygium syndrome: a case report.

PubMed

Hasegawa, Akihiro; Hanaoka, Mieko; Murakoshi, Takeshi

2017-07-01

Lethal multiple pterygium syndrome (LMPS) is a fatal hereditary disease associated with abnormalities such as pterygium-induced congenital contractures. Fetal hydrops is present in more than half of all patients with LMPS, and all patients with LMPS are either stillborn or die in the early neonatal period. Ultrasonography findings for the prenatal diagnosis of LMPS include the detection of cutaneous webbing at multiple joints, multiple joint contractures, absent limb movement, and increased nuchal translucency. Here, we describe a patient who was diagnosed as having LMPS due to continuous fetal head flexion, despite the absence of the usual characteristics of the condition, including pterygium at the joints. Thus, continuous fetal head flexion can be a useful marker for prenatally diagnosing LMPS.

Safety profile and complications of autologous limbal conjunctival transplantation for primary pterygium

PubMed Central

Prabhakar, Srinivasapuram Krishnachary

2014-01-01

Purpose Primary pterygium is a fibrovascular proliferation over the nasal cornea, probably resulting from the limbal stem cell deficiency. Intraoperative mitomycin-C application seems to associate with reduced recurrences, however produced ocular surface problems and vision threatening complications. The present clinical study investigated the safety profile of autologous limbal conjunctival transplantation in terms of recurrence rate, as the main outcome measure and complications as the secondary outcome. Methods The present study was randomised, interventional and prospective clinical study conducted from a tertiary Hospital. Pterygium excision was performed with limbal conjunctival autograft availed from the affected eye. Secondary pterygia resulting from inflammation, trauma and other diseases were excluded. Patients were followed up for 18 months for recurrence and other complications. Microsoft Office Excel 2007 was used for statistical analysis. Results A total of 71 eyes of sixty-eight patients with primary pterygia included between November 2007 and October 2010. The study recruited 35 (51%) males and 33 (49%) females with mean age of 36.9 with ±12.82 years standard deviation (mean, SD) ranging from 19 to 75 years. Age grouped by range intervals categorised into six groups. Pterygium was diagnosed in 32 (45%) right eyes and 39 (55%) left eyes. There were 65 (91.55%) nasal and 4 (5.63%) temporal pterygium and no case of double head pterygia found. Average horizontal extension of the pterygium measured was 1.67 mm (±4.23) from the apex to the corneal limbus. Graft oedema in 1 (0.71%) patient, graft bleed in 2 (1.42%) cases and 1 (0.72%) case of granuloma observed. No recurrences encountered during 18 months follow up. Conclusions Pterygium occurred predominantly in the younger population group 36.9 mm (±12.82) probably due to the increased outdoor activity with high exposure to sunlight and dusty atmosphere. Absence of recurrences was probably attributable to the smaller pterygium size of 1.67 mm (±4.23), use of the autologous limbal conjunctival graft and treatable intra and post operative complications successfully. PMID:25473341

Pterygium among Latino migrant farmworkers in North Carolina.

PubMed

Taylor, Sarah L; Coates, Michael L; Vallejos, Quirina; Feldman, Steven R; Schulz, Mark R; Quandt, Sara A; Fleischer, Alan B; Arcury, Thomas A

2006-01-01

The authors describe the prevalence and severity of pterygium among Latino migrant farmworkers in North Carolina and delineate its risk factors. They selected a sample of 304 farmworkers working in eastern North Carolina in 2005. Digital photographs were taken of each farmworker, including a facial view showing the eyes. Two physicians independently rated each farmworker for the presence and severity of pterygia, with an initial intercoder agreement of 91%. Sixty-eight (23.3%) participants had a pterygium in at least 1 eye; 28 (9.5%) had bilateral pterygia. Age was significantly associated with pterygia (odds ratio = 1.07; 95% confidence interval = 1.03-1.11). Research on the causes of pterygium among farmworkers is needed. In the interim, improvements in farmworkers' preventive behaviors, such as wearing ultraviolet protective lenses and brimmed hats, are reasonable and inexpensive measures.

Pterygium removal using a polyethylene glycol hydrogel adherent ocular bandage.

PubMed

Hirst, Lawrence W

2013-06-01

To describe the result of using a polyethylene glycol hydrogel contact lens (ReSure; Ocular Therapeutix, Inc, Bedford, MA) as a protective bandage over denuded areas of Tenons after pterygium removal. Five sequential patients underwent pterygium removal with a conjunctival autograft and painting of bare Tenons in the area of the graft retrieval with a biodegradable polymer, and these patients were followed for 1 year for immediate postoperative pain, epithelial healing, and long-term conjunctival scarring. All patients showed prolonged persistence of the polymer for up to 8 to 10 weeks with resultant increased conjunctival inflammation and scarring with no evidence of decreased postoperative pain. This hydrogel polymer seems to cause prolonged inflammation and resultant scarring when used over extended areas of Tenons, and it has no role in reducing pain after pterygium surgery.

Fibrin glue versus autologous blood for conjunctival autograft fixation in pterygium surgery.

PubMed

Boucher, Sophie; Conlon, Ronan; Teja, Salina; Teichman, Joshua C; Yeung, Season; Ziai, Setareh; Baig, Kashif

2015-08-01

To compare the outcomes between autologous blood- and fibrin glue-fixated conjunctival autografts in pterygium excision surgery. Retrospective case series. Forty eyes of 40 patients who had a primary nasal pterygium excision. A retrospective comparative case series of 40 eyes (40 patients) that had a primary nasal pterygium excision. All eyes had a conjunctival autograft from the superior bulbar conjunctiva to cover the scleral bed. Twenty eyes (20 patients) had fixation of the autograft using autologous blood (AB), and 20 eyes (20 patients) had fixation using fibrin glue (FG). One year of follow-up data included conjunctival graft stability (graft loss, graft retraction), pterygium recurrence, visual acuity, and postoperative complications. Descriptive and inferential statistics were performed. Intraoperatively, no complications occurred in either group. Graft loss occurred in 6 patients in the AB group, compared with none in the FG group. Graft retraction occurred in 3 patients in the AB group and 2 patients in the FG group. At 1 year postoperatively, pterygium recurrence occurred in 4 patients in the AB group and 1 patient in the FG group. One patient in the AB group developed a small pyogenic granuloma that resolved by 6 months with conservative management. Visual acuity remained stable in both groups. Conjunctival autograft fixation with autologous blood resulted in less stable conjunctival autografts and a higher recurrence rate compared with fixation with fibrin glue. Copyright © 2015 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

Autologous Blood Versus Fibrin Glue in Pterygium Excision With Conjunctival Autograft Surgery.

PubMed

Nadarajah, Gaayathri; Ratnalingam, Vanitha Hema; Mohd Isa, Hazlita

2017-04-01

To evaluate graft stability and recurrence rate between fibrin glue and autologous blood in pterygium conjunctival autograft surgery. A prospective, randomized, single-blinded clinical trial to assess the efficacy of autologous blood in place of fibrin glue in pterygium surgery. A total of 120 eyes of 111 patients were randomized according to pterygium morphology, to undergo pterygium surgery with autografting using either autologous blood or fibrin glue. All patients were operated by a single surgeon; 58 eyes were operated using fibrin glue and 62 eyes had a conjunctival autograft with autologous blood. Patients were seen on postoperative day 1, 1 week, 1 month, 6 months, and 1 year after surgery. Graft stability and pterygium recurrence were graded by an independent observer who was masked to the method of treatment. All 120 eyes completed the 1-year follow-up. Graft loss was seen only in the autologous blood group. Of the 62 eyes in this group, a total of 15 (24.2%) grafts dislodged. Recurrence was calculated after excluding grafts that were dislodged. Of the 105 patients, there were a total of 7 recurrences, 2 (3.4%) from the fibrin adhesive method and 5 (10.6%) from the autologous blood method. This was not statistically significant (P = 0.238). Autologous blood does not exhibit similar graft stability seen with fibrin glue. Although the recurrence rate may not be significant, careful patient selection and a standard method needs to be laid out before the use of this method is widely accepted.

A Comparative Study of the Effect of Fibrin Glue versus Sutures on Clinical Outcome in Patients Undergoing Pterygium Excision and Conjunctival Autografts

PubMed Central

Cha, Dong Min; Kim, Kyeong Hwan; Choi, Hyuk Jin; Wee, Won Ryang

2012-01-01

Purpose To compare the effect of using fibrin glue or 10-0 nylon sutures on the clinical outcome of patients undergoing pterygium excision and conjunctival autografting. Methods We retrospectively reviewed the medical records of 52 eyes from 46 patients who underwent pterygium excision and conjunctival autografting and were followed up for more than 3 months. The operation duration, postoperative inflammation, complications, and recurrence rates were compared between groups of 20 patients (22 eyes) for whom fibrin glue was used (fibrin glue group) and 26 patients (30 eyes) for whom suturing was performed with 10-0 nylon (suture group) in pterygium excision and conjunctival autografting. Results The operation duration was 27.71 (5.22) minutes in the fibrin glue group and 43.30 (8.18) minutes in the suture group (p = 0.000). Seven days after the operation, the fibrin glue group showed milder conjunctival inflammation than the suture group (p = 0.000). Postoperative complications and corneal recurrence rates were not statistically different between the two groups. Conclusions The use of fibrin glue in pterygium excision with conjunctival autografting is likely to be a more effective, safer procedure than suturing. PMID:23204794

Genetics Home Reference: multiple pterygium syndrome

MedlinePlus

... Lethal multiple pterygium syndrome Sources for This Page Cox PM, Brueton LA, Bjelogrlic P, Pomroy P, Sewry ... article on PubMed Central Morgan NV, Brueton LA, Cox P, Greally MT, Tolmie J, Pasha S, Aligianis IA, ...

Aetiology of climatic droplet keratopathy and pterygium.

PubMed Central

Taylor, H R

1980-01-01

The association of various personal, occupational, and environmental factors with climatic droplet keratopathy and pterygium was examined in a group of Australian Aborigines. Climatic droplet keratopathy was seen especially in aboriginal males who had worked as stockmen for more than 20 years. Although no definite association with a single causal factor could be made, there is circumstantial evidence for the importance of ultraviolet radiation. Pterygium was more commonly seen in those who worked outside, and it was positively correlated with lower latitudes and high ultraviolet levels. Images PMID:7387947

Comparison of mitomycin C and limbal-conjunctival autograft in the prevention of pterygial recurrence in Turkish patients: A one-year, randomized, assessor-masked, controlled trial

PubMed Central

Ari, Şeyhmus; Çaca, Îhsan; Yildiz, Zennure Özdemir; Şakalar, Yildirim Bayezit; Dogan, Eyüp

2009-01-01

Background: A pterygium is a fibrovascular overgrowth of degenerative bulbar conjunctival tissue that grows over the limbus onto the cornea. Although various approaches have been proposed for the treatment of pterygium, the common problem after these treatments is recurrence. Objectives: The goals of this study were to compare the efficacy of mitomycin C (MMC) and limbal-conjunctival autograft (LCAU) in preventing recurrence of primary pterygia and to monitor long-term adverse effects (AEs). Methods: Patients undergoing pterygium surgery between February 2006 and May 2007 were assessed prospectively and randomly divided into 2 groups using a random number table. The MMC group underwent pterygium excision and received 0.02% MMC intraoperatively for 2 minutes. The LCAU group underwent pterygium excision and LCAU. Recurrence and AE rates of the 2 treatments were compared during the 1-year follow-up period. Assessors for pterygial recurrence were masked to treatment group. Results: One hundred thirteen eyes (57 patients in the MMC group and 56 patients in the LCAU group) were included in the study. Thirteen of the patients (7 in the MMC group and 6 in the LCAU group) were withdrawn due to irregular attendance at follow-up visits or lack of sufficient dose and duration for postoperative topical antibiotic and steroid administration; their data were excluded from analysis. Fifty patients (MMC group: 26 men, 24 women; mean [SD] age, 48.0 [12.3] years; age range, 30–73 years; LCAU group: 27 men, 23 women; mean age, 49.0 [12.6] years; age range, 28–71 years) in each group completed the study. The mean (SD) length of the pterygium across the limbus was similar in the MMC group and the LCAU group (4.18 [1.27] vs 4.07 [1.24] mm). The mean follow-up period was also similar in the 2 groups (16.0 [1.9] vs 15.0 [1.7] months). The rate of recurrence was significantly greater in the MMC group than in the LCAU group (10 [20.0%] vs 2 [4.0%] patients; P=0.035). Seven patients (14.0%) in the MMC group experienced AEs: conjunctival cyst (3 patients), symblepharon (2), conjunctival granuloma (1), and dellen (1). In the LCAU group, 1 patient (2.0%; P=0.032 vs MMC group) experienced permanent graft edema. All patients in the LCAU group experienced transient graft edema, with recovery occurring in 3 to 4 weeks. There were no intraoperative complications and there was no graft rejection. Conclusions: Recurrence and postoperative AEs were less frequently observed in primary excision with LCAU than with MMC in these Turkish patients who completed the study. This study found that pterygium excision with LCAU was well tolerated and effective in these patients. PMID:24683237

Comparison of self-made cryopreservative fibrin glue and commercial fibrin glue kit in pterygium surgery: 1-year follow-up.

PubMed

Gong, Jingwen; Fan, Jiaqi; Shen, Ting; Jiang, Jin

2018-03-01

To assess long-term efficacy and safety of self-made cryopreservative fibrin glue (SMC) applied in pterygium surgery. Prospective, comparative, interventional case series. Forty eyes of 40 patients with nasal primary pterygium, 24 male and 16 female, were enrolled. The patients were assigned to two groups and each contained 12 male and eight female based on the pterygium area encroaching onto the cornea. In one group, the conjunctival autograft was attached to the sclera with SMC stored for 2 months, and in the other group, commercial fibrin glue kit (CK) was applied after the pterygium was removed. All the patients were followed up postoperatively on days 1, 3, 7 and 14 then at months 1, 3, 6, 12. The main outcome measures included operating time, postoperative discomfort, recurrence rate and complications. There were no significant differences in surgery time (p = 0.713) and postoperative discomfort (day 1, 3, 7; p = 0.747, p = 0.766, p = 0.983, respectively) between the two groups. By the end of 1-year follow-up, the recurrence rate was 0% in the SMC group and 5% in the CK group (p = 1.000). There were no infections and severe visual acuity (VA) threatening complications in either group. Self-made cryopreservative fibrin glue (SMC) is as effective as standard CK for autograft fixation in pterygium surgery and it also has good safety after long-term follow-up. For its convenience and low cost, this new methods should be popularized, especially in underdeveloped area. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

[Efficacy of fibrin tissue adhesive in the attachment of autogenous conjuntival graft on primary pterygium surgery].

PubMed

Rubin, Michel Risnic; Dantas, Paulo Elias C; Nishiwaki-Dantas, M Cristina; Felberg, Sergio

2011-01-01

To compare the efficacy of conjunctival autograft surgery with the attachment to the scleral bed using fibrin tissue adhesive or mononylon 10-0 suture after resection of primary pterygium. A comparative, prospective and randomized clinical trial was performed in 47 eyes of 47 patients with primary medial located pterygium. Group 1 (adhesive) was composed by 21 patients that underwent conjunctival autograft closure with fibrin tissue adhesive (Quixil™) and Group 2 (suture) was composed by 26 patients that underwent pterygium surgery with mononylon 10-0 (Ethicon(®)) suture (suture group) after pterygium excision. All surgeries were performed by the same surgeon. Patients were assessed on the preoperative period and on the 1(st), 14(th) and 21(st) postoperative days. They were followed-up with a questionnaire of ocular discomfort and by the surgical time spent, ocular hyperemia, complications and recurrence signals, being the recurrence also evaluated at the 6th postoperative month. Data were submitted to statistical analysis. A value of p<0.005 was considered statistically significant. The average surgical time was 19.05 ± 6.12 minutes in group 1 (glue) and 48.15 ± 7.13 minutes in the group 2 (suture) (p<0.001). The ocular discomfort scale analysis showed a lower score in the 1(st) (p<0.005), 7(th) (p<0.001) and 21(th) (p<0.001) postoperative days in group 1. Ocular hyperemia was less intense in all periods of this study in group 1 (p<0.001). Complications were one in each group and both were managed with clinical treatment until the 21(th) postoperative day. There was one recurrence in group 1 and two in group 2 until the 6(th) postoperative month. In the surgical management of primary pterygium, fibrin tissue adhesive attached the conjunctival autograft, decreased the surgical time and diminished the conjunctival hyperemia and ocular discomfort with similar recurrences on the postoperative period, compared to fixation with mononylon 10.0 suture, proving to be an excellent option for conjunctival autograft attachment in primary pterygium surgery.

Anatomic Severity, Midfacial Growth, and Speech Outcomes in Van der Woude/Popliteal Pterygium Syndromes Compared to Nonsyndromic Cleft Lip/Palate.

PubMed

Reardon, Jeffrey B; Brustowicz, Katherine A; Marrinan, Eileen M; Mulliken, John B; Padwa, Bonnie L

2015-11-01

To summarize the clinical characteristics and surgical and speech outcomes for patients with Van der Woude/popliteal pterygium syndromes (VWS/PPS) and to compare them with a historic cohort of patients with nonsyndromic cleft lip/cleft palate (CL/P). Retrospective chart review. Tertiary care center. All patients with VWS/PPS seen at Boston Children's Hospital from 1979 to 2012: 28 patients with VWS (n = 21)/PPS (n = 7) whose mean age was 17.3 ± 10.4 years, including 18 females (64%) and 10 males (36%); 18 patients (64%) had a family history of VWS/PPS. Cleft type, operative procedures, speech, and midfacial growth. Data were compared with historic cohorts of patients with nonsyndromic CL/P treated at one tertiary care center. There were 24 patients (86%) with CP±L, Veau types I (n = 4, 17%), II (n = 4, 17%), III (n = 5, 21%), and IV (n = 11, 46%). Nine patients (38%) had palatal fistula after palatoplasty. Fourteen of 23 (61%) patients with CL/P age 5 years or older had midfacial retrusion, and 10 (43%) required a pharyngeal flap for velopharyngeal insufficiency. Fisher's exact test demonstrated higher frequencies of Veau type IV CP±L (P = .0016), bilateral CL±P (P = .0001), and complete CL±P (P < .0001) in VWS/PPS compared with nonsyndromic patients. Incidences of midfacial retrusion (P = .0001), palatal fistula (P < .0001), and need for pharyngeal flap (P = .0014) were significantly greater in patients with VWS/PPS. Patients with VWS/PPS have more severe forms of labiopalatal clefting and higher incidences of midfacial retrusion, palatal fistula, and velopharyngeal insufficiency following primary repair as compared with nonsyndromic CL/P.

Role of concanavalin A lectin in recognition of pterygium remnant after surgical excision: Preliminary results of a prospective study

PubMed Central

Díaz-González, Juan A; Mayoral-Chávez, Miguel A; Bohórquez, Paulina Leyva; de la Torre, Ma. del Pilar Gabriel; Hernández-Cruz, Pedro; Martínez-Cruz, Ruth

2007-01-01

Background: Pterygium is one of the most common conjunctival diseases among ophthalmic pathologies. The frequency of recurrences is high, either after surgical treatment or after treatment combined with mitomycin C or beta-radiation therapy. Aims: The purpose of this study was to determine whether concanavalin A (ConA) lectin bound to the pterygial surface can be used to detect recurrence or remnants of pterygium after surgical excision. Materials and Methods: This was a prospective study on 20 patients with pterygium, divided in five stages, pre-surgery, early post-surgery (24h), late post-surgery (seven days), very late post-surgery (four weeks) and two months after the procedure. A drop of fluorescein-marked Con A (35 µg/mL) was instilled in the lower conjunctival eyelid sac and the eye was exposed to the light of a Wood′s lamp for an average of five seconds. Results: Out of the 20 patients, eight patients were found to have fluorescent stretch marks over the scar corresponding to residual pterygial tissue at four weeks; two months after the procedure of re-surgery we observed no fluorescent remnants. All residual pterygia were confirmed through histochemistry studies. Conclusion: It was possible to detect remnants of pterygium in postoperative patients and recurrences in early pre-clinical stages through the visualization of fluorescent ConA bound to the pterygial surface. PMID:17699943

Inhibitory effects of rosmarinic acid on pterygium epithelial cells through redox imbalance and induction of extrinsic and intrinsic apoptosis.

PubMed

Chen, Ya-Yu; Tsai, Chia-Fang; Tsai, Ming-Chu; Hsu, Yu-Wen; Lu, Fung-Jou

2017-07-01

Pterygium is a common tumor-like ocular disease, which may be related to exposure to chronic ultraviolet (UV) radiation. Although the standard treatment for pterygium is surgical intervention, the recurrence rate of pterygium is high when no effective inhibitory drug is used after surgery. Rosmarinic acid (RA) is a polyphenol antioxidant with many biological activities, including anti-UV and anti-tumor properties. This study aimed to examine the inhibitory effects of RA on pterygium epithelial cells (PECs). Methylthiazolyldiphenyl-tetrazolium bromide (MTT) assay was used to examine the cell cytotoxicity of PECs after RA treatment. A fluorescent probe, DCFH-DA (2',7'-dichlorofluorescin diacetate), was stained with PECs to measure intracellular reactive oxygen species (ROS) levels. Antioxidant activity assays were used to measure the levels of superoxide dismutase (SOD) and catalase (CAT) in PECs. Western blot analysis was used to determine the protein expression of nuclear factor E2-related factor 2 (Nrf2), heme oxygenase 1 (HO-1), quinone acceptor oxidoreductase 1 (NQO1), and apoptosis-associated proteins. RA significantly reduced the cell viability of the PECs. Treatment with RA remarkably increased the Nrf2 protein expression levels in the nucleus, HO-1 and NQO1 protein expression levels, and the activities of SOD and CAT. As a result, intracellular ROS levels in PECs were decreased. Additionally, the induction of extrinsic apoptosis on PECs by RA was associated with increasing expressions levels of Fas, Fas-associated protein with death domain (FADD), tumor necrosis factor-alpha (TNF-α), and caspase 8 protein. Moreover, the induction of intrinsic apoptotic cell death in PECs was confirmed through upregulation of cytochrome c, Bax, caspase 9, and caspase 3 and downregulation of Bcl-2 and pro-caspase 3. Our study demonstrated that RA could inhibit the viability of PECs through regulation of extrinsic and intrinsic apoptosis pathways. Therefore, RA may have potential as a therapeutic medication for pterygium. Copyright © 2017 Elsevier Ltd. All rights reserved.

Tyrosine Kinase Inhibitor, Vatalanib, Inhibits Proliferation and Migration of Human Pterygial Fibroblasts.

PubMed

Kim, Hong Kyu; Choi, Ji-Young; Park, Sang Min; Rho, Chang Rae; Cho, Kyong Jin; Jo, Sangmee Ahn

2017-09-01

Vatalanib is a small-molecule tyrosine kinase inhibitor. We investigated the effects of vatalanib on the proliferation and migration of cultured human pterygial fibroblasts (HPFs). Pterygium tissues were obtained after pterygium excision surgery and subjected to primary culture. HPFs were treated with vatalanib at various concentrations. Mitomycin C (MMC) was used as a positive control. Cell proliferation and migration assays were used to investigate the effects of vatalanib. Cell death was measured using flow cytometry analysis. Western blot analysis was performed to identify signaling molecules associated with the response to vatalanib. Vatalanib inhibited both proliferation and migration of HPFs in a dose-dependent manner. Cell proliferation was significantly suppressed by vatalanib (10 and 100 μM) and MMC (0.004% and 0.04%) treatments. Migration assays revealed significant HPF delay when treated with vatalanib (1, 10, and 100 μM) and MMC (0.004% and 0.04%) compared with that in a negative control. Cell death analysis showed that high concentrations of vatalanib (100 μM) and MMC (0.004% and 0.04%) decreased cell numbers. Western blot analysis of vatalanib-treated cells showed vascular endothelial growth factor and transforming growth factor-β significantly reduced, but there was no alteration in p53 protein levels in HPFs. These results indicate that vatalanib significantly suppressed the proliferation and migration of HPFs by decreasing vascular endothelial growth factor and transforming growth factor-β. Vatalanib showed less toxicity than that of MMC. Based on these results, vatalanib may potentially serve as a new adjuvant treatment after pterygium excision surgery.

Evaluation of Topical Lignocaine Jelly 2% for Recurrent Pterygium Surgery with Glue-free Autologous Conjunctival Graft

PubMed Central

Joshi, Rajesh Subhash

2017-01-01

AIM: This study aims to evaluate the efficacy of lignocaine 2% jelly as a topical anesthesia in recurrent pterygium surgery with glue-free conjunctival limbal autograft. MATERIALS AND METHODS: A prospective, nonrandomized, observational study, comprising of 51 patients (51 eyes) having recurrent pterygium, was conducted at a tertiary eye care center in central India. Pterygium excision with glue-free autologous conjunctival grafting was done under 2% lignocaine jelly. The visual analog scale was utilized to record the intra- and post-operative pain score. Patient comfort, intraoperative painful sensations perceived by the patient, supplemental anesthesia, complications, and surgeon discomfort were noted. Anesthetist also noted vital parameters and any intravenous drugs required. RESULTS: No difference in intra- and post-operative pain score (P = 0.24) was observed in the patients. Zero score, i.e. no pain was noticed in 30 patients (58.8%) patients. The average surgical time was 29.20 min (+1.11). The average surgeon discomfort score was 0.18 + 0.51. Inadvertent eye movement was seen in 3 patients (5.9%). Lid squeeze was noted in 45 patients (88.2%) during placement of lid speculum. Forty-eight patients (94.1%) gave preference to the topical anesthesia of 2% lignocaine jelly compared to the previous mode of anesthesia. CONCLUSION: Pterygium surgery with glue-free autogenous conjunctival grafting can be performed successfully by preoperative local application of 2% lignocaine jelly. The ease of application, lack of toxicity and sufficient effect to complete the surgery make it an efficient alternative to injectable anesthetics. PMID:29279652

Preoperative subpterygeal injection vs intraoperative mitomycin C for pterygium removal: comparison of results and complications.

PubMed

Khakshoor, Hamid; Razavi, Mohammad Etezad; Daneshvar, Ramin; Shakeri, Mohammad Taghi; Ghate, Majid Farrokh; Ghooshkhanehi, Haleh

2010-08-01

To evaluate and compare the recurrence rates and complications between 2 therapeutic methods for primary pterygium: subconjunctival injection of mitomycin C (MMC) 1 month before bare scleral excision and conjunctival rotational flap with intraoperative MMC use. Prospective, interventional, randomized clinical trial. setting: Institutional clinical trial in a tertiary, specialty eye hospital. study population and intervention: We included 82 eyes diagnosed with primary pterygium and randomly allocated them into 2 groups. Group A consisted of 36 eyes treated with subconjunctival injection of 0.02% MMC 1 month before bare scleral excision, and group B comprised 46 eyes that underwent conjunctival rotational flap with intraoperative 0.02% MMC for 2 minutes. Follow-up periods were at least 12 months (range, 12 to 18 months). main outcome measure: Recurrence and complication rate in each arm of study. During the 1-year follow-up, 2 cases of clinical recurrence in third and sixth month of follow-up occurred in group B (recurrence rate, 4.3%). In group A, there was no clinically significant recurrence, but 2 cases of hypovascularity and whitening of sclera at the site of pterygium excision was observed. There was no other serious complication. There was no statistically significant difference between groups for recurrence rate, mean age, sex, or pterygium area. Subconjunctival injection of MMC 0.02% (0.1 ml of 0.02% solution) 1 month before bare scleral excision is a quick, easy, and safe surgical procedure and is at least as effective as conjunctival rotational flap with intraoperative MMC for 2 minutes. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Preoperative Subconjunctival Injection of Mitomycin C Versus Intraoperative Topical Application as an Adjunctive Treatment for Surgical Removal of Primary Pterygium

PubMed Central

Ghoneim, Ehab M.; Abd-El Ghny, Ahmed A.; Gab-Allah, Amro A.; Kamal, Mohamed Z.

2011-01-01

Purpose: To compare the efficacy of preoperative local injection of mitomycin C (MMC) to intraoperative application of MMC in the prevention of pterygium recurrence after surgical removal. Materials and Methods: Seventy eyes of 70 patients with primary pterygia were randomly allocated to two groups. The first group (Group A, 35 eyes) received 0.1 ml of 0.15 mg/ml of subconjunctival MMC injected into the head of the pterygium 24 h before surgical excision with the bare sclera technique. The second group (Group B 35 eyes) underwent surgical removal with the bare sclera technique with intraoperative application of MMC (0.15 mg/ml) over bare sclera for 3 min. The study was performed between March 2007 and December 2008, and follow up was performed for 1 year postoperatively. Differences between frequencies in both groups were compared by the Chi-square test or Fisher exact test. Differences between means in both groups were compared by Student’s t-test. P < 0.05 was considered significant. Results: The rate of pterygium recurrence was 5.70% in Group A and 8.57% in Group B at 1 year postoperatively (P>0.05). Postoperatively, scleral thinning occurred in one eye in each group that resolved by 5 months postoperatively. No serious postoperative complications occurred in either group. Conclusion: Preoperative local injection of 0.15 mg/ml MMC is as effective as intraoperative topical application of 0.15 mg/ml MMC for preventing pterygium recurrence after surgical removal. PMID:21572732

Clinical outcome of combined conjunctival autograft transplantation and amniotic membrane transplantation in pterygium surgery

PubMed Central

Malla, Tejsu; Jiang, Jing; Hu, Kai

2018-01-01

AIM To compare long-term outcome of primary and recurrent pterygium surgery with three different techniques: combined conjunctival autograft and overlay amniotic membrane transplantation (CAT with AMT), conjunctival autograft transplantation (CAT) alone and amniotic membrane transplantation (AMT) alone. METHODS In this retrospective study, 142 eyes of 142 pterygium patients (104 primary, 38 recurrent) who underwent CAT (group A), AMT (group B) or CAT with AMT (group C) respectively following surgical excision were reviewed and compared based on the recurrences and post-operative complications. RESULTS The number of recurrence post-surgery were 17 (9 from primary, 8 from recurrent; the same description below), 18 (10, 8) and 2 (1, 1) in groups A, B, and C respectively; dry eyes were 22 (16, 6), 27 (18, 9) and 7 (3, 4); conjunctival inflammations were 30 (17, 13), 27 (16, 11) and 11 (6, 5). Patients in group C (either primary or recurrent or both) mainly showed significantly better results than those in group A or B (P<0.05) regarding above-mentioned clinical effects. CONCLUSION Combined CAT and overly AMT have significantly lower rates of recurrence and postoperative complications for primary and recurrent pterygium surgery than CAT or AMT alone. PMID:29600172

Evaluation of epithelial cell proliferating activity and fibroblast nuclear kariometry in recurrent pterygium treated with mitomycin C.

PubMed

Almeida Junior, Gildasio Castello de; Frederico, Fabio Batista; Watanabe, Karina Paula; Garcia, Tatiana Vanucci; Iquejiri, Angela Yuri; Cury, Patrícia Maluf; Taboga, Sebastião Roberto; Azoubel, Reinaldo

2008-01-01

To evaluate the effectiveness of mitomycin C (MMC) in preventing recurrence of pterygium following conjunctival autograft transplantation (CAT). Ki-67 antigen to evaluate epithelial cell proliferation and fibroblast nuclear kariometry were used to assist treatment evaluation. Twenty-nine patients with recurrent pterygium were divided into three groups: Group (G) 1--CAT and placebo eyedrops (PED); G2--CAT, 0.015% MMC subconjunctivally, and PED; G3--CAT and 0.02% MMC eyedrops. Immunohistochemistry for the Ki-67 antigen and fibroblast nuclei kariometry were performed on the excised tissue, divided into nasal and temporal sides. Kariometry was evaluated in terms of volume (Vl) and area (Ar) using at least 50 cells/patient. The percentage of positive epithelial cells for the Ki-67 antigen on the nasal and temporal side after treatment of the three groups were: nasal (5.39% G1, 4.49% G2, and 3.88% G3); temporal (3.30% G1, 4.46% G2, 4.14% G3), did not show significant differences. Fibroblast nucleus kariometry was: nasal Vl (792.1 mu3 G1, 605.1 mu3 G2, and 549.9 mu3 G3) and Ar (100.58 mu2 G1, 83.13 mu2 G2, and 78.41 mu2 G3). The three groups showed significant differences: p=0.039 and p=0.035, for respectively Vl and Ar, on the nasal side. After a six month of treatment, the three groups presented the following recurrence rates: G1, 22.22%, G2, 18.18% and G3, 33.33%, respectively. MMC did not reduce the number of positive epithelial cells for the Ki-67 antigen in recurrent pterygium, but decreased fibroblast nucleus volume and area on the nasal side of the pterygia. The number of positive epithelial cells for the Ki-67 antigen seemed not to be related to pterygium recurrence observed over a six-month post-surgery period. The role of epithelial cell proliferation in pterygium recurrence should be evaluated by further studies.

Large pterygium surgery: When coverage of the scleral bed justifies graft rotation.

PubMed

Gargallo-Benedicto, A; Hernández Pérez, D; Olate-Pérez, Á; Betancur-Delgado, E; Cerdà-Ibáñez, M; Duch-Samper, A

2016-10-01

To perform a 12 month follow-up study to assess the safety and effectiveness of resection and conjunctival autograft fixed with Tissucol® in selected cases of large pterygium. The orientation of the graft was adapted to the morphology of the scleral bed for a better coverage free of traction, with limbal position being lost. A prospective, non-comparative study of 10 cases of grade II or superior pterygium (7 primary, 3 recurrent) with at least 8mm of limbal extension. A wide scleral bed was obtained after pterygium and Tenon resection, with larger grafts being required to cover the defects. A superior conjunctival autograft was harvested and fixed to bare sclera using Tissucol. The orientation was adapted to the morphology of the scleral bed and limbal position was lost. Patients were periodically assessed for recurrence and complications for a period of 12 months. Minor complications occurred in 4 eyes. In one case a buttonhole was formed during dissection of the graft. Two presented with small limbal dehiscence, but epithelialisation was completed in the first week. In a third case, it was necessary to increase topical corticosteroids for pyogenic granuloma on the donor site, with secondary increased intraocular pressure (IOP). There were no recurrences after 12 months follow-up. A conjunctival graft of appropriate size adapted to the morphology of the scleral bed to ensure good coverage free of tension, provides good surgical results in selected cases of pterygium, regardless of the conservation the limbal orientation, with no recurrences after one year follow-up. Copyright © 2016 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

Vascularization of conjunctival autografts in pterygium surgery: comparison of fibrin glue with sutures.

PubMed

Küçükerdönmez, Cem; Karalezli, Aylin; Zengin, Mehmet Ozgur; Akova, Yonca Aydin

2014-01-01

To monitor the development of graft vascularization after pterygium excision with conjunctival autograft transplantation (CAT) using indocyanine green angiography (ICGA) and to compare the graft vascularization between 2 different fixation techniques (fibrin glue and sutures). A total of 26 eyes of 26 patients with primary pterygium were randomly assigned after pterygium excision as having either fibrin glue (13 eyes) or Vicryl sutures (13 eyes) for CAT. Anterior segment ICGA findings were evaluated postoperatively at 1, 7, and 15 days and the percentages of graft vascularization in both groups were compared using pixel analysis software program. The mean ± SD age of patients in the suture and fibrin glue groups was 52.1 ± 12.7 years and 57.1 ± 9.82 years, respectively. There was no statistically significant difference between the groups regarding age, sex, or follow-up (p<0.05 for all). Also, the mean intraoperative defect size was not significantly different between the groups, which was measured as 20.11 ± 10.44 mm2 in the suture group and 23.44 ± 12.34 mm2 in the fibrin glue group (p = 0.343). The mean percentage of vascularized graft area at postoperative day 1 and 7 was 18.1 ± 7.8% and 25.3 ± 8.6% in the suture group and 34.8 ± 10.2% and 66.1 ± 17.8% in the fibrin glue group. The difference between the groups was statistically significant (p<0.01 for both). At postoperative day 15, all grafts were 100% perfused in both groups. Fibrin glue fixation of conjunctival autografts led to more vascularization in the early postoperative period than suture fixated grafts, which in turn may have significance in terms of graft health and pterygium recurrence.

Topical dobesilate eye drops for ophthalmic primary pterygium

PubMed Central

Cuevas, Pedro; Outeiriño, Luis A; Angulo, Javier; Giménez-Gallego, Guillermo

2012-01-01

Selective inhibition of fibroblast growth factor and vascular endothelial growth factor signalling pathways is effective in causing regression of pterygia. Prompt regression of fibrovascular mass and conjunctival angiogenesis was documented 2 weeks after topical administration of dobesilate eye drops twice daily. At 3-month follow-up, no recurrence was seen and no ocular irritation and burning were noted. The authors believe that this is the first known successful use of topical dobesilate in primary pterygium. PMID:22605609

Low-dose strontium-90 irradiation is effective in preventing the recurrence of pterygia: a ten-year study.

PubMed

Qin, Xue-jiao; Chen, Hong-mei; Guo, Liang; Guo, Yong-yuan

2012-01-01

To study the long-term effects of low-dosage strontium-90 (Sr90) irradiation on the recurrence of pterygium. One hundred twenty eyes from 104 patients with primary or recurrent pterygia were treated with surgery followed by Sr90 irradiation. In brief, starting on the sixth day after surgery, patients were treated with irradiation three times every other day at a total combined dosage of 2000 cGy to 3000 cGy. Corneal topography was used to evaluate ocular surface regularity before and after treatment. Patient follow-up was performed 2 days, 5 days, 2 weeks, 1 month, 3 months, 1 year, 5 years, and 10 years after surgery. Recurrence of pterygium was not observed in any of the patients in this study. Obvious cataract progression was observed in 6 eyes, which may be due to aging. During follow-up studies, only one eye was reported with dryness and foreign-body sensation. Significant pterygium-induced astigmatism was observed in corneal topography, which decreased after surgery. Sr90 irradiation is effective in preventing the recurrence of primary and recurrent pterygia. We recommend delivering a total combined dosage of 2000 cGy to 3000 cGy of Sr90 irradiation administered in three batches every other day starting from the sixth day after surgery. Surgery is important in the rapid recovery of the cornea from pterygium-induced astigmatism.

Verrucous Onychomycosis Caused by Curvularia in a Patient with Congenital Pterygium.

PubMed

Vineetha, Mary; Palakkal, Seena; Sobhanakumari, K; Celine, M I; Letha, V

2016-01-01

A 57 year healthy farmer with congenital nail pterygium presented with a verrucous growth on nail bed since 8 months. He was not diabetic and HIV rapid card test negative. Our clinical diagnosis was chromoblastomycosis but culture showed growth of curvularia species on two occasions and histopathology showed hyphal and yeast forms of the pigmented fungus. After excision biopsy patient was started on oral itraconazole. This case is reported due to rarity of verrucous cutaneous lesions caused by curvularia in immunocompetent individuals.

Solar keratosis, pterygium, and squamous cell carcinoma of the conjunctiva in Malawi.

PubMed Central

Clear, A S; Chirambo, M C; Hutt, M S

1979-01-01

The histological features of 234 conjunctival biopsies from Africans in Malawi have been re-examined. The appearances of solar keratosis, pinguecula, and pterygium are presented as part of a continuous spectrum of the same pathological process and aetiology, which may lead to carcinomatous change. The results are discussed with regard to the specific geographical distribution of such lesions found by other workers, with particular emphasis on ultraviolet radiation as the main aetiological factor. Images PMID:427069

Pterygium in Indonesia: prevalence, severity and risk factors

PubMed Central

Gazzard, G; Saw, S-M; Farook, M; Koh, D; Widjaja, D; Chia, S-E; Hong, C-Y; Tan, D T H

2002-01-01

Aim: To determine prevalence rates, severity, and risk factors for pterygium in adults in provincial Indonesia and to validate a clinical grading scheme in a population based setting. Methods: A population based prevalence survey of 1210 adults aged 21 years and above was conducted in five rural villages and one provincial town in Riau province, Sumatra, Indonesia, an area near to the equator. A one stage household cluster sampling procedure was employed: 100 households were randomly selected from each village or town. Pterygia were graded for severity (T1 to T3, by visibility of episcleral vessels) and the basal and apical extent measured by an ophthalmologist (GG) with a hand held slit lamp. Refraction was measured by hand held autorefractor (Retinomax). Face to face household interviews assessed outdoor activity, occupation, and smoking. The participation rate was 96.7%. Results: The mean age was 36.6 years (SD 13.1), 612 were male. The age adjusted prevalence rate of any pterygium was 10.0% (95% confidence intervals (CI) 8.2 to 11.7) and of bilateral pterygia was 4.1% (95% CI 2.9 to 5.3). There was a significant dose-response relation with age (2.9% (95% CI 0.4 to 5.8) for 21–29 years versus 17.3% (95% CI 10.4 to 24.2) 50 years and above; p for trend <0.001) and occupations with more time outdoors (p for trend = 0.02). This was true for both sexes, all grades of lesion (T1 to T3), and bilateral disease. A multivariate logistic regression model showed pterygium was independently related to increasing age and outdoor activity 10 years earlier. The mean basal diameter = 3.3 mm (SD 1.51, range 0.1–9.5) and extent from limbus = 1.4 mm (SD 1.18, range 0.1–8.0). Higher grade pterygia were larger for basal and apical extent (p for trend <0.001). The presence of pterygium was associated with astigmatism (defined as cylinder at least −0.5 dioptres (D); p <0.001). This association increased with increasing grade of lesion (p for trend <0.001). Median cylinder for those with pterygium (−0.50 D) was greater than for those without (−0.25D), (p <0.001), and increased with higher grade of lesion (p for trend <0.001). For eyes with pterygia, magnitude of astigmatism was associated with greatest extent from the limbus, (p = 0.03), but not basal width (p = 0.99). Conclusions: There is a high prevalence rate of pterygia in provincial Sumatra. The independent increase with age and past outdoor activity (a surrogate for sun exposure) is consistent with previous findings. Clinical grading of pterygium morphology by the opacity of the lesion was a useful additional marker of severity. PMID:12446360

Preoperative factors influencing success in pterygium surgery.

PubMed

Torres-Gimeno, Ana; Martínez-Costa, Lucía; Ayala, Guillermo

2012-08-08

To identify preoperative, perioperative and postoperative risk factors that influence the success of pterygium surgery. This is a prospective study of thirty-six patients with primary or recurrent pterygia. A detailed anamnesis and an ophthalmological examination were performed looking for the following factors: age, race, latitude and altitude of the main place of residence, hours of exposure to the sun, use of protective measures against UV-radiation, classification of pterygium, width of the pterygium at limbus, surgical technique (conjunctival autograft plus suturing versus tissue glue), graft alterations (misapposition, granuloma, haemorrhage, oedema, retraction or necrosis), and postoperative symptoms (foreign-body sensation, pain). The examinations were performed 2 and 7 days and 2, 6 and 12 months after surgery. In addition, recurrence was defined as any growth of conjunctiva into the cornea. A logistic regression and a survival analysis have been used to perform data analysis. A total number of 36 patients completed a one year follow-up. A total of 13 patients were born and lived in Spain, and 26 came from other countries, mostly Latin America. A total number of 8 males (no women) presented a recurrence, mainly between 2 and 6 months. The hours of sun exposure through their life was independently related to surgical success. Pterygia of less than 5 mm of base width showed a weak positive correlation with recurrence. None of the other factors considered were significantly related to recurrence. Male gender and high sun exposure are strongly and independently related to surgical success after the removal of pterygia.

Efficacy of fibrin glue versus sutures for attaching conjunctival autografts in pterygium surgery: a systematic review with meta-analysis and trial sequential analysis of evidence.

PubMed

Lan, Aihua; Xiao, Feifan; Wang, Yun; Luo, Zhen; Cao, Qixin

2017-06-20

Previous meta-analyses have been conducted to compare the efficacy of fibrin glue (FG) versus sutures in pterygium surgery; however, additional clinical trials have since been published. Therefore, we conducted an updated meta-analysis to further explore the association between FG application in pterygium surgery, and the recurrence rate, complication rate, and surgical duration. An electronic literature search for eligible studies published before July 29, 2016 was conducted across multiple databases. Odds ratios (ORs), standardized mean difference (SMD), and 95% confidence intervals (CI) were calculated. Publication bias of the included articles was evaluated by funnel plots. Differences in recurrence rate and complication rate between the FG and suture groups were evaluated in terms of OR with 95% CI, and SMD with 95% CI were used to estimate the difference in surgical duration. Trial sequential analysis (TSA) was used to determine whether the currently available evidence was sufficient and conclusive. Twenty-four studies were included in this study. The pooled ORs for recurrence rate and complication rate were 0.35 and 1.121, respectively. The pooled SMD for surgical duration was -4.142. The TSA results indicated that evidence of the effect was sufficient in the recurrence group and surgical duration group. Although there was no difference in complication rate between FG and sutures, the apparent advantages of FG over sutures are shorter surgical duration and greater reduction in the recurrence rate of pterygium.

Low-Dose Strontium-90 Irradiation Is Effective in Preventing the Recurrence of Pterygia: A Ten-Year Study

PubMed Central

Guo, Liang; Guo, Yong-yuan

2012-01-01

Background To study the long-term effects of low-dosage strontium-90 (Sr90) irradiation on the recurrence of pterygium. Methodology/Principal Findings One hundred twenty eyes from 104 patients with primary or recurrent pterygia were treated with surgery followed by Sr90 irradiation. In brief, starting on the sixth day after surgery, patients were treated with irradiation three times every other day at a total combined dosage of 2000 cGy to 3000 cGy. Corneal topography was used to evaluate ocular surface regularity before and after treatment. Patient follow-up was performed 2 days, 5 days, 2 weeks, 1 month, 3 months, 1 year, 5 years, and 10 years after surgery. Recurrence of pterygium was not observed in any of the patients in this study. Obvious cataract progression was observed in 6 eyes, which may be due to aging. During follow-up studies, only one eye was reported with dryness and foreign-body sensation. Significant pterygium-induced astigmatism was observed in corneal topography, which decreased after surgery. Conclusions/Significance Sr90 irradiation is effective in preventing the recurrence of primary and recurrent pterygia. We recommend delivering a total combined dosage of 2000 cGy to 3000 cGy of Sr90 irradiation administered in three batches every other day starting from the sixth day after surgery. Surgery is important in the rapid recovery of the cornea from pterygium-induced astigmatism. PMID:22952695

Efficacy of fibrin glue versus sutures for attaching conjunctival autografts in pterygium surgery: a systematic review with meta-analysis and trial sequential analysis of evidence

PubMed Central

Luo, Zhen; Cao, Qixin

2017-01-01

Previous meta-analyses have been conducted to compare the efficacy of fibrin glue (FG) versus sutures in pterygium surgery; however, additional clinical trials have since been published. Therefore, we conducted an updated meta-analysis to further explore the association between FG application in pterygium surgery, and the recurrence rate, complication rate, and surgical duration. An electronic literature search for eligible studies published before July 29, 2016 was conducted across multiple databases. Odds ratios (ORs), standardized mean difference (SMD), and 95% confidence intervals (CI) were calculated. Publication bias of the included articles was evaluated by funnel plots. Differences in recurrence rate and complication rate between the FG and suture groups were evaluated in terms of OR with 95% CI, and SMD with 95% CI were used to estimate the difference in surgical duration. Trial sequential analysis (TSA) was used to determine whether the currently available evidence was sufficient and conclusive. Twenty-four studies were included in this study. The pooled ORs for recurrence rate and complication rate were 0.35 and 1.121, respectively. The pooled SMD for surgical duration was −4.142. The TSA results indicated that evidence of the effect was sufficient in the recurrence group and surgical duration group. Although there was no difference in complication rate between FG and sutures, the apparent advantages of FG over sutures are shorter surgical duration and greater reduction in the recurrence rate of pterygium. PMID:28489563

Proposal for a Novel Severity Grading System for Pterygia Based on Corneal Topographic Data.

PubMed

Miyata, Kazunori; Minami, Keiichiro; Otani, Atsushi; Tokunaga, Tadatoshi; Tokuda, Shouta; Amano, Shiro

2017-07-01

To propose a grading system of pterygium severity based on corneal higher-order irregularity (HOI) and to evaluate postoperative changes in corneal irregularity of the graded pterygia. In 268 eyes of 226 patients undergoing excision surgery of primary nasal pterygium, Placido corneal topography images were taken before and until 6 months after surgery. The best-corrected visual acuity (BCVA) and pterygium size with respect to the corneal diameter were also measured. HOI components within 1.0-, 3.0-, and 5.0-mm diameters were obtained using Fourier harmonic analysis of corneal topography data. With threshold levels when the HOIs for 3 diameters steeply increased, 4 levels of grading from 0 (mild) to 3 (severe) were determined. Associations of the grades with the preoperative surface regularity index (SRI), irregular components (IRRs) obtained from the 3.0-mm diameter Fourier analysis, and BCVA were examined. Time-course changes in the indexes after surgery were evaluated for each grade. There were 62, 65, 41, and 100 eyes in grades 0 to 3, respectively. Preoperatively, the SRI in grade 3 was significantly higher than in the other grades (P < 0.001), and the IRR and BCVA varied with the grade (P < 0.001). Between 1 and 6 months postoperatively, grade 3 pterygia showed significant changes in the SRI and IRR (P = 0.013 and 0.017, respectively), whereas there was no change after 3 months postoperatively in the SRI, IRR, and BCVA for all other grades. The proposed grading effectively classified the severity of pterygia and evaluated postoperative restoration of corneal irregularity. Using corneal topographic data allowed for objective evaluation of pterygium severity.

Pattern of eye diseases among welders in a Nigeria community.

PubMed

Ajayi Iyiade, A; Omotoye Olusola, J

2012-06-01

Welders have been identified as a high risk group for eye disorders due to their exposure to ultraviolet radiation. To determine the prevalence and types of eye diseases amongst welders in Ile-Ife, Osun state. This is a cross sectional descriptive study of 405 consenting welders. Information on socio-demographic characteristics was obtained using a pre-tested proforma and all subjects had visual actuity test, anterior and posterior segments examination, test of stereopsis and macular function. Two hundred and seventy five (67.9%) of the respondents were arc welders, 99(22.5%) were gas welders while 39(9.6%) utilized both welding techniques. The age of the respondents ranged from 16 years to 80 years with a mean of 38 ± 13 years. Conjunctival degenerative disorders like pingueculum (50.1%) and pterygium(17.5%) constituted the commonest eye disorders among the welders. There were 6 blind eyes of 5 welders with pigmentary maculopathy accounting for the single case of bilateral blindness. There is a greater odd in developing pingueculum and Pterygium (OR=1.015, 1.039 respectively) in arc welders than in gas welders. Pingueculum, Pterygium, corneal opacity, and pigmentary macular deposits were the common eye disorders among welders.

[Etiopathogenic aspects in development and evolution of pterigyum].

PubMed

Crăiţoiu, Stefania; Ciprian, Livezeanu; Rodica, Mănescu; Mihai, Afrem; Anca, Eremia Irina

2008-01-01

Pterygium is an epithelial hyperplasia accompanied by a fibrovascular growth originating at the corneo-conjunctival junction, from where the modified limbic cells migrate and surpass the cornea. The studies reviewed show that it is an active process associated with cell growth, remodelling of the connective tissue, angiogenesis and inflammation. Despite the lack of knowledge regarding the pathogenesis of pterygia, epidemiologic evidence suggests that exposure to UV-irradiation may be an initial trigger in the development of this lesion. Other theories include changes of the apoptotic pathway the presence of some active angiogenetic factors or involvement of the MMPs, cytokines and growths factors. UV light could be the initial trigger that activates epithelial cells at or near the limbus to produce cytokines such as IL-6 and IL-8 and growth factors. These multifactorial proteins set up a cascade of events that include inflammation, proliferation, angiogenesis and antiapoptosis. Cytokines are able to induce the expression of MMPs and their tissue inhibitors (TIMPs) making it likely that they would also affect the rate of tissue remodeling, such as destruction of Bowman's membrane and the invasion of pterygium. In the etiology of pterygium abnormalities in tear functions have also been emphasized.

Conjunctival Autograft Alone or Combined With Adjuvant Beta-Radiation? A Randomized Clinical Trial

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

Arruda Viani, Gustavo, E-mail: gusviani@gmail.com; Carrara Fonseca, Ellen; Department of Ophthalmology, Marilia Medical School, Marilia, Sao Paulo

2012-03-01

Purpose: To evaluate the effectiveness and safety of postoperative low single-dose of beta-irradiation ({beta}-RT) in pterygium comparing conjunctival autograft (CAG) surgery with CAG plus adjuvant {beta}-RT in a randomized clinical trial. Methods: This trial was designed as a prospective, randomized, single-center study. Surgery was performed in all cases according to the CAG technique. One hundred and eight pterygia were postoperatively randomized to CAG + {beta}-RT or CAG alone. In the case of {beta}-RT, a (90) Sr eye applicator was used to deliver 10 Gy to the sclera surface at a dose rate of between 200 and 250 cGy/min. After treatment,more » both an ophthalmologist and a radiation oncologist performed the follow-up examinations. The accumulated data were analyzed using a group sequential test. Results: Between February 2008 and September 2008, 116 eyes with primary pterygium were operated on according to the trial protocol. Adjuvant treatment was performed within 24 h postoperatively. Eight patients were lost to follow-up, resulting in 108 patients who could be analyzed. At a mean follow-up of 18 months (range, 8-33), in the 54 eyes randomized to receive CAG + {beta}-RT, 5 relapses occurred compared with 12 recurrences in the 54 eyes in CAG, for a crude control rate of 90.8 % vs. 78%; p = 0.032, respectively. The treatment complications as hyperemia, total dehiscence of the autograft and dellen were significantly more frequent in the CAG (p < 0.05). The arm of {beta}-RT resulted in better cosmetic results and improves of symptoms than CAG. Conclusions: A low single-dose of {beta}-RT of 10 Gy after CAG surgery was a simple, effective, and safe treatment that reduced the risk of primary pterygium recurrence, improved symptoms after surgery, resulting in a better cosmetic effect than only CAG.« less

Bartsocas-Papas syndrome with variable expressivity in an Egyptian family.

PubMed

Zaki, M S; Kamel, A K; Effat, L K; El-Ruby, M O

2012-01-01

Bartsocas-Papas syndrome (BPS) is an autosomal recessively inherited sublethal popliteal pterygium condition characterized by intrauterine or neonatal death, severe popliteal webbing, oligosyndactyly, ankyloblepharon, orofacial clefts, intraoral filiform bands and genital anomalies. Internal organ involvement has seldom been identified. We report on a 3 years old female patient of healthy first cousin parents with BPS. She presented with orofacial clefting, severe popliteal webs, club feet, oligosyndactyly of the toes, hypogenitalism and normal hands and internal organs. Ankyloblepharon and filiform bands between the alveolar ridges were evident at birth. Pedigree analysis revealed a more severely affected female sib, who died a few minutes after birth with additional manifestations including near complete lip fusion without oral cleft, complete syndactyly in both hands and an omphalocele. Linkage was excluded to the IRF6 gene; a candidate gene implicated in the Van der Woude and popliteal pterygium syndromes, with overlapping features with BPS. To our knowledge, this is the 5th surviving patient with this syndrome in the literature. In this report, we also discuss the proposed pathogenetic mechanisms for BPS and compare our patients with similarly described cases as well as overlapping spectrum of other popliteal pterygium syndromes. Our findings provide further evidence of intrafamilial clinical heterogeneity in families with BPS.

Effect of chronic exposure to welding light on Calabar welders.

PubMed

Davies, K G; Asanga, U; Nku, C O; Osim, E E

2007-01-01

It was generally observed that welders in Calabar, Nigeria did not always wear their protective goggles during welding. Since chronic exposure to welding light can impair vision this study was done to assess the effect of exposure to welding light on ocular function of welders in Calabar, Nigeria. There were 195 subjects comprising 110 welders (test) and 85 control subjects. Both groups were all male and had similar age range. The tests employed were clinical examination for ocular disorders, assessment of visual acuity, and opthalmoscopy. Test questionnaire was also used to record information on length of service, precautionary measures at work place, age and past ocular illnesses. The study also compared incidence of ocular disorders between the two groups of welders (arc and carbide welders). The mean ages of the welders and their control were not significantly different (27.53 +/- 10.0 vs 27.78 +/- 8.5 yrs respectively). There was a significantly [P < 0.01] higher incidence of pingueculum, cataract, allergic conjunctivitis, corneal opacity, and keratoconjunctivitis (arc eye) in welders than in their control subjects. However, visual acuity, incidence of pterygium and glaucoma were similar. Between the two groups of welders, the incidence of pterygium, corneal opacity and keratoconjunctivitis was significantly [P < 0.01] higher in arc welders than carbide welders. The incidence of pingueculum and glaucoma were however, similar. In conclusion, chronic exposure to welding light without adequate precaution may cause ocular disorders. Arc welding is more dangerous to ocular function than carbide welding. Length of service and age are predisposing factors to ocular disorders in the welding business.

Regulation of vascular endothelial growth factor-C by tumor necrosis factor-α in the conjunctiva and pterygium.

PubMed

Dong, Yoko; Kase, Satoru; Dong, Zhenyu; Fukuhara, Junichi; Tagawa, Yoshiaki; Ishizuka, Erdal Tan; Murata, Miyuki; Shinmei, Yasuhiro; Ohguchi, Takeshi; Kanda, Atsuhiro; Noda, Kousuke; Ishida, Susumu

2016-08-01

Vascular endothelial growth factor C (VEGF-C) plays an important role in the development of a pterygium through lymphangiogenesis. We examined the association between VEGF-C and tumor necrosis factor-α (TNF-α) in the pathogenesis of pterygia. Cultured conjunctival epithelial cells were treated with TNF-α, and the gene expression levels of VEGFC were evaluated by quantitative polymerase chain reaction (qPCR) and VEGF-C protein expression levels were measured using an enzyme-linked immunosorbent assay (ELISA). In addition, using ELISA, we evaluated the VEGF-C protein expression in the supernatants of cultured conjunctival epithelial cells, in which we neutralized TNF-α using anti‑TNF-α antibody. The gene expression of tumor necrosis factor receptor superfamily, member 1A (TNFRSF1A), known as TNF receptor 1 (TNFR1), was confirmed using reverse transcription PCR in cultured conjunctival epithelial cells. Immunofluorescence microscopy was used to examine the localization of VEGF-C and TNFR1 in pterygium tissues and TNFR1 expression in cultured conjunctival epithelial cells. Immunohistochemistry was used to examine the localization of TNFR1 in pterygia and normal conjunctival tissues. VEGFC gene expression increased in cultured conjunctival epithelial cells 24 h after the addition of TNF-α. The secretion of VEGF-C protein was significantly increased 48 h after the stimulation of cultured conjunctival epithelial cells with TNF-α. Increased VEGF-C protein secretion stimulated by TNF-α was significantly reduced by anti-TNF-α neutralizing antibody treatment. In cultured conjunctival epithelial cells, TNFRSF1A and TNFR1 were expressed. TNFR1 was immunolocalized in normal conjunctival tissues and in human pterygium tissues as well as in VEGF‑C‑positive epithelial cells from human pterygia. Our data demonstrate that TNF-α mediates VEGF-C expression, which plays a critical role in the pathogenesis of pterygia.

Prevalence and risk factors associated with dry eye symptoms: a population based study in Indonesia

PubMed Central

Lee, A J; Lee, J; Saw, S-M; Gazzard, G; Koh, D; Widjaja, D; Tan, D T H

2002-01-01

Aim: To determine the prevalence and identify associated risk factors for dry eye syndrome in a population in Sumatra, Indonesia. Methods: A one stage cluster sampling procedure was conducted to randomly select 100 households in each of the five rural villages and one provincial town of the Riau province, Indonesia, from April to June 2001. Interviewers collected demographic, lifestyle, and medical data from 1058 participants aged 21 years or over. Symptoms of dry eye were assessed using a six item validated questionnaire. Presence of one or more of the six dry eye symptoms often or all the time was analysed. Presence of pterygium was documented. Results: Prevalence of one or more of the six dry eye symptoms often or all the time adjusted for age was 27.5% (95% confidence interval (CI) 24.8 to 30.2). After adjusting for all significant variables, independent risk factors for dry eye were pterygium (p<0.001, multivariate odds ratio (OR) 1.8; 95% CI 1.4 to 2.5) and a history of current cigarette smoking (p=0.05, multivariate OR 1.5; 95% CI 1.0 to 2.2). Conclusions: This population based study provides prevalence rates of dry eye symptoms in a tropical developing nation. From our findings, pterygium is a possible independent risk factor for dry eye symptoms. PMID:12446361

Characterisation of myofibroblasts in fibrovascular tissues of primary and recurrent pterygia

PubMed Central

Touhami, A; Di Pascuale, M A; Kawatika, T; Valle, M Del; Rosa, R H; Dubovy, S; Tseng, S C G

2005-01-01

Aims: To determine the presence and origin of myofibroblasts in pterygia. Methods: 86 specimens including head, body, and fibrovascular tissue from 52 primary and 34 recurrent pterygia and five exenterated eyes without pterygia were searched for the origin of myofibroblasts. All tissues were subjected to haematoxylin and eosin staining, immunohistochemistry using antibodies against alpha smooth muscle actin (α-SMA), desmin, vimentin, and caldesmon, and transmission electron microscopy (TEM). The phenotype of fibroblasts subcultured in a serum free medium from pterygium fibrovascular tissues was characterised by the above antibodies. Bundles of dense fibrous tissues were noted in 86% of the fibrovascular tissue specimens evaluated. Cells within these bundles were characterised as myofibroblasts based on positive staining to α-SMA, but negative to desmin and caldesmon, markers for smooth muscle cells. Interestingly, positive α-SMA staining was also found in the periorbital fibroadipose tissue posterior to Tenon’s capsule near the nasal conjunctiva in all exenterated specimens. All first passage fibroblasts expressed vimentin, some were positive to α-SMA, but all were negative to desmin or caldesmon. Cells in pterygium fibrovascular tissues showed ultrastructural features of intracytoplasmic bundles of microfilaments, consistent with myofibroblastic differentiation. Conclusion: These studies collectively demonstrate the presence of contractile myofibroblasts bundle in pterygia and in the periorbital fibroadipose tissue posterior to Tenon’s capsule of exenterated eyes without pterygium. PMID:15722301

Long-term results of fractionated strontium-90 radiation therapy for pterygia.

PubMed

Nishimura, Y; Nakai, A; Yoshimasu, T; Yagyu, Y; Nakamatsu, K; Shindo, H; Ishida, O

2000-01-01

The long-term safety and effectiveness of fractionated strontium-90 radiation therapy (RT) for pterygium were reviewed retrospectively. Between 1984 and 1996, 399 patients with 490 pterygia were treated with a strontium-90 eye applicator following surgical removal of the pterygium. The median follow-up period was 61 months (range 2-178). Of the 490 pterygia, 452 were fresh, 17 were recurrences after surgical removal alone, and 21 were recurrences after surgical removal plus postoperative RT. Fractionated RT of 31-42 Gy/4-5 fractions/22-29 days was given for 95.1% of the pterygia. In total, 58 (11.8%) local recurrences of pterygia were noted. The median time of local recurrences was 10 months, ranging from 2 to 93 months, and 16 recurrences (28%) were noted later than 24 months after treatment. The interval between surgery and the start of RT (1-3 days vs. >3 days) and recurrent pterygia were significant variables for local control in the multivariate analysis, while total RT dose (7-29 Gy vs. 31-50 Gy) was a marginally significant variable. Late toxicities that may be associated with strontium-90 RT were scleromalacia (scleral thinning) in 4 eyes, adhesion of eyelids in 3 eyes, and scleral ulcer in 2 eyes. Fractionated strontium-90 RT of approximately 40 Gy/4-5 fractions was safe and effective for preventing recurrence of pterygia, when RT was started within 3 days of surgery.

What Is a Pinguecula and a Pterygium?

MedlinePlus

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[Conjunctival fibrous histiocytoma simulating atipical pterygium in the Amazon region: case report].

PubMed

Carvalho, Roberto Murillo Limongi de Souza; Taleb, Alexandre; Carvalho, Giulianna Limongi de Souza; Avila, Marcos

2010-01-01

An inedited case in the Brazilian literature of conjunctival fibrous histiocytoma discovered during a wide scale community project accomplished by the team of the Center of Reference in Ophthalmology of the Hospital das Clínicas da Universidade Federal de Goiás in the Amazon region is reported. A 38 year-old caucasian woman presented with a vascularized lesion on the medial portion of the bulbar conjunctiva and caruncular region of the right eye with extension for the limbus and invading about 2 mm of the medial cornea resembling a pterygium. Pathologic findings revealed that the lesion was constituted by spindle-shaped cells, with storiform arrangement, and large histocytelike cells. The immunohistochemistry revealed strong positivity for vimentin and the neoplastic cells were negative for AE1/AE3, HMB 45, S 100 protein. The histopathologic diagnosis was fibrous histiocytoma. The evolution demonstrated the tumoral growth and the possibility of a malignant lesion.

Physical therapy intervention for an adolescent with a knee flexion contracture and diagnosis of multiple pterygium syndrome.

PubMed

Bellamy, Sandra Gail; Gibbs, Karen; Lazaro, Rolando

2007-01-01

The purpose of this case report is to describe a course of physical therapy for a client with a rare genetic condition, multiple pterygium syndrome (MPS). MPS is a rare genetic disorder characterized by connective tissue webbing across multiple joints, dysmorphic facies, and various visceral and skeletal deformities. Before the patient commenced physical therapy, surgical amputation was recommended for the client's knee flexion contracture. The client's treatment plan included stretching, manual therapy, and resisted exercise. Long-term outcomes were decreased back and knee pain and improved range of motion, strength, and ambulation. Therapists using techniques to improve joint range of motion in clients with MPS should be aware that pterygia may include contractile tissue, nerves, and blood vessels and there may be underlying skeletal deformity or weakness in these areas. Children with MPS are at high risk of developing scoliosis and should be appropriately assessed in early childhood.

Ophthalmic indications of amniotic membrane transplantation in Mexico: an eight years Amniotic Membrane Bank experience.

PubMed

Chávez-García, César; Jiménez-Corona, Aída; Graue-Hernández, Enrique O; Zaga-Clavellina, Verónica; García-Mejía, Mariana; Jiménez-Martínez, María Carmen; Garfias, Yonathan

2016-06-01

Amniotic membrane, the inner layer of the placenta, has biological properties (e.g. promotes epithelization, reduces fibrosis, secretes antimicrobial products and inhibits immune responses) which make it a useful option for several ophthalmologic procedures, especially those involving the ocular surface. Its use in eye surgery has been reported by other authors. To our knowledge, there is a lack of descriptive studies on surgical indications using amniotic membrane in Mexican population. Here we describe the eight years Amniotic Membrane Bank experience in Mexico, including a detailed protocol of the donors selection, tissue harvesting, preparation, storage and distribution of amniotic membrane since its establishment in 2007. Moreover, we describe the Ophthalmological indications of amniotic membrane transplantation of the total of 1686 amniotic membranes fragments used during eight years. The five most common indications for amniotic membrane transplantation were pterygium (46 %), corneal ulcers (12.6 %), conjunctival surface repair (11.1 %), neoplasms (7.4 %), and persistent epithelial defects (7.3 %). In addition, we compared the indications of amniotic membrane use in two different types of Institutions: general hospitals and ophthalmologic reference hospitals. We found interesting differences between the indications and use rates between these institutions, although pterygium was the most frequent pathology that amniotic membrane fragments were used in both institutions, there was up to a five-fold increase in the use of amniotic membrane for correction of persistent epithelial defects in reference hospitals which could be explained due to the more complex and severe ophthalmological pathologies admitted in reference hospitals. In conclusion, Amniotic Membrane is used in a numerous ocular pathologies and especially on pterygium in our Mexican population.

Familial pterygium syndrome.

PubMed

Stoll, C; Levy, J M; Kehr, P; Roth, M P

1980-11-01

Two sisters affected with the same disorder are described. They had webbing of the neck, the antecubital fossae and the popliteal regions, together with flexion deformities of the limb joints and anomalies of the vertebrae. Eight other cases are known. The condition is inherited in an autosomal recessive mode.

Limitations in imaging common conjunctival and corneal pathologies with fourier-domain optical coherence tomography.

PubMed

Demirci, Hakan; Steen, Daniel W

2014-01-01

To describe the limitations of Fourier-domain optical coherence tomography (OCT) in imaging common conjunctival and corneal pathology. Retrospective, single-center case series of 40 patients with conjunctival and cornea pathology. Fourier-domain OCT imaged laser in situ keratomileusis (LASIK) flaps in detail, including its relation to other corneal structures and abnormalities. Similarly, in infectious or degenerative corneal disorders, Fourier-domain OCT successfully showed the extent of infiltration or material deposition, which appeared as hyper-reflective areas. In cases with pterygium, the underlying cornea could not be imaged. All cases of common conjunctival pathologies, such as nevus or pinguecula, were successfully imaged in detail. Nevi, scleritis, pterygium, pinguecula, and subconjunctival hemorrhage were hyper-reflective lesions, while cysts and lymphangiectasia were hyporeflective. The details of the underlying sclera were not uniformly imaged in conjunctival pathologies. Fourier-domain OCT imaged the trabeculectomy bleb in detail, whereas the details of structures of the anterior chamber angle were not routinely visualized in all cases. Light scatter through vascularized, densely inflamed, or thick lesions limits the imaging capabilities of Fourier-domain anterior segment OCT.

Case for diagnosis. Actinic prurigo.

PubMed

Daldon, Patricia Erica Christofoletti; Pascini, Mirella; Correa, Mariane

2010-01-01

A 13-year-old black boy had pruritic papular and nodular lesions on his forearms associated to edema of the lower lip, photophobia, conjunctivitis and pterygium. Skin biopsy of the lower lip revealed acanthosis, spongiosis with dermal perivascular mononuclear cell infiltration composed by lymphocytes, plasma cells and eosinophils consistent with actinic prurigo. Lesions improved considerably with the use of thalidomide 100mg/ day.

Determining the pharmacological activity of Physalis peruviana fruit juice on rabbit eyes and fibroblast primary cultures.

PubMed

Pardo, Juan Manuel; Fontanilla, Marta Raquel; Ospina, Luis Fernando; Espinosa, Lady

2008-07-01

The pharmacologic activity of compounds isolated from Physalis peruviana has been demonstrated. The use of this fruit juice for treating pterygium has been reported in Colombian traditional medicine. However, studies demonstrating the fruit juice's pharmacologic activity when used in this disease have not been published to date. In the present study the anti-inflammatory and cytostatic activities of P. peruviana fruit juice in a rabbit eye inflammatory model were investigated. A novel rabbit eye inflammation model was developed for studying the juice's anti-inflammatory activity (based on an adaptation of the Draize test). Cytostatic activity was evaluated by measuring and comparing growth rates of cultured fibroblasts exposed and not exposed to various fruit juice concentrations. P. peruviana fruit juice exhibited a mild anti-inflammatory activity compared with methylprednisolone, a known anti-inflammatory drug. An interesting dose-dependent cytostatic effect on cultured fibroblasts was also established. The data found suggest that the P. peruviana fruit juice anti-pterygium effect described in traditional medicine may be related to its inhibiting fibroblast growth. The present study contributes to the pharmacologic knowledge regarding a remedy commonly used in Colombian traditional medicine.

Atomic force microscope-related study membrane-associated cytotoxicity in human pterygium fibroblasts induced by mitomycin C.

PubMed

Cai, Xiaofang; Yang, Xiaoxi; Cai, Jiye; Wu, Shixian; Chen, Qian

2010-03-25

Mitomycin C (MMC) has been shown to have a therapeutic effect against human pterygium fibroblasts (HPFs) by inducing apoptosis. However, there is little data about the effect of it on plasma membrane. In the present study, the cytotoxicity of MMC to HPFs including inhibiting cell growth, inducing apoptosis and bringing about membrane toxicity was investigated. It was found that MMC could significantly suppress the proliferation of HPFs in a dose-dependent manner by CCK-8 assay. Flow cytometric analysis also revealed that treatment with MMC resulted in increased percentages of apoptotic cells in a dose-dependent manner. Membrane lipid peroxidation level, lactate dehydrogenase (LDH) leakage, membrane surface topography, and membrane rigidity alterations were investigated to assess the membrane toxicity induced by MMC. Treatment with MMC at different concentrations accelerated membrane lipid peroxidation and potentiated LDH leakage, which was consistent with disturbance of membrane surface and decrease of membrane elasticity detected by atomic force microscopy. All the above changes led to the disturbed intracellular Ca(2+) homeostasis, which was an important signal triggering apoptosis. Hence, the membrane toxicity induced by MMC might play an important role in the process of apoptotic induction and the calcium channel may be one of the apoptosis mechanisms.

Comparison of fibrin glue and Vicryl sutures in conjunctival autografting for pterygium surgery.

PubMed

Wang, Xiu; Zhang, Yan; Zhou, Lei; Wei, Ruihua; Dong, Lijie

2017-01-01

To compare clinical parameters and the tear levels of inflammatory cytokines between pterygium surgery using sutures or fibrin glue. Fifty-six patients with primary pterygium were divided into the suture group and the glue group, in which the autograft was secured with 10-0 Vicryl sutures and fibrin glue, respectively. A questionnaire, slit-lamp examination, Schirmer test, and visual acuity test were performed in all participants. Real-time quantitative PCR (q-PCR) was used to analyze the expression of genes in pterygium and healthy conjunctival tissues. Based on the qPCR results and literature reports, five inflammatory cytokines, including hepatocyte growth factor (HGF), fibroblast growth factor 2 (FGF2), transforming growth factor-β1 (TGF-β1), matrix metalloproteinase 2 (MMP2), and tumor necrosis factor-α (TNF-α), were selected, and their protein levels were measured with enzyme-linked immunosorbent assay (ELISA) in patient tears before surgery as well as at postoperative day 1, 7, and 30. There are 28 patients in either the suture or the glue group. The average duration of surgery was 20.17 ± 3.23 min for the glue group and 32.42 ± 4.47 min for the suture group (p = 0.000). Visual acuity in both groups was improved (p = 0.002) after the surgical procedures. There were more symptoms in the suture group than in the glue group at postoperative day 7 (p = 0.002). Postoperative symptoms disappeared in both groups at 1 month after surgery. Recurrence was observed in one case in the glue group and in two cases in the suture group at the 6 month postoperative follow-up (p = 0.714). In comparison to the preoperative levels (4.33 ± 0.43 ng/ml for the suture group; 4.20 ± 0.26 ng/ml for the glue group), the levels of TNF-α in tears increased in the suture group (5.02 ± 0.49 ng/ml, p = 0.016) and decreased in the glue group (3.84 ± 0.35 ng/ml, p = 0.052) on postoperative day 1. The glue treatment induced higher HGF production (4.78 ± 1.25 ng/ml) than the suture treatment (3.04 ± 1.18 ng/ml) at postoperative day 1 (p = 0.020). Higher levels of TGF-β1 in the glue group were detected at postoperative day 1 (3.71 ± 0.18 ng/ml) and postoperative day 30 (4.50 ± 0.51 ng/ml), compared to those in the suture group, respectively (2.74 ± 0.21 ng/ml, p = 0.000 for day 1; 3.36 ± 0.96 ng/ml, p = 0.017 for postoperative day 30). Fibrin glue is effective and safe for attaching conjunctival autografts with an easy surgical procedure, shortened operating time, and less postoperative discomfort. In the early postoperative period, the protein expression of inflammatory cytokines implicates that fibrin glue may induce accelerated healing and subdued inflammation on the ocular surface compared to sutures.

Uses and complications of mitomycin C in ophthalmology.

PubMed

Mearza, Ali A; Aslanides, Ioannis M

2007-01-01

Mitomycin C is a chemotherapeutic agent that acts by inhibiting DNA synthesis. Its use and application in ophthalmology has been increasing in recent years because of its modulatory effects on wound healing. Current applications include pterygium surgery, glaucoma surgery, corneal refractive surgery, cicatricial eye disease, conjunctival neoplasia and allergic eye disease. Although it has been used successfully in these conditions, it has also been associated with significant complications. This article reviews the current trends and uses of mitomycin C in the eye and its reported complications.

Blindness and visual impairment in Remo, Ogun State, Nigeria: a hospital-based study.

PubMed

Otulana, T O

2012-09-01

This study was conducted to determine the magnitude and causes of blindness and visual impairment in Remo, Ogun State, Nigeria. A retrospective clinic based study to analyse the cases of patients with blindness in general hospitals of Iperu and Isara areas of Ogun state between May 2005 and December 2005. The data of demographic characteristics and diagnosis were retrieved from the outpatient cards. Three hundred and sixty-nine cases registered in the eye clinic during the period of the study and were examined. 177 were males and 190 were females. The age range of patients seen was between 17 days and 89years with a mean age of 43.3 years, ± 23.62(SD). 116 patients were aged 70years and above while 13 patients were less than 10years. 29.5% of the clinic attendance were uniocularly blind, 21.1% were bilaterally blind while 25 2% were visually impaired. 55.1% of the bilateral blindness was in males. 30.8% cases of the bilaterally blind were from age related cataract, 23.1% from glaucoma, 6 cases were due to Retinitis Pigmentosa and 3 from pterygium, Cataract followed by glaucoma was the leading cause of uniocular blindness. Cataract was responsible for 66.7% of visually impairment. Blindness and visual impairment is a public health problem in Remo Ogun State, Nigeria; cataract, glaucoma and pterygium were the important causes of blindness and visual impairment. The major causes of blindness in this part of Ogun state are preventable.

Germline mutations in RYR1 are associated with foetal akinesia deformation sequence/lethal multiple pterygium syndrome.

PubMed

McKie, Arthur B; Alsaedi, Atif; Vogt, Julie; Stuurman, Kyra E; Weiss, Marjan M; Shakeel, Hassan; Tee, Louise; Morgan, Neil V; Nikkels, Peter G J; van Haaften, Gijs; Park, Soo-Mi; van der Smagt, Jasper J; Bugiani, Marianna; Maher, Eamonn R

2014-12-05

Foetal akinesia deformation sequence syndrome (FADS) is a genetically heterogeneous disorder characterised by the combination of foetal akinesia and developmental defects which may include pterygia (joint webbing). Traditionally multiple pterygium syndrome (MPS) has been divided into two forms: prenatally lethal (LMPS) and non-lethal Escobar type (EVMPS) types. Interestingly, FADS, LMPS and EVMPS may be allelic e.g. each of these phenotypes may result from mutations in the foetal acetylcholine receptor gamma subunit gene (CHRNG). Many cases of FADS and MPS do not have a mutation in a known FADS/MPS gene and we undertook molecular genetic studies to identify novel causes of these phenotypes. After mapping a novel locus for FADS/LMPS to chromosome 19, we identified a homozygous null mutation in the RYR1 gene in a consanguineous kindred with recurrent LMPS pregnancies. Resequencing of RYR1 in a cohort of 66 unrelated probands with FADS/LMPS/EVMPS (36 with FADS/LMPS and 30 with EVMPS) revealed two additional homozygous mutations (in frame deletions). The overall frequency of RYR1 mutations in probands with FADS/LMPS was 8.3%. Our findings report, for the first time, a homozygous RYR1 null mutation and expand the range of RYR1-related phenotypes to include early lethal FADS/LMPS. We suggest that RYR1 mutation analysis should be performed in cases of severe FADS/LMPS even in the absence of specific histopathological indicators of RYR1-related disease.

Safety, efficacy, and patient acceptability of lidocaine hydrochloride ophthalmic gel as a topical ocular anesthetic for use in ophthalmic procedures

PubMed Central

Page, Michael A; Fraunfelder, Frederick W

2009-01-01

Purpose: To review the current literature on safety, efficacy, and measures of surgeon and patient satisfaction with lidocaine hydrochloride gel as a tool for ocular anesthesia. Methods: Pubmed search using keywords “lidocaine gel,” “ophthalmic,” and “surgery” and compiling cross-references. Twenty-six total references were reviewed, including 15 prospective randomized controlled trials (RCTs, total N = 933, average N = 62), 6 nonrandomized prospective studies (total N = 234, average N = 39), 2 animal studies, 1 microbiologic study, and 2 letters to the editor. Results: The RCTs and nonrandomized prospective studies evaluated a number of measures including timing of onset of anesthesia, duration of anesthesia, intraoperative and postoperative pain, need for additional anesthetic applications, intracameral lidocaine levels, and adverse effects. Control groups received topical drops, subconjunctival anesthetic, retrobulbar anesthetic, or sham gel. Lidocaine gel was shown to be at least as effective for pain control as alternative therapies in all studies, with longer duration of action than topical drops. Patient and surgeon satisfaction were high, and adverse effects were rare and comparable to those for anesthetic drop formulations. Surgical settings included cataract, pterygium, trabeculectomy, strabismus, intravitreal injection, vitrectomy, and penetrating keratoplasty. Conclusions: Lidocaine gel is a safe, effective, and potentially underutilized tool for ophthalmic surgery. PMID:19898665

Human forniceal region is the stem cell-rich zone of the conjunctival epithelium.

PubMed

Harun, Mohd Hairul Nizam; Sepian, Siti Norzalehawati; Chua, Kien-Hui; Ropilah, Abd Rahman; Abd Ghafar, Norzana; Che-Hamzah, Jemaima; Bt Hj Idrus, Ruszymah; Annuar, Faridah Hanom

2013-03-01

The anterior surface of the eye is covered by several physically contiguous but histologically distinguishable epithelia overlying the cornea, limbus, bulbar conjunctiva, fornix conjunctiva, and palpebral conjunctiva. The self-renewing nature of the conjunctival epithelia makes their long-term survival ultimately dependent on small populations of stem cells. Hence, the objective of this study was to investigate the expression of the stem cell genes Sox2, OCT4, NANOG, Rex1, NES, and ABCG2 in cultured human conjunctival epithelium from different conjunctival zones, namely, the bulbar, palpebral and fornix zones. Three samples were taken from patients with primary pterygium and cataract (age range 56-66 years) who presented to our eye clinic at the UKM Medical Centre. The eye was examined with slit lamp to ensure there was no underlying ocular surface diseases and glaucoma. Conjunctival tissue was taken from patients who underwent a standard cataract or pterygium operation as a primary procedure. Tissues were digested, cultured, and propagated until an adequate number of cells was obtained. Total RNA was extracted and subjected to expression analysis of conjunctival epithelium genes (KRT4, KRT13, KRT19) and stem cell genes (Sox2, OCT4, NANOG, Rex1, NES, ABCG2) by reverse transcriptase-PCR and 2% agarose gel electrophoresis. The expression of Sox2, OCT4, and NANOG genes were detected in the fornical cells, while bulbar cells only expressed Sox2 and palpebral cells only expressed OCT4. Based on these results, the human forniceal region expresses a higher number of stem cell genes than the palpebral and bulbar conjunctiva.

Regulation of ocular surface inflammation by prostaglandin E receptor subtype EP3.

PubMed

Ueta, Mayumi

2010-11-01

We first investigated whether the prostaglandin (PG) E2-PGE receptor subtype EP3 axis regulates the development of murine experimental allergic conjunctivitis because it has been reported that this pathway negatively regulates allergic reactions in a murine allergic asthma model. We observed that EP3 is constitutively expressed in mice conjunctival epithelium. EP3 knockout mice demonstrated significantly increased eosinophil infiltration in conjunctiva after ragweed challenge compared with wild-type mice. Consistently, significantly higher expression of eotaxin-1 messenger RNA was observed in Ptger3-/- mice. Conversely, treatment of wild-type mice with an EP3-selective agonist significantly decreased eosinophil infiltration, which was blunted in Ptger3-/- mice. Expression of cyclooxygenase-2 and PGE synthases was upregulated and PGE2 content increased in the eyelids after ragweed challenge. These data suggest that PGE2 acts on EP3 in the conjunctival epithelium and downregulates the progression of experimental allergic conjunctivitis. We next examined and compared the expression of EP3 in human conjunctival epithelium in various ocular surface diseases. Human conjunctival epithelium expressed EP3-specific messenger RNA and EP3 protein. Although we could clearly find positive signals in the conjunctival epithelium from patients with noninflammatory ocular surface diseases such as conjunctivochalasis and pterygium, we could not find positive signals in that from those with inflammatory disorders such as Stevens-Johnson syndrome and ocular cicatricial pemphigoid. Likewise, expression of the PGE receptor subtype EP4 was clearly found in the conjunctival epithelium from patients with conjunctivochalasis and pterygium but not from patients with Stevens-Johnson syndrome and ocular cicatricial pemphigoid.

Expanding the phenotype of spondylospinal thoracic dysostosis (the Turkel-Chen-Johnson syndrome).

PubMed

Becerra-Solano, Luis E; Chacon, Liliana; Morales-Mata, Dinorah; Ramírez-Dueñas, Maria de Lourdes; García-Ortiz, José E

2015-01-01

Spondylospinal thoracic dysostosis can be considered a type of spondylocostal dysostosis because of the occurrence of vertebral defects (hemivertebrae and vertebral body fusion) and thoracic anomalies (short thorax and pulmonary hypoplasia). This syndrome was described by Johnson et al. (1997) in two siblings with dwarfism, short thorax, curved spine, fusion of the vertebrae and spinal process, multiple pterygium, and arthrogryposis. We describe the case of a 16-year-old Mexican girl with the longest survival recorded (the previous oldest patient was 7 years old) and analyze the natural history and describe some new features of this rare entity.

Integration of IRF6 and Jagged2 signalling is essential for controlling palatal adhesion and fusion competence

PubMed Central

Richardson, Rebecca J.; Dixon, Jill; Jiang, Rulang; Dixon, Michael J.

2009-01-01

In mammals, adhesion and fusion of the palatal shelves are essential mechanisms during the development of the secondary palate; failure of these processes leads to the congenital anomaly, cleft palate. The mechanisms that prevent pathological adhesion between the oral and palatal epithelia while permitting adhesion and subsequent fusion of the palatal shelves via their medial edge epithelia remain obscure. In humans, mutations in the transcription factor interferon regulatory factor 6 (IRF6) underlie Van der Woude syndrome and popliteal pterygium syndrome. Recently, we have demonstrated that mice homozygous for a mutation in Irf6 exhibit abnormalities of epithelial differentiation that results in cleft palate as a consequence of adhesion between the palatal shelves and the tongue. In the current paper, we demonstrate that Irf6 is essential for oral epithelial differentiation and that IRF6 and the Notch ligand Jagged2 function in convergent molecular pathways during this process. We further demonstrate that IRF6 plays a key role in the formation and maintenance of the oral periderm, spatio-temporal regulation of which is essential for ensuring appropriate palatal adhesion. PMID:19439425

Randomized clinical trial of postoperative strontium-90 radiation therapy for pterygia: treatment using 30 Gy/3 fractions vs. 40 Gy/4 fractions.

PubMed

Nakamatsu, Kiyoshi; Nishimura, Yasumasa; Kanamori, Shuichi; Koike, Ryuta; Tachibana, Izumi; Nishikawa, Tatsuyuki; Shibata, Toru

2011-07-01

Postoperative adjuvant treatment with strontium-90 radiation therapy (RT) is a proven technique for reducing the recurrence of pterygium. This randomized trial was conducted to evaluate whether a total dose of 40 Gy provides a better local control rate than a total dose of 30 Gy for surgically resected pterygia. A single institutional randomized trial was conducted. Between 1999 and 2003, 74 pterygia in 71 patients were randomly allocated to 30 Gy/3 fractions/15 days (arm A) or to 40 Gy/4 fractions/22 days (arm B). Only primary pterygia for which RT could be started within 3 days of surgical resection were included. Postoperative RT was given by a strontium-90 eye applicator, and a dose of 10 Gy per fraction was delivered in weekly fractions (day 1, 8, 15, 22). Of the 74 pterygia treated, 73 in 70 patients were analyzed. Of the 73 pterygia, 41 were allocated to arm A, and the remaining 32 to arm B. The 2-year local control rates for arm A and arm B were 85% and 75%, respectively, without significant difference. No serious acute and late complications were noted in either arm. Our new standard fractionation for postoperative RT for pterygia is 30 Gy/3 fractions.

Bartsocas-Papas Syndrome: A Case Report and Review of the Literature.

PubMed

Erturan, Gurhan; Holton, James; Wall, Steven; Giele, Henk

2016-04-01

Bartsocas-Papas syndrome (BPS) is an autosomal recessively inherited form of the popliteal pterygium syndrome characterized by severe growth retardation, midface hypoplasia, popliteal pterygia, and syndactyly. Almost all affected babies die in utero or infancy. We report the difficulties of reconstruction and ongoing plastic surgical management in an 8-year-old child with BPS. With increasingly sophisticated resuscitation and supportive techniques, it is possible that more patients with BPS will survive beyond the neonatal period. This raises new challenges with reconstruction highlighted by this case with a difficult balance between trying to overcome some of the profound effects of the syndrome versus diminishing quality of life for the child by repeated and often unsuccessful surgical procedures.

Clinical Applications of Wavefront Refraction

PubMed Central

Bruce, Adrian S.; Catania, Louis J.

2014-01-01

ABSTRACT Purpose To determine normative reference ranges for higher-order wavefront error (HO-WFE), compare these values with those in common ocular pathologies, and evaluate treatments. Methods A review of 17 major studies on HO-WFE was made, involving data for a total of 31,605 subjects. The upper limit of the 95% confidence interval (CI) for HO-WFE was calculated from the most comprehensive of these studies using normal healthy patients aged 20 to 80 years. There were no studies identified using the natural pupil size for subjects, and for this reason, the HO-WFE was tabulated for pupil diameters of 3 to 7 mm. Effects of keratoconus, pterygium, cataract, and dry eye on HO-WFE were reviewed and treatment efficacy was considered. Results The calculated upper limit of the 95% CI for HO-WFE in a healthy normal 35-year-old patient with a mesopic pupil diameter of 6 mm would be 0.471 μm (471 nm) root-mean-square or less. Although the normal HO-WFE increases with age for a given pupil size, it is not yet completely clear how the concurrent influence of age-related pupillary miosis affects these findings. Abnormal ocular conditions such as keratoconus can induce a large HO-WFE, often in excess of 3.0 μm, particularly attributed to coma. For pterygium or cortical cataract, a combination of coma and trefoil was more commonly induced. Nuclear cataract can induce a negative spherical HO-WFE, usually in excess of 1.0 μm. Conclusions The upper limit of the 95% CI for HO-WFE root-mean-square is about 0.5 μm with normal physiological pupil sizes. With ocular pathologies, HO-WFE can be in excess of 1.0 μm, although many devices and therapeutic and surgical treatments are reported to be highly effective at minimizing HO-WFE. More accurate normative reference ranges for HO-WFE will require future studies using the subjects’ natural pupil size. PMID:25216319

Factors Associated with Awareness, Attitudes and Practices Regarding Common Eye Diseases in the General Population in a Rural District in Bangladesh: The Bangladesh Population-based Diabetes and Eye Study (BPDES).

PubMed

Islam, Fakir M Amirul; Chakrabarti, Rahul; Islam, Silvia Z; Finger, Robert P; Critchley, Christine

2015-01-01

To assess the awareness, attitudes, and practices associated with common eye diseases and eye care utilization in a rural district of Bangladesh. Data were collected using a multilevel cluster random sampling technique from 3104 adults aged ≥30 years from the Banshgram union with a questionnaire assessing the awareness, attitudes and practice about diabetes and common eye diseases, educational attainment, socio-economic status, and medical history. Participants were aged between 30 and 89 years with a mean (SD) age of 51 (12) years and 65% were female. The majority of participants had heard of cataracts (90%), trachoma (86%) and Pterygium (84%), yet only 4% had heard of diabetic retinopathy (DR), 7% of glaucoma and 8% of Age-related macular degeneration (AMD). However, 58% of participants did not know vision loss could be prevented. Factors associated with lower awareness regarding common eye diseases were increasing age, lack of formal schooling, and lower socio-economic status. A lower proportion (57%) of people with no schooling compared to those who had attained at least secondary school certificate education (72%) reported that they knew that vision loss could be prevented (p<0.001). Overall 51% of people had heard of at least six (67%) out of nine items relating to awareness of common eye diseases. This included 41% of participants aged 65 years or older compared to 61% of those aged 30-35 years (p<0.001). Only 4% had an eye check at least once a year and higher education and better SES were associated with higher frequency of eye checks. In rural Bangladesh awareness of cataract, trachoma and pterygium was good but limited in relation to the potentially blinding conditions of glaucoma, DR, and AMD. The results show a large gap between public awareness and treatment practices about common eye diseases. Public health promotion should be designed to address these knowledge gaps.

Genomic, cDNA and embryonic expression analysis of zebrafish IRF6, the gene mutated in the human oral clefting disorders Van der Woude and popliteal pterygium syndromes.

PubMed

Ben, Jin; Jabs, Ethylin Wang; Chong, Samuel S

2005-06-01

Van der Woude syndrome (VWS) and popliteal pterygium syndrome (PPS) are autosomal dominant clefting disorders recently discovered to be caused by mutations in the IRF6 (Interferon Regulatory Factor 6) gene. The IRF gene family consists of nine members encoding transcription factors that share a highly conserved helix-turn-helix DNA-binding domain and a less conserved protein-binding domain. Most IRFs regulate the expression of interferon-alpha and -beta after viral infection, but the function of IRF6 remains unknown. We have isolated a full-length zebrafish irf6 cDNA, which encodes a 492 amino acid protein that contains a Smad-IRF interaction motif and a DNA-binding domain. The zebrafish irf6 gene consists of eight exons and maps to linkage group 22 closest to marker unp1375. By in situ hybridization analysis of embryo whole-mounts and cryosections, we demonstrate that irf6 is first expressed as a maternal transcript. During gastrulation, irf6 expression was concentrated in the forerunner cells. From the bud stage to the 3-somite stage, irf6 expression was observed in the Kupffer's vesicle. No expression could be detected at the 6-somite and 10-somite stages. At the 14-somite stage, expression was detected in the otic placode. At the 17-somite stage, strong expression was also observed in the cloaca. During the pharyngula, hatch and larva periods up to 5 days post-fertilization, irf6 was expressed in the pharyngeal arches, olfactory and otic placodes, and in the epithelial cells of endoderm derived tissues. The latter tissues include the mouth, pharynx, esophagus, endodermal lining of swim bladder, liver, exocrine pancreas, and associated ducts. Overall, the zebrafish expression data are consistent with the observations of lip pits in VWS patients, as well as more recent reports of alae nasi, otitis media and sensorineural hearing loss documented in some patients.

Geometrical gradients in the distribution of temperature and absorbed ultraviolet radiation in ocular tissues.

PubMed

Sliney, David H

2002-01-01

The geographical variations in the incidence of age-related ocular changes such as presbyopia and cataracts and diseases such as pterygium and droplet keratopathies have led to theories pointing to sunlight, ultraviolet radiation (UVR) exposure and ambient temperature as potential etiological factors. Some epidemiological evidence also points to an association of age-related macular degeneration to sunlight exposure. The actual distribution of sunlight exposure and the determination of temperature variations of different tissues within the anterior segment of the eye are difficult to assess. Of greatest importance are the geometrical factors that influence selective UVR exposures to different segments of the lens, cornea and retina. Studies show that the temperature of the lens and cornea varies by several degrees depending upon climate, and that the incidence of nuclear cataract incidence is greater in areas of higher ambient temperature (i.e., in the tropics). Likewise, sunlight exposure to local areas of the cornea, lens and retina varies greatly in different environments. However, epidemiological studies of the influence of environmental UVR in the development of cataract, pterygium, droplet keratopathies and age-related macular degeneration have produced surprisingly inconsistent findings. The lack of consistent results is seen to be due largely to either incomplete or erroneous estimates of outdoor UV exposure dose. Geometrical factors dominate the determination of UVR exposure of the eye. The degree of lid opening limits ocular exposure to rays entering at angles near the horizon. Clouds redistribute overhead UVR to the horizon sky. Mountains, trees and building shield the eye from direct sky exposure. Most ground surfaces reflect little UVR. The result is that highest UVR exposure occurs during light overcast where the horizon is visible and ground surface reflection is high. By contrast, exposure in a high mountain valley (lower ambient temperature) with green foliage results in a much lower ocular dose. Other findings of these studies show that retinal exposure to light and UVR in daylight occurs largely in the superior retina.

Visual indices of motor vehicle drivers in relation to road safety in Nigeria.

PubMed

Emerole, C G; Nneli, R O

2013-06-30

This study assessed the visual profile of motor vehicle drivers in Owerri, Nigeria and to analyse the relationship between the various aspects of visual function in relation to road safety. A cross-sectional descriptive study of 150 commercial vehicles drivers and 130 private vehicles drivers was conducted between November 2005 and February 2006. Data were obtained using structured interviewer administered questionnaires and clinical examination was done. Standards procedures were used to determine visual indices. Data from the better eye (eye with a better visual acuity according to international and national standards) were reported, except in the analysis of near vision of the respondents. Twenty percent of the study group had normal visual acuity of ≥6/6 compared with 46.2% in the control group. The tonometric value in 88.0% and 93.1% of study and control groups respectively was less than 24mmHg. Both groups (96.8%) had normal confrontation visual field while 95.3% of study group and 97.7% of control group had normal colour vision. The most prevailing eye conditions that may reduce visual acuity were pterygium (51.3% in study group and 13.8% in the control group), retinopathy (16.7% of study group and 6.2% of control group) and glaucoma (12.0% and 6.9% of study and control groups respectively). Nineteen percent of the study group had regular eye examination compared with 38.5% in the control group. Alcohol consumption was 64.7% in the study group and 32.3% in the control group. Most of the commercial motor drivers in Owerri, Nigeria did not meet the Federal Road Safety Commission visual acuity standard for commercial motor drivers. Visual impairments and poor visibility are strongly associated with RTA among Nigerian motor vehicle drivers. Visual acuity and visual health care were poor among commercial motor drivers. There is need for renewed efforts to enforce a compulsory periodic visual examination for drivers, and to ensure that visual requirements for driving are met.

36 CFR 251.122 - Historical operator special use authorizations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... this section; (3) A change in the controlling interest of a historical operator through sale...) A change in the controlling interest of a historical operator that results only in the acquisition of the controlling interest by an individual or individuals, who were personally engaged in the...

Deep lamellar keratoplasty on air with lyophilised tissue.

PubMed Central

Chau, G K; Dilly, S A; Sheard, C E; Rostron, C K

1992-01-01

Deep lamellar keratoplasty on air involves injecting air into the corneal stroma to expand it to several times its normal thickness. This method is designed to facilitate dissection of the deep stroma and reduce the risk of perforation of Descemet's membrane when carrying out deep lamellar keratoplasty. We have modified the technique by using prelathed freeze-dried donor tissue and report our results in a series of patients with corneal stromal scarring owing to a variety of corneal problems, namely, keratoconus, pterygium, and herpes zoster ophthalmicus. All patients achieved best corrected postoperative visual acuity of 6/12 or better without problems associated with graft failure or rejection. Histopathological examination of corneal tissue following air injection showed surgical emphysema within the cornea and separation of deep stromal fibres from the underlying Descemet's membrane. Images PMID:1477037

Adaptive adjustment of the randomization ratio using historical control data

PubMed Central

Hobbs, Brian P.; Carlin, Bradley P.; Sargent, Daniel J.

2013-01-01

Background Prospective trial design often occurs in the presence of “acceptable” [1] historical control data. Typically this data is only utilized for treatment comparison in a posteriori retrospective analysis to estimate population-averaged effects in a random-effects meta-analysis. Purpose We propose and investigate an adaptive trial design in the context of an actual randomized controlled colorectal cancer trial. This trial, originally reported by Goldberg et al. [2], succeeded a similar trial reported by Saltz et al. [3], and used a control therapy identical to that tested (and found beneficial) in the Saltz trial. Methods The proposed trial implements an adaptive randomization procedure for allocating patients aimed at balancing total information (concurrent and historical) among the study arms. This is accomplished by assigning more patients to receive the novel therapy in the absence of strong evidence for heterogeneity among the concurrent and historical controls. Allocation probabilities adapt as a function of the effective historical sample size (EHSS) characterizing relative informativeness defined in the context of a piecewise exponential model for evaluating time to disease progression. Commensurate priors [4] are utilized to assess historical and concurrent heterogeneity at interim analyses and to borrow strength from the historical data in the final analysis. The adaptive trial’s frequentist properties are simulated using the actual patient-level historical control data from the Saltz trial and the actual enrollment dates for patients enrolled into the Goldberg trial. Results Assessing concurrent and historical heterogeneity at interim analyses and balancing total information with the adaptive randomization procedure leads to trials that on average assign more new patients to the novel treatment when the historical controls are unbiased or slightly biased compared to the concurrent controls. Large magnitudes of bias lead to approximately equal allocation of patients among the treatment arms. Using the proposed commensurate prior model to borrow strength from the historical data, after balancing total information with the adaptive randomization procedure, provides admissible estimators of the novel treatment effect with desirable bias-variance trade-offs. Limitations Adaptive randomization methods in general are sensitive to population drift and more suitable for trials that initiate with gradual enrollment. Balancing information among study arms in time-to-event analyses is difficult in the presence of informative right-censoring. Conclusions The proposed design could prove important in trials that follow recent evaluations of a control therapy. Efficient use of the historical controls is especially important in contexts where reliance on pre-existing information is unavoidable because the control therapy is exceptionally hazardous, expensive, or the disease is rare. PMID:23690095

Adaptive adjustment of the randomization ratio using historical control data.

PubMed

Hobbs, Brian P; Carlin, Bradley P; Sargent, Daniel J

2013-01-01

Prospective trial design often occurs in the presence of 'acceptable' historical control data. Typically, these data are only utilized for treatment comparison in a posteriori retrospective analysis to estimate population-averaged effects in a random-effects meta-analysis. We propose and investigate an adaptive trial design in the context of an actual randomized controlled colorectal cancer trial. This trial, originally reported by Goldberg et al., succeeded a similar trial reported by Saltz et al., and used a control therapy identical to that tested (and found beneficial) in the Saltz trial. The proposed trial implements an adaptive randomization procedure for allocating patients aimed at balancing total information (concurrent and historical) among the study arms. This is accomplished by assigning more patients to receive the novel therapy in the absence of strong evidence for heterogeneity among the concurrent and historical controls. Allocation probabilities adapt as a function of the effective historical sample size (EHSS), characterizing relative informativeness defined in the context of a piecewise exponential model for evaluating time to disease progression. Commensurate priors are utilized to assess historical and concurrent heterogeneity at interim analyses and to borrow strength from the historical data in the final analysis. The adaptive trial's frequentist properties are simulated using the actual patient-level historical control data from the Saltz trial and the actual enrollment dates for patients enrolled into the Goldberg trial. Assessing concurrent and historical heterogeneity at interim analyses and balancing total information with the adaptive randomization procedure lead to trials that on average assign more new patients to the novel treatment when the historical controls are unbiased or slightly biased compared to the concurrent controls. Large magnitudes of bias lead to approximately equal allocation of patients among the treatment arms. Using the proposed commensurate prior model to borrow strength from the historical data, after balancing total information with the adaptive randomization procedure, provides admissible estimators of the novel treatment effect with desirable bias-variance trade-offs. Adaptive randomization methods in general are sensitive to population drift and more suitable for trials that initiate with gradual enrollment. Balancing information among study arms in time-to-event analyses is difficult in the presence of informative right-censoring. The proposed design could prove important in trials that follow recent evaluations of a control therapy. Efficient use of the historical controls is especially important in contexts where reliance on preexisting information is unavoidable because the control therapy is exceptionally hazardous, expensive, or the disease is rare.

Using historical control information for the design and analysis of clinical trials with overdispersed count data.

PubMed

Gsteiger, Sandro; Neuenschwander, Beat; Mercier, Francois; Schmidli, Heinz

2013-09-20

Results from clinical trials are never interpreted in isolation. Previous studies in a similar setting provide valuable information for designing a new trial. For the analysis, however, the use of trial-external information is challenging and therefore controversial, although it seems attractive from an ethical or efficiency perspective. Here, we consider the formal use of historical control data on lesion counts in a multiple sclerosis trial. The approach to incorporating historical data is Bayesian, in that historical information is captured in a prior that accounts for between-trial variability and hence leads to discounting of historical data. We extend the meta-analytic-predictive approach, a random-effects meta-analysis of historical data combined with the prediction of the parameter in the new trial, from normal to overdispersed count data of individual-patient or aggregate-trial format. We discuss the prior derivation for the lesion mean count in the control group of the new trial for two populations. For the general population (without baseline enrichment), with 1936 control patients from nine historical trials, between-trial variability was moderate to substantial, leading to a prior effective sample size of about 45 control patients. For the more homogenous population (with enrichment), with 412 control patients from five historical trials, the prior effective sample size was approximately 63 patients. Although these numbers are small relative to the historical data, they are fairly typical in settings where between-trial heterogeneity is moderate. For phase II, reducing the number of control patients by 45 or by 63 may be an attractive option in many multiple sclerosis trials. Copyright © 2013 John Wiley & Sons, Ltd.

Factors Associated with Awareness, Attitudes and Practices Regarding Common Eye Diseases in the General Population in a Rural District in Bangladesh: The Bangladesh Population-based Diabetes and Eye Study (BPDES)

PubMed Central

Islam, Fakir M. Amirul; Chakrabarti, Rahul; Islam, Silvia Z.; Finger, Robert P.; Critchley, Christine

2015-01-01

Background To assess the awareness, attitudes, and practices associated with common eye diseases and eye care utilization in a rural district of Bangladesh. Methods Data were collected using a multilevel cluster random sampling technique from 3104 adults aged ≥30 years from the Banshgram union with a questionnaire assessing the awareness, attitudes and practice about diabetes and common eye diseases, educational attainment, socio-economic status, and medical history. Results Participants were aged between 30 and 89 years with a mean (SD) age of 51 (12) years and 65% were female. The majority of participants had heard of cataracts (90%), trachoma (86%) and Pterygium (84%), yet only 4% had heard of diabetic retinopathy (DR), 7% of glaucoma and 8% of Age-related macular degeneration (AMD). However, 58% of participants did not know vision loss could be prevented. Factors associated with lower awareness regarding common eye diseases were increasing age, lack of formal schooling, and lower socio-economic status. A lower proportion (57%) of people with no schooling compared to those who had attained at least secondary school certificate education (72%) reported that they knew that vision loss could be prevented (p<0.001). Overall 51% of people had heard of at least six (67%) out of nine items relating to awareness of common eye diseases. This included 41% of participants aged 65 years or older compared to 61% of those aged 30–35 years (p<0.001). Only 4% had an eye check at least once a year and higher education and better SES were associated with higher frequency of eye checks. Conclusions In rural Bangladesh awareness of cataract, trachoma and pterygium was good but limited in relation to the potentially blinding conditions of glaucoma, DR, and AMD. The results show a large gap between public awareness and treatment practices about common eye diseases. Public health promotion should be designed to address these knowledge gaps. PMID:26200458

Bayesian selective response-adaptive design using the historical control.

PubMed

Kim, Mi-Ok; Harun, Nusrat; Liu, Chunyan; Khoury, Jane C; Broderick, Joseph P

2018-06-13

High quality historical control data, if incorporated, may reduce sample size, trial cost, and duration. A too optimistic use of the data, however, may result in bias under prior-data conflict. Motivated by well-publicized two-arm comparative trials in stroke, we propose a Bayesian design that both adaptively incorporates historical control data and selectively adapt the treatment allocation ratios within an ongoing trial responsively to the relative treatment effects. The proposed design differs from existing designs that borrow from historical controls. As opposed to reducing the number of subjects assigned to the control arm blindly, this design does so adaptively to the relative treatment effects only if evaluation of cumulated current trial data combined with the historical control suggests the superiority of the intervention arm. We used the effective historical sample size approach to quantify borrowed information on the control arm and modified the treatment allocation rules of the doubly adaptive biased coin design to incorporate the quantity. The modified allocation rules were then implemented under the Bayesian framework with commensurate priors addressing prior-data conflict. Trials were also more frequently concluded earlier in line with the underlying truth, reducing trial cost, and duration and yielded parameter estimates with smaller standard errors. © 2018 The Authors. Statistics in Medicine Published by John Wiley & Sons, Ltd.

Fibrin glue in ophthalmology

PubMed Central

Panda, Anita; Kumar, Sandeep; Kumar, Abhiyan; Bansal, Raseena; Bhartiya, Shibal

2009-01-01

Suturing is a time consuming task in ophthalmology and suture induced irritation and redness are frequent problems. Postoperative wound infection and corneal graft rejection are examples of possible suture related complications. To prevent these complications, ophthalmic surgeons are switching to sutureless surgery. A number of recent developments have established tissue adhesives like cyanoacrylate glue and fibrin glue as attractive alternatives to sutures. A possible and promising new application for tissue adhesives is to provide a platform for tissue engineering. Currently, tissue glue is being used for conjunctival closure following pterygium and strabismus surgery, forniceal reconstruction surgery, amniotic membrane transplantation, lamellar corneal grafting, closure of corneal perforations and descematoceles, management of conjunctival wound leaks after trabeculectomy, lid surgery, adnexal surgery and as a hemostat to minimise bleeding. The purpose of this review is to discuss the currently available information on fibrin glue. PMID:19700876

Repurposing historical control clinical trial data to provide safety context.

PubMed

Bhuyan, Prakash; Desai, Jigar; Louis, Matthew St; Carlsson, Martin; Bowen, Edward; Danielson, Mark; Cantor, Michael N

2016-02-01

Billions of dollars spent, millions of subject-hours of clinical trial experience and an abundance of archived study-level data, yet why are historical data underutilized? We propose that historical data can be aggregated to provide safety, background incidence rate and context to improve the evaluation of new medicinal products. Here, we describe the development and application of the eControls database, which is derived from the control arms of studies of licensed products, and discuss the challenges and potential solutions to the proper application of historical data to help interpret product safety. Copyright © 2015 Elsevier Ltd. All rights reserved.

Comparison of anticipated and actual control group outcomes in randomised trials in paediatric oncology provides evidence that historically controlled studies are biased in favour of the novel treatment.

PubMed

Moroz, Veronica; Wilson, Jayne S; Kearns, Pamela; Wheatley, Keith

2014-12-10

Historically controlled studies are commonly undertaken in paediatric oncology, despite their potential biases. Our aim was to compare the outcome of the control group in randomised controlled trials (RCTs) in paediatric oncology with those anticipated in the sample size calculations in the protocols. Our rationale was that, had these RCTs been performed as historical control studies instead, the available outcome data used to calculate the sample size in the RCT would have been used as the historical control outcome data. A systematic search was undertaken for published paediatric oncology RCTs using the Cochrane Central Register of Controlled Trials (CENTRAL) database from its inception up to July 2013. Data on sample size assumptions and observed outcomes (timetoevent and proportions) were extracted to calculate differences between randomised and historical control outcomes, and a one-sample t-test was employed to assess whether the difference between anticipated and observed control groups differed from zero. Forty-eight randomised questions were included. The median year of publication was 2005, and the range was from 1976 to 2010. There were 31 superiority and 11 equivalence/noninferiority randomised questions with time-to-event outcomes. The median absolute difference between observed and anticipated control outcomes was 5.0% (range: -23 to +34), and the mean difference was 3.8% (95% CI: +0.57 to +7.0; P = 0.022). Because the observed control group (that is, standard treatment arm) in RCTs performed better than anticipated, we found that historically controlled studies that used similar assumptions for the standard treatment were likely to overestimate the benefit of new treatments, potentially leading to children with cancer being given ineffective therapy that may have additional toxicity.

41 CFR 102-78.65 - What are Federal agencies' historic preservation responsibilities when disposing of real property...

Code of Federal Regulations, 2012 CFR

2012-01-01

... agencies' historic preservation responsibilities when disposing of real property under their control? 102... real property under their control? Federal agencies must— (a) To the extent practicable, establish and implement alternatives for historic properties, including adaptive use, that are not needed for current or...

41 CFR 102-78.65 - What are Federal agencies' historic preservation responsibilities when disposing of real property...

Code of Federal Regulations, 2013 CFR

2013-07-01

... agencies' historic preservation responsibilities when disposing of real property under their control? 102... real property under their control? Federal agencies must— (a) To the extent practicable, establish and implement alternatives for historic properties, including adaptive use, that are not needed for current or...

41 CFR 102-78.65 - What are Federal agencies' historic preservation responsibilities when disposing of real property...

Code of Federal Regulations, 2014 CFR

2014-01-01

... agencies' historic preservation responsibilities when disposing of real property under their control? 102... real property under their control? Federal agencies must— (a) To the extent practicable, establish and implement alternatives for historic properties, including adaptive use, that are not needed for current or...

41 CFR 102-78.65 - What are Federal agencies' historic preservation responsibilities when disposing of real property...

Code of Federal Regulations, 2011 CFR

2011-01-01

... agencies' historic preservation responsibilities when disposing of real property under their control? 102... real property under their control? Federal agencies must— (a) To the extent practicable, establish and implement alternatives for historic properties, including adaptive use, that are not needed for current or...

41 CFR 102-78.65 - What are Federal agencies' historic preservation responsibilities when disposing of real property...

Code of Federal Regulations, 2010 CFR

2010-07-01

... agencies' historic preservation responsibilities when disposing of real property under their control? 102... real property under their control? Federal agencies must— (a) To the extent practicable, establish and implement alternatives for historic properties, including adaptive use, that are not needed for current or...

Composite and Loose Concepts, Historical Analogies, and the Logic of Control in Comparative Historical Analysis

ERIC Educational Resources Information Center

Møller, Jørgen

2016-01-01

The use of controlled comparisons pervades comparative historical analysis. Heated debates have surrounded the methodological purchase of such comparisons. However, the quality and validity of the conceptual building blocks on which the comparisons are based have largely been ignored. This article discusses a particular problem pertaining to these…

Use of historical control data for assessing treatment effects in clinical trials.

PubMed

Viele, Kert; Berry, Scott; Neuenschwander, Beat; Amzal, Billy; Chen, Fang; Enas, Nathan; Hobbs, Brian; Ibrahim, Joseph G; Kinnersley, Nelson; Lindborg, Stacy; Micallef, Sandrine; Roychoudhury, Satrajit; Thompson, Laura

2014-01-01

Clinical trials rarely, if ever, occur in a vacuum. Generally, large amounts of clinical data are available prior to the start of a study, particularly on the current study's control arm. There is obvious appeal in using (i.e., 'borrowing') this information. With historical data providing information on the control arm, more trial resources can be devoted to the novel treatment while retaining accurate estimates of the current control arm parameters. This can result in more accurate point estimates, increased power, and reduced type I error in clinical trials, provided the historical information is sufficiently similar to the current control data. If this assumption of similarity is not satisfied, however, one can acquire increased mean square error of point estimates due to bias and either reduced power or increased type I error depending on the direction of the bias. In this manuscript, we review several methods for historical borrowing, illustrating how key parameters in each method affect borrowing behavior, and then, we compare these methods on the basis of mean square error, power and type I error. We emphasize two main themes. First, we discuss the idea of 'dynamic' (versus 'static') borrowing. Second, we emphasize the decision process involved in determining whether or not to include historical borrowing in terms of the perceived likelihood that the current control arm is sufficiently similar to the historical data. Our goal is to provide a clear review of the key issues involved in historical borrowing and provide a comparison of several methods useful for practitioners. Copyright © 2013 John Wiley & Sons, Ltd.

Use of historical control data for assessing treatment effects in clinical trials

PubMed Central

Viele, Kert; Berry, Scott; Neuenschwander, Beat; Amzal, Billy; Chen, Fang; Enas, Nathan; Hobbs, Brian; Ibrahim, Joseph G.; Kinnersley, Nelson; Lindborg, Stacy; Micallef, Sandrine; Roychoudhury, Satrajit; Thompson, Laura

2014-01-01

Clinical trials rarely, if ever, occur in a vacuum. Generally, large amounts of clinical data are available prior to the start of a study, particularly on the current study’s control arm. There is obvious appeal in using (i.e., ‘borrowing’) this information. With historical data providing information on the control arm, more trial resources can be devoted to the novel treatment while retaining accurate estimates of the current control arm parameters. This can result in more accurate point estimates, increased power, and reduced type I error in clinical trials, provided the historical information is sufficiently similar to the current control data. If this assumption of similarity is not satisfied, however, one can acquire increased mean square error of point estimates due to bias and either reduced power or increased type I error depending on the direction of the bias. In this manuscript, we review several methods for historical borrowing, illustrating how key parameters in each method affect borrowing behavior, and then, we compare these methods on the basis of mean square error, power and type I error. We emphasize two main themes. First, we discuss the idea of ‘dynamic’ (versus ‘static’) borrowing. Second, we emphasize the decision process involved in determining whether or not to include historical borrowing in terms of the perceived likelihood that the current control arm is sufficiently similar to the historical data. Our goal is to provide a clear review of the key issues involved in historical borrowing and provide a comparison of several methods useful for practitioners. PMID:23913901

Total anomalous pulmonary venous connection and a constellation of craniofacial, skeletal, and urogenital anomalies in a newborn and similar features in his 36-year-old father.

PubMed

Pierson, D M; Taboada, E M; Lofland, G K; Begleiter, M L; Smith, G S; Hall, F; Butler, M G

2001-04-01

We report on a newborn male born to non-consanguineous parents with total anomalous pulmonary venous connection (TAPVC) and additional findings of malformed ears, hypertelorism, brachyphalangy in the hands, pterygium of the elbows, knees, and wrists, complex lower limb pre-axial polydactyly, tibial shortening, clubfeet, horseshoe kidney and a micropenis. He had a 46,XY karyotype. His 36-year-old father had similar craniofacial and limb anomalies suggesting an autosomal dominant syndrome with variable expression. Our patients may represent the 3rd and 4th examples of a newly-described syndrome by Baraitser et al. [(1997) Clin Dysmorphol 6:111-121] which is distinguished by malformed ears, complex pre-axial polydactyly and tibial aplasia in the lower limbs, severe brachyphalangy in the hands, and a micropenis.

An Overview of Ophthalmologic Survey Methodology in the 2008-2015 Korean National Health and Nutrition Examination Surveys.

PubMed

Yoon, Kyung Chul; Choi, Won; Lee, Hyo Seok; Kim, Sang-Duck; Kim, Seung-Hyun; Kim, Chan Yun; Park, Ki Ho; Park, Young Jeung; Baek, Seung-Hee; Song, Su Jeong; Shin, Jae Pil; Yang, Suk-Woo; Yu, Seung-Young; Lee, Jong Soo; Lim, Key Hwan; Oh, Kyung Won; Kang, Se Woong

2015-12-01

The Korea National Health and Nutrition Examination Survey (KNHANES) is a national program designed to assess the health and nutritional status of the noninstitutionalized population of South Korea. The KNHANES was initiated in 1998 and has been conducted annually since 2007. Starting in the latter half of 2008, ophthalmologic examinations were included in the survey in order to investigate the prevalence and risk factors of common eye diseases such as visual impairment, refractive errors, strabismus, blepharoptosis, cataract, pterygium, diabetic retinopathy, age-related macular degeneration, glaucoma, dry eye disease, and color vision deficiency. The measurements included in the ophthalmic questionnaire and examination methods were modified in the KNHANES IV, V, and VI. In this article, we provide detailed information about the methodology of the ophthalmic examinations in KNHANES in order to aid in further investigations related to major eye diseases in South Korea.

The role of ultraviolet radiation in the pathogenesis of pterygia (Review).

PubMed

Zhou, Wei-Ping; Zhu, Yuan-Fang; Zhang, Bei; Qiu, Wen-Ya; Yao, Yu-Feng

2016-07-01

Pterygium is a common ophthalmic disease affecting humans only. Extensive epidemiological data have demonstrated a causative effect of chronic ultraviolet (UV) radiation on pterygia. Progress has been made in determining the origin of pterygia, their nasal predilection and wing‑shaped appearance, and the roles of UV radiation in the initiation and the development of pterygia. In the present review, the current understanding of the involvement of UV radiation in the pathogenesis of pterygia is summarized. This involvement includes the alteration of limbal stem cells and fibroblasts that contribute to the initiation of pterygia and the induction of various pro‑inflammatory cytokines, growth factors and matrix metalloproteinases that promote the progression of pterygia. Further elucidation of the roles of UV radiation in the pathogenesis of pterygia may help to encourage individuals at risk of developing pterygia to take preventive measures and aid researchers in the development of novel targeted therapeutic agents to treat pterygia.

Confirmation that RIPK4 mutations cause not only Bartsocas-Papas syndrome but also CHAND syndrome.

PubMed

Busa, Tiffany; Jeraiby, Mohammed; Clémenson, Alix; Manouvrier, Sylvie; Granados, Viviana; Philip, Nicole; Touraine, Renaud

2017-11-01

CHAND syndrome is an autosomal recessive disorder characterized by curly hair, ankyloblepharon, and nail dysplasia. Only few patients were reported to date. A homozygous RIPK4 mutation was recently identified by homozygosity mapping and whole exome sequencing in three patients from an expanded consanguineous kindred with a clinical diagnosis of CHAND syndrome. RIPK4 was previously known to be implicated in Bartsocas-Papas syndrome, the autosomal recessive form of popliteal pterygium syndrome. We report here two cases of RIPK4 homozygous mutations in a fetus with severe Bartsocas-Papas syndrome and a patient with CHAND syndrome. The patient with CHAND syndrome harbored the same mutation as the one identified in the family previously reported. We thus confirm the implication of RIPK4 gene in CHAND syndrome in addition to Bartsocas-Papas syndrome and discuss genotype/phenotype correlations. © 2017 Wiley Periodicals, Inc.

Identification of monoclinic calcium pyrophosphate dihydrate and hydroxyapatite in human sclera using Raman microspectroscopy.

PubMed

Chen, Ko-Hua; Li, Mei-Jane; Cheng, Wen-Ting; Balic-Zunic, Tonci; Lin, Shan-Yang

2009-02-01

Raman microspectroscopy was first used to determine the composition of a calcified plaque located at the pterygium-excision site of a 51-year-old female patient's left nasal sclera after surgery. It was unexpectedly found that the Raman spectrum of the calcified sample at 1149, 1108, 1049, 756, 517, 376 and 352/cm was similar to the Raman spectrum of monoclinic form of calcium pyrophosphate dihydrate (CPPD) crystal, but differed from the Raman spectrum of triclinic form of CPPD. An additional peak at 958/cm was also observed in the Raman spectrum of the calcified plaque, which was identical to the characteristic peak at 958/cm of hydroxyapatite (HA). This is the first study to report the spectral biodiagnosis of both monoclinic CPPD and HA co-deposited in the calcified plaque of a patient with sclera dystrophic calcification using Raman microspectroscopy.

Identification of monoclinic calcium pyrophosphate dihydrate and hydroxyapatite in human sclera using Raman microspectroscopy

PubMed Central

Chen, Ko-Hua; Li, Mei-Jane; Cheng, Wen-Ting; Balic-Zunic, Tonci; Lin, Shan-Yang

2009-01-01

Raman microspectroscopy was first used to determine the composition of a calcified plaque located at the pterygium-excision site of a 51-year-old female patient's left nasal sclera after surgery. It was unexpectedly found that the Raman spectrum of the calcified sample at 1149, 1108, 1049, 756, 517, 376 and 352/cm was similar to the Raman spectrum of monoclinic form of calcium pyrophosphate dihydrate (CPPD) crystal, but differed from the Raman spectrum of triclinic form of CPPD. An additional peak at 958/cm was also observed in the Raman spectrum of the calcified plaque, which was identical to the characteristic peak at 958/cm of hydroxyapatite (HA). This is the first study to report the spectral biodiagnosis of both monoclinic CPPD and HA co-deposited in the calcified plaque of a patient with sclera dystrophic calcification using Raman microspectroscopy. PMID:19200254

Ozone depletion and solar ultraviolet radiation: ocular effects, a United nations environment programme perspective.

PubMed

Cullen, Anthony P

2011-07-01

To describe he role played by the United Nations Environmental Effects Panel with respect to the ocular effects of stratospheric ozone depletion and present the essence of the Health Chapter of the 2010 Assessment. A consideration of solar ultraviolet radiation (UVR) at the Earth's surface as it is affected by atmospheric changes and how these influence sunlight-related eye diseases. A review of the current Assessment with emphasis on pterygium, cataract, ocular melanoma, and age-related macular degeneration. Although the ozone layer is projected to recover slowly in the coming decades, continuing vigilance is required regarding exposure to the sun. Evidence implicating solar UVR, especially UVB, in every tissue of the eye continues to be amassed. The need for ocular UV protection existed before the discovery of the depletion of the ozone layer and will continue even when the layer fully recovers in approximately 2100.

Ophthalmologic Findings in H Syndrome: A Unique Diagnostic Clue.

PubMed

Molho-Pessach, Vered; Mechoulam, Hadas; Siam, Rula; Babay, Sofia; Ramot, Yuval; Zlotogorski, Abraham

2015-01-01

H syndrome is an autosomal recessive histiocytosis with multisystemic involvement caused by mutations in the SLC29A3 gene. The term H syndrome was coined to denote the major clinical findings which include hyperpigmentation, hypertrichosis, hearing loss, hepatosplenomegaly, hypogonadism, hyperglycemia/diabetes mellitus and hallux valgus/flexion contractures. Almost 100 individuals affected with this disorder have been reported, however, a thorough evaluation of the ophthalmologic features of H syndrome has not yet been performed. Ophthalmic examination of a 50-year-old male with H syndrome. Mutation analysis of SLC29A3 was also performed in this patient. Ophthalmic findings included; shallow orbits with exorbitism, bilateral pterygium, limbal thickening, corneal arcus and cortical cataract. We also review ophthalmologic findings in previously reported H syndrome patients. The presence of dilated lateral scleral vessels, corneal arcus and shallow orbits should raise the suspicion of H syndrome, especially when seen in young age.

75 FR 72829 - Los Alamos Historical Document Retrieval and Assessment (LAHDRA) Project

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-26

... Historical Document Retrieval and Assessment (LAHDRA) Project The Centers for Disease Control and Prevention... release of the Final Report of the Los Alamos Historical Document Retrieval and Assessment (LAHDRA)Project... information about historical chemical or radionuclide releases from facilities at the Los Alamos National...

76 FR 28071 - Notice of Inventory Completion: Colorado Historical Society (History Colorado), Denver, CO

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-13

...: Colorado Historical Society (History Colorado), Denver, CO AGENCY: National Park Service, Interior. ACTION... control of the Colorado Historical Society (History Colorado), Denver, CO. The human remains were removed.... A detailed assessment of the human remains was made by the Colorado Historical Society (History...

A Transferencia do Controle da Educacao da Igreja para o Estado (The Transfer of Educational Control from the Church to the State).

ERIC Educational Resources Information Center

Silva, Marcos

2000-01-01

Analyzes the principal phases in the historical process of the occidental world that resulted in the transfer of educational control from the church to the state, demonstrating some of the consequences of this historic turn. (BT)

A phase II flexible screening design allowing for interim analysis and comparison with historical control.

PubMed

Wu, Wenting; Bot, Brian; Hu, Yan; Geyer, Susan M; Sargent, Daniel J

2013-07-01

Sargent and Goldberg [1] proposed a randomized phase II flexible screening design (SG design) which took multiple characteristics of candidate regimens into consideration in selecting a regimen for further phase III testing. In this paper, we extend the SG design by including provisions for an interim analysis and/or a comparison to a historical control. By including a comparison with a historical control, a modified SG design not only identifies a more promising treatment but also assures that the regimen has a clinically meaningful level of efficacy as compared to a historical control. By including an interim analysis, a modified SG design could reduce the number of patients exposed to inferior treatment regimens. When compared to the original SG design, the modified designs increase the sample size moderately, but expand the utility of the flexible screening design substantially. Copyright © 2013 Elsevier Inc. All rights reserved.

Sandia National Laboratories, Tonopah Test Range Fire Control Bunker (Building 09-51): Photographs and Written Historical and Descriptive Data

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

Ullrich, Rebecca A.

The Fire Control Bunker (Building 09-51) is a contributing element to the Sandia National Laboratories (SNL) Tonopah Test Range (TTR) Historic District. The SNL TTR Historic District played a significant role in U.S. Cold War history in the areas of stockpile surveillance and non-nuclear field testing of nuclear weapons design. The district covers approximately 179,200 acres and illustrates Cold War development testing of nuclear weapons components and systems. This report includes historical information, architectural information, sources of information, project information, maps, blueprints, and photographs.

12. Historic view of Building 100 control room, showing television ...

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

12. Historic view of Building 100 control room, showing television monitoring of tests and personnel operating rocket engine test controls. May 27, 1957. On file at NASA Plumbrook Research Facility, Sandusky, Ohio. NASA photo number C-45021. - Rocket Engine Testing Facility, GRC Building No. 100, NASA Glenn Research Center, Cleveland, Cuyahoga County, OH

Impact of Eighteen-Year Varied Compliance to Onchocerciasis Treatment with Ivermectin in Sentinel Savannah Agrarian Communities in Kaduna State of Nigeria.

PubMed

Osue, Hudu O; Inabo, Helen I; Yakubu, Sabo E; Audu, Patrick A; Galadima, Musa; Odama, Lillian E; Musa, Danjuma; Ado, Saleh A; Mamman, Mohammed

2013-01-01

Baseline and impact assessment data were generated in 1994 (n = 532) and 2011 (n = 593) from 6 sentinel villages with generalized onchocerciasis. Only volunteers and a cohort (n = 445, 75%) were screened at both visits. Each village had received 11 (64.7%) annual treatments and 92.6%, range 88.7-100%, treatment compliance. Overall mean number of treatment was 2.9 ± 1.6 with a range 2.0 ± 1.2-3.3 ± 0.6. Significant decreases in skin microfilaria prevalence from 201 (38%) to 0 (0%), palpable nodule from 77 (15%) to 4 (0.7%), dermal changes from 51 (9.6%) to 2 (0.04%), optic nerve disease from 24 (4.5%) to 4 (2.0%), and onchocercal inducible ocular lesions from 31 (5.8%) to 12 (2.0%) were recorded, P < 0.05, (t-test of unpaired data). Cases of glaucoma, 8 (1.4%), and blindness, 6 (1.05%), remained unchanged. Visual acuity ≥6/24 in one or both eyes, 198 (33.45%); cataract, 169 (28.5%); pterygium 157 (26.5%); and acute senilis, 165 (27.9%), were significantly increased and positively correlated with increase in age (R (2) = 0.898 - 0.949). Dissected parous Simulium damnosum caught (n = 222) were without infective third stage larva. Active onchocerciasis transmission seems halted despite varied compliance to long-term ivermectin treatment. We recommend continued surveillance and targeted treatment of controlled and hypoendemic areas.

Yaughan and Curriboo Plantations. Studies in Afro-American Archaeology,

DTIC Science & Technology

1983-04-01

ceramics pres- ent were produced by Indians instead of Blacks. Careful historical research was employed to control that variable. The third variable...studies without independ- ent controls over some classes of non -material variables. Historical archaeology offers the opportunity for controlling some of...these non -material variables. The non -material variables must be controlled so that attention can be focused on the archaeological data. Once models

Using Historical Data to Automatically Identify Air-Traffic Control Behavior

NASA Technical Reports Server (NTRS)

Lauderdale, Todd A.; Wu, Yuefeng; Tretto, Celeste

2014-01-01

This project seeks to develop statistical-based machine learning models to characterize the types of errors present when using current systems to predict future aircraft states. These models will be data-driven - based on large quantities of historical data. Once these models are developed, they will be used to infer situations in the historical data where an air-traffic controller intervened on an aircraft's route, even when there is no direct recording of this action.

11. Historic view of Building 100 control room, showing personnel ...

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

11. Historic view of Building 100 control room, showing personnel operating rocket engine test controls and observer watching activity from observation room. May 27, 1957. On file at NASA Plumbrook Research Center, Sandusky, Ohio. NASA photo number C-45020. - Rocket Engine Testing Facility, GRC Building No. 100, NASA Glenn Research Center, Cleveland, Cuyahoga County, OH

Bias from historical control groups used in orthodontic research: a meta-epidemiological study.

PubMed

Papageorgiou, Spyridon N; Koretsi, Vasiliki; Jäger, Andreas

2017-02-01

The validity of meta-analysis is dependent upon the quality of included studies. Here, we investigated whether the design of untreated control groups (i.e. source and timing of data collection) influences the results of clinical trials in orthodontic research. This meta-epidemiological study used unrestricted literature searching for meta-analyses in orthodontics including clinical trials with untreated control groups. Differences in standardized mean differences (ΔSMD) and their 95% confidence intervals (CIs) were calculated according to the untreated control group through multivariable random-effects meta-regression controlling for nature of the interventional group and study sample size. Effects were pooled with random-effects synthesis, followed by mixed-effect subgroup and sensitivity analyses. Studies with historical control groups reported deflated treatment effects compared to studies with concurrent control groups (13 meta-analyses; ΔSMD = -0.31; 95% CI = -0.53, -0.10; P = 0.004). Significant differences were found according to the type of historical control group (based either on growth study or clinical archive; 11 meta-analyses; ΔSMD = 0.40; 95% CI = 0.21, 0.59; P < 0.001). The use of historical control groups in orthodontic clinical research was associated with deflation of treatment effects, which was independent from whether the interventional group was prospective or retrospective and from the study's sample size. Caution is warranted when interpreting clinical studies with historical untreated control groups or when interpreting systematic reviews that include such studies. PROSPERO (CRD42015024179). None. © The Author 2016. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Propulsion Control Technology Development in the United States A Historical Perspective

NASA Technical Reports Server (NTRS)

Jaw, Link C.a; Garg, Sanjay

2005-01-01

This paper presents a historical perspective of the advancement of control technologies for aircraft gas turbine engines. The paper primarily covers technology advances in the United States in the last 60 years (1940 to approximately 2002). The paper emphasizes the pioneering technologies that have been tested or implemented during this period, assimilating knowledge and experience from industry experts, including personal interviews with both current and retired experts. Since the first United States-built aircraft gas turbine engine was flown in 1942, engine control technology has evolved from a simple hydro-mechanical fuel metering valve to a full-authority digital electronic control system (FADEC) that is common to all modern aircraft propulsion systems. At the same time, control systems have provided engine diagnostic functions. Engine diagnostic capabilities have also evolved from pilot observation of engine gauges to the automated on-board diagnostic system that uses mathematical models to assess engine health and assist in post-flight troubleshooting and maintenance. Using system complexity and capability as a measure, we can break the historical development of control systems down to four phases: (1) the start-up phase (1942 to 1949), (2) the growth phase (1950 to 1969), (3) the electronic phase (1970 to 1989), and (4) the integration phase (1990 to 2002). In each phase, the state-of-the-art control technology is described and the engines that have become historical landmarks, from the control and diagnostic standpoint, are identified. Finally, a historical perspective of engine controls in the last 60 years is presented in terms of control system complexity, number of sensors, number of lines of software (or embedded code), and other factors.

18. Historic plan of Building 100 control room. March 21, ...

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

18. Historic plan of Building 100 control room. March 21, 1956. NASA GRC drawing number CE-101736. (On file at NASA Glenn Research Center). - Rocket Engine Testing Facility, GRC Building No. 100, NASA Glenn Research Center, Cleveland, Cuyahoga County, OH

Best Practices for Use of Historical Control Data of Proliferative Rodent Lesions.

EPA Science Inventory

The Historical Control Data Working Group under the direction of the Scientific and Regulatory Policy Committee (SRPC) of the Society of Toxicologic Pathology (STP) was tasked with reviewing the current scientific practices, regulatory guidance and relevant literature pertaining ...

Standard care versus protocol based therapy for new onset Pseudomonas aeruginosa in cystic fibrosis.

PubMed

Mayer-Hamblett, Nicole; Rosenfeld, Margaret; Treggiari, Miriam M; Konstan, Michael W; Retsch-Bogart, George; Morgan, Wayne; Wagener, Jeff; Gibson, Ronald L; Khan, Umer; Emerson, Julia; Thompson, Valeria; Elkin, Eric P; Ramsey, Bonnie W

2013-10-01

The Early Pseudomonal Infection Control (EPIC) randomized trial rigorously evaluated the efficacy of different antibiotic regimens for eradication of newly identified Pseudomonas (Pa) in children with cystic fibrosis (CF). Protocol based therapy in the trial was provided based on culture positivity independent of symptoms. It is unclear whether outcomes observed in the clinical trial were different than those that would have been observed with historical standard of care driven more heavily by respiratory symptoms than culture positivity alone. We hypothesized that the incidence of Pa recurrence and hospitalizations would be significantly reduced among trial participants as compared to historical controls whose standard of care preceded the widespread adoption of tobramycin inhalation solution (TIS) as initial eradication therapy at the time of new isolation of Pa. Eligibility criteria from the trial were used to derive historical controls from the Epidemiologic Study of CF (ESCF) who received standard of care treatment from 1995 to 1998, before widespread availability of TIS. Pa recurrence and hospitalization outcomes were assessed over a 15-month time period. As compared to 100% of the 304 trial participants, only 296/608 (49%) historical controls received antibiotics within an average of 20 weeks after new onset Pa. Pa recurrence occurred among 104/298 (35%) of the trial participants as compared to 295/549 (54%) of historical controls (19% difference, 95% CI: 12%, 26%, P < 0.001). No significant differences in the incidence of hospitalization were observed between cohorts. Protocol-based antimicrobial therapy for newly acquired Pa resulted in a lower rate of Pa recurrence but comparable hospitalization rates as compared to a historical control cohort less aggressively treated with antibiotics for new onset Pa. © 2013 Wiley Periodicals, Inc.

Standard Care versus Protocol Based Therapy for New Onset Pseudomonas aeruginosa in Cystic Fibrosis

PubMed Central

Mayer-Hamblett, Nicole; Rosenfeld, Margaret; Treggiari, Miriam M.; Konstan, Michael W.; Retsch-Bogart, George; Morgan, Wayne; Wagener, Jeff; Gibson, Ronald L.; Khan, Umer; Emerson, Julia; Thompson, Valeria; Elkin, Eric P.; Ramsey, Bonnie W.

2014-01-01

Rationale The Early Pseudomonal Infection Control (EPIC) randomized trial rigorously evaluated the efficacy of different antibiotic regimens for eradication of newly identified Pseudomonas (Pa) in children with cystic fibrosis (CF). Protocol based therapy in the trial was provided based on culture positivity independent of symptoms. It is unclear whether outcomes observed in the clinical trial were different than those that would have been observed with historical standard of care driven more heavily by respiratory symptoms than culture positivity alone. We hypothesized that the incidence of Pa recurrence and hospitalizations would be significantly reduced among trial participants as compared to historical controls whose standard of care preceded the widespread adoption of tobramycin inhalation solution (TIS) as initial eradication therapy at the time of new isolation of Pa. Methods Eligibility criteria from the trial were used to derive historical controls from the Epidemiologic Study of CF (ESCF) who received standard of care treatment from 1995 to 1998, before widespread availability of TIS. Pa recurrence and hospitalization outcomes were assessed over a 15-month time period. Results As compared to 100% of the 304 trial participants, only 296/608 (49%) historical controls received antibiotics within an average of 20 weeks after new onset Pa. Pa recurrence occurred among 104/298 (35%) of the trial participants as compared to 295/549 (54%) of historical controls (19% difference, 95% CI: 12%, 26%, p<0.001). No significant differences in the incidence of hospitalization were observed between cohorts. Conclusions Protocol-based antimicrobial therapy for newly acquired Pa resulted in a lower rate of Pa recurrence but comparable hospitalization rates as compared to a historical control cohort less aggressively treated with antibiotics for new onset Pa. PMID:23818295

Reproductive health policy affecting low-income women: historical precedents and current need for social work action.

PubMed

Averitt Taylor, Jessica

2014-01-01

This article provides an overview of the historical arguments surrounding reproductive health policy and current policy initiatives. Because reproductive policy itself is a vast subject matter with sometimes blurry boundaries, the struggle concerning the advent of birth control is used to illustrate the historic complexities of policy affecting such a wide array of individuals. The battle over introduction of the birth control pill is pertinent because the very same arguments are used today in debates over reproductive health policy.

14. Historic view of engineer in Building 100 control room ...

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

14. Historic view of engineer in Building 100 control room examining data printout. 1957. On file at NASA Plumbrook Research Facility, Sandusky, Ohio. NASA photo number C-46210. - Rocket Engine Testing Facility, GRC Building No. 100, NASA Glenn Research Center, Cleveland, Cuyahoga County, OH

13. Historic view of Building 100 control room, showing personnel ...

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

13. Historic view of Building 100 control room, showing personnel with data recording instrumentation. 1957. On file at NASA Plumbrook Research Facility, Sandusky, Ohio. NASA photo number C-46211. - Rocket Engine Testing Facility, GRC Building No. 100, NASA Glenn Research Center, Cleveland, Cuyahoga County, OH

Iron homeostasis and eye disease

PubMed Central

Loh, Allison; Hadziahmetovic, Majda; Dunaief, Joshua L.

2009-01-01

Summary Iron is necessary for life, but excess iron can be toxic to tissues. Iron is thought to damage tissues primarily by generating oxygen free radicals through the Fenton reaction. We present an overview of the evidence supporting iron's potential contribution to a broad range of eye disease using an anatomical approach. Firstly, iron can be visualized in the cornea as iron lines in the normal aging cornea as well as in diseases like keratoconus and pterygium. In the lens, we present the evidence for the role of oxidative damage in cataractogenesis. Also, we review the evidence that iron may play a role in the pathogenesis of the retinal disease age-related macular degeneration. Although currently there is no direct link between excess iron and development of optic neuropathies, ferrous iron's ability to form highly reactive oxygen species may play a role in optic nerve pathology. Lastly, we discuss recent advances in prevention and therapeutics for eye disease with antioxidants and iron chelators,. PMID:19059309

Secondary nerve lengthening to obtain full knee extension in popliteal pterygium syndrome.

PubMed

Boeckx, Willy; Misani, Marta; Vandermeeren, Liesbeth; Franck, Diane; Zirak, Christophe; Demey, Albert

2014-05-01

Microsurgical nerve lengthening was performed in two siblings presenting a popliteal pterigium syndrome with a knee flexion contracture of 80 degrees. After the first attempt for nerve lengthening and knee extension elsewhere, a repeated lengthening was required due to continuing tip-toe walking and recurrent knee contracture at the age of 3 years. An extensive external and internal interfascicular microsurgical neurolysis resulted in a lengthening of the nerves. A full length of leg procedure had to be performed, inclusive of Achilles tendon lengthening to obtain a complete extension of the knee and a 90-degree ankle flexion. Maintaining the leg in a fully extended position was obtained with a dynamic splinting in the first month after the operation. When timing the operation we have to consider the importance of adequate precision of the microsurgical neurolysis, down to the identification of the Fontana bands, and the adequate postoperative splinting. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

15. Historic view of engineer in Building 100 control room ...

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

15. Historic view of engineer in Building 100 control room examining data printout. August 28, 1962. On file at NASA Plumbrook Research Facility, Sandusky, Ohio. NASA photo number C-61500. - Rocket Engine Testing Facility, GRC Building No. 100, NASA Glenn Research Center, Cleveland, Cuyahoga County, OH

Quasi-Experiments in Schools: The Case for Historical Cohort Control Groups

ERIC Educational Resources Information Center

Walser, Tamara M.

2014-01-01

There is increased emphasis on using experimental and quasi-experimental methods to evaluate educational programs; however, educational evaluators and school leaders are often faced with challenges when implementing such designs in educational settings. Use of a historical cohort control group design provides a viable option for conducting…

VIEW OF HISTORIC SLATE SWITCHBOARD IN THE CONTROL ROOM OF ...

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

VIEW OF HISTORIC SLATE SWITCHBOARD IN THE CONTROL ROOM OF THE ELWHA POWERHOUSE, INCLUDING: METERS, PROTECTIVE RELAYS, AND SWITCHES. NOTE ADDITION OF PERSONAL COMPUTERS FOR POWER METERING AND OPERATIONS. PHOTO BY JET LOWE, HAER, 1995. - Elwha River Hydroelectric System, Elwha Hydroelectric Dam & Plant, Port Angeles, Clallam County, WA

75 FR 21018 - Notice of Proposed Information Collection for Public Comment: Notice of Funding Availability for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-22

... Availability for the Historically Black Colleges and Universities (HBCU) Program. OMB Control Number: 2528-0235...-27300. Members of the Affected Public: Historically Black Colleges and Universities (HBCU). Estimation... Information Collection for Public Comment: Notice of Funding Availability for the Historically Black Colleges...

Strings Attached? Linking Historically Black Colleges and Universities Public Revenue Sources with Efficiency

ERIC Educational Resources Information Center

Coupet, Jason

2017-01-01

Historically Black Colleges and Universities (HBCUs), a set of US higher education institutions historically tasked with educating African-American students, receive both state and federal funding. However, state governments often assert operational control through the political process, potentially influencing how key resources are used. Do these…

76 FR 17444 - Notice of Inventory Completion: Colorado Historical Society (History Colorado), Denver, CO

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-29

...: Colorado Historical Society (History Colorado), Denver, CO AGENCY: National Park Service, Interior. ACTION... control of the Colorado Historical Society (History Colorado), Denver, CO. The human remains were removed... (History Colorado) professional staff in consultation with representatives of the Hopi Tribe of Arizona...

Historical climate controls soil respiration responses to current soil moisture.

PubMed

Hawkes, Christine V; Waring, Bonnie G; Rocca, Jennifer D; Kivlin, Stephanie N

2017-06-13

Ecosystem carbon losses from soil microbial respiration are a key component of global carbon cycling, resulting in the transfer of 40-70 Pg carbon from soil to the atmosphere each year. Because these microbial processes can feed back to climate change, understanding respiration responses to environmental factors is necessary for improved projections. We focus on respiration responses to soil moisture, which remain unresolved in ecosystem models. A common assumption of large-scale models is that soil microorganisms respond to moisture in the same way, regardless of location or climate. Here, we show that soil respiration is constrained by historical climate. We find that historical rainfall controls both the moisture dependence and sensitivity of respiration. Moisture sensitivity, defined as the slope of respiration vs. moisture, increased fourfold across a 480-mm rainfall gradient, resulting in twofold greater carbon loss on average in historically wetter soils compared with historically drier soils. The respiration-moisture relationship was resistant to environmental change in field common gardens and field rainfall manipulations, supporting a persistent effect of historical climate on microbial respiration. Based on these results, predicting future carbon cycling with climate change will require an understanding of the spatial variation and temporal lags in microbial responses created by historical rainfall.

Teaching the Meaning of the Second Amendment: A Brief Note on Recent Research.

ERIC Educational Resources Information Center

Oder, Broeck N.

1998-01-01

Provides a brief overview of historical and legal scholarship on gun control and the Second Amendment to the United States Constitution. Limits its scope to works by acknowledged legal and historical scholars, avoiding contemporary pro- and anti-gun-control opinion pieces. Includes a bibliography of further resources for teachers. (DSK)

Pregnancy prevention among American Indian men ages 18 to 24: the role of mental health and intention to use birth control.

PubMed

Rink, Elizabeth; FourStar, Kris; Medicine Elk, Jarrett; Dick, Rebecca; Jewett, Lacey; Gesink, Dionne

2012-01-01

The Fort Peck Sexual Health Project: A Contextual Analysis of Native American Men is a community-based participatory research (CBPR) project that explores the extent to which knowledge, attitudes, and beliefs about sex, intimate relationships, and mental health influence sexual and reproductive health. For the purpose of this study, the influence of age, fatherhood, and mental health factors related to historical trauma and loss on young American Indian (AI) men's intention to use birth control was examined. In-depth interviews were conducted with 112 Native American men between the ages of 18 and 24 years. The mean age reported was 21 years. Thirty-eight percent of the young men reported having children. The young men reported experiences of historical trauma during their lifetime as well as emotional responses due to historical losses. Ninety-five percent reported that it was very important that they use some form of birth control to prevent their partner from getting pregnant within the next year. Logistic regression analysis indicated that, as age increased, young men were less likely to use birth control to prevent pregnancy. The young men who reported feelings of loss due to experiences related to historical trauma and loss were more likely to use birth control. Findings from this study suggest that public health efforts to educate AI men about planned pregnancies and the use of birth control may be most effective in adolescence. Public health programs that address mental health concerns such as the emotional responses due to historical losses may assist young AI men in their decision to use birth control.

Archaeological and Historic Cultural Resources Inventory for a Flood Control Project at Halstad, Norman County, Minnesota.

DTIC Science & Technology

1982-05-21

2476 Prepared for: St. Paul District, Corps of Engineers St. Paul, Minnesota Prepared by: HISTORICAL AND ARCHAEOLOGICAL SURVEYS, INC. 1702 Dyke Avenue...HISTORICAL STUDIES . . 9 3. ENVIRONMENTAL SETTING . . . . . . . . . 15 3.1 Geology . . . . . . . . . . . 15 3.2 Soils . . . . . . . . . . . 16 3.3 Climate...Historical and archaeological data from HASI’s company library in Grand Forks, North Dakota, also were used in preparing overviews and in analysis

75 FR 1793 - Study Team for the Los Alamos Historical Document Retrieval and Assessment (LAHDRA) Project

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-13

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Study Team for the Los Alamos Historical Document Retrieval and Assessment (LAHDRA) Project The Centers for Disease... the following meeting. Name: Public Meeting of the Study Team for the Los Alamos Historical Document...

Lessons learned in command environment development

NASA Astrophysics Data System (ADS)

Wallace, Daniel F.; Collie, Brad E.

2000-11-01

As we consider the issues associated with the development of an Integrated Command Environment (ICE), we must obviously consider the rich history in the development of control rooms, operations centers, information centers, dispatch offices, and other command and control environments. This paper considers the historical perspective of control environments from the industrial revolution through the information revolution, and examines the historical influences and the implications that that has for us today. Environments to be considered are military command and control spaces, emergency response centers, medical response centers, nuclear reactor control rooms, and operations centers. Historical 'lessons learned' from the development and evolution of these environments will be examined to determine valuable models to use, and those to be avoided. What are the pitfalls? What are the assumptions that drive the environment design? Three case histories will be presented, examining (1) the control room of the Three Mile Island power plant, (2) the redesign of the US Naval Space Command operations center, and (3) a testbed for an ICE aboard a naval surface combatant.

Constructing the effect of alternative intervention strategies on historic epidemics.

PubMed

Cook, A R; Gibson, G J; Gottwald, T R; Gilligan, C A

2008-10-06

Data from historical epidemics provide a vital and sometimes under-used resource from which to devise strategies for future control of disease. Previous methods for retrospective analysis of epidemics, in which alternative interventions are compared, do not make full use of the information; by using only partial information on the historical trajectory, augmentation of control may lead to predictions of a paradoxical increase in disease. Here we introduce a novel statistical approach that takes full account of the available information in constructing the effect of alternative intervention strategies in historic epidemics. The key to the method lies in identifying a suitable mapping between the historic and notional outbreaks, under alternative control strategies. We do this by using the Sellke construction as a latent process linking epidemics. We illustrate the application of the method with two examples. First, using temporal data for the common human cold, we show the improvement under the new method in the precision of predictions for different control strategies. Second, we show the generality of the method for retrospective analysis of epidemics by applying it to a spatially extended arboreal epidemic in which we demonstrate the relative effectiveness of host culling strategies that differ in frequency and spatial extent. Some of the inferential and philosophical issues that arise are discussed along with the scope of potential application of the new method.

Infections and their control: a historical perspective Swb Newsom Infections and their control: a historical perspective Sage/Infection Prevention Society £17.95 235pp 9781849204538 1849204535 [Formula: see text].

PubMed

2010-10-27

BILL NEWSOM, an eminent, but now retired, medical microbiologist, provides a personal but engaging review of infections and our attempts to control them. it is a fascinating social history of what has become an essential service, and Newsom highlights the need to be aware of past struggles and avoid repeating mistakes.

The chemical characteristics of soil in control and experimentally thinned plots in mesic oak forests along a historical deposition gradient

Treesearch

Ralph E. J. Boerner; Elaine Kennedy Sutherland

1997-01-01

This study examined the variations in the chemical parameters of soils of seven forests located along a historical deposition gradient spanning 8.5° longitude from southern Illinois to central West Virginia. Four to six mature control plots were sampled on two of the sites, and two experimentally thinned and two control plots were sampled on the remaining five sites....

The research on regional conservation planning of urban historical and cultural areas based on GIS

NASA Astrophysics Data System (ADS)

Li, Shangli; Xu, Jian; Li, Qian

2017-06-01

With the rapid economic development and the growth of population happening in the urban historical and cultural areas, heritage and historical buildings along with their natural and artificial surrounding environments are suffering constructive destruction. Due to the lack of precise partition of protection region and construction control region in the local cultural relics protection law, traditional regional conservation planning cannot engaged with the urban controllability detailed planning very well. According to the several protection regulations about heritage and historical buildings from latest laws, we choose Baxian Temple area to study on the improvments of traditional regional conservation planning. The technical methods of this study mainly rely on GIS, which can complete the fundamental work of each stage. With the analytic hierarchy process(AHP), the comprehensive architectural value assessments can be calculated according to the investigation results. Based on the calculation results and visual corridor analysis, the precise range of protection region and construction control region can be decided and the specific protection measures can be formulated.

Historical climate controls soil respiration responses to current soil moisture

PubMed Central

Waring, Bonnie G.; Rocca, Jennifer D.; Kivlin, Stephanie N.

2017-01-01

Ecosystem carbon losses from soil microbial respiration are a key component of global carbon cycling, resulting in the transfer of 40–70 Pg carbon from soil to the atmosphere each year. Because these microbial processes can feed back to climate change, understanding respiration responses to environmental factors is necessary for improved projections. We focus on respiration responses to soil moisture, which remain unresolved in ecosystem models. A common assumption of large-scale models is that soil microorganisms respond to moisture in the same way, regardless of location or climate. Here, we show that soil respiration is constrained by historical climate. We find that historical rainfall controls both the moisture dependence and sensitivity of respiration. Moisture sensitivity, defined as the slope of respiration vs. moisture, increased fourfold across a 480-mm rainfall gradient, resulting in twofold greater carbon loss on average in historically wetter soils compared with historically drier soils. The respiration–moisture relationship was resistant to environmental change in field common gardens and field rainfall manipulations, supporting a persistent effect of historical climate on microbial respiration. Based on these results, predicting future carbon cycling with climate change will require an understanding of the spatial variation and temporal lags in microbial responses created by historical rainfall. PMID:28559315

[Intraoperative chemotherapy against peritoneal dissemination of gastric cancer with intraperitoneal activated carbon particles adsorbing mitomycin C].

PubMed

Hagiwara, A; Takahashi, T; Sawai, K; Yamaguchi, T; Iwamoto, A; Yoneyama, C

1989-02-01

For prevention and therapy of peritoneal dissemination, a new dosage from (MMC-CH) comprising carbon particles adsorbing mitomycin C was given to 44 patients (the MMC-CH group) undergoing gastrectomy for gastric cancer, of which advancing stage was classified into the category of H0, and S2 or S3, and P0, P1, P2 or P3 according to the General Rules for the Gastric Cancer Study. MMC-CH, principally at 50 mg person in terms of mitomycin C was administered intraperitoneally before the surgical wound was closed. Historical control group was composed of 53 patients not given MMC-CH, who underwent gastrectomy for gastric cancer in the same advancing stage as those of the 44 patients. There was statistically no significant difference of age, sex, depth of infiltration, macroscopically and microscopically defined progression of lymph-nodal metastases, between the MMC-CH group and the historical control group. The survival rate of the overall patients, and each group of the patients with the lesion defined as P0, P1, P2, or P3 was compared with Kaplan-Meier's method between the MMC-CH group and the historical control group. In the MMC-CH group, the survival rates of the overall patients and the patients with P0, P1, or P2 lesion were statistically significantly higher than those in the historical control group. However, the rate of the P3 patients in the MMC-CH group was statistically significantly lower than in the historical control group.

Traffic Predictive Control: Case Study and Evaluation

DOT National Transportation Integrated Search

2017-06-26

This project developed a quantile regression method for predicting future traffic flow at a signalized intersection by combining both historical and real-time data. The algorithm exploits nonlinear correlations in historical measurements and efficien...

VEMAP phase 2 bioclimatic database. I. Gridded historical (20th century) climate for modeling ecosystem dynamics across the conterminous USA

Treesearch

Timothy G.F. Kittel; Nan. A. Rosenbloom; J.A. Royle; C. Daly; W.P. Gibson; H.H. Fisher; P. Thornton; D.N. Yates; S. Aulenbach; C. Kaufman; R. McKeown; Dominque Bachelet; David S. Schimel

2004-01-01

Analysis and simulation of biospheric responses to historical forcing require surface climate data that capture those aspects of climate that control ecological processes, including key spatial gradients and modes of temporal variability. We developed a multivariate, gridded historical climate dataset for the conterminous USA as a common input database for the...

DEPRESSED AFFECT AND HISTORICAL LOSS AMONG NORTH AMERICAN INDIGENOUS ADOLESCENTS

PubMed Central

Whitbeck, Les B.; Walls, Melissa L.; Johnson, Kurt D.; Morrisseau, Allan D.; McDougall, Cindy M.

2011-01-01

This study reports on the prevalence and correlates of perceived historical loss among 459 North American Indigenous adolescents aged 11–13 years from the northern Midwest of the United States and central Canada. The adolescents reported daily or more thoughts of historical loss at rates similar to their female caretakers. Confirmatory factor analysis indicated that our measure of perceived historical loss and the Center for Epidemiologic Studies Depression scale were separate but related constructs. Regression analysis indicated that, even when controlling for family factors, perceived discrimination, and proximal negative life events, perceived historical loss had independent effects on adolescent’s depressive symptoms. The construct of historical loss is discussed in terms of Indigenous ethnic cleansing and life course theory. PMID:20052631

Depressed affect and historical loss among North American Indigenous adolescents.

PubMed

Whitbeck, Les B; Walls, Melissa L; Johnson, Kurt D; Morrisseau, Allan D; McDougall, Cindy M

2009-01-01

This study reports on the prevalence and correlates of perceived historical loss among 459 North American Indigenous adolescents aged 11-13 years from the northern Midwest of the United States and central Canada. The adolescents reported daily or more thoughts of historical loss at rates similar to their female caretakers. Confirmatory factor analysis indicated that our measure of perceived historical loss and the Center for Epidemiologic Studies Depression scale were separate but related constructs. Regression analysis indicated that, even when controlling for family factors, perceived discrimination, and proximal negative life events, perceived historical loss had independent effects on adolescents' depressive symptoms. The construct of historical loss is discussed in terms of Indigenous ethnic cleansing and life course theory.

Learning Historical Thinking with Oral History Interviews: A Cluster Randomized Controlled Intervention Study of Oral History Interviews in History Lessons

ERIC Educational Resources Information Center

Bertram, Christiane; Wagner, Wolfgang; Trautwein, Ulrich

2017-01-01

The present study examined the effectiveness of the oral history approach with respect to students' historical competence. A total of 35 ninth-grade classes (N = 900) in Germany were randomly assigned to one of four conditions--live, video, text, or a (nontreated) control group--in a pretest, posttest, and follow-up design. Comparing the three…

Using a stochastic model and cross-scale analysis to evaluate controls on historical low-severity fire regimes

Treesearch

Maureen C. Kennedy; Donald McKenzie

2010-01-01

Fire-scarred trees provide a deep temporal record of historical fire activity, but identifying the mechanisms therein that controlled landscape fire patterns is not straightforward. We use a spatially correlated metric for fire co-occurrence between pairs of trees (the Sørensen distance variogram), with output from a neutral model for fire history, to infer the...

Elder American Indian women's knowledge of pelvic floor disorders and barriers to seeking care.

PubMed

Dunivan, Gena C; Komesu, Yuko M; Cichowski, Sara B; Lowery, Christine; Anger, Jennifer T; Rogers, Rebecca G

2015-01-01

The objectives of this study are to evaluate urinary incontinence and pelvic organ prolapse knowledge among elder southwestern American Indian women and to assess barriers to care for pelvic floor disorders through community-engaged research. Our group was invited to provide an educational talk on urinary incontinence and pelvic organ prolapse at an annual meeting of American Indian elders. Female attendees aged 55 years or older anonymously completed demographic information and 2 validated questionnaires, the Prolapse and Incontinence Knowledge Questionnaire (PIKQ) and Barriers to Incontinence Care Seeking Questionnaire (BICS-Q). Questionnaire results were compared with historical controls from the original PIKQ and BICS-Q validation study. One hundred forty-four women completed the questionnaires. The mean age was 77.7 ± 9.1 years. The mean (SD) for PIKQ of urinary incontinence score was 6.6 (3.0) (similar to historic gynecology controls 6.8 [3.3], P = 0.49), and the mean (SD) for PIKQ on pelvic organ prolapse score was 5.4 (2.9) (better than historic gynecology controls 3.6 [3.2], P < 0.01). Barriers to care seeking reported by the elder women were highest on the BICS-Q subscales of "cost" and "inconvenience." Urinary incontinence knowledge is similar to historic gynecology controls, and pelvic organ prolapse knowledge is higher than historic gynecology controls among elder southwestern American Indian women. American Indian elder women report high levels of barriers to care. The greatest barriers to care seeking for this population were related to cost and inconvenience, reflecting the importance of assessing socioeconomic status when investigating barriers to care. Addressing these barriers may enhance care-seeking southwestern American Indian women.

National Historic Preservation Act (NHPA) Section 106 Process: Florence Copper, Inc. (FCI)

EPA Pesticide Factsheets

Collection of National Historic Preservation Act (NHPA) documents relating to Public Notice of Intent to Issue a Class III Underground Injection Control Area Permit for Florence Copper, Inc. (FCI) - Florence, AZ (closed)

CDC Releases Report on 30-Year Low in Youth Homicide Rates

MedlinePlus

... CDC Newsroom Share Compartir This page is a historical archive and is no longer maintained. For current ... site? Print Updates Subscribe Listen This is a Historical Document Content source: Centers for Disease Control and ...

32. HISTORIC VIEW OF GERMAN ROCKET SOCIETY VETERAN KURT HEINISCH ...

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

32. HISTORIC VIEW OF GERMAN ROCKET SOCIETY VETERAN KURT HEINISCH IN CONTROL ROOM AT TEST STAND NO. 1, PEENEMUENDE. - Marshall Space Flight Center, Redstone Rocket (Missile) Test Stand, Dodd Road, Huntsville, Madison County, AL

Evaluation of Marine Corps Manpower Computer Simulation Model

DTIC Science & Technology

2016-12-01

merit- based promotion selection that is in conjunction with the “up or out” manpower system. To ensure mission accomplishment within M&RA, it is...historical data the MSM pulls from an online Oracle database. Two types of data base pulls occur here: acquiring historical data of manpower pyramid...is based off of the assumption that the historical manpower progression is constant, and therefore is controllable. This unfortunately does not marry

41 CFR 102-83.105 - What happens if there is no available space in non-historic buildings under the custody and...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What happens if there is no available space in non-historic buildings under the custody and control of the U.S. Postal Service... Space Urban Areas § 102-83.105 What happens if there is no available space in non-historic buildings...

The influence of prophylactic proton pump inhibitor treatment on the development of symptomatic marginal ulceration in Roux-en-Y gastric bypass patients: a historic cohort study.

PubMed

Coblijn, Usha K; Lagarde, Sjoerd M; de Castro, Steve M M; Kuiken, Sjoerd D; van Tets, Willem F; van Wagensveld, Bart A

2016-02-01

Marginal ulceration at the gastrojejunostomy is a serious complication after laparoscopic Roux-en-Y gastric bypass surgery (LRYGB) and occurs in 1%-16% of patients. Proton pump inhibitors (PPIs) might lower the occurrence of these ulcers. The aim of the present study was to evaluate the effect of 6 months prophylactic usage of PPIs on the development of marginal ulceration and compare this with a historic patient control group. A single institution cohort at a bariatric center of excellence, The Sint Lucas Andreas Zienkenhuis, Amsterdam A consecutive database of patients who underwent LRYGB from November 2007 to September 2012 in a single institution was retrospectively reviewed. From August 2011, patients received a standard dose of pantozol 40 mg once daily directly postoperatively for 6 months. No standard PPI prophylaxis was administered before August 2011, and the patients not using PPIs in this historic cohort served as the control group. A total of 610 patients underwent LRYGB, of which 128 patients (21.0%) underwent revisional surgery. Postoperative PPIs were administered in the intervention group of 337 patients, compared with the historic control group consisting of 273 patients. Six patients (1.2%) who received postoperative PPIs versus 20 patients (7.3 %) in the historic control group developed marginal ulceration (P = .001). Patients using proton pump inhibitors developed fewer gastrointestinal complaints postoperatively (P< .001). Routine usage of PPIs reduced the occurrence of marginal ulceration after LRYGB. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Sexual selection under parental choice: evidence from sixteen historical societies.

PubMed

Apostolou, Menelaos

2012-08-11

Asymmetrical fitness benefits between parents and offspring result in the ideal spouse not being the ideal in-law. This enables parents to attempt to control the mating behavior of their children, and when they succeed, parental choice becomes a primary sexual selection force. A number of studies indicate that parental choice is dominant in contemporary pre-industrial societies. This paper presents evidence from the historical record which indicates that parental choice was also dominant during the later stages of human evolution. More specifically, 40 variables have been coded for a sample of 16 historical societies. Consistent with the model of parental choice, it is found that mating is controlled by parents, male parents exercise more control over marriage arrangements than females, and more control is exercised over female than male offspring. Finally, the specific qualities that parents desire in an in-law and offspring desire in a spouse have also been identified. The implications of these findings are discussed.

Low cortical bone density measured by computed tomography in children and adolescents with untreated hyperthyroidism.

PubMed

Numbenjapon, Nawaporn; Costin, Gertrude; Gilsanz, Vicente; Pitukcheewanont, Pisit

2007-05-01

To determine whether increased thyroid hormones levels have an effect on various bone components (cortical vs cancellous bone). The anthropometric and 3-dimensional quantitative computed tomography (CT) bone measurements, including bone density (BD), cross-sectional area (CSA) of the lumbar spine and femur, and cortical bone area (CBA) of the femur, of 18 children and adolescents with untreated hyperthyroidism were reviewed and compared with those of age-, sex-, and ethnicity-matched historical controls. No significant differences in height, weight, body mass index (BMI), or pubertal staging between patients and controls were found. Cortical BD was significantly lower (P < .001) in children and adolescents with hyperthyroidism compared with historical controls. After adjusting for weight and height, no difference in femur CSA between hyperthyroid children and historical controls was evident. No significant correlations among thyroid hormone levels, antithyroid antibody levels, and cortical BD values were found. As determined by CT, cortical bone is the preferential site of bone loss in children and adolescents with untreated hyperthyroidism.

Impact of prescription drug-monitoring program on controlled substance prescribing in the ED.

PubMed

McAllister, Matthew W; Aaronson, Patrick; Spillane, Joe; Schreiber, Mark; Baroso, Genelyn; Kraemer, Dale; Smotherman, Carmen; Gray-Eurom, Kelly

2015-06-01

In 2009, Florida initiated a statewide prescription drug-monitoring program (PDMP) to encourage safer prescribing of controlled substances and reduce drug abuse and diversion. Data supporting the utility of such programs in the emergency department (ED) is scarce. This study sought to determine the effect of PDMP data on controlled substance prescribing from the ED. In this pre-post study utilizing a historical control, pharmacists in the ED provided prescribers with a summary of the PDMP data for their patients. The number of controlled substances prescribed in the intervention group was compared with that prescribed in the historical control to determine if the intervention resulted in a change in the average number of controlled substance prescribed. Among the 710 patients evaluated, providing prescribers with PDMP data did not alter the average number of controlled substance per patient prescribed (0.23 controlled substances per patient in the historical control compared with 0.28 controlled substances per patient in the intervention group; 95% confidence interval [CI], -0.016 to 0.116; P = .125). All prescribers surveyed indicated that having PDMP data altered their controlled substance prescribing and felt more comfortable prescribing controlled substances. Although the results did not demonstrate a change in the average number of controlled substances prescribed when prescribers were provided with PDMP data, results from the survey indicate that prescribers felt the data altered their prescribing of controlled substances, and thus were more contented prescribing controlled substances. Copyright © 2015 Elsevier Inc. All rights reserved.

Nonlinear control systems - A brief overview of historical and recent advances

NASA Astrophysics Data System (ADS)

Iqbal, Jamshed; Ullah, Mukhtar; Khan, Said Ghani; Khelifa, Baizid; Ćuković, Saša

2017-12-01

Last five decades witnessed remarkable developments in linear control systems and thus problems in this subject has been largely resolved. The scope of the present paper is beyond linear solutions. Modern technology demands sophisticated control laws to meet stringent design specifications thus highlighting the increasingly conspicuous position of nonlinear control systems, which is the topic of this paper. Historical role of analytical concepts in analysis and design of nonlinear control systems is briefly outlined. Recent advancements in these systems from applications perspective are examined with critical comments on associated challenges. It is anticipated that wider dissemination of this comprehensive review will stimulate more collaborations among the research community and contribute to further developments.

Airborne Operations in World War II, European Theater

DTIC Science & Technology

1956-09-01

GARDEN Gee Hamilcar HANDS UP Formation usually composed of two or more elements and roughly equivalent to a squadron Forward Visual Control Post Ground...USAF HISTORICAL STUDIES: NO. 97 AIRBORNE OPERATIONS IN WORLD WAR II, EUROPEAN THEATER By Dr. John C. Warren USAF Historical Division Research Studies...OMB control number. 1. REPORT DATE SEP 1956 2. REPORT TYPE 3. DATES COVERED - 4. TITLE AND SUBTITLE Airborne Operations in World War II 5a

Improving Operational Acceptability of Dynamic Weather Routes Through Analysis of Commonly Use Routings

NASA Technical Reports Server (NTRS)

Evans, Antony D.; Sridhar, Banavar; McNally, David

2016-01-01

The Dynamic Weather Routes (DWR) tool is a ground-based trajectory automation system that continuously and automatically analyzes active in-flight aircraft in en route airspace to find simple modifications to flight plan routes that can save significant flying time, while avoiding weather and considering traffic conflicts, airspace sector congestion, special use airspace, and FAA routing restrictions. Trials of the DWR system have shown that significant delay savings are possible. However, some DWR advised routes are also rejected by dispatchers or modified before being accepted. Similarly, of those sent by dispatchers to flight crews as proposed route change requests, many are not accepted by air traffic control, or are modified before implementation as Center route amendments. Such actions suggest that the operational acceptability of DWR advised route corrections could be improved, which may reduce workload and increase delay savings. This paper analyzes the historical usage of different flight routings, varying from simple waypoint pairs to lengthy strings of waypoints incorporating jet routes, in order to improve DWR route acceptability. An approach is developed that can be incorporated into DWR, advising routings with high historical usage and savings potential similar to that of the nominal DWR advisory. It is hypothesized that modifying a nominal DWR routing to one that is commonly used, and nearby, will result in more actual savings since common routings are generally familiar and operationally acceptable to air traffic control. The approach allows routing segments with high historical usage to be concatenated to form routes that meet all DWR constraints. The relevance of a route's historical usage to its acceptance by dispatchers and air traffic control is quantified by analyzing historical DWR data. Results indicate that while historical usage may be less of a concern to flight dispatchers accepting or rejecting DWR advised route corrections, it may be important to air traffic control acceptance of DWR routes.

A method to characterise site, urban and regional ambient background radiation.

PubMed

Passmore, C; Kirr, M

2011-03-01

Control dosemeters are routinely provided to customers to monitor the background radiation so that it can be subtracted from the gross response of the dosemeter to arrive at the occupational dose. Landauer, the largest dosimetry processor in the world with subsidiaries in Australia, Brazil, China, France, Japan, Mexico and the UK, has clients in approximately 130 countries. The Glenwood facility processes over 1.1 million controls per year. This network of clients around the world provides a unique ability to monitor the world's ambient background radiation. Control data can be mined to provide useful historical information regarding ambient background rates and provide a historical baseline for geographical areas. Historical baseline can be used to provide site or region-specific background subtraction values, document the variation in ambient background radiation around a client's site or provide a baseline for measuring the efficiency of clean-up efforts in urban areas after a dirty bomb detonation.

Designing a SCADA system simulator for fast breeder reactor

NASA Astrophysics Data System (ADS)

Nugraha, E.; Abdullah, A. G.; Hakim, D. L.

2016-04-01

SCADA (Supervisory Control and Data Acquisition) system simulator is a Human Machine Interface-based software that is able to visualize the process of a plant. This study describes the results of the process of designing a SCADA system simulator that aims to facilitate the operator in monitoring, controlling, handling the alarm, accessing historical data and historical trend in Nuclear Power Plant (NPP) type Fast Breeder Reactor (FBR). This research used simulation to simulate NPP type FBR Kalpakkam in India. This simulator was developed using Wonderware Intouch software 10 and is equipped with main menu, plant overview, area graphics, control display, set point display, alarm system, real-time trending, historical trending and security system. This simulator can properly simulate the principle of energy flow and energy conversion process on NPP type FBR. This SCADA system simulator can be used as training media for NPP type FBR prospective operators.

Genetic adaptation to historical pathogen burdens.

PubMed

Fedderke, Johannes W; Klitgaard, Robert E; Napolioni, Valerio

2017-10-01

Historical pathogen burdens are examined as possible triggers for genetic adaptation. Evidence of adaptation emerges for the acid phosphatase locus 1 (ACP1), interleukin-6 (IL6), interleukin-10 (IL10 ), human leukocyte antigen (HLA) polymorphisms, along with a measure of heterozygosity over 783 alleles. Results are robust to controlling for the physical and historical environment humans faced, and to endogeneity of the historical pathogen burden measure. The present study represents a proof-of-concept which may pave the way to the analysis of future aggregate measures coming from whole-genome sequencing/genotyping data. Copyright © 2017 Elsevier B.V. All rights reserved.

Down-regulation of Pax6 is associated with abnormal differentiation of corneal epithelial cells in severe ocular surface diseases

PubMed Central

Li, W; Chen, Y-T; Hayashida, Y; Blanco, G; Kheirkah, A; He, H; Chen, S-Y; Liu, C-Y; Tseng, SCG

2010-01-01

Pax6 is the universal master control gene for eye morphogenesis. Other than retina and lens, Pax6 also expressed in the ocular surface epithelium from early gestation until the postnatal stage, in which little is known about the function of Pax6. In this study, corneal pannus tissues from patients with ocular surface diseases such as Stevens–Johnson syndrome (SJS), chemical burn, aniridia and recurrent pterygium were investigated. Our results showed that normal ocular surface epithelial cells expressed Pax6. However, corneal pannus epithelial cells from the above patients showed a decline or absence of Pax6 expression, accompanied by a decline or absence of K12 keratin but an increase of K10 keratin and filaggrin expression. Pannus basal epithelial cells maintained nuclear p63 expression and showed activated proliferation, evidenced by positive Ki67 and K16 keratin staining. On 3T3 fibroblast feeder layers, Pax6 immunostaining was negative in clones generated from epithelial cells harvested from corneal pannus from SJS or aniridia, but positive in those from the normal limbal epithelium; whereas western blots showed that some epithelial clones expanded from pannus retained Pax6 expression. Transient transfection of an adenoviral vector carrying EGFP–Pax6 transgenes into these Pax6− clones increased both Pax6 and K12 keratin expression. These results indicate that Pax6 helps to maintain the normal corneal epithelial phenotype postnatally, and that down-regulation of Pax6 is associated with abnormal epidermal differentiation in severe ocular surface diseases. Reintroduction of activation of the Pax6 gene might be useful in treating squamous metaplasia of the ocular surface epithelium. PMID:18027901

Efficacy of induction therapy with ATG and intravenous immunoglobulins in patients with low-level donor-specific HLA-antibodies.

PubMed

Bächler, K; Amico, P; Hönger, G; Bielmann, D; Hopfer, H; Mihatsch, M J; Steiger, J; Schaub, S

2010-05-01

Low-level donor-specific HLA-antibodies (HLA-DSA) (i.e. detectable by single-antigen flow beads, but negative by complement-dependent cytotoxicity crossmatch) represent a risk factor for early allograft rejection. The short-term efficacy of an induction regimen consisting of polyclonal anti-T-lymphocyte globulin (ATG) and intravenous immunoglobulins (IvIg) in patients with low-level HLA-DSA is unknown. In this study, we compared 67 patients with low-level HLA-DSA not having received ATG/IvIg induction (historic control) with 37 patients, who received ATG/IvIg induction. The two groups were equal regarding retransplants, HLA-matches, number and class of HLA-DSA. The overall incidence of clinical/subclinical antibody-mediated rejection (AMR) was lower in the ATG/IvIg than in the historic control group (38% vs. 55%; p = 0.03). This was driven by a significantly lower rate of clinical AMR (11% vs. 46%; p = 0.0002). Clinical T-cell-mediated rejection (TCR) was significantly lower in the ATG/IvIg than in the historic control group (0% vs. 50%; p < 0.0001). Within the first year, allograft loss due to AMR occurred in 7.5% in the historic control and in 0% in the ATG/IvIg group. We conclude that in patients with low-level HLA-DSA, ATG/IvIg induction significantly reduces TCR and the severity of AMR, but the high rate of subclinical AMR suggests an insufficient control of the humoral immune response.

88. Photographic copy of historic photo, June 25, 1930 (original ...

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

88. Photographic copy of historic photo, June 25, 1930 (original print filed in Record Group 115, National Archives, Washington, D.C.). CEMENT AGGREGATE AND WATER CONTROLS AT OWYHEE DAM MIXING PLANT. - Owyhee Dam, Across Owyhee River, Nyssa, Malheur County, OR

Allelic distribution of human leucocyte antigen in historical and recently diagnosed tuberculosis patients in Southern Italy.

PubMed

Ruggiero, Giuseppina; Cosentini, Elena; Zanzi, Delia; Sanna, Veronica; Terrazzano, Giuseppe; Matarese, Giuseppe; Sanduzzi, Alessandro; Perna, Francesco; Zappacosta, Serafino

2004-03-01

This study addresses the analysis of the human leucocyte antigen (HLA) allele distribution in 54 historical and in 68 recently diagnosed tuberculosis (TB) patients. The historical cohort was characterized by the presence of large fibrocavernous lesions effectively treated with therapeutic pneumothorax during the period 1950-55. Patients and healthy controls enrolled in the study were from the Campania region of southern Italy. No significant association between HLA alleles and TB in the population of recently diagnosed TB patients was observed. On the contrary, among the historical TB patients there was a strong association with an increased frequency of the HLA-DR4 allele alone and/or in the presence of the HLA-B14 allele (P = 0.000004; Pc = 0.0008), as well as with a decreased frequency of the HLA-A2+,-B14-,DR4- allele association (P = 0.00005; Pc = 0.01). In order to exclude any interference from age-related factors, these results were confirmed by comparing the historical cohort of TB patients with an age-matched healthy control population of the same ethnic origin (P = 0.00004; Pc = 0.008; and P = 0.0001; and Pc = 0.02, respectively).

Desert Talons: Historical Perspectives and Implications of Air Policing in the Middle East

DTIC Science & Technology

2009-04-01

predominant role in support of a smaller ground force has historical precedent. During the 1920s, the Royal Air Forces (RAF) air control method adhered...the Royal Air Force’s (RAF) air control method adhered to the concepts of the inverted blockade, minimum force, precision targeting, and force...owing to its process of rapid communications, Air Methods are, in short, the reverse of the old punitive column. Our policy is one of prevention

Feature-based registration of historical aerial images by Area Minimization

NASA Astrophysics Data System (ADS)

Nagarajan, Sudhagar; Schenk, Toni

2016-06-01

The registration of historical images plays a significant role in assessing changes in land topography over time. By comparing historical aerial images with recent data, geometric changes that have taken place over the years can be quantified. However, the lack of ground control information and precise camera parameters has limited scientists' ability to reliably incorporate historical images into change detection studies. Other limitations include the methods of determining identical points between recent and historical images, which has proven to be a cumbersome task due to continuous land cover changes. Our research demonstrates a method of registering historical images using Time Invariant Line (TIL) features. TIL features are different representations of the same line features in multi-temporal data without explicit point-to-point or straight line-to-straight line correspondence. We successfully determined the exterior orientation of historical images by minimizing the area formed between corresponding TIL features in recent and historical images. We then tested the feasibility of the approach with synthetic and real data and analyzed the results. Based on our analysis, this method shows promise for long-term 3D change detection studies.

Digitalizing historical high resolution water level data: Challenges and opportunities

NASA Astrophysics Data System (ADS)

Holinde, Lars; Hein, Hartmut; Barjenbruch, Ulrich

2017-04-01

Historical tide-gauge data offer the opportunities for determining variations in key characteristics for water level data and the analyses of past extreme events (storm surges). These information are important for calculating future trends and scenarios. But there are challenges involved due to the extensive effort needed to digitalize gauge sheets and quality control the resulting historical data. Based on these conditions, two main sources for inaccuracies in historical time series can be identified. First are several challenges due to the digitalization of the historical data, e.g. general quality of the sheets, multiple crossing lines of the observed water levels and additional comments on the sheet describing problems or additional information during the measurements. Second are problems during the measurements themselves. These can include the incorrect positioning of the sheets, trouble with the tide-gauge and maintenance. Errors resulting from these problems can be e.g. flat lines, discontinuities and outlier. Especially, the characterization of outliers has to be conducted carefully, to distinguish between real outliers and the appearance of extreme events. Methods for the quality control process involve the use of statistics, machine learning and neural networks. These will be described and applied to three different time series from tide gauge stations at the cost of Lower Saxony, Germany. Resulting difficulties and outcomes of the quality control process will be presented and explained. Furthermore, we will present a first glance at analyses for these time series.

Triage and optimization: A new paradigm in the treatment of massive pulmonary embolism.

PubMed

Pasrija, Chetan; Shah, Aakash; George, Praveen; Kronfli, Anthony; Raithel, Maxwell; Boulos, Francesca; Ghoreishi, Mehrdad; Bittle, Gregory J; Mazzeffi, Michael A; Rubinson, Lewis; Gammie, James S; Griffith, Bartley P; Kon, Zachary N

2018-04-07

Massive pulmonary embolism (PE) remains a highly fatal condition. Although venoarterial extracorporeal membrane oxygenation (VA-ECMO) and surgical pulmonary embolectomy in the management of massive PE have been reported previously, the outcomes remain less than ideal. We hypothesized that the institution of a protocolized approach of triage and optimization using VA-ECMO would result in improved outcomes compared with historical surgical management. All patients with a massive PE referred to the cardiac surgery service between 2010 and 2017 were retrospectively reviewed. Patients were stratified by treatment strategy: historical control versus the protocolized approach. In the historical control group, the primary intervention was surgical pulmonary embolectomy. In the protocol approach group, patients were treated based on an algorithmic approach using VA-ECMO. The primary outcome was 1-year survival. A total of 56 patients (control, n = 27; protocol, n = 29) were identified. All 27 patients in the historical control group underwent surgical pulmonary embolectomy, whereas 2 of 29 patients in the protocol approach group were deemed appropriate for direct surgical pulmonary embolectomy. The remaining 27 patients were placed on VA-ECMO. In the protocol approach group, 15 of 29 patients were treated with anticoagulation alone and 14 patients ultimately required surgical pulmonary embolectomy. One-year survival was significantly lower in the historical control group compared with the protocol approach group (73% vs 96%; P = .02), with no deaths occurring after surgical pulmonary embolectomy in the protocol approach group. A protocolized strategy involving the aggressive institution of VA-ECMO appears to be an effective method to triage and optimize patients with massive PE to recovery or intervention. Implementation of this strategy rather than an aggressive surgical approach may reduce the mortality associated with massive PE. Copyright © 2018 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Historical Review of Environmental Education in China

ERIC Educational Resources Information Center

Qing, Tian

2004-01-01

This article presents the historical review of environmental education in China. As China's economy began to grow, environmental pollution and ecological destruction initially appeared locally in the early 1980s. These local environmental issues were primarily managed and controlled by state and local environmental protection agencies. In…

Historical and Future Trends in Global Source-receptor Relationships of Mercury

NASA Astrophysics Data System (ADS)

Chen, L.; Zhang, W.; Wang, X.

2017-12-01

Growing concerns about the risk associated with increasing environmental Mercury (Hg) levels have resulted in a focus on the relationships between intercontinental emitted and accumulated Hg. We use a global biogeochemical Hg model with eight continental regions and a global ocean to evaluate the legacy impacts of historical anthropogenic releases (2000 BC to 2008 AD) on global source-receptor relationships of Hg. The legacy impacts of historical anthropogenic releases are confirmed to be significant on the source-receptor relationships according to our results. Historical anthropogenic releases from Asia account for 8% of total soil Hg in North America, which is smaller than the proportion ( 17%) from previous studies. The largest contributors to the global oceanic Hg are historical anthropogenic releases from North America (26%), Asia (16%), Europe (14%) and South America (14%). Although anthropogenic releases from Asia have exceeded North America since the 1970s, source contributions to global Hg receptors from Asia have not exceeded North America so far. Future projections indicate that if Hg emissions are not effectively controlled, Asia will exceed North America as the largest contributor to the global ocean in 2019 and this has a long-term adverse impact on the future environment. For the Arctic Ocean, historical anthropogenic release from North America contributes most to the oceanic Hg reservoir and future projections reveal that the legacy impacts of historical releases from mid-latitudes would lead to the potential of rising Hg in the Arctic Ocean in the future decades, which calls for more effective Hg controls on mid-latitude releases.

Historical and future trends in global source-receptor relationships of mercury.

PubMed

Chen, Long; Zhang, Wei; Zhang, Yanxu; Tong, Yindong; Liu, Maodian; Wang, Huanhuan; Xie, Han; Wang, Xuejun

2018-01-01

Growing concern about the risk associated with increasing environmental mercury (Hg) concentrations has resulted in a focus on the relationships between intercontinental emitted and accumulated Hg. We use a global biogeochemical Hg model with 8 continental regions and a global ocean to evaluate the legacy impacts of historical anthropogenic releases (2000BCE to 2008AD) on global source-receptor relationships of Hg. Legacy impacts of historical anthropogenic releases are confirmed to be significant on the source-receptor relationships according to our results. Historical anthropogenic releases from Asia account for 8% of total soil Hg in North America, which is smaller than the proportion (~17%) from previous studies. The largest contributors to the global oceanic Hg are historical anthropogenic releases from North America (26%), Asia (16%), Europe (14%) and South America (14%). Although anthropogenic releases from Asia have exceeded North America since the 1970s, source contributions to global Hg receptors from Asia have not exceeded North America so far. Future projections indicate that if Hg emissions are not effectively controlled, Asia will exceed North America as the largest contributor to the global ocean in 2019 and this has a long-term adverse impact on the future environment. For the Arctic Ocean, historical anthropogenic release from North America contributes most to the oceanic Hg reservoir and future projections reveal that the legacy impacts of historical releases from mid-latitudes would lead to the potential of rising Hg in the Arctic Ocean in the future decades, which calls for more effective Hg controls on mid-latitude releases. Copyright © 2017 Elsevier B.V. All rights reserved.

40 CFR 798.5460 - Rodent heritable translocation assays.

Code of Federal Regulations, 2010 CFR

2010-07-01

... treatment and control groups. (4) Control groups—(i) Concurrent controls. No concurrent positive or negative... control groups. Historical or concurrent controls shall be specified, as well as the randomization... SUBSTANCES CONTROL ACT (CONTINUED) HEALTH EFFECTS TESTING GUIDELINES Genetic Toxicity § 798.5460 Rodent...

40 CFR 798.5460 - Rodent heritable translocation assays.

Code of Federal Regulations, 2013 CFR

2013-07-01

... treatment and control groups. (4) Control groups—(i) Concurrent controls. No concurrent positive or negative... control groups. Historical or concurrent controls shall be specified, as well as the randomization... SUBSTANCES CONTROL ACT (CONTINUED) HEALTH EFFECTS TESTING GUIDELINES Genetic Toxicity § 798.5460 Rodent...

40 CFR 798.5460 - Rodent heritable translocation assays.

Code of Federal Regulations, 2012 CFR

2012-07-01

... treatment and control groups. (4) Control groups—(i) Concurrent controls. No concurrent positive or negative... control groups. Historical or concurrent controls shall be specified, as well as the randomization... SUBSTANCES CONTROL ACT (CONTINUED) HEALTH EFFECTS TESTING GUIDELINES Genetic Toxicity § 798.5460 Rodent...

40 CFR 798.5460 - Rodent heritable translocation assays.

Code of Federal Regulations, 2011 CFR

2011-07-01

... treatment and control groups. (4) Control groups—(i) Concurrent controls. No concurrent positive or negative... control groups. Historical or concurrent controls shall be specified, as well as the randomization... SUBSTANCES CONTROL ACT (CONTINUED) HEALTH EFFECTS TESTING GUIDELINES Genetic Toxicity § 798.5460 Rodent...

40 CFR 798.5460 - Rodent heritable translocation assays.

Code of Federal Regulations, 2014 CFR

2014-07-01

... treatment and control groups. (4) Control groups—(i) Concurrent controls. No concurrent positive or negative... control groups. Historical or concurrent controls shall be specified, as well as the randomization... SUBSTANCES CONTROL ACT (CONTINUED) HEALTH EFFECTS TESTING GUIDELINES Genetic Toxicity § 798.5460 Rodent...

Residual Effects of Fertilization History Increase Nitrous Oxide Emissions from Zero-N Controls: Implications for Estimating Fertilizer-Induced Emission Factors.

PubMed

LaHue, Gabriel T; van Kessel, Chris; Linquist, Bruce A; Adviento-Borbe, Maria Arlene; Fonte, Steven J

2016-09-01

Agricultural N fertilization is the dominant driver of increasing atmospheric nitrous oxide (NO) concentrations over the past half-century, yet there is considerable uncertainty in estimates of NO emissions from agriculture. Such estimates are typically based on the amount of N applied and a fertilizer-induced emission factor (EF), which is calculated as the difference in emissions between a fertilized plot and a zero-N control plot divided by the amount of N applied. A fertilizer-induced EF of 1% is currently recognized by the Intergovernmental Panel on Climate Change (IPCC) based on several studies analyzing published field measurements of NO emissions. Although many zero-N control plots used in these measurements received historical N applications, the potential for a residual impact of these inputs on NO emissions has been largely ignored and remains poorly understood. To address this issue, we compared NO emissions under laboratory conditions from soils sampled within zero-N control plots that had historically received N inputs versus soils from plots that had no N inputs for 20 yr. Historical N fertilization of zero-N control plots increased initial NO emissions by roughly one order of magnitude on average relative to historically unfertilized control plots. Higher NO emissions were positively correlated with extractable N and potentially mineralizable N. This finding suggests that accounting for fertilization history may help reduce the uncertainty associated with the IPCC fertilizer-induced EF and more accurately estimate the contribution of fertilizer N to agricultural NO emissions, although further research to demonstrate this relationship in the field is needed. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

Commentary on: Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research

PubMed Central

Van Der Linden, Martial

2015-01-01

This commentary proposes a complementary perspective to that developed by Billieux, Schimmenti, Khazaal, Maurage and Heeren (2015). The addiction-as-disease approach tends to sideline explanatory factors of a psychosocial, cultural, political, or historical nature. I therefore suggest taking into account not only the personal characteristics (loss of self-control, impulsivity) related to the disease model, but also the social determinants of addictive behaviors (weak social ties, social exclusion, hyperindividualism, poverty, unemployment, etc.). Moreover, the disease model of addiction removes addictive behaviors from the cultural and historical contexts that shape them. I argue that the cultural and historical reasons for which certain factors (such as loss of self-control) became so important in the explanation of addictive behaviors should be more thoroughly considered. PMID:26551902

Vehicle and positive control values from the in vivo rodent comet assay and biomonitoring studies using human lymphocytes: historical database and influence of technical aspects.

PubMed

Pant, Kamala; Springer, S; Bruce, S; Lawlor, T; Hewitt, N; Aardema, M J

2014-10-01

There is increased interest in the in vivo comet assay in rodents as a follow-up approach for determining the biological relevance of chemicals that are genotoxic in in vitro assays. This is partly because, unlike other assays, DNA damage can be assessed in this assay in virtually any tissue. Since background levels of DNA damage can vary with the species, tissue, and cell processing method, a robust historical control database covering multiple tissues is essential. We describe extensive vehicle and positive control data for multiple tissues from rats and mice. In addition, we report historical data from control and genotoxin-treated human blood. Technical issues impacting comet results are described, including the method of cell preparation and freezing. Cell preparation by scraping (stomach and other GI tract organs) resulted in higher % tail DNA than mincing (liver, spleen, kidney etc) or direct collection (blood or bone marrow). Treatment with the positive control genotoxicant, ethyl methanesulfonate (EMS) in rats and methyl methanesulfonate in mice, resulted in statistically significant increases in % tail DNA. Background DNA damage was not markedly increased when cell suspensions were stored frozen prior to preparing slides, and the outcome of the assay was unchanged (EMS was always positive). In conclusion, historical data from our laboratory for the in vivo comet assay for multiple tissues from rats and mice, as well as human blood show very good reproducibility. These data and recommendations provided are aimed at contributing to the design and proper interpretation of results from comet assays. © 2014 Wiley Periodicals, Inc.

SMS text messaging improves outpatient attendance.

PubMed

Downer, Sean R; Meara, John G; Da Costa, Annette C; Sethuraman, Kannan

2006-08-01

To evaluate the operational and financial efficacy of sending short message service (SMS) text message reminders to the mobile telephones of patients with scheduled outpatient clinic appointments. Cohort study with historical control. Royal Children's Hospital, Melbourne, Victoria. Patients who gave a mobile telephone contact number and were scheduled to attend an outpatient clinic at the Royal Children's Hospital, Melbourne in October, November and December 2004 (trial group) or in October, November and December 2003 (historical control group). Failure-to-attend (FTA) rate compared between the trial group, whose members were sent a reminder, and the historical control group, whose members were not sent a reminder. Financial benefits versus cost of sending reminders. 22,658 patients with a mobile telephone contact number scheduled to attend an outpatient clinic appointment in October, November and December 2004 were sent an SMS reminder; 20,448 (90.2%) of these patients attended their appointment. The control group included 22,452 patients with a mobile telephone contact number scheduled to attend an appointment, with 18,073 (80.5%) patients attending. The FTA rate was significantly lower in the trial group than in the historical control group (9.8% v 19.5%; P < 0.001). The cost of sending the SMS reminders was small compared with the increase in patient revenue and associated benefits generated as a result of improved attendance. The observed reduction in FTA rate was in line with that found using traditional reminder methods and a prior pilot study using SMS. The FTA reduction coupled with the increase in patient revenue suggests that reminding patients using SMS is a very cost effective approach for improving patient attendance.

The Role of Women in Chinese Society.

ERIC Educational Resources Information Center

Biaggio, Mary Kay

Historically, men's and women's roles in China have been highly structured. The People's Republic of China has stressed the importance of women overcoming historical oppression and has adopted policies aimed at emancipating women. When the Chinese Communist Party took control of China in 1949, the new government clearly stated the importance of…

Education in Bosnia: Religion, Language and Control.

ERIC Educational Resources Information Center

McCreight, Richard Douglas

This book investigates the forces shaping the development of education systems in Bosnia and the impact those historical forces may, or may not, have on the condition of secondary education in Bosnia today. Initial chapters offer historical background about educational development in the Balkans and in Bosnia. The volume outlines the accumulative…

A Synthesis of Equilibrium and Historical Models of Landform Development.

ERIC Educational Resources Information Center

Renwick, William H.

1985-01-01

The synthesis of two approaches that can be used in teaching geomorphology is described. The equilibrium approach explains landforms and landform change in terms of equilibrium between landforms and controlling processes. The historical approach draws on climatic geomorphology to describe the effects of Quaternary climatic and tectonic events on…

Ideological and Historical Challenges in Business Education

ERIC Educational Resources Information Center

Nino, Lana

2011-01-01

Business schools bear a central mission in our society and are responsible for training business managers who work in, lead, and indeed control our corporations and drive our economy's wealth. Historical and ideological challenges have influenced business education and steered it off the expected path. Several theoretical frameworks such as…

94. Photographic copy of historic photo, December 26, 1929 (original ...

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

94. Photographic copy of historic photo, December 26, 1929 (original print filed in Record Group 115, National Archives, Washington, D.C.). OWYHEE DAM-LOADING CAR FROM CABLEWAY SKIP. CABLEWAY CONTROL HOUSE IN UPPER RIGHT, PART OF UPPER COFFERDAM AT LEFT. - Owyhee Dam, Across Owyhee River, Nyssa, Malheur County, OR

Bayesian Phase II optimization for time-to-event data based on historical information.

PubMed

Bertsche, Anja; Fleischer, Frank; Beyersmann, Jan; Nehmiz, Gerhard

2017-01-01

After exploratory drug development, companies face the decision whether to initiate confirmatory trials based on limited efficacy information. This proof-of-concept decision is typically performed after a Phase II trial studying a novel treatment versus either placebo or an active comparator. The article aims to optimize the design of such a proof-of-concept trial with respect to decision making. We incorporate historical information and develop pre-specified decision criteria accounting for the uncertainty of the observed treatment effect. We optimize these criteria based on sensitivity and specificity, given the historical information. Specifically, time-to-event data are considered in a randomized 2-arm trial with additional prior information on the control treatment. The proof-of-concept criterion uses treatment effect size, rather than significance. Criteria are defined on the posterior distribution of the hazard ratio given the Phase II data and the historical control information. Event times are exponentially modeled within groups, allowing for group-specific conjugate prior-to-posterior calculation. While a non-informative prior is placed on the investigational treatment, the control prior is constructed via the meta-analytic-predictive approach. The design parameters including sample size and allocation ratio are then optimized, maximizing the probability of taking the right decision. The approach is illustrated with an example in lung cancer.

Comparison of a Stratified Group Intervention (STarT Back) With Usual Group Care in Patients With Low Back Pain: A Nonrandomized Controlled Trial.

PubMed

Murphy, Susan E; Blake, Catherine; Power, Camillus K; Fullen, Brona M

2016-04-01

A nonrandomized controlled trial. This study aims to explore the effectiveness of group-based stratified care in primary care. Stratified care based on psychosocial screening (STarT Back) has demonstrated greater clinical and cost-effectiveness in patients with low back pain. However, low back pain interventions are often delivered in groups and evaluating this system of care in a group setting is important. Patients were recruited from 60 general practices and linked physiotherapy services. A new group stratified intervention was compared with a historical nonstratified control group. Patients stratified as low, medium and high risk were offered risk-matched group care. Consenting participants completed self-report measures of functional disability (primary outcome measure), pain, psychological distress, and beliefs. The historical control received a generic group intervention. Analysis was by intention to treat. In total, 251 patients in the new stratified intervention and 332 in the historical control were included in the primary analysis at 12 weeks. The mean age of patients was 43 ± 10.98 years. Overall adjusted mean changes in the RMDQ scores were higher in the stratified intervention than in the control arm at 12-week follow-up (P = 0.028). Exploring the risk groups, individually the high-risk stratified group, demonstrated better outcome over the controls (P = 0.031). The medium-risk stratified intervention demonstrated equally good outcomes (P = 0.125), and low-risk stratified patients, despite less intervention, did as well as the historical controls (P = 0.993). Stratified care delivered in a group setting demonstrated superior outcomes in the high-risk patients, and equally good outcomes for the medium and low-risk groups. This model, embedded in primary care, provides an early and effective model of chronic disease management and adds another dimension to the utility of the STarT Back system of care. 2.

15. INTERIOR OVERVIEW TO SOUTHEAST. ACTIVE CONTROL PANEL AND GENERATORS ...

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

15. INTERIOR OVERVIEW TO SOUTHEAST. ACTIVE CONTROL PANEL AND GENERATORS AT LEFT, HISTORIC CONTROL PANEL AT RIGHT. - Santa Ana River Hydroelectric System, SAR-1 Powerhouse, Redlands, San Bernardino County, CA

The Extinction of Dengue through Natural Vulnerability of Its Vectors

PubMed Central

Williams, Craig R.; Bader, Christie A.; Kearney, Michael R.; Ritchie, Scott A.; Russell, Richard C.

2010-01-01

Background Dengue is the world's most important mosquito-borne viral illness. Successful future management of this disease requires an understanding of the population dynamics of the vector, especially in the context of changing climates. Our capacity to predict future dynamics is reflected in our ability to explain the significant historical changes in the distribution and abundance of the disease and its vector. Methodology/Principal Findings Here we combine daily weather records with simulation modelling techniques to explain vector (Aedes aegypti (L.)) persistence within its current and historic ranges in Australia. We show that, in regions where dengue presently occurs in Australia (the Wet Tropics region of Far North Queensland), conditions are persistently suitable for year-round adult Ae. aegypti activity and oviposition. In the historic range, however, the vector is vulnerable to periodic extinction due to the combined influence of adult activity constraints and stochastic loss of suitable oviposition sites. Conclusions/Significance These results, together with changes in water-storage behaviour by humans, can explain the observed historical range contraction of the disease vector. For these reasons, future eradication of dengue in wet tropical regions will be extremely difficult through classical mosquito control methods alone. However, control of Ae. aegypti in sub-tropical and temperate regions will be greatly facilitated by government policy regulating domestic water-storage. Exploitation of the natural vulnerabilities of dengue vectors (e.g., habitat specificity, climatic limitations) should be integrated with the emerging novel transgenic and symbiotic bacterial control techniques to develop future control and elimination strategies. PMID:21200424

Process identification of the SCR system of coal-fired power plant for de-NOx based on historical operation data.

PubMed

Li, Jian; Shi, Raoqiao; Xu, Chuanlong; Wang, Shimin

2018-05-08

The selective catalytic reduction (SCR) system, as one principal flue gas treatment method employed for the NO x emission control of the coal-fired power plant, is nonlinear and time-varying with great inertia and large time delay. It is difficult for the present SCR control system to achieve satisfactory performance with the traditional feedback and feedforward control strategies. Although some improved control strategies, such as the Smith predictor control and the model predictive control, have been proposed for this issue, a well-matched identification model is essentially required to realize a superior control of the SCR system. Industrial field experiment is an alternative way to identify the SCR system model in the coal-fired power plant. But it undesirably disturbs the operation system and is costly in time and manpower. In this paper, a process identification model of the SCR system is proposed and developed by applying the asymptotic method to the sufficiently excited data, selected from the original historical operation database of a 350 MW coal-fired power plant according to the condition number of the Fisher information matrix. Numerical simulations are carried out based on the practical historical operation data to evaluate the performance of the proposed model. Results show that the proposed model can efficiently achieve the process identification of the SCR system.

Study of Automatic Image Rectification and Registration of Scanned Historical Aerial Photographs

NASA Astrophysics Data System (ADS)

Chen, H. R.; Tseng, Y. H.

2016-06-01

Historical aerial photographs directly provide good evidences of past times. The Research Center for Humanities and Social Sciences (RCHSS) of Taiwan Academia Sinica has collected and scanned numerous historical maps and aerial images of Taiwan and China. Some maps or images have been geo-referenced manually, but most of historical aerial images have not been registered since there are no GPS or IMU data for orientation assisting in the past. In our research, we developed an automatic process of matching historical aerial images by SIFT (Scale Invariant Feature Transform) for handling the great quantity of images by computer vision. SIFT is one of the most popular method of image feature extracting and matching. This algorithm extracts extreme values in scale space into invariant image features, which are robust to changing in rotation scale, noise, and illumination. We also use RANSAC (Random sample consensus) to remove outliers, and obtain good conjugated points between photographs. Finally, we manually add control points for registration through least square adjustment based on collinear equation. In the future, we can use image feature points of more photographs to build control image database. Every new image will be treated as query image. If feature points of query image match the features in database, it means that the query image probably is overlapped with control images.With the updating of database, more and more query image can be matched and aligned automatically. Other research about multi-time period environmental changes can be investigated with those geo-referenced temporal spatial data.

Nuclear Technology Requires Control by the People, anywhere on Our Planet.

NASA Astrophysics Data System (ADS)

Synek, Miroslav

2000-03-01

------- Human society on our planet, in its historical development, utilizing the knowledge of physics, has reached a powerful technology of nuclear intercontinental ballistic missiles, conceivably controllable through a computerized "push-button". Whenever this technology falls under the control of an irresponsible , miscalculating, or, insane, DICTATOR, with powerful means of a mass-produced nuclear built-up, anywhere on our planet, the very survival of all humanity on our planet could be threatened. --- Therefore, it is a historical urgency that this technology is under the control by a government of the people, by the people and for the people, based on a sufficiently secure system of FREE ELECTIONS, in any country on our planet, wherever and whenever such a threatening possibility exists.

Mission Control Center/Building 30. Historical Documentation

NASA Technical Reports Server (NTRS)

2010-01-01

As part of this nation-wide study, in September 2006, historical survey and evaluation of NASA-owned and managed facilities was conducted by NASA's Lyndon B. Johnson Space Center (JSC) in Houston, Texas. The results of this study are presented in a report entitled, Survey and Evaluation of NASA-owned Historic Facilities and Properties in the Context of the U.S. Space Shuttle Program, Lyndon B. Johnson Space Center, Houston, Texas, prepared in November 2007 by NASA JSC s contractor, Archaeological Consultants, Inc. As a result of this survey, the Mission Control Center (Building 30) was determined eligible for listing in the NRHP, with concurrence by the Texas State Historic Preservation Officer (SHPO). The survey concluded that Building 30 is eligible for the NRHP under Criteria A and C in the context of the U.S. Space Shuttle Program (1969-2010). Because it has achieved significance within the past 50 years, Criteria Consideration G applies. It should be noted that the Mission Control Center was designated a National Historic Landmark in 1985 for its role in the Apollo 11 Lunar Landing. At the time of this documentation, Building 30 was still used to support the SSP as an engineering research facility, which is also sometimes used for astronaut training. This documentation package precedes any undertaking as defined by Section 106 of the NHPA, as amended, and implemented in 36 CFR Part 800, as NASA JSC has decided to proactively pursue efforts to mitigate the potential adverse affects of any future modifications to the facility. It includes a historical summary of the Space Shuttle program; the history of JSC in relation to the SSP; a narrative of the history of Building 30 and how it supported the SSP; and a physical description of the structure. In addition, photographs documenting the construction and historical use of Building 30 in support of the SSP, as well as photographs of the facility documenting the existing conditions, special technological features, and engineering details, are included. A contact sheet printed on archival paper, and an electronic copy of the work product on CD, are also provided.

Historical and Cultural Perspectives on Centralization/Decentralization in Continuing Education.

ERIC Educational Resources Information Center

Edelson, Paul J.

1995-01-01

Views centralization/decentralization from four perspectives: historical, as an outgrowth of professionalism, in the culture of higher education, and management theory. Suggests that some form of centralized control will always be necessary if continuing education is to function in a larger organization, but smaller units may be the wave of the…

Modern Universities, Absent Citizenship? Historical Perspectives. CIRCLE Working Paper 39

ERIC Educational Resources Information Center

Talcott, William

2005-01-01

The historical study of university campuses can tell us much about the changing character and presuppositions of citizenship. Likewise, the study of citizenship can shed considerable light on the nature of universities. Throughout American history, various elite institutions can be seen struggling to establish a semblance of order and control in…

83. Photographic copy of historic photo, December 16, 1929 (original ...

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

83. Photographic copy of historic photo, December 16, 1929 (original print filed in Record Group 115, National Archives, Washington, D.C.). OWYHEE DAM-LOOKING DOWNSTREAM FROM UPPER COFFERDAM (POINT #15) SHOWING CREVICE AND KEYWAY CUTOFF; ALSO CABLEWAY CONTROL HOUSE AND ENTRANCE ADIT. - Owyhee Dam, Across Owyhee River, Nyssa, Malheur County, OR

Scleritis Caused by In Vitro Linezolid-Resistant Nocardia asteroides

PubMed Central

Tuli, Sonal

2014-01-01

Purpose. To describe a case of postoperative scleritis caused by a novel strain of Nocardia resistant to linezolid and trimethoprim-sulfamethoxazole (TMP-SMX). Methods. Case report of a patient with microbiologically proven scleritis due to Nocardia asteroides. Results. The patient presented with pain, redness, and nodules on the sclera three months following pterygium excision with mitomycin C and amniotic membrane placement. As no response was noted with empiric treatment for bacterial scleritis, debridement was performed. The cytopathology report showed gram positive filamentous bacteria. A presumptive diagnosis of Nocardia scleritis was made and therapy was initiated based on a literature review on treatments for Nocardia infections. Cultures returned growing Nocardia asteroides. Antibiotic sensitivity testing revealed resistance to linezolid and TMP-SMX which are the traditional drugs of choice for Nocardia. The patient was treated with amikacin and imipenem as well as extensive debridement with pedicle grafts. The patient's scleritis resolved with a good visual outcome. Conclusions. Cultures should be obtained in all cases of necrotizing scleritis in patients with a recent history of conjunctival surgery to rule out unusual organisms such as Nocardia. Although literature states that resistance to linezolid and TMP-SMX is rare in Nocardia, sensitivity testing can be useful in unresponsive cases. PMID:25400961

Scleritis Caused by In Vitro Linezolid-Resistant Nocardia asteroides.

PubMed

Gonzalez, Andres; Fakhar, Kaihan; Gubernick, David; Tuli, Sonal

2014-01-01

Purpose. To describe a case of postoperative scleritis caused by a novel strain of Nocardia resistant to linezolid and trimethoprim-sulfamethoxazole (TMP-SMX). Methods. Case report of a patient with microbiologically proven scleritis due to Nocardia asteroides. Results. The patient presented with pain, redness, and nodules on the sclera three months following pterygium excision with mitomycin C and amniotic membrane placement. As no response was noted with empiric treatment for bacterial scleritis, debridement was performed. The cytopathology report showed gram positive filamentous bacteria. A presumptive diagnosis of Nocardia scleritis was made and therapy was initiated based on a literature review on treatments for Nocardia infections. Cultures returned growing Nocardia asteroides. Antibiotic sensitivity testing revealed resistance to linezolid and TMP-SMX which are the traditional drugs of choice for Nocardia. The patient was treated with amikacin and imipenem as well as extensive debridement with pedicle grafts. The patient's scleritis resolved with a good visual outcome. Conclusions. Cultures should be obtained in all cases of necrotizing scleritis in patients with a recent history of conjunctival surgery to rule out unusual organisms such as Nocardia. Although literature states that resistance to linezolid and TMP-SMX is rare in Nocardia, sensitivity testing can be useful in unresponsive cases.

Robotic-assisted surgery in ophthalmology.

PubMed

de Smet, Marc D; Naus, Gerrit J L; Faridpooya, Koorosh; Mura, Marco

2018-05-01

Provide an overview of the current landscape of robotics in ophthalmology, including the pros and cons of system designs, the clinical development path, and the likely future direction of the field. Robots designed for eye surgery should meet certain basic requirements. Three designs are currently being developed: smart surgical tools such as the steady hand, comanipulation devices and telemanipulators using either a fixed or virtual remote center of motion. Successful human intraocular surgery is being performed using the Preceyes surgical system. Another telemanipulation robot, the da Vinci Surgical System, has been used to perform a pterygium repair in humans and was successful in ex-vivo corneal surgery despite its nonophthalmic design. Apart from Preceyes' BV research platform, none of the currently eye-specific systems has reached a commercial stage. Systems are likely to evolve from robotic assistance during specific procedural steps to semiautonomous surgery, as smart sensors are introduced to enhance the basic functionalities of robotic systems. Robotics is still in its infancy in ophthalmology but is rapidly reaching a stage wherein it will be introduced into everyday ophthalmic practice. It will most likely be introduced first for demanding vitreo-retinal procedures, followed by anterior segment applications.

Commentary on: Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research. Addictions as a psychosocial and cultural construction.

PubMed

van der Linden, Martial

2015-09-01

This commentary proposes a complementary perspective to that developed by Billieux, Schimmenti, Khazaal, Maurage and Heeren (2015). The addiction-as-disease approach tends to sideline explanatory factors of a psychosocial, cultural, political, or historical nature. I therefore suggest taking into account not only the personal characteristics (loss of self-control, impulsivity) related to the disease model, but also the social determinants of addictive behaviors (weak social ties, social exclusion, hyperindividualism, poverty, unemployment, etc.). Moreover, the disease model of addiction removes addictive behaviors from the cultural and historical contexts that shape them. I argue that the cultural and historical reasons for which certain factors (such as loss of self-control) became so important in the explanation of addictive behaviors should be more thoroughly considered.

Influence of an injury reduction program on injury and fitness outcomes among soldiers

PubMed Central

Knapik, J; Bullock, S; Canada, S; Toney, E; Wells, J; Hoedebecke, E; Jones, B

2004-01-01

Objective: This study evaluated the influence of a multiple injury control intervention on injury and physical fitness outcomes among soldiers attending United States Army Ordnance School Advanced Individual Training. Methods: The study design was quasiexperimental involving a historical control group (n = 2559) that was compared to a multiple intervention group (n = 1283). Interventions in the multiple intervention group included modified physical training, injury education, and a unit based injury surveillance system (UBISS). The management responsible for training independently formed an Injury Control Advisory Committee that examined surveillance reports from the UBISS and recommended changes to training. On arrival at school, individual soldiers completed a demographics and lifestyle questionnaire and took an army physical fitness test (APFT: push-ups, sit-ups, and two mile run). Injuries among soldiers were tracked by a clinic based injury surveillance system that was separate from the UBISS. Soldiers completed a final APFT eight weeks after arrival at school. Results: Cox regression (survival analysis) was used to examine differences in time to the first injury while controlling for group differences in demographics, lifestyle characteristics, and physical fitness. The adjusted relative risk of a time loss injury was 1.5 (95% confidence interval 1.2 to 1.8) times higher in the historical control men and 1.8 (95% confidence interval 1.1 to 2.8) times higher in the historical control women compared with the multiple intervention men and women, respectively. After correcting for the lower initial fitness of the multiple intervention group, there were no significant differences between the multiple intervention and historical control groups in terms of improvements in push-ups, sit-ups, or two mile run performance. Conclusions: This multiple intervention program contributed to a reduction in injuries while improvements in physical fitness were similar to a traditional physical training program previously used at the school. PMID:14760025

Brainwashing, LSD, and CIA: historical and ethical perspective.

PubMed

Buckman, J

1977-01-01

The history of various attempts at thought control and chemical warfare is briefly reviewed. Brainwashing, thought control, industrial and national espionage, and covert activities are becoming more sophisticated. These issues have been revived and accentuated by the Vietnam war, the Middle East Crisis, Watergate, the CIA investigations and the Patty Hearst trial. Historical perspective and the ethical implications of these activities are explored. It is suggested that there is a growing level of individual and international mistrust amounting to paranoia and complicating the issues of individual freedom, civil rights and human experimentation.

Improving overlay control through proper use of multilevel query APC

NASA Astrophysics Data System (ADS)

Conway, Timothy H.; Carlson, Alan; Crow, David A.

2003-06-01

Many state-of-the-art fabs are operating with increasingly diversified product mixes. For example, at Cypress Semiconductor, it is not unusual to be concurrently running multiple technologies and many devices within each technology. This diverse product mix significantly increases the difficulty of manually controlling overlay process corrections. As a result, automated run-to-run feedforward-feedback control has become a necessary and vital component of manufacturing. However, traditional run-to-run controllers rely on highly correlated historical events to forecast process corrections. For example, the historical process events typically are constrained to match the current event for exposure tool, device, process level and reticle ID. This narrowly defined process stream can result in insufficient data when applied to lowvolume or new-release devices. The run-to-run controller implemented at Cypress utilizes a multi-level query (Level-N) correlation algorithm, where each subsequent level widens the search criteria for available historical data. The paper discusses how best to widen the search criteria and how to determine and apply a known bias to account for tool-to-tool and device-to-device differences. Specific applications include offloading lots from one tool to another when the first tool is down for preventive maintenance, utilizing related devices to determine a default feedback vector for new-release devices, and applying bias values to account for known reticle-to-reticle differences. In this study, we will show how historical data can be leveraged from related devices or tools to overcome the limitations of narrow process streams. In particular, this paper discusses how effectively handling narrow process streams allows Cypress to offload lots from a baseline tool to an alternate tool.

Powerful nuclear technology, anywhere, requires functioning system of free elections

NASA Astrophysics Data System (ADS)

Synek, Miroslav

2000-03-01

Historical development on our planet, utilizing the knowledge of physics, has reached a powerful technology of nuclear intercontinental ballistic missiles, conceivably controllable through a computerized ``push-button". Whenever this technology falls under the control of an irresponsible, miscalculating, or, insane, dictator, with powerful means of a mass-produced nuclear built-up, anywhere on our planet, the very survival of all humanity on our planet could be threatened. Therefore, it is a historical urgency that this technology is under the control by a government of the people, by the people and for the people, based on a sufficiently secure system of free elections, in any country on our planet, wherever and whenever such a threatening possibility exists.

Gender Differences in Student Engagement among African American Undergraduates at Historically Black Colleges and Universities

ERIC Educational Resources Information Center

Harper, Shaun R.; Carini, Robert M.; Bridges, Brian K.; Hayek, John C.

2004-01-01

Differences in student engagement between women and men at historically Black colleges and universities (HBCUs) are examined in this study. Data were collected from 1,167 African American undergraduate students at 12 four-year HBCUs that participated in the National Survey of Student Engagement. Controlling for several factors that might obscure…

Bassett Creek Watershed, Hennepin County, Minnesota. Feasibility Report for Flood Control.

DTIC Science & Technology

1976-03-01

acuat ion of oc residence in the upper wnter- hl~t., ail .- [it iliii.lnC (f e loial f lood plain ordtinances moidif i(d to rc.l et ,,rnpo.-,,1 ,,,ni i...groups such as insects , earthworms, clams and snails. ’HISTORICAL AND ARCHAEOLOGICAL RESOURCES Coordination with state and county historical

Democracy is a historical urgency

NASA Astrophysics Data System (ADS)

Synek, Miroslav

2014-03-01

Survival of human society on this planet depends heavily on coping with advanced nuclear technological development. Democracy is a historical urgency, in the age of intercontinental nuclear missiles, computerized on a push-button, conceivably controllable by a miscalculating, suicidal and very powerful dictator, producing a global nuclear holocaust, on our entire planet. Diplomacy should help humanity to approach the contemporary situation.

The historical foundations of prescribed burning for wildlife: a southeastern perspective

Treesearch

A. Sydney Johnson; Philip E. Hale

2002-01-01

Controlled burning has deep historical roots in the South, where the practice was quickly adopted from the Indians by early European settlers. It became used widely, primarily to improve forage conditions for free-ranging cattle and to improve visibility and access. Likewise, hunting is deeply imbedded in southern culture and was an attraction to visitors throughout...

Dexamethasone modifies mitomycin C-triggered interleukin-8 secretion in isolated human Tenon's capsule fibroblasts.

PubMed

Ho, Wei-Ting; Chen, Tsan-Chi; Chou, San-Fang; Chang, Shu-Wen

2014-07-01

Intraoperative mitomycin C (MMC) is widely used to prevent pterygium recurrence and glaucoma filtering bleb failure, but it has been shown to induce corneal inflammation and cell death. Postoperative dexamethasone (DEX) is advocated to reduce MMC-related inflammation and cell death in corneal fibroblasts. Nevertheless, its long-term regulation mechanism in Tenon's capsule remains to be explored. The purpose of this study was to investigate how DEX modifies MMC's effects in human Tenon's capsule fibroblasts (HTFs). HTFs isolated from the pterygium surgical patients (n = 6) were treated with MMC at 0, 0.1, 0.2, and 0.4 mg/ml for 5 min and incubated in DEX at 10 μM for 0, 1, 2, and 3 days. Recombinant interleukin-8 (IL-8) was used to verify the effect of MMC-related IL-8 secretion. Cell proliferation of all the treated cells was analyzed by WST-1 assay. The amount of IL-8 secretion in HTFs was determined by enzyme-linked immunosorbent assay. Immunoblotting assay was used to analyze the expression of peroxisome-proliferator-activated receptor gamma (PPARγ) and B-cell lymphoma-extra large (Bcl-xL). Our results revealed that MMC significantly reduced the HTF cell proliferation rate. Additionally, MMC significantly upregulated IL-8 secretion in HTFs concentration-dependently. At 3 days post treatment (dpt), 5-min exposures to 0.1, 0.2, and 0.4 mg/ml MMC resulted in 1.4-fold (p = 0.012), 1.6-fold (p = 0.012), and 2.5-fold (p = 0.001) increases of IL-8 secretion. In contrast, DEX reversed the MMC-retarded cell proliferation rate (p = 0.036) and repressed MMC-related IL-8 secretion by 33.5% at 3 dpt (p = 0.003). Addition of recombinant IL-8 noticeably suppressed HTF cell proliferation in a concentration-dependent manner. DEX stimulated upregulation of both PPARγ and Bcl-xL at 1 dpt in normal HTFs and at 2 dpt in MMC-treated HTFs. PPARγ silencing reduced expression of PPARγ and Bcl-xL, but enhanced IL-8 secretion (p < 0.001). On the other hand, Bcl-xL silencing enhanced IL-8 secretion (p < 0.001), but did not affect PPARγ expression. These revealed that IL-8 secretion in HTFs is modulated by PPARγ-dependent Bcl-xL signaling. We conclude that DEX reversed the MMC-inhibited HTF cell proliferation via diminishing the MMC-induced IL-8 secretion, which resulted from a late-phase upregulation of the PPARγ and Bcl-xL. These long-term effects suggest a beneficial postoperative DEX treatment following intraoperative MMC application. Copyright © 2014 Elsevier Ltd. All rights reserved.

A boundary-optimized rejection region test for the two-sample binomial problem.

PubMed

Gabriel, Erin E; Nason, Martha; Fay, Michael P; Follmann, Dean A

2018-03-30

Testing the equality of 2 proportions for a control group versus a treatment group is a well-researched statistical problem. In some settings, there may be strong historical data that allow one to reliably expect that the control proportion is one, or nearly so. While one-sample tests or comparisons to historical controls could be used, neither can rigorously control the type I error rate in the event the true control rate changes. In this work, we propose an unconditional exact test that exploits the historical information while controlling the type I error rate. We sequentially construct a rejection region by first maximizing the rejection region in the space where all controls have an event, subject to the constraint that our type I error rate does not exceed α for any true event rate; then with any remaining α we maximize the additional rejection region in the space where one control avoids the event, and so on. When the true control event rate is one, our test is the most powerful nonrandomized test for all points in the alternative space. When the true control event rate is nearly one, we demonstrate that our test has equal or higher mean power, averaging over the alternative space, than a variety of well-known tests. For the comparison of 4 controls and 4 treated subjects, our proposed test has higher power than all comparator tests. We demonstrate the properties of our proposed test by simulation and use our method to design a malaria vaccine trial. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

Self-Esteem, Locus of Control, and First-Time NCLEX-RN Passage of BSN Students at Historically Black Colleges and Universities.

PubMed

Chavis, Pamella Ivey

Relationships between self-esteem, locus of control (LOC), and first-time passage of National Council Licensure Examination for Registered Nurses (NCLEX-RN®) were examined at baccalaureate nursing programs at two historically black colleges and universities. Shortages continue to exceed demands for RNs prepared at the baccalaureate level. Inconsistent pass rates on the NCLEX-RN for graduates of historically black colleges and universities impede the supply of RNs. Surveys and archival data were used to examine characteristics of the sample and explore relationships among variables. All participants (N = 90) reported high self-esteem and internal LOC. Models suggested that all those with high self-esteem and internal LOC would pass the NCLEX-RN; only 85 percent passed the first time. Statistical analysis revealed a lack of statistical significance between self-esteem, LOC, and first-time passage. Variables not included in the study may have affected first-time passage.

Space Station Displays and Controls Technology Evolution

NASA Technical Reports Server (NTRS)

Blackburn, Greg C.

1990-01-01

Viewgraphs on space station displays and controls technology evolution are presented. Topics covered include: a historical perspective; major development objectives; current development activities; key technology areas; and technology evolution issues.

Antihyperlipidemic Medication Treatment Patterns and Statin Adherence Among Patients with ASCVD in a Managed Care Plan After Release of the 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol.

PubMed

Bellows, Brandon K; Olsen, Cody J; Voelker, Jennifer; Wander, Curtis

2016-08-01

The American College of Cardiology (ACC) and American Heart Association (AHA) released a new blood cholesterol treatment guideline in November 2013. It is unknown how the new recommendations have affected cholesterol medication use and adherence in a commercial health plan. To evaluate the effect of the 2013 guideline release on antihyperlipidemic treatment patterns and statin adherence in patients with atherosclerotic cardiovascular disease (ASCVD) compared with a historical control group. This study was a historical cohort analysis of adult patients (aged 21-75 years) with clinical ASCVD enrolled in a SelectHealth commercial health plan. Patients were included in the guideline implementation cohort if they had a medical claim with an ICD-9-CM diagnosis of ASCVD in the year before the November 2013 ACC/AHA guideline release. The index date was defined as the first outpatient medical claim with an ICD-9-CM for ASCVD in the first 6 months after the guideline was released. Patients were required to have continuous enrollment for ≥ 1 year before and after the index date. These same criteria were applied to patients exactly 4 years earlier to identify a historical control group. Patients meeting these criteria formed the antihyperlipidemic treatment patterns cohort. Of these, patients who also had ≥1 pharmacy claim for a statin in the 1-year pre- and post-index periods were included in the statin adherence cohort. Antihyperlipidemic treatment patterns were assessed using pharmacy claims for antihyperlipidemic medications in the 1-year pre- and post-index periods. Antihyperlipidemic medication claims were classified as a nonstatin cholesterol medication, low-intensity statin, moderate-intensity statin, or high-intensity statin. To address differences in pre-index antihyperlipidemic medications between the guideline implementation and historical control groups, patients were randomly matched 1:1 based on pre-index classification in a post hoc analysis. Post-index antihyperlipidemic classifications were compared between groups using a Stuart-Maxwell test. The change in mean statin adherence (proportion of days covered [PDC]) was compared within and between groups using paired and independent t-tests, respectively. The proportion of adherent patients (PDC ≥ 0.80) in the pre- and post-index periods was compared between groups using a chi-square test. A multivariable logistic regression was used to compare the likelihood of being adherent in the post-index period while controlling for pre-index adherence and other potential confounders. A total of 7,818 adult members with ASCVD in the index period and 1 year before the index period were identified. Of those, 1,841 patients met the criteria to be included in the analysis, and 1,526 patients were matched on antihyperlipidemic classification and included in the antihyperlipidemic treatment patterns analysis. Baseline characteristics were similar, although the guideline implementation group was younger (58.3 vs. 60.5 years, P < 0.001), and more were male (74.8% vs. 71.3%, P = 0.106) than the historical control group. In the matched cohort, there was a significant difference in the post-index antihyperlipidemic classification (P < 0.001), which appeared to be a result of the difference in nonstatin cholesterol medications (guideline 6.9% vs. historical 13.0%) and high-intensity statins (guideline 23.7% vs. historical 16.3%). Of the 1,841 patients in the antihyperlipidemic treatment patterns cohort, 919 patients met inclusion criteria for the statin adherence analysis. Although PDC decreased over time in both groups, significantly more patients in the guideline implementation group were adherent in the post-index period than the historical control group (66.5% vs. 57.3%, respectively; P = 0.005). Additionally, patients in the guideline implementation group were more likely than the historical control to be adherent in the post-index period when adjusting for potential confounders (OR = 1.49, 95% CI = 1.10-2.03; P = 0.011). Since the release of the updated ACC/AHA treatment guideline, more commercial health plan patients with ASCVD used high-intensity statins and fewer used nonstatin cholesterol medications than historical controls. Additionally, since the guideline release, more patients are adherent to statin therapy than historical controls. This study provides managed care organizations with valuable information regarding the effect of the 2013 ACC/AHA guideline. No outside funding or services were received for this work. Outside of the current study, Bellows has received research funding from Biogen Idec, Regeneron Pharmaceuticals, Myriad Genetic Laboratories, Shire Development, and Bristol-Myers Squibb and an honorariam from Avanir Pharmaceuticals. Voelker received summer intern support from Pfizer and the AMCP Foundation during the time of this study. The remaining authors have nothing to disclose. All authors contributed to study concept and design and to the revision of the manuscript. Bellows, Olsen, and Voelker collected the data, assisted by Wander; data interpretation was performed primarily by Bellows, along with Olsen and Voelker and assisted by Wander. The manuscript was primarily written by Bellows, along with the other authors.

Efficacy and safety of conversion to monotherapy with eslicarbazepine acetate in adults with uncontrolled partial-onset seizures: a historical-control phase III study.

PubMed

Jacobson, Mercedes P; Pazdera, Ladislav; Bhatia, Perminder; Grinnell, Todd; Cheng, Hailong; Blum, David

2015-03-28

Eslicarbazepine acetate (ESL, Aptiom®) is a once-daily (QD) anticonvulsant, approved as adjunctive treatment of partial-onset seizures (POS). It is extensively converted after oral administration to eslicarbazepine, and is believed to exert its effect through inhibition of voltage-gated sodium channels. The possible role of ESL as monotherapy to treat POS has not yet been established. This study was an 18-week, multicenter, randomized double-blind trial of gradual conversion to ESL monotherapy in adults with POS not well controlled by 1-2 antiepileptic drugs (AEDs), using historical data as the control. The study comprised an 8-week baseline period, a 2-week titration period, a 6-week AED conversion period, a 10-week monotherapy period, and either a 1-week taper period or optional entry to an open-label extension study. The primary endpoint compared the Kaplan-Meier (KM)-estimated 112-day exit rate with a threshold value calculated from the historical controls. There were 172 randomized patients; 154 (90%) entered the AED conversion period and 121 (70%) completed the study. The KM-estimated exit rates [confidence interval (CI)] were 15.6% [8.1-28.7%] for ESL 1200 mg, and 12.8% [7.5-21.5%] for ESL 1600 mg. The upper limits of the 95% CI KM-estimates were below the pre-specified threshold for historical control of 65.3%, indicating that ESL was efficacious in reducing seizure-related exits, compared with historical control. During the 18-week double-blind treatment period, median reductions in standardized seizure frequency occurred with ESL 1200 mg (36.1%) and ESL 1600 mg (47.5%). The responder rates (a 50% or greater reduction in seizure frequency from baseline) during the 18-week double-blind period and the monotherapy period, respectively, were 35.2% and 38.9% for ESL 1200 mg, and 46.0% and 46.0% for ESL 1600 mg. The overall adverse event profile was consistent with the known safety profile of ESL. These findings indicate that ESL monotherapy (1200 and 1600 mg QD) was efficacious and well tolerated in this study. NCT01091662 ; EudraCT No. 2010-018684-42.

Efficacy and safety of conversion to monotherapy with eslicarbazepine acetate in adults with uncontrolled partial-onset seizures: a randomized historical-control phase III study based in North America.

PubMed

Sperling, Michael R; Harvey, Jay; Grinnell, Todd; Cheng, Hailong; Blum, David

2015-04-01

To assess the efficacy and safety of eslicarbazepine acetate (ESL) as monotherapy in North American patients with partial-onset seizures (POS). This multicenter, randomized, double-blind "withdrawal to monotherapy" study used historical control data as the comparator. Adults with POS medically uncontrolled by one to two antiepileptic drugs gradually converted to ESL monotherapy. Following an 8-week baseline period, patients were randomized 2:1 to receive ESL 1,600 mg (n = 128) or 1,200 mg QD (n = 65) for 18 weeks. The primary end point was the proportion of patients meeting predefined exit criteria (signifying worsening seizure control). Treatment was considered effective if the 95% upper confidence limit (UCL) for the Kaplan-Meier estimated exit rate was lower than the exit rate threshold calculated from the historical control (65.3%). Kaplan-Meier estimated exit rates were: ESL 1,600 mg, 28.7% (95% CI 21.2-38.1%) and 1,200 mg, 44.4% (32.5-58.3%). The difference between doses was not significant (p = 0.07). For both doses, the 95% UCLs for the exit rate were ˂ 65.3%; ESL monotherapy was considered superior to the historical control. There was no statistically significant increase in the risk of study exit related to carbamazepine use. Nine (7.6%) and five patients (8.3%) remained seizure-free during the 10-week monotherapy period, while taking ESL 1,600 and 1,200 mg, respectively. The reductions in median standardized seizure frequency (seizures per 28 days) between baseline and the 18-week treatment period were: ESL 1,600 mg, 42% and 1,200 mg, 31%. Treatment-emergent adverse events (TEAEs) occurring in ≥ 10% of patients were dizziness, headache, fatigue, somnolence, nausea, and nasopharyngitis. The TEAE most frequently leading to discontinuation was hyponatremia (2.1%). ESL was efficacious and well tolerated as monotherapy in North American patients, and led to a reduction in seizure frequency. Exit rates for ESL 1,600 and 1,200 mg QD were superior to the historical control; the difference in exit rates between doses was not statistically significant. © 2015 The Authors. Epilepsia published by Wiley Periodicals, Inc. on behalf of International League Against Epilepsy.

Colours Convey Lanna Identity in Lamphun and Chiang Mai Area

NASA Astrophysics Data System (ADS)

Raksawin, Karuna; Wonglaksanapan, Arphaphon; Suthasupa, Supagtra

2017-10-01

Colour control is a specific tool to identify local environment. Especially in the historic area or conservation area, to promote colour control is very necessary. Therefore, there are many standards of colour to control such as Munsell, colour name, and L*a*b*. This research is aimed to analyze the appropriate colour control by using a Munsell standard colour which is suitable to visual perception. The study area is scoped in northern region of Lanna culture in Thailand which nowadays used names of colours to control. Chiang Mai and Lamphun are selected to be case study because they are in a center of Lanna Empire of Thailand and have many historic significant things such as city wall, temple, monastery, palace, and city moat. The mainly procedure conducts in this article is based on the analysis of material colour. The study chose local natural materials which are used in the historic significant things. Earthen clay tile, wooden roof tile, burnt clay brick, laterites, hard wood, bamboo, silver, and gold are evaluated. The procedure used the DIC application of android processor on smart phone. This application has a conversion data to switch a colour value from pick-up point in photo to many colour values such as RGB, CMYK which Munsell value is included. The photos were taken within the historic area of Chiang Mai and Lamphun by random. The result can scope a range of colours of Munsell standard of natural colour (N), red (R), yellow (Y), and yellow-red (YR). A natural colour (N) can be suggested a range 1.0-9.0 (N 1.0-9.0). Red can be ranged the value between 3.0-7.0 and chroma between 3.0-9.0 (R 3.0-7.0/3.0-9.0). Yellow can be ranged the value between 6.0-9.0 and chroma between 4.0-12.0 (Y 6.0-9.0/4.0-12.0). Yellow-red can be ranged the value between 2.0-8.0 and chroma between 2.0-11.0 (YR 2.0-8.0/2.0-11.0). The results can be revealed a process of colour analysis of historic colour control and may offer to be an ordinance in further.

78 FR 18364 - Electronic Prescriptions for Controlled Substances Notice of Approved Certification Process

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-26

... DEPARTMENT OF JUSTICE Drug Enforcement Administration [Docket No. DEA-364] Electronic... certification processes for providers of Electronic Prescriptions for Controlled Substances (EPCS) applications... established by Congress. Electronic Prescriptions for Controlled Substances (EPCS) Historically, where federal...

Russian Dreams and Prussian Ghosts: Immanuel Kant Baltic Federal University and Debates over Historical Memory and Identity in Kaliningrad

ERIC Educational Resources Information Center

Clarkson, Alexander

2017-01-01

This article examines how the Immanuel Kant Baltic Federal University and the Kaliningrad State Technical University have come to exert considerable influence over debates surrounding historical memory and identity in the Kaliningrad region. Under the direct control of the Russian Federation, the Baltic exclave of Kaliningrad is surrounded by…

Invasive Species Guidebook for Department of Defense Installations in the Delaware River Basin: Identification, Control, and Restoration

DTIC Science & Technology

2009-06-01

155 SECTION II: PREVENTING RECURRING INVASIVE SPECIES AND RESTORING HISTORICAL PLANT COMMUNITIES ...Wilcove et al. 1998, Westbrook et al. 2005). Beyond degradation to ecological communities , invasive species can threaten human health and cause...recurrence of problem invasive species. This section also gives recommendations for returning management areas to historical native plant communities

Methodological proceedings to evaluate the physical accessibility in urban historic sites.

PubMed

Ribeiro, Gabriela Sousa; Martins, Laura Bezerra; Monteiro, Circe Maria Gama

2012-01-01

Historic urban sites are set by cultural and social diversities, generating multiple activities and use and access to these sites should be available to all people including those with disabilities. Taking into consideration that using the same methodology that was used in different historic sites researches with positive results facilitates replication, we aimed to develop methodological procedures that identify conditions of physical accessibility in open public spaces and access to public buildings in historic urban sites to support proposals about design requirements for improvements to the problems diagnosed and control inadequacies of the physical environment. The study methods and techniques from different areas of knowledge culminated in a proposal built with an emphasis on user participation that could be applied with low cost and in relatively short period of time.

40 CFR Appendix A to Part 57 - Primary Nonferrous Smelter Order (NSO) Application

Code of Federal Regulations, 2011 CFR

2011-07-01

... Profit and Loss Summary A.4 Historical Capital Investment Summary B.1 Pre-Control Revenue Forecast B.2 Pre-Control Cost Forecast B.3 Pre-Control Forecast Profit and Loss Summary B.4 Constant Controls Revenue Forecast B.5 Constant Controls Cost Forecast B.6 Constant Controls Forecast Profit and Loss...

Physics Leads to Free Elections in the Nuclear Age.

NASA Astrophysics Data System (ADS)

Synek, Miroslav

2001-10-01

------------- Complex historical development on our planet, utilizing the knowledge of physics, has reached a powerful technology of nuclear intercontinental missiles, conceivably controllable through a computerized "push-button". Whenever this technology falls under the control of an irresponsible, miscalculating, or, insane dictator, with sufficiently powerful means of a huge, mass-produced, nuclear-missile built-up, anywhere on our planet, the very survival of all humanity on our planet could be threatened. Therefore, it is a historical urgency that this technology be under the control by a government of the people, by the people and for the people, based on a sufficiently reliable system of free elections, in any country on our planet, wherever and whenever a total nuclear holocaust could originate.

World Ocean Database and the Global Temperature and Salinity Profile Program Database: Synthesis of historical and near real-time ocean profile data

NASA Astrophysics Data System (ADS)

Boyer, T.; Sun, L.; Locarnini, R. A.; Mishonov, A. V.; Hall, N.; Ouellet, M.

2016-02-01

The World Ocean Database (WOD) contains systematically quality controlled historical and recent ocean profile data (temperature, salinity, oxygen, nutrients, carbon cycle variables, biological variables) ranging from Captain Cooks second voyage (1773) to this year's Argo floats. The US National Centers for Environmental Information (NCEI) also hosts the Global Temperature and Salinity Profile Program (GTSPP) Continuously Managed Database (CMD) which provides quality controlled near-real time ocean profile data and higher level quality controlled temperature and salinity profiles from 1990 to present. Both databases are used extensively for ocean and climate studies. Synchronization of these two databases will allow easier access and use of comprehensive regional and global ocean profile data sets for ocean and climate studies. Synchronizing consists of two distinct phases: 1) a retrospective comparison of data in WOD and GTSPP to ensure that the most comprehensive and highest quality data set is available to researchers without the need to individually combine and contrast the two datasets and 2) web services to allow the constantly accruing near-real time data in the GTSPP CMD and the continuous addition and quality control of historical data in WOD to be made available to researchers together, seamlessly.

VEMAP Phase 2 bioclimatic database. I. Gridded historical (20th century) climate for modeling ecosystem dynamics across the conterminous USA

USGS Publications Warehouse

Kittel, T.G.F.; Rosenbloom, N.A.; Royle, J. Andrew; Daly, Christopher; Gibson, W.P.; Fisher, H.H.; Thornton, P.; Yates, D.N.; Aulenbach, S.; Kaufman, C.; McKeown, R.; Bachelet, D.; Schimel, D.S.; Neilson, R.; Lenihan, J.; Drapek, R.; Ojima, D.S.; Parton, W.J.; Melillo, J.M.; Kicklighter, D.W.; Tian, H.; McGuire, A.D.; Sykes, M.T.; Smith, B.; Cowling, S.; Hickler, T.; Prentice, I.C.; Running, S.; Hibbard, K.A.; Post, W.M.; King, A.W.; Smith, T.; Rizzo, B.; Woodward, F.I.

2004-01-01

Analysis and simulation of biospheric responses to historical forcing require surface climate data that capture those aspects of climate that control ecological processes, including key spatial gradients and modes of temporal variability. We developed a multivariate, gridded historical climate dataset for the conterminous USA as a common input database for the Vegetation/Ecosystem Modeling and Analysis Project (VEMAP), a biogeochemical and dynamic vegetation model intercomparison. The dataset covers the period 1895-1993 on a 0.5?? latitude/longitude grid. Climate is represented at both monthly and daily timesteps. Variables are: precipitation, mininimum and maximum temperature, total incident solar radiation, daylight-period irradiance, vapor pressure, and daylight-period relative humidity. The dataset was derived from US Historical Climate Network (HCN), cooperative network, and snowpack telemetry (SNOTEL) monthly precipitation and mean minimum and maximum temperature station data. We employed techniques that rely on geostatistical and physical relationships to create the temporally and spatially complete dataset. We developed a local kriging prediction model to infill discontinuous and limited-length station records based on spatial autocorrelation structure of climate anomalies. A spatial interpolation model (PRISM) that accounts for physiographic controls was used to grid the infilled monthly station data. We implemented a stochastic weather generator (modified WGEN) to disaggregate the gridded monthly series to dailies. Radiation and humidity variables were estimated from the dailies using a physically-based empirical surface climate model (MTCLIM3). Derived datasets include a 100 yr model spin-up climate and a historical Palmer Drought Severity Index (PDSI) dataset. The VEMAP dataset exhibits statistically significant trends in temperature, precipitation, solar radiation, vapor pressure, and PDSI for US National Assessment regions. The historical climate and companion datasets are available online at data archive centers. ?? Inter-Research 2004.

Retesting young STI clinic visitors with urogenital Chlamydia trachomatis infection in the Netherlands; response to a text message reminder and reinfection rates: a prospective study with historical controls.

PubMed

Kampman, Cjg; Koedijk, Fdh; Driessen-Hulshof, Hcm; Hautvast, Jla; van den Broek, Ivf

2016-03-01

The objective of this study is to assess the effect of reminder text messages 6 months after the initial treatment on retest and chlamydia reinfection rates in young heterosexuals compared with a historical control group and to assess factors associated with both outcomes. Heterosexual people (aged 16-23 years), testing positive for urogenital chlamydia, were offered a retest after 6 months. Participants received a text message reminder at 6 months after the initial chlamydia diagnosis. Rates of retest uptake and the result of the retest were analysed using Cox regression. Prevalence ratios (PRs) were calculated to identify factors associated with these outcomes. Furthermore, the retest rate was compared with the retest rate of a historical control group. 30.6% (253/838) of the study group returned within 5-8 months compared with 9.2% (140/1530) in the historical control group. Women and persons who were not notified for a sexually transmitted infection (STI) at inclusion were more likely to return for a retest. 20.4% (56/275) of participants had a chlamydia reinfection upon retesting. Reinfection was higher in participants reporting STI-related symptoms (PR 3.2, 95% CI 1.8 to 5.6) and in participants who were notified for an STI at retest (PR 5.3, 95% CI 2.4 to 11.5). A text message reminder appeared to have a clear, positive impact on the resulting retest rate. These results also indicate that retesting is necessary to identify chlamydia reinfections. 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/

Malaria resurgence: a systematic review and assessment of its causes

PubMed Central

2012-01-01

Background Considerable declines in malaria have accompanied increased funding for control since the year 2000, but historical failures to maintain gains against the disease underscore the fragility of these successes. Although malaria transmission can be suppressed by effective control measures, in the absence of active intervention malaria will return to an intrinsic equilibrium determined by factors related to ecology, efficiency of mosquito vectors, and socioeconomic characteristics. Understanding where and why resurgence has occurred historically can help current and future malaria control programmes avoid the mistakes of the past. Methods A systematic review of the literature was conducted to identify historical malaria resurgence events. All suggested causes of these events were categorized according to whether they were related to weakened malaria control programmes, increased potential for malaria transmission, or technical obstacles like resistance. Results The review identified 75 resurgence events in 61 countries, occurring from the 1930s through the 2000s. Almost all resurgence events (68/75 = 91%) were attributed at least in part to the weakening of malaria control programmes for a variety of reasons, of which resource constraints were the most common (39/68 = 57%). Over half of the events (44/75 = 59%) were attributed in part to increases in the intrinsic potential for malaria transmission, while only 24/75 (32%) were attributed to vector or drug resistance. Conclusions Given that most malaria resurgences have been linked to weakening of control programmes, there is an urgent need to develop practical solutions to the financial and operational threats to effectively sustaining today’s successful malaria control programmes. PMID:22531245

The Development of the Final Approach Spacing Tool (FAST): A Cooperative Controller-Engineer Design Approach

DOT National Transportation Integrated Search

1995-08-01

Historically, the development of advanced automation for air traffic control in : the United States has excluded the input of the air traffic controller until the : end of the development process. In contrast, the development of the Final : Approach ...

Adjuvant NY-ESO-1 vaccine immunotherapy in high-risk resected melanoma: a retrospective cohort analysis.

PubMed

Lattanzi, Michael; Han, Joseph; Moran, Una; Utter, Kierstin; Tchack, Jeremy; Sabado, Rachel Lubong; Berman, Russell; Shapiro, Richard; Huang, Hsin-Hui; Osman, Iman; Bhardwaj, Nina; Pavlick, Anna C

2018-05-18

Cancer-testis antigen NY-ESO-1 is a highly immunogenic melanoma antigen which has been incorporated into adjuvant vaccine clinical trials. Three such early-phase trials were conducted at our center among patients with high-risk resected melanoma. We herein report on the pooled long-term survival outcomes of these patients in comparison to historical controls. All melanoma patients treated at NYU Langone Health under any of three prospective adjuvant NY-ESO-1 vaccine trials were retrospectively pooled into a single cohort. All such patients with stage III melanoma were subsequently compared to historical control patients identified via a prospective institutional database with protocol-driven follow-up. Survival times were calculated using the Kaplan-Meier method, and Cox proportional hazard models were employed to identify significant prognostic factors and control for confounding variables. A total of 91 patients were treated with an NY-ESO-1 vaccine for the treatment of high-risk resected melanoma. Of this group, 67 patients were stage III and were selected for comparative analysis with 123 historical control patients with resected stage III melanoma who received no adjuvant therapy. Among the pooled vaccine cohort (median follow-up 61 months), the estimated median recurrence-free survival was 45 months, while the median overall survival was not yet reached. In the control cohort of 123 patients (median follow-up 30 months), the estimated median recurrence-free and overall survival were 22 and 58 months, respectively. Within the retrospective stage III cohort, NY-ESO-1 vaccine was associated with decreased risk of recurrence (HR = 0.56, p < 0.01) and death (HR = 0.51, p = 0.01). Upon controlling for sub-stage, the adjuvant NY-ESO-1 clinical trial cohort continued to exhibit decreased risk of recurrence (HR = 0.45, p < 0.01) and death (HR = 0.40, p < 0.01). In this small retrospective cohort of resected stage III melanoma patients, adjuvant NY-ESO-1 vaccine immunotherapy was associated with longer recurrence-free and overall survival relative to historical controls. These data support the continued investigation of adjuvant NY-ESO-1 based immunotherapy regimens in melanoma.

Non-inferiority tests for anti-infective drugs using control group quantiles.

PubMed

Fay, Michael P; Follmann, Dean A

2016-12-01

In testing for non-inferiority of anti-infective drugs, the primary endpoint is often the difference in the proportion of failures between the test and control group at a landmark time. The landmark time is chosen to approximately correspond to the qth historic quantile of the control group, and the non-inferiority margin is selected to be reasonable for the target level q. For designing these studies, a troubling issue is that the landmark time must be pre-specified, but there is no guarantee that the proportion of control failures at the landmark time will be close to the target level q. If the landmark time is far from the target control quantile, then the pre-specified non-inferiority margin may not longer be reasonable. Exact variable margin tests have been developed by Röhmel and Kieser to address this problem, but these tests can have poor power if the observed control failure rate at the landmark time is far from its historic value. We develop a new variable margin non-inferiority test where we continue sampling until a pre-specified proportion of failures, q, have occurred in the control group, where q is the target quantile level. The test does not require any assumptions on the failure time distributions, and hence, no knowledge of the true [Formula: see text] control quantile for the study is needed. Our new test is exact and has power comparable to (or greater than) its competitors when the true control quantile from the study equals (or differs moderately from) its historic value. Our nivm R package performs the test and gives confidence intervals on the difference in failure rates at the true target control quantile. The tests can be applied to time to cure or other numeric variables as well. A substantial proportion of new anti-infective drugs being developed use non-inferiority tests in their development, and typically, a pre-specified landmark time and its associated difference margin are set at the design stage to match a specific target control quantile. If through changing standard of care or selection of a different population the target quantile for the control group changes from its historic value, then the appropriateness of the pre-specified margin at the landmark time may be questionable. Our proposed test avoids this problem by sampling until a pre-specified proportion of the controls have failed. © The Author(s) 2016.

A Quasi-Experimental Control Group Design Study to Determine the Effect of Integrating Character Education into a High School Social Studies Curriculum through Storytelling

ERIC Educational Resources Information Center

Long, Russell L.

2014-01-01

The purpose of this study was to offer evidence for the development of student character through the integration of historical storytelling into a social studies classroom. A quasi-experimental study was conducted to determine the effect of character education through historical storytelling integrated into a United States history curriculum on…

Archeological and Historic Cultural Resources Inventory for a Proposed Flood Control Project at Devils Lake, Ramsey County, North Dakota.

DTIC Science & Technology

1983-10-01

Chautauqua Association signed a contract with J.H. McCulloch to secure a right-of- way for the Chautauqua Railway. McCulloch received a 30 year franchise in...excavation at Bakery of U.S. military fort Palo Duro St. Park, TX; Test excavation at historic dugout Sea Rim State Park, TX; Archaeological survey San

World population, world health and security: 20th century trends.

PubMed

Bashford, A

2008-03-01

The connection between infectious disease control and national security is now firmly entrenched. This article takes a historical look at another security issue once prominent in debate on foreign policy and international relations, but now more or less absent: overpopulation. It explores the nature of the debate on population as a security question, and its complicated historical relation to the development of world health.

Ancient DNA reveals substantial genetic diversity in the California Condor (Gymnogyps californianus) prior to a population bottleneck

USGS Publications Warehouse

D'Elia, Jesse; Haig, Susan M.; Mullins, Thomas D.; Miller, Mark P.

2016-01-01

Critically endangered species that have undergone severe population bottlenecks often have little remaining genetic variation, making it difficult to reconstruct population histories to apply in reintroduction and recovery strategies. By using ancient DNA techniques, it is possible to combine genetic evidence from the historical population with contemporary samples to provide a more complete picture of a species' genetic variation across its historical range and through time. Applying this approach, we examined changes in the mitochondrial DNA (mtDNA) control region (526 base pairs) of the endangered California Condor (Gymnogyps californianus). Results showed a >80% reduction in unique haplotypes over the past 2 centuries. We found no spatial sorting of haplotypes in the historical population; the periphery of the range contained haplotypes that were common throughout the historical range. Direct examination of mtDNA from California Condor museum specimens provided a new window into historical population connectivity and genetic diversity showing: (1) a substantial loss of haplotypes, which is consistent with the hypothesis that condors were relatively abundant in the nineteenth century, but declined rapidly as a result of human-caused mortality; and (2) no evidence of historical population segregation, meaning that the available genetic data offer no cause to avoid releasing condors in unoccupied portions of their historical range.

The relationship between historical development and potentially toxic element concentrations in urban soils.

PubMed

McIlwaine, Rebekka; Doherty, Rory; Cox, Siobhan F; Cave, Mark

2017-01-01

Increasing urbanisation has a direct impact on soil quality, resulting in elevated concentrations of potentially toxic elements (PTEs) in soils. This research aims to assess if soil PTE concentrations can be used as an 'urbanisation tracer' by investigating geogenic and anthropogenic source contributions and controls, and considering PTE enrichment across historical urban development zones. The UK cities of Belfast and Sheffield are chosen as study areas, where available shallow and deep concentrations of PTEs in soil are compared to identify geogenic and anthropogenic contributions to PTEs. Cluster analysis and principal component analysis are used to elucidate the main controls over PTE concentrations. Pollution indices indicate that different periods of historical development are linked to enrichment of different PTEs. Urban subdomains are identified and background values calculated using various methodologies and compared to generic site assessment criteria. Exceedances for a number of the PTEs considered suggest a potential human health risk could be posed across subdomains of both Belfast and Sheffield. This research suggests that airborne diffuse contamination from often historical sources such as traffic, domestic combustion and industrial processes contribute greatly to soil contamination within urban environments. The relationship between historical development and differing PTEs is a novel finding, suggesting that PTEs have the potential for use as 'urbanisation tracers'. The investigative methodology employed has potential applications for decision makers, urban planners, regulators and developers of urban areas. Copyright © 2016 Elsevier Ltd. All rights reserved.

40 CFR 799.9130 - TSCA acute inhalation toxicity.

Code of Federal Regulations, 2012 CFR

2012-07-01

... of the substance in the atmosphere, a vehicle control group should be used when historical data are... system to assign animals to test groups and control groups randomly is required. (2) Control groups. A concurrent untreated control group is not necessary. Where a vehicle other than water is used to generate an...

40 CFR 799.9130 - TSCA acute inhalation toxicity.

Code of Federal Regulations, 2013 CFR

2013-07-01

... of the substance in the atmosphere, a vehicle control group should be used when historical data are... system to assign animals to test groups and control groups randomly is required. (2) Control groups. A concurrent untreated control group is not necessary. Where a vehicle other than water is used to generate an...

40 CFR 799.9130 - TSCA acute inhalation toxicity.

Code of Federal Regulations, 2014 CFR

2014-07-01

... of the substance in the atmosphere, a vehicle control group should be used when historical data are... system to assign animals to test groups and control groups randomly is required. (2) Control groups. A concurrent untreated control group is not necessary. Where a vehicle other than water is used to generate an...

Historical perspective on biological control of postharvest diseases – past, present, and future

USDA-ARS?s Scientific Manuscript database

The birth of the field of biological control of postharvest diseases can be traced back to 1984 when a researcher testing an antagonist (Bacillus subtilis) in the field to control brown rot of peaches (caused by Monilinia fructicola ) decided to apply the antagonist directly to the peach to control ...

What Can We Learn From Historical Trends and Distributions of Malaria? Historical Case Studies From the US, Italy, and Sri Lanka

NASA Astrophysics Data System (ADS)

Matthews, E.

2008-12-01

Malaria is currently prevalent in many countries and has been for centuries. Primary controllers of the distribution and incidence of malaria in the past have been economic, social, military, political etc. with a modest contribution from local climate variations. Studies of potential impacts of climate change on the epidemiology of diseases such as malaria have focused on the impact of changing environmental conditions on vector physiology but little attention has been paid to factors that explain historical variations in spatial and temporal distributions of the disease. This talk reports results of three historical case studies from the US, Italy and Sri Lanka that bring together a breadth of information from varied sources in order to illustrate the value of including such information in studies of disease-climate connections.

SEWER-SEDIMENT CONTROL: OVERVIEW OF AN EPA WET-WEATHER FLOW RESEARCH PROGRAM

EPA Science Inventory

This paper presents a historical overview of the sewer sediment control projects conducted by the Wet-Weather Flow Research Program of the USEPA. Research presented includes studies of the causes of sewer solids deposition and development/evaluation of control methods that can pr...

Conversion to lacosamide monotherapy in the treatment of focal epilepsy: Results from a historical-controlled, multicenter, double-blind study

PubMed Central

Wechsler, Robert T; Li, George; French, Jacqueline; O'Brien, Terence J; D'Cruz, O'Neill; Williams, Paulette; Goodson, Robin; Brock, Melissa

2014-01-01

Objective To evaluate the efficacy and safety of conversion to lacosamide 400 mg/day monotherapy in adults with focal epilepsy. Methods This historical-controlled, double-blind study (NCT00520741) enrolled patients aged 16–70 years on stable doses of 1–2 antiepileptic drugs (AEDs) and experiencing 2–40 partial-onset seizures per 28 days during the 8-week prospective Baseline. Patients were randomized to lacosamide 400 or 300 mg/day (3:1 ratio), starting at 200 mg/day and titrated over 3 weeks to randomized dose. Patients then withdrew background AEDs over 6 weeks and entered a 10-week Monotherapy Phase. The primary assessment was the Kaplan-Meier–predicted percentage of patients on 400 mg/day in the full analysis set (FAS) meeting ≥1 predefined seizure-related exit criterion by day 112, compared with the historical-control threshold (65.3%). Results Four hundred twenty-five patients were enrolled and were eligible for safety analyses (400 mg/day, n = 319; 300 mg/day, n = 106). A total of 271 (63.8%) of 425 patients completed the Lacosamide Maintenance Phase (combined AED Withdrawal and Monotherapy Phases). Among 284 patients in the 400 mg/day group in the FAS, 82 (28.9%) met ≥1 exit criterion; the Kaplan-Meier–predicted exit percentage at day 112 for 400 mg/day (30.0%; 95% confidence interval [CI] 24.6–35.5%) was lower than the historical control. When exit events, withdrawal due to treatment-emergent adverse events (TEAEs), and withdrawal due to lack of efficacy were summed (n = 90), the predicted exit percentage (32.3%; 95% CI 26.8–37.8%) was also lower than the historical control. Most patients receiving 400 mg/day reported some improvement on the Clinical Global Impression of Change (75.4%) and Patient Global Impression of Change (74.3%). Overall, the most common (>10%) TEAEs were dizziness (24.0%), headache (14.4%), nausea (13.4%), convulsion (11.5%), somnolence (10.4%), and fatigue (10.1%); most (74.1%) were mild-to-moderate in intensity. Seventy-two patients (16.9%) discontinued due to TEAEs. Seventeen patients (4%, all receiving 400 mg/day) experienced serious AEs. Significance Lacosamide 400 mg/day monotherapy was effective, with a favorable safety profile in patients with focal epilepsy. PMID:24915838

Conversion to lacosamide monotherapy in the treatment of focal epilepsy: results from a historical-controlled, multicenter, double-blind study.

PubMed

Wechsler, Robert T; Li, George; French, Jacqueline; O'Brien, Terence J; D'Cruz, O'Neill; Williams, Paulette; Goodson, Robin; Brock, Melissa

2014-07-01

To evaluate the efficacy and safety of conversion to lacosamide 400 mg/day monotherapy in adults with focal epilepsy. This historical-controlled, double-blind study (NCT00520741) enrolled patients aged 16-70 years on stable doses of 1-2 antiepileptic drugs (AEDs) and experiencing 2-40 partial-onset seizures per 28 days during the 8-week prospective Baseline. Patients were randomized to lacosamide 400 or 300 mg/day (3:1 ratio), starting at 200 mg/day and titrated over 3 weeks to randomized dose. Patients then withdrew background AEDs over 6 weeks and entered a 10-week Monotherapy Phase. The primary assessment was the Kaplan-Meier-predicted percentage of patients on 400 mg/day in the full analysis set (FAS) meeting ≥ 1 predefined seizure-related exit criterion by day 112, compared with the historical-control threshold (65.3%). Four hundred twenty-five patients were enrolled and were eligible for safety analyses (400 mg/day, n = 319; 300 mg/day, n = 106). A total of 271 (63.8%) of 425 patients completed the Lacosamide Maintenance Phase (combined AED Withdrawal and Monotherapy Phases). Among 284 patients in the 400 mg/day group in the FAS, 82 (28.9%) met ≥ 1 exit criterion; the Kaplan-Meier-predicted exit percentage at day 112 for 400 mg/day (30.0%; 95% confidence interval [CI] 24.6-35.5%) was lower than the historical control. When exit events, withdrawal due to treatment-emergent adverse events (TEAEs), and withdrawal due to lack of efficacy were summed (n = 90), the predicted exit percentage (32.3%; 95% CI 26.8-37.8%) was also lower than the historical control. Most patients receiving 400 mg/day reported some improvement on the Clinical Global Impression of Change (75.4%) and Patient Global Impression of Change (74.3%). Overall, the most common (>10%) TEAEs were dizziness (24.0%), headache (14.4%), nausea (13.4%), convulsion (11.5%), somnolence (10.4%), and fatigue (10.1%); most (74.1%) were mild-to-moderate in intensity. Seventy-two patients (16.9%) discontinued due to TEAEs. Seventeen patients (4%, all receiving 400 mg/day) experienced serious AEs. Lacosamide 400 mg/day monotherapy was effective, with a favorable safety profile in patients with focal epilepsy. Wiley Periodicals, Inc. © 2014 International League Against Epilepsy.

Light use study for vertical channelization devices

DOT National Transportation Integrated Search

2003-05-01

Although the Manual on Uniform Traffic Control Devices (MUTCD) does not require the use of warning lights on channelization devices, the Arizona Department of Transportation (ADOT) has historically required their use on all traffic control devices us...

Waterflood control system for maximizing total oil recovery

DOEpatents

Patzek, Tadeusz Wiktor; Silin, Dimitriy Borisovic; De, Asoke Kumar

2005-06-07

A control system and method for determining optimal fluid injection pressure is based upon a model of a growing hydrofracture due to waterflood injection pressure. This model is used to develop a control system optimizing the injection pressure by using a prescribed injection goal coupled with the historical times, pressures, and volume of injected fluid at a single well. In this control method, the historical data is used to derive two major flow components: the transitional component, where cumulative injection volume is scaled as the square root of time, and a steady-state breakthrough component, which scales linearly with respect to time. These components provide diagnostic information and allow for the prevention of rapid fracture growth and associated massive water break through that is an important part of a successful waterflood, thereby extending the life of both injection and associated production wells in waterflood secondary oil recovery operations.

Waterflood control system for maximizing total oil recovery

DOEpatents

Patzek, Tadeusz Wiktor [Oakland, CA; Silin, Dimitriy Borisovich [Pleasant Hill, CA; De, Asoke Kumar [San Jose, CA

2007-07-24

A control system and method for determining optimal fluid injection pressure is based upon a model of a growing hydrofracture due to waterflood injection pressure. This model is used to develop a control system optimizing the injection pressure by using a prescribed injection goal coupled with the historical times, pressures, and volume of injected fluid at a single well. In this control method, the historical data is used to derive two major flow components: the transitional component, where cumulative injection volume is scaled as the square root of time, and a steady-state breakthrough component, which scales linearly with respect to time. These components provide diagnostic information and allow for the prevention of rapid fracture growth and associated massive water break through that is an important part of a successful waterflood, thereby extending the life of both injection and associated production wells in waterflood secondary oil recovery operations.

Nuclear technology requires free elections

NASA Astrophysics Data System (ADS)

Synek, Miroslav

1999-10-01

The historical development on our planet has reached a powerful technology of nuclear intercontinental ballistic missiles, conceivably controllable through a computerized ``push-button." If this technology ever falls under the control of an irresponsible, miscalculating, or insane DICTATOR, with powerful means of a mass-produced nuclear built-up, anywhere on our planet, the very SURVIVAL OF ALL HUMANITY on our planet could be threatened. Therefore, it is a historical urgency that this technology is under the control by the people, through a sufficiently secure system of FREE ELECTIONS, in any country, wherever and whenever such a threatening possibility exists. Of course, a starting system of FREE ELECTIONS, even if quite rudimentary, should try to provide for its continuous functioning, with an underlying appropriate freedom of expression and with rules for its continuation, while aiming towards continuous improvements.

Intrapartum diagnostic of Roberts syndrome - case presentation.

PubMed

Socolov, Răzvan Vladimir; Andreescu, Nicoleta Ioana; Haliciu, Ana Maria; Gorduza, Eusebiu Vlad; Dumitrache, Florentin; Balan, Raluca Anca; Puiu, Maria; Dobrescu, Mihaela Amelia; Socolov, Demetra Gabriela

2015-01-01

Roberts syndrome is a rare disease, with multiple limb and skeletal abnormalities (called "pseudothalidomide disease"). There are only around 150 cases described in literature. We present a case of Roberts syndrome, diagnosed in moment of delivery, after a pregnancy without prenatal follow-up. The stillborn baby was naturally delivered by a 17-year-old primiparous woman at 38 weeks of amenorrhea. The pregnancy was not followed due to socioeconomic and family situation, and no prenatal ultrasound was performed. The male baby has 2650 g and presented several morphological abnormalities and tight double umbilical abdominal loop. The macroscopic evaluation showed: dolichocephaly, hypoplastic inferior maxilla with micrognathia, antimongoloid palpebral slant, pterygium colli, abnormal and lower implanted ears, superior limbs phocomelia, syndactyly at lower left limb and tetradactyly in all limbs, bilateral cryptorchidism, pancreatic aplasia. Roberts syndrome is a rare genetic disease with recessive autosomal transmission generated by mutations in ESCO2 gene, located on chromosome 8. The disease should be easy to diagnose by antenatal ultrasound examination, but in our case, the lack of prenatal follow-up determined the diagnostic at term. We believe consider this case is an argument towards introducing ultrasound-screening compulsory to all pregnancies. To identify a possible genetic mutation, further investigations of the parents are in progress, but classically the disease has a recessive autosomal transmission.

Ocular health assessment of cocoa farmers in a rural community in Ghana.

PubMed

Boadi-Kusi, Samuel Bert; Hansraj, Rekha; Kumi-Kyereme, Akwasi; Mashige, Khathutshelo Percy; Awusabo-Asare, Kofi; Ocansey, Stephen; Kyei, Samuel

2014-01-01

Cocoa farming provides employment for over 800,000 households in rural Ghana, with the country currently touted as the second largest producer of cocoa worldwide. Agriculture is one of the riskiest occupations for the eyes due to the numerous ocular hazards on farms. The authors conducted an ocular health assessment among cocoa farmers at Mfuom, a rural community in the Central Region of Ghana, to examine the ocular health status and the ocular safety measures used by cocoa farmers. A structured questionnaire was used to evaluate demographic characteristics, ocular injuries, and utilization of eye care services and ocular protection, and a clinical examination was used to evaluate their ocular status. Cocoa farmers were at high risk for ocular injuries and farm-related vision disorders and utilized eye care services and ocular protection poorly. Ocular condition identified were mainly refractive error (28.6%), cataract (20.0%), glaucoma (11.7%), conjunctivitis (13%), pterygium (2.7%), and cornea opacity (2.2%). There is a need for the introduction of an interventional eye care program to help address the ocular health challenges identified among the farmers. This can be done through collaborative efforts by educational institutions, government, and other role players in the agricultural industry to improve the quality of life of the vulnerable cocoa farmers in rural Ghana.

Toward an Orofacial Gene Regulatory Network

PubMed Central

Kousa, Youssef A.; Schutte, Brian C.

2015-01-01

Orofacial clefting is a common birth defect with significant morbidity. A panoply of candidate genes have been discovered through synergy of animal models and human genetics. Among these, variants in Interferon Regulatory Factor 6 (IRF6) cause syndromic orofacial clefting and contribute risk toward isolated cleft lip and palate (1/700 live births). Rare variants in IRF6 can lead to Van der Woude Syndrome (1/35,000 live births) and Popliteal Pterygium Syndrome (1/300,000 live births). Furthermore, IRF6 regulates GRHL3 and rare variants in this downstream target can also lead to Van der Woude Syndrome. In addition, a common variant (rs642961) in the IRF6 locus is found in 30% of the world’s population and contributes risk for isolated orofacial clefting. Biochemical studies revealed that rs642961 abrogates one of four AP-2alpha binding sites. Like IRF6 and GRHL3, rare variants in TFAP2A can also lead to syndromic orofacial clefting with lip pits (Branchio-oculo-facial Syndrome). The literature suggests that AP-2alpha, IRF6 and GRHL3 are part of a pathway that is essential for lip and palate development. In addition to updating the pathways, players and pursuits, this review will highlight some of the current questions in the study of orofacial clefting. PMID:26332872

Health hazards and mitigation of chronic poisoning from arsenic in drinking water: Taiwan experiences.

PubMed

Chen, Chien-Jen

2014-01-01

There are two endemic areas of long-term exposure to arsenic from drinking water in Taiwan. Residents in the southwestern and northeastern endemic areas started using high-arsenic artesian well water in the early 1910s and late 1940s, respectively. Public water supply system using surface water was implemented in southwestern and northeastern endemic areas in the 1970s and 1990s, respectively. Systemic health hazards of long-term exposure to arsenic in drinking water have been intensively investigated since the 1960s, especially after 1985 in Taiwan. Several diseases have been well documented to be associated with chronic arsenic poisoning from drinking water showing a dose-response relation. They include characteristic skin lesions like hyperpigmentation or depigmentation, hyperkeratosis in palms and soles, and Bowen disease, peripheral vascular disease (specifically blackfoot disease), ischemic heart disease, cerebral infarction, microvascular diseases, abnormal peripheral microcirculation, carotid atherosclerosis, QT prolongation and increased dispersion in electrocardiography, hypertension, goiter, diabetes mellitus, cataract (specifically posterior subcapsular lens opacity), pterygium, slow neural conduction, retarded neurobehavioral development, erectile dysfunction, and cancers of the skin, lung, urinary bladder, kidney, and liver. The method of choice to mitigate arsenic poisoning through drinking water is to use safe drinking water from uncontaminated sources.

Future Years Defense Program (FYDP) Structure

DTIC Science & Technology

2004-04-01

JC - United States Central Command DoD 7045.7-H, April 2004 12 JCA - CJCS Controlled Activities JE - United States European Command JFC - United...Codes ARMY TITLECODE TITLECODE(H) = Historical (H) = Historical 1291 Line of Sight Anti-Tank (LOSAT) Battalion 1295 Armored Cavalry Squadrons (ACR) 1296...TRI-TAC) 0208010N Joint Tactical Communications Program (TRI-TAC) 0208011A CJCS Exercise Program 0208011F CJCS Exercise Program 0208011J CJCS Exercise

Austrian Daily Climate Data Rescue and Quality Control

NASA Astrophysics Data System (ADS)

Jurkovic, A.; Lipa, W.; Adler, S.; Albenberger, J.; Lechner, W.; Swietli, R.; Vossberg, I.; Zehetner, S.

2010-09-01

Checked climate datasets are a "conditio sine qua non" for all projects that are relevant for environment and climate. In the framework of climate change studies and analysis it is essential to work with quality controlled and trustful data. Furthermore these datasets are used as input for various simulation models. In regard to investigations of extreme events, like strong precipitation periods, drought periods and similar ones we need climate data in high temporal resolution (at least in daily resolution). Because of the historical background - during Second World War the majority of our climate sheets were sent to Berlin, where the historical sheets were destroyed by a bomb attack and so important information got lost - only several climate sheets, mostly duplicates, before 1939 are available and stored in our climate data archive. In 1970 the Central Institute for Meteorology and Geodynamics in Vienna started a first attempt to digitize climate data by means of punch cards. With the introduction of a routinely climate data quality control in 1984 we can speak of high-class-checked daily data (finally checked data, quality flag 6). Our group is working on the processing of digitization and quality control of the historical data for the period 1872 to 1983 for 18 years. Since 2007 it was possible to intensify the work (processes) in the framework of an internal project, namely Austrian Climate Data Rescue and Quality Control. The aim of this initiative was - and still is - to supply daily data in an outstanding good and uniform quality. So this project is a kind of pre-project for all scientific projects which are working with daily data. In addition to routine quality checks (that are running since 1984) using the commercial Bull Software we are testing our data with additional open source software, namely ProClim.db. By the use of this spatial and statistical test procedure, the elements air temperature and precipitation - for several sites in Carinthia - could already be checked, flagged and corrected. Checking the output (so called- error list) of ProClim is very time consuming and needs trained staff; however, in last instance it is necessary. Due to the guideline "Your archive is your business card for quality" the sub-project NEW ARCHIVE was initialized and started at the end of 2009. Our paper archive contains historical, up to 150 year-old, climate sheets that are valuable cultural assets. Unfortunately the storage of these historical and actual data treasures turned out to be more than suboptimal (insufficient protection against dust, dirt, humidity and light incidence). Because of this fact a concept for a new storage system and archive database was generated and already partly realized. In a nutshell this presentation shows on the one hand the importance of recovering historical climate sheets for climate change research - even if it is exhausting and time consuming - and gives on the other hand a general overview of used quality control procedures at our institute.

COLLECTION SYSTEM SOLIDS CONTROL: OVERVIEW OF AN EPA WET-WEATHER FLOW RESEARCH PROGRAM

EPA Science Inventory

This paper presents an historical overview of the sewer-solids control projects conducted by the Wet-Weather Flow Research Program of the US EPA. Research includes studies of the causes of sewer-solids deposition and development/evaluation of control methods that can prevent sewe...

The effect of motor control and tactile acuity training on patients with non-specific low back pain and movement control impairment.

PubMed

Gutknecht, Magdalena; Mannig, Angelika; Waldvogel, Anja; Wand, Benedict M; Luomajoki, Hannu

2015-10-01

Movement control impairment is a clinical subgroup of non-specific low back pain which can be assessed reliably. There is a strong correlation between tactile acuity and movement control suggesting these two treatments might have additive effects. The first research aim was to determine if patients with a motor control impairment demonstrated improvement in outcome with combined tactile acuity and motor control training. The second aim was to determine if tactile acuity training enhanced the effect of motor control training. The primary study was a single-arm cohort study conducted in three physiotherapy practices in the German-speaking part of Switzerland. 40 patients (23 males and 17 females) suffering from non-specific low back pain (NSLBP) and movement control impairment were treated. Patients were assessed at baseline and immediately post treatment. Treatment included exercises to lumbopelvic control and graphesthesia training to improve tactile acuity. Treatment effects were evaluated using the Roland Morris disability questionnaire (RMQ) and the patient-specific functional scale (PSFS). The performance on a set of six movement control tests and lumbar two-point discrimination were also assessed. The results of this cohort study were compared with a historic control group which was comparable with the primary study but included only motor control exercises. All the outcomes improved significantly with the combined training (RMQ - 2.2 pts., PSFS - 2.8 pts.; MCTB - 2.02 pts. & TPD - 17.07 mm; all p < 0.05). In comparison to the outcomes of the historic control, there was no significant differences in movement control, patient-specific functional complaints or disability between the groups. The results of this study, based on a before and after intervention comparison, showed that outcome improved significantly following combined tactile acuity and motor control training. However, compared to an earlier study, the tactile acuity training did not have an additional effect to the results. The use of historical controls does not control for allocation bias and the results obtained here require verification in a randomized controlled trial. Copyright © 2014 Elsevier Ltd. All rights reserved.

Command generator tracker based direct model reference adaptive control of a PUMA 560 manipulator. Thesis

NASA Technical Reports Server (NTRS)

Swift, David C.

1992-01-01

This project dealt with the application of a Direct Model Reference Adaptive Control algorithm to the control of a PUMA 560 Robotic Manipulator. This chapter will present some motivation for using Direct Model Reference Adaptive Control, followed by a brief historical review, the project goals, and a summary of the subsequent chapters.

Control of Initialized Fractional-Order Systems. Revised

NASA Technical Reports Server (NTRS)

Hartley, Tom T.; Lorenzo, Carl F.

2002-01-01

Due to the importance of historical effects in fractional-order systems, this paper presents a general fractional-order control theory that includes the time-varying initialization response. Previous studies have not properly accounted for these historical effects. The initialization response, along with the forced response, for fractional-order systems is determined. Stability properties of fractional-order systems are presented in the complex w-plane, which is a transformation of the s-plane. Time responses are discussed with respect to pole positions in the complex w-plane and frequency response behavior is included. A fractional-order vector space representation, which is a generalization of the state space concept, is presented including the initialization response. Control methods for vector representations of initialized fractional-order systems are shown. Nyquist, root-locus, and other input-output control methods are adapted to the control of fractional-order systems. Finally, the fractional-order differintegral is generalized to continuous order-distributions that have the possibility of including a continuum of fractional orders in a system element.

Control of Initialized Fractional-Order Systems

NASA Technical Reports Server (NTRS)

Hartly, Tom T.; Lorenzo, Carl F.

2002-01-01

Due to the importance of historical effects in fractional-order systems, this paper presents a general fractional-order control theory that includes the time-varying initialization response. Previous studies have not properly accounted for these historical effects. The initialization response, along with the forced response, for fractional-order systems is determined. Stability properties of fractional-order systems are presented in the complex Airplane, which is a transformation of the s-plane. Time responses are discussed with respect to pole positions in the complex Airplane and frequency response behavior is included. A fractional-order vector space representation, which is a generalization of the state space concept, is presented including the initialization response. Control methods for vector representations of initialized fractional-order systems are shown. Nyquist, root-locus, and other input-output control methods are adapted to the control of fractional-order systems. Finally, the fractional-order differintegral is generalized to continuous order-distributions that have the possibility of including a continuum of fractional orders in a system element.

Aerodynamic design via control theory

NASA Technical Reports Server (NTRS)

Jameson, Antony

1988-01-01

The question of how to modify aerodynamic design in order to improve performance is addressed. Representative examples are given to demonstrate the computational feasibility of using control theory for such a purpose. An introduction and historical survey of the subject is included.

Incorporating historical information in biosimilar trials: Challenges and a hybrid Bayesian-frequentist approach.

PubMed

Mielke, Johanna; Schmidli, Heinz; Jones, Byron

2018-05-01

For the approval of biosimilars, it is, in most cases, necessary to conduct large Phase III clinical trials in patients to convince the regulatory authorities that the product is comparable in terms of efficacy and safety to the originator product. As the originator product has already been studied in several trials beforehand, it seems natural to include this historical information into the showing of equivalent efficacy. Since all studies for the regulatory approval of biosimilars are confirmatory studies, it is required that the statistical approach has reasonable frequentist properties, most importantly, that the Type I error rate is controlled-at least in all scenarios that are realistic in practice. However, it is well known that the incorporation of historical information can lead to an inflation of the Type I error rate in the case of a conflict between the distribution of the historical data and the distribution of the trial data. We illustrate this issue and confirm, using the Bayesian robustified meta-analytic-predictive (MAP) approach as an example, that simultaneously controlling the Type I error rate over the complete parameter space and gaining power in comparison to a standard frequentist approach that only considers the data in the new study, is not possible. We propose a hybrid Bayesian-frequentist approach for binary endpoints that controls the Type I error rate in the neighborhood of the center of the prior distribution, while improving the power. We study the properties of this approach in an extensive simulation study and provide a real-world example. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Mackay campus of environmental education and digital cultural construction: the application of 3D virtual reality

NASA Astrophysics Data System (ADS)

Chien, Shao-Chi; Chung, Yu-Wei; Lin, Yi-Hsuan; Huang, Jun-Yi; Chang, Jhih-Ting; He, Cai-Ying; Cheng, Yi-Wen

2012-04-01

This study uses 3D virtual reality technology to create the "Mackay campus of the environmental education and digital cultural 3D navigation system" for local historical sites in the Tamsui (Hoba) area, in hopes of providing tourism information and navigation through historical sites using a 3D navigation system. We used Auto CAD, Sketch Up, and SpaceEyes 3D software to construct the virtual reality scenes and create the school's historical sites, such as the House of Reverends, the House of Maidens, the Residence of Mackay, and the Education Hall. We used this technology to complete the environmental education and digital cultural Mackay campus . The platform we established can indeed achieve the desired function of providing tourism information and historical site navigation. The interactive multimedia style and the presentation of the information will allow users to obtain a direct information response. In addition to showing the external appearances of buildings, the navigation platform can also allow users to enter the buildings to view lifelike scenes and textual information related to the historical sites. The historical sites are designed according to their actual size, which gives users a more realistic feel. In terms of the navigation route, the navigation system does not force users along a fixed route, but instead allows users to freely control the route they would like to take to view the historical sites on the platform.

Strategy And The Spreadsheet: Optimizing The Total Army To Satisfy Both

DTIC Science & Technology

2016-02-11

historically reduces military end strength at the conclusion of major conflicts. The Budget Control Act of 2011 imposed sequestration spending limits on...the military that began the process of drawing down the military through fiscal year 2021. While the 2016 defense budget delays sequestration cuts... budget by a wide margin, has started repeating a historical cycle of budget driven defense cuts. The Army’s large force represents an attractive

Malaria and the work of WHO.

PubMed Central

Najera, J. A.

1989-01-01

Malaria has been one of the main health problems demanding the attention of WHO from the time the Organization was created. This review of the historical record analyses the different approaches to the malaria problem in the past 40 years and shows how WHO tried to fulfil its constitutional mandate. The article exposes the historical roots of the present situation and helps towards an understanding of current problems and approaches to malaria control. PMID:2670294

Studies of poststrike air traffic control specialist trainees. II., Selection and screening programs.

DOT National Transportation Integrated Search

1988-07-01

Specific contributions of aviation psychologists to the selection and Academy training of FAA air traffic control specialists are presented in an historical context. Research results which formed the basis for the written aptitude selection tests, Th...

HISTORICAL DEVELOPMENT OF WET-WEATHER FLOW MANAGEMENT

EPA Science Inventory

The management of wet-weather flow (WWF) is necessary to maintain the quality of urban water resources. Throughout history strategies were implemented to control WWF for reasons, e.g., flood and water quality control, aesthetic improvement, waste removal and others. A comprehen...

Integrated Vehicle Ground Vibration Testing of Manned Spacecraft: Historical Precedent

NASA Technical Reports Server (NTRS)

Lemke, Paul R.; Tuma, Margaret L.; Askins, Bruce R.

2008-01-01

For the first time in nearly 30 years, NASA is developing a new manned space flight launch system. The Ares I will carry crew and cargo to not only the International Space Station, but onward for the future exploration of the Moon and Mars. The Ares I control system and structural designs use complex computer models for their development. An Integrated Vehicle Ground Vibration Test (IVGVT) will validate the efficacy of these computer models. The IVGVT will reduce the technical risk of unexpected conditions that could place the vehicle or crew in jeopardy. The Ares Project Office's Flight and Integrated Test Office commissioned a study to determine how historical programs, such as Saturn and Space Shuttle, validated the structural dynamics of an integrated flight vehicle. The study methodology was to examine the historical record and seek out members of the engineering community who recall the development of historic manned launch vehicles. These records and interviews provided insight into the best practices and lessons learned from these historic development programs. The information that was gathered allowed the creation of timelines of the historic development programs. The timelines trace the programs from the development of test articles through test preparation, test operations, and test data reduction efforts. These timelines also demonstrate how the historical tests fit within their overall vehicle development programs. Finally, the study was able to quantify approximate staffing levels during historic development programs. Using this study, the Flight and Integrated Test Office was able to evaluate the Ares I Integrated Vehicle Ground Vibration Test schedule and workforce budgets in light of the historical precedents to determine if the test had schedule or cost risks associated with it.

Primitive environment control for preservation of pit relics in archeology museums of China.

PubMed

Gu, Zhaolin; Luo, Xilian; Meng, Xiangzhao; Wang, Zanshe; Ma, Tao; Yu, Chuck; Rong, Bo; Li, Ku; Li, Wenwu; Tan, Ying

2013-02-05

Immovable historical relics in some archeology museums of China suffer deterioration due to their improper preservation environment. The existing environmental control systems used in archeology museums are often designed for the amenities of visitors, and these manipulated environments are often inappropriate for the conservation of abiotic relics. This paper points out that the large open space of the existing archeology museum could be a cause of deterioration of the relics from the point of view of indoor air convective flow. The paper illustrates the need to introduce a local pit environmental control, which could reintegrate a pit primitive environment for the preservation of the historical relics by using an air curtain system, orientated to isolate the unearthed relics, semiexposed in pits to the large gallery open space of the exhibition hall.

Arsenic solid-phase speciation and reversible binding in long-term contaminated soils.

PubMed

Rahman, M S; Clark, M W; Yee, L H; Comarmond, M J; Payne, T E; Kappen, P; Mokhber-Shahin, L

2017-02-01

Historic arsenic contamination of soils occurs throughout the world from mining, industrial and agricultural activities. In Australia, the control of cattle ticks using arsenicals from the late 19th to mid 20th century has led to some 1600 contaminated sites in northern New South Wales. The effect of aging in As-mobility in two dip-site soil types, ferralitic and sandy soils, are investigated utilizing isotopic exchange techniques, and synchrotron X-ray adsorption spectroscopy (XAS). Findings show that historic soil arsenic is highly bound to the soils with >90% irreversibly bound. However, freshly added As (either added to historically loaded soils or pristine soils) has a significantly higher degree of As-accessibility. XAS data indicates that historic soil arsenic is dominated as Ca- (svenekite, & weilite), Al-(mansfieldite), and Fe- (scorodite) like mineral precipitates, whereas freshly added As is dominated by mineral adsorption surfaces, particularly the iron oxy-hydroxides (goethite and hematite), but also gibbsite and kaolin surfaces. SEM data further confirmed the presence of scorodite and mansfieldite formation in the historic contaminated soils. These data suggest that aging of historic soil-As has allowed neoformational mineral recrystallisation from surface sorption processes, which greatly reduces As-mobility and accessibility. Copyright © 2016 Elsevier Ltd. All rights reserved.

Determinants of fire activity during the last 3500 yr at a wildland-urban interface, Alberta, Canada

NASA Astrophysics Data System (ADS)

Davis, Emma L.; Courtney Mustaphi, Colin J.; Gall, Amber; Pisaric, Michael F. J.; Vermaire, Jesse C.; Moser, Katrina A.

2016-11-01

Long-term records of wildfires and their controlling factors are important sources of information for informing land management practices. Here, dendrochronology and lake sediment analyses are used to develop a 3500-yr fire and vegetation history for a montane forest in Jasper National Park, Alberta, Canada. The tree-ring record (AD 1771-2012) indicates that this region historically experienced a mixed-severity fire regime, and that effective fire suppression excluded widespread fire events from the study area during the 20th century. A sediment core collected from Little Trefoil Lake, located near the Jasper townsite, is analyzed for subfossil pollen and macroscopic charcoal (>150 μm). When comparing the tree-ring record to the 3500-yr record of sediment-derived fire events, only high-severity fires are represented in the charcoal record. Comparisons between the charcoal record and historical climate and pollen data indicate that climate and vegetation composition have been important controls on the fire regime for most of the last 3500 yr. Although fire frequency is presently within the historical range of variability, the fire return interval of the last 150 yr is longer than expected given modern climate and vegetation conditions, indicating that humans have become the main control on fire activity around Little Trefoil Lake.

Randomized Phase II Trial of High-Dose Melatonin and Radiation Therapy for RPA Class 2 Patients With Brain Metastases (RTOG 0119)

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

Berk, Lawrence; Berkey, Brian; Rich, Tyvin

Purpose: To determine if high-dose melatonin for Radiation Therapy Oncology Group (RTOG) recursive partitioning analysis (RPA) Class 2 patients with brain metastases improved survival over historical controls, and to determine if the time of day melatonin was given affected its toxicity or efficacy. RTOG 0119 was a phase II randomized trial for this group of patients. Methods and Materials: RTOG RPA Class 2 patients with brain metastases were randomized to 20 mg of melatonin, given either in the morning (8-9 AM) or in the evening (8-9 PM). All patients received radiation therapy (30 Gy in 10 fractions) in the afternoon.more » Melatonin was continued until neurologic deterioration or death. The primary endpoint was overall survival time. Neurologic deterioration, as reflected by the Mini-Mental Status Examination, was also measured. Results: Neither of the randomized groups had survival distributions that differed significantly from the historic controls of patients treated with whole-brain radiotherapy. The median survivals of the morning and evening melatonin treatments were 3.4 and 2.8 months, while the RTOG historical control survival was 4.1 months. Conclusions: High-dose melatonin did not show any beneficial effect in this group of patients.« less

Pregabalin monotherapy in patients with partial-onset seizures

PubMed Central

Kwan, Patrick; Fakhoury, Toufic; Pitman, Verne; DuBrava, Sarah; Knapp, Lloyd; Yurkewicz, Lorraine

2014-01-01

Objective: To assess pregabalin monotherapy for partial-onset seizures using a historical-controlled conversion-to-monotherapy design. Methods: Adults with inadequately controlled partial-onset seizures while receiving 1 or 2 antiepileptic drugs during an 8-week prospective baseline were randomized to double-blind monotherapy with pregabalin 600 or 150 mg/d (4:1) for 20 weeks (8-week conversion and 12-week monotherapy period). The primary endpoint was the seizure-related exit rate for pregabalin 600 mg/d, based on discontinuations due to predefined criteria. Efficacy was declared if the upper limit of the 95% confidence interval for the exit rate was below a historical-control threshold of 74%, with stepwise evaluation using a threshold of 68%. Results: The trial was stopped early for positive efficacy after an interim analysis in 125 patients. The full study population included 161 patients, with 148 evaluable for efficacy. The mean time since epilepsy diagnosis was 14 years. Overall, 54.3% (600 mg/d) and 46.9% (150 mg/d) of patients completed 20 weeks of double-blind treatment. Seizure-related exit rate in the 600 mg/d group (27.5%; 95% confidence interval, 17.8%–37.2%) was significantly below the 74% and 68% thresholds (p < 0.001 for both). Eight patients on 600 mg/d and 2 on 150 mg/d were seizure-free throughout pregabalin monotherapy. Pregabalin's overall safety profile was consistent with prior trials. Conclusions: Pregabalin monotherapy was safe and efficacious for patients with inadequately controlled partial-onset seizures. Classification of evidence: This study provides Class III evidence that patients with inadequately controlled partial-onset seizures switched to pregabalin monotherapy have fewer seizure-related exit events compared with historical controls switched to pseudo-placebo monotherapy. PMID:24415567

How Do Quality-of-Life and Gastrointestinal Symptoms Differ Between Post-cholecystectomy Patients and the Background Population?

PubMed

Wanjura, Viktor; Sandblom, Gabriel

2016-01-01

Previous studies have indicated a correlation between indication for cholecystectomy and long-term gastrointestinal quality-of-life (QoL). The aim of the present study was to compare QoL in a post-cholecystectomy cohort with the background population and with historical controls. A post-cholecystectomy study group (on average 4 years after cholecystectomy) was compared with a control group from the background population using the Gastrointestinal Quality-of-Life Index (GIQLI). EQ-5D scores were compared with expected scores derived from recent historical data. The post-cholecystectomy study group (N = 451) had better QoL measured by the EQ-5D compared with historical controls (p < 0.001), similar total GIQLI scores as the control group (N = 390), but scored worse on the GIQLI gastrointestinal symptoms subscale score (p < 0.001). The results include an item-by-item breakdown of the GIQLI questionnaire where the scores for diarrhea, bowel urgency, bloating, regurgitation, abdominal pain, flatus, fullness, nausea, uncontrolled stools, belching, heartburn, restricted eating, and bowel frequency were found to be significantly lower (i.e. worse) in the post-cholecystectomy cohort than in the control group. The opposite was true for relationships, endurance, sexual life, physical strength, feeling fit, not being frustrated by illness, and being able to carry out leisure activities, i.e. items related to general performance and well-being. In this study, QoL after cholecystectomy was good, but there was an increased prevalence of gastrointestinal symptoms compared to the background population.

Establishing a Traumatic Brain Injury Program of Care: Benchmarking Outcomes after Institutional Adoption of Evidence-Based Guidelines.

PubMed

Tarapore, Phiroz E; Vassar, Mary J; Cooper, Shelly; Lay, Twyila; Galletly, Julia; Manley, Geoffrey T; Huang, Michael C

2016-11-15

Traumatic brain injury (TBI) is a widespread global disease, often with widely varying outcomes. Standardization of care and adherence to established guidelines are central to the effort to improve outcomes. At our level I urban trauma center, we developed and implemented a Joint Commission-certified TBI Program of Care in 2011 and compared our post-implementation patient data set with historical controls, using the International Mission for Prognosis and Analysis of Clinical Trials (IMPACT) prognostic model. Historical controls were drawn from the San Francisco General Hospital Traumatic Coma Data Bank (SFGH/TCDB) from 1987 to 1996. Recent era patients were drawn from the NeuroTracker database, a customized electronic medical record used in our clinical practice. Descriptive statistics were calculated. Adherence to four quality-of-care metrics on the clinical service was tracked for 2011-2013. The IMPACT prognostic model was used to calculate expected versus observed mortality for current and historical patient groups. In the historical control group, 832 patients were identified and 6-month mortality was available for 592. Observed 6-month mortality was 49%. In the recent era patient group, 211 patients were identified and 6-month mortality was 38%. The IMPACT prognostic model was applied to each patient group. Areas under the curve for each analysis were >0.85 and goodness of fit was satisfactory, indicating good performance of the IMPACT model. Comparison of observed versus expected deaths in the recent versus the control patient sets revealed a drop of 59% in early mortality. The greatest reductions in mortality were observed in the group of patients with IMPACT-predicted mortality ≤50%. Significant progress has been made in reducing the percentage of unexpected deaths in TBI patients. It is likely that major factors include more aggressive management and tracking of compliance with the implementation of guidelines for the management of TBI patients.

Historical Footage of John Glenn Friendship 7

NASA Technical Reports Server (NTRS)

1962-01-01

The Friendship mission launch on the 20th day of February marked the first time that an American attempts to orbit the Earth. Historical footage of John Glenn's suit up, ride out to the launch pad, countdown, liftoff, booster engine cutoff, and separation of the booster engine escape tower is shown. Views of the Earth, Glenn's manual control of the electrical fly-by wire system, and the recovery of the landing vehicle from the ocean are presented.

Arms control: moral, political and historical lesson

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

Thompson, K.W.

1990-01-01

Many of the world's most influential policy-makers and analysts view arms control as a scientific and technological problem. They measure a nation's nuclear power exclusively by megatonnage and throw-weights leaving the intangible elements of military and political power to philosophers and historians. They tend to ignore the human and qualitative aspects of power. This is a book that shift the emphasis to aspects of the nuclear problem which are sometimes overlooked. Basically, these elements are bound up in the moral, political, and historical lessons of the nuclear age. Nonquantitative factors have been central to studies of national defense and militarymore » power since the rise of the modern nation state system. However, most students of present-day nuclear weapons tend to stress their revolutionary character. Because they are considered wholly unique, analysts tend to write about them in a historical and apolitical terms. One purpose of the collection of papers in this little volume is to redirect attention to the moral, political, and historical lessons that the nuclear age presents. What most distinguishes the writings of contributors to this volume is their use of certain well-established principles and concepts long acknowledged in military and foreign policy analysis. Thus Father Hehir asks many of the same questions that students of ethics and foreign policy have asked for four hundred years.« less

Impact of a Newly Implemented Burn Protocol on Surgically Managed Partial Thickness Burns at a Specialized Burns Center in Singapore.

PubMed

Tay, Khwee-Soon Vincent; Chong, Si-Jack; Tan, Bien-Keem

2016-03-01

This study evaluated the impact of a newly implemented protocol for superficial to mid-dermal partial thickness burns which involves early surgery and rapid coverage with biosynthetic dressing in a specialized national burns center in Singapore. Consecutive patients with 5% or greater total body surface area (TBSA) superficial to mid-dermal partial thickness burns injury admitted to the Burns Centre at the Singapore General Hospital between August and December 2014 for surgery within 48 hours of injury were prospectively recruited into the study to form the protocol group. Comparable historical cases from the year 2013 retrieved from the burns center audit database were used to form the historical control group. Demographics (age, sex), type and depth of burns, %TBSA burnt, number of operative sessions, and length of stay were recorded for each patient of both cohorts. Thirty-nine burns patients managed under the new protocol were compared with historical control (n = 39) comparable in age and extensiveness of burns. A significantly shorter length of stay (P < 0.05) per TBSA burns was observed in the new protocol group (0.74 day/%TBSA) versus historical control (1.55 day/%TBSA). Fewer operative sessions were needed under the new protocol for burns 10% or greater TBSA burns (P < 0.05). The authors report their promising experience with a newly implemented protocol for surgically managed burns patients which involves early surgery and appropriate use of biosynthetic dressing on superficial to mid-dermal partial thickness burns. Clinically, shorter lengths of stay, fewer operative sessions, and decreased need for skin grafting of burns patient were observed.

Measurement of historical cliff-top changes and estimation of future trends using GIS data between Bridlington and Hornsea - Holderness Coast (UK)

NASA Astrophysics Data System (ADS)

Castedo, Ricardo; de la Vega-Panizo, Rogelio; Fernández-Hernández, Marta; Paredes, Carlos

2015-02-01

A key requirement for effective coastal zone management is good knowledge of historical rates of change and the ability to predict future shoreline evolution, especially for rapidly eroding areas. Historical shoreline recession analysis was used for the prediction of future cliff shoreline positions along a section of 9 km between Bridlington and Hornsea, on the northern area of the Holderness Coast, UK. The analysis was based on historical maps and aerial photographs dating from 1852 to 2011 using the Digital Shoreline Analysis System (DSAS) 4.3, extension of ESRI's ArcInfo 10.×. The prediction of future shorelines was performed for the next 40 years using a variety of techniques, ranging from extrapolation from historical data, geometric approaches like the historical trend analysis, to a process-response numerical model that incorporates physically-based equations and geotechnical stability analysis. With climate change and sea-level rise implying that historical rates of change may not be a reliable guide for the future, enhanced visualization of the evolving coastline has the potential to improve awareness of these changing conditions. Following the IPCC, 2013 report, two sea-level rise rates, 2 mm/yr and 6 mm/yr, have been used to estimate future shoreline conditions. This study illustrated that good predictive models, once their limitations are estimated or at least defined, are available for use by managers, planners, engineers, scientists and the public to make better decisions regarding coastal management, development, and erosion-control strategies.

Power laws reveal phase transitions in landscape controls of fire regimes

Treesearch

Donald McKenzie; Maureen C. Kennedy

2012-01-01

Understanding the environmental controls on historical wildfires, and how they changed across spatial scales, is difficult because there are no surviving explicit records of either weather or vegetation (fuels). Here we show how power laws associated with fire-event time series arise in limited domains of parameters that represent critical transitions in the controls...

The Control of Food among Schoolchildren Who Have Been Racially and Economically Marginalized across the Cityscape

ERIC Educational Resources Information Center

Hall, Julia

2014-01-01

This analysis involves an investigation of the corporate control of food in relation to low income and culturally dominated schoolchildren in cities. This includes an exploration of the problem as expressed globally and historically in relation to transnational policy networks. Since corporate growth always necessitates controlling the direction…

Multiple year effects of a biological control agent (Diorhabda carinulata) on Tamarix (saltcedar) ecosystem exchanges of carbon dioxide and water

USDA-ARS?s Scientific Manuscript database

Biological control of Tamarix spp. (saltcedar) with Diorhabda carinulata (the northern tamarisk beetle) is currently underway in several western states U.S.A. through historical releases and the natural migration of this insect. Given the widespread dispersal of this biological control agent and its...

Hypnosis as sole anesthesia for major surgeries: historical & contemporary perspectives.

PubMed

Hammond, D Corydon

2008-10-01

Hypnosis is a well validated treatment for acute and chronic pain (Montgomery, DuHamel, & Redd, 2000). It has been found capable of reducing inflammation, altering blood flow, and producing beneficial effects when hypnotic suggestions are provided during and prior to surgery (Frederick, 2001) and other painful medical procedures. This paper quotes extensively from historical examples of the use of hypnosis (mesmerism) as the sole anesthesia for major surgeries in the 1800's. These historic examples by themselves provide powerful documentation of the ability of the mind to influence the body, but they are then followed by a review of contemporary literature and controlled research on the use in hypnosis in relation to surgery and prior to medical procedures.

Improved statistical method for temperature and salinity quality control

NASA Astrophysics Data System (ADS)

Gourrion, Jérôme; Szekely, Tanguy

2017-04-01

Climate research and Ocean monitoring benefit from the continuous development of global in-situ hydrographic networks in the last decades. Apart from the increasing volume of observations available on a large range of temporal and spatial scales, a critical aspect concerns the ability to constantly improve the quality of the datasets. In the context of the Coriolis Dataset for ReAnalysis (CORA) version 4.2, a new quality control method based on a local comparison to historical extreme values ever observed is developed, implemented and validated. Temperature, salinity and potential density validity intervals are directly estimated from minimum and maximum values from an historical reference dataset, rather than from traditional mean and standard deviation estimates. Such an approach avoids strong statistical assumptions on the data distributions such as unimodality, absence of skewness and spatially homogeneous kurtosis. As a new feature, it also allows addressing simultaneously the two main objectives of an automatic quality control strategy, i.e. maximizing the number of good detections while minimizing the number of false alarms. The reference dataset is presently built from the fusion of 1) all ARGO profiles up to late 2015, 2) 3 historical CTD datasets and 3) the Sea Mammals CTD profiles from the MEOP database. All datasets are extensively and manually quality controlled. In this communication, the latest method validation results are also presented. The method has already been implemented in the latest version of the delayed-time CMEMS in-situ dataset and will be deployed soon in the equivalent near-real time products.

Improved Statistical Method For Hydrographic Climatic Records Quality Control

NASA Astrophysics Data System (ADS)

Gourrion, J.; Szekely, T.

2016-02-01

Climate research benefits from the continuous development of global in-situ hydrographic networks in the last decades. Apart from the increasing volume of observations available on a large range of temporal and spatial scales, a critical aspect concerns the ability to constantly improve the quality of the datasets. In the context of the Coriolis Dataset for ReAnalysis (CORA) version 4.2, a new quality control method based on a local comparison to historical extreme values ever observed is developed, implemented and validated. Temperature, salinity and potential density validity intervals are directly estimated from minimum and maximum values from an historical reference dataset, rather than from traditional mean and standard deviation estimates. Such an approach avoids strong statistical assumptions on the data distributions such as unimodality, absence of skewness and spatially homogeneous kurtosis. As a new feature, it also allows addressing simultaneously the two main objectives of a quality control strategy, i.e. maximizing the number of good detections while minimizing the number of false alarms. The reference dataset is presently built from the fusion of 1) all ARGO profiles up to early 2014, 2) 3 historical CTD datasets and 3) the Sea Mammals CTD profiles from the MEOP database. All datasets are extensively and manually quality controlled. In this communication, the latest method validation results are also presented. The method has been implemented in the latest version of the CORA dataset and will benefit to the next version of the Copernicus CMEMS dataset.

36 CFR 1256.70 - What controls access to national security-classified information?

Code of Federal Regulations, 2010 CFR

2010-07-01

... national security-classified information? 1256.70 Section 1256.70 Parks, Forests, and Public Property... HISTORICAL MATERIALS Access to Materials Containing National Security-Classified Information § 1256.70 What controls access to national security-classified information? (a) The declassification of and public access...

A Journey from Coercion to Building Courage

ERIC Educational Resources Information Center

DeSalvatore, Gino; Millspaugh, Carla; Long, Cindy

2009-01-01

Historically, behavior management in treatment settings has focused on external controls such as points, tokens, and level systems. This article describes one program's transformation where troubled youth develop internal controls and become active participants in their own change. The authors describe their program's journey to help troubled and…

Development of Methodology to Classify Historical Panchromatic Aerial Photography. Analysis of Landscape Features on Point Au Fer Island, Louisiana - from 1956 to 2009: A Case Study

DTIC Science & Technology

2011-12-01

7,386 acres). Hurricanes and other extreme extratropical storms have been shown to contribute to extensive shoreline erosion and breaching, and the...that provide protection from storms ; serve as species habitat; act as a control for nutrient and pollution transfer; support fish, agriculture...quickly and accurately classify historical panchromatic photography in order to identify storm -induced land loss and impacts (Morton et al. 2005; Barras

Archeological and Literature Search, Pedestrian Reconnaissance, and Limited Shovel Testing for the Ecorse Creek Flood Protection Project, Wayne County, Michigan.

DTIC Science & Technology

1985-05-01

Springtime activities followed by the Indians and their early Euro- American successors in the area included pickerel or pike fishing during the two...SOCIETIES: Society for American Archaeology .4" Society for Historical Archeology National Trust for Historic Preservation Plains Conference for... NATIONAL BUREAU OF STANDARDS-1963-A LID In AM -~E -HMIE N ECORSE CREEK f FLOOD CONTROL POJECT WAYNE-COUNTY, MICHIGAN UJU U.- I lCUTO U.S. ARMY H1011100

Reconstruction and restoration of historical buildings of transport infrastructure

NASA Astrophysics Data System (ADS)

Kareeva, Daria; Glazkova, Valeriya

2017-10-01

The aim of this article is to identify the main problems in the restoration of the historical objects. For this reason, it is rationally to collect and analyze the existing world experience of restoration. The information which was put together showed that there are some problems which are common and can be solved. In addition, the protection of the Monuments of Culture and Architecture Comittees always makes the restoration and reconstruction of the historical buildings complicated. By the examples of Germany, Italy and Russia it is shown that there are problems in organization, economy, planning and control. Engineers should think of and justify the methodology of organizing and monitoring of the restoration of the historical buildings. As a second solution, it will be possible to minimize time and financial costs through a favorable financial and legal background for investors and through the creation of a system of restoration work organizing. And for a faster process of restoration the imitation programs should be optimized for research and selection of the reconstruction technological and economic methods.

Bacterial diversity is strongly associated with historical penguin activity in an Antarctic lake sediment profile.

PubMed

Zhu, Renbin; Shi, Yu; Ma, Dawei; Wang, Can; Xu, Hua; Chu, Haiyan

2015-11-25

Current penguin activity in Antarctica affects the geochemistry of sediments and their microbial communities; the effects of historical penguin activity are less well understood. Here, bacterial diversity in ornithogenic sediment was investigated using high-throughput pyrosequencing. The relative abundances of dominant phyla were controlled by the amount of historical penguin guano deposition. Significant positive correlations were found between both the bacterial richness and diversity, and the relative penguin number (p < 0.01); this indicated that historical penguin activity drove the vertical distribution of the bacterial communities. The lowest relative abundances of individual phyla corresponded to lowest number of penguin population at 1,800-2,300 yr BP during a drier and colder period; the opposite was observed during a moister and warmer climate (1,400-1,800 yr BP). This study shows that changes in the climate over millennia affected penguin populations and the outcomes of these changes affect the sediment bacterial community today.

Bacterial diversity is strongly associated with historical penguin activity in an Antarctic lake sediment profile

PubMed Central

Zhu, Renbin; Shi, Yu; Ma, Dawei; Wang, Can; Xu, Hua; Chu, Haiyan

2015-01-01

Current penguin activity in Antarctica affects the geochemistry of sediments and their microbial communities; the effects of historical penguin activity are less well understood. Here, bacterial diversity in ornithogenic sediment was investigated using high-throughput pyrosequencing. The relative abundances of dominant phyla were controlled by the amount of historical penguin guano deposition. Significant positive correlations were found between both the bacterial richness and diversity, and the relative penguin number (p < 0.01); this indicated that historical penguin activity drove the vertical distribution of the bacterial communities. The lowest relative abundances of individual phyla corresponded to lowest number of penguin population at 1,800–2,300 yr BP during a drier and colder period; the opposite was observed during a moister and warmer climate (1,400–1,800 yr BP). This study shows that changes in the climate over millennia affected penguin populations and the outcomes of these changes affect the sediment bacterial community today. PMID:26601753

The contaminant legacy from historic coastal landfills and their potential as sources of diffuse pollution.

PubMed

O'Shea, Francis T; Cundy, Andrew B; Spencer, Kate L

2018-03-01

Prior to modern environmental regulation landfills in low-lying coastal environments were frequently constructed without leachate control, relying on natural attenuation within inter-tidal sediments to dilute and disperse contaminants reducing environmental impact. With sea level rise and coastal erosion these sites may now pose a pollution risk, yet have received little investigation. This work examines the extent of metal contamination in saltmarsh sediments surrounding a historic landfill in the UK. Patterns of sediment metal data suggest typical anthropogenic pollution chronologies for saltmarsh sediments in industrialised nations. However, many metals were also enriched at depth in close proximity to the landfill boundary and are indicative of a historical leachate plume. Though this total metal load is low, e.g., c. 1200 and 1650kg Pb and Zn respectively, with >1000 historic landfills on flood risk or eroding coastlines in the UK this could represent a significant, yet under-investigated, source of diffuse pollution. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Effect of historical land-use and climate change on tree-climate relationships in the upper Midwestern United States.

PubMed

Goring, Simon J; Williams, John W

2017-04-01

Contemporary forest inventory data are widely used to understand environmental controls on tree species distributions and to construct models to project forest responses to climate change, but the stability and representativeness of contemporary tree-climate relationships are poorly understood. We show that tree-climate relationships for 15 tree genera in the upper Midwestern US have significantly altered over the last two centuries due to historical land-use and climate change. Realised niches have shifted towards higher minimum temperatures and higher rainfall. A new attribution method implicates both historical climate change and land-use in these shifts, with the relative importance varying among genera and climate variables. Most climate/land-use interactions are compounding, in which historical land-use reinforces shifts in species-climate relationships toward wetter distributions, or confounding, in which land-use complicates shifts towards warmer distributions. Compounding interactions imply that contemporary-based models of species distributions may underestimate species resilience to climate change. © 2017 John Wiley & Sons Ltd/CNRS.

How Do We Advise the Pest Control Industry in the Post-Organochlorine Era?

Treesearch

J.R.J. French

1991-01-01

Given the banning of organochlorines for use as termiticides in North America, and with the possibility of such bans occurring in future in Australia and elsewhere, how do we as entomologists advise the pest control industry in termite control? A brief historical review of pesticide bans and the relevance of these bans to the present situation are discussed....

An Historical Approach to the Relationship between Adult Education and the Workplace: Path to Empowerment in the 80s.

ERIC Educational Resources Information Center

Anderson, Carmell F.

From its beginnings the history of adult education has been entwined with the evolutionary struggle between labor and management for workplace control. The history of worker's education is, in reality, the history of two types of education--worker's education under worker's control and labor-management adult education under company control. Each…

American Curriculum Theory and the Problem of Social Control, 1918-1938.

ERIC Educational Resources Information Center

Franklin, Barry M.

Curriculum as a field of study emerged in an intellectual climate in which the idea of social control was dominant. The intent of this paper is to look historically at the integration of the idea of social control into curriculum discourse, to indicate its dominant position as the underlying assumption of most early curriculum work, and to suggest…

Real-time management of an urban groundwater well field threatened by pollution.

PubMed

Bauser, Gero; Franssen, Harrie-Jan Hendricks; Kaiser, Hans-Peter; Kuhlmann, Ulrich; Stauffer, Fritz; Kinzelbach, Wolfgang

2010-09-01

We present an optimal real-time control approach for the management of drinking water well fields. The methodology is applied to the Hardhof field in the city of Zurich, Switzerland, which is threatened by diffuse pollution. The risk of attracting pollutants is higher if the pumping rate is increased and can be reduced by increasing artificial recharge (AR) or by adaptive allocation of the AR. The method was first tested in offline simulations with a three-dimensional finite element variably saturated subsurface flow model for the period January 2004-August 2005. The simulations revealed that (1) optimal control results were more effective than the historical control results and (2) the spatial distribution of AR should be different from the historical one. Next, the methodology was extended to a real-time control method based on the Ensemble Kalman Filter method, using 87 online groundwater head measurements, and tested at the site. The real-time control of the well field resulted in a decrease of the electrical conductivity of the water at critical measurement points which indicates a reduced inflow of water originating from contaminated sites. It can be concluded that the simulation and the application confirm the feasibility of the real-time control concept.

NCLB and Its Wake: Bad News for Democracy

ERIC Educational Resources Information Center

Meens, David E.; Howe, Kenneth R.

2015-01-01

Background: Local control has historically been a prominent principle in education policymaking and governance. Culminating with the passage of No Child Left Behind (NCLB), however, the politics of education have been nationalized to an unprecedented degree, and local control has all but disappeared as a principle framing education policymaking.…

Standardizing power monitoring and control at exascale

DOE PAGES

Grant, Ryan E.; Levenhagen, Michael; Olivier, Stephen L.; ...

2016-10-20

Power API-the result of collaboration among national laboratories, universities, and major vendors-provides a range of standardized power management functions, from application-level control and measurement to facility-level accounting, including real-time and historical statistics gathering. Here, support is already available for Intel and AMD CPUs and standalone measurement devices.

U. S. Naval Forces, Vietnam Monthly Historical Summary for February 1970

DTIC Science & Technology

1970-04-09

Search Turn Campaign .................... 28 Riverine Strike Grouo ..... .............. . . . . . . 33 Breezy Cove. ......... . . . . . . . . . 34...116 MVAYAL ADIVYSORY GROUP SUMRY . .. .. .. .. .. .. . .. 119 Vietnamese Mdarine Corps .. .. .. .. .. .. .. ... . 137 VNMC Operations Control ...helicopter (Dustoff) and artillery assistance wias requested. At 1 9377, -an Air Force rors-ard Air Controller arrived on station and air elements

Women: A Feminist Perspective. Third Edition.

ERIC Educational Resources Information Center

Freeman, Jo, Ed.

Feminist issues are discussed in 33 scholarly articles that cover the following areas: the body and its control, the family, growing up female, the working woman, institutions of social control, and historical and contemporary developments in feminism. Titles and authors include: "Sexual Terrorism" (Carole J. Sheffield); "The Rape Culture" (Dianne…

The geomorphic legacy of water and sediment control structures in a semiarid rangeland watershed

USDA-ARS?s Scientific Manuscript database

An inventory of water and sediment control structures remnant of historic cattle ranching was assembled for the Buenos Aires National Wildlife Refuge (BANWR) in southern Arizona, USA. An assessment of structural condition based on aerial imagery identified headcut initiation and channel incision as...

Hydrogeologic controls on streamflow sensitivity to climate variation

Treesearch

Anne Jefferson; Anne Nolin; Sarah Lewis; Christina Tague

2008-01-01

Climate models project warmer temperatures for the north-west USA, which will result in reduced snowpacks and decreased summer streamflow. This paper examines how groundwater, snowmelt, and regional climate patterns control discharge at multiple time scales, using historical records from two watersheds with contrasting geological properties and drainage efficiencies....

Estimation of the probability of success in petroleum exploration

USGS Publications Warehouse

Davis, J.C.

1977-01-01

A probabilistic model for oil exploration can be developed by assessing the conditional relationship between perceived geologic variables and the subsequent discovery of petroleum. Such a model includes two probabilistic components, the first reflecting the association between a geologic condition (structural closure, for example) and the occurrence of oil, and the second reflecting the uncertainty associated with the estimation of geologic variables in areas of limited control. Estimates of the conditional relationship between geologic variables and subsequent production can be found by analyzing the exploration history of a "training area" judged to be geologically similar to the exploration area. The geologic variables are assessed over the training area using an historical subset of the available data, whose density corresponds to the present control density in the exploration area. The success or failure of wells drilled in the training area subsequent to the time corresponding to the historical subset provides empirical estimates of the probability of success conditional upon geology. Uncertainty in perception of geological conditions may be estimated from the distribution of errors made in geologic assessment using the historical subset of control wells. These errors may be expressed as a linear function of distance from available control. Alternatively, the uncertainty may be found by calculating the semivariogram of the geologic variables used in the analysis: the two procedures will yield approximately equivalent results. The empirical probability functions may then be transferred to the exploration area and used to estimate the likelihood of success of specific exploration plays. These estimates will reflect both the conditional relationship between the geological variables used to guide exploration and the uncertainty resulting from lack of control. The technique is illustrated with case histories from the mid-Continent area of the U.S.A. ?? 1977 Plenum Publishing Corp.

Evaluation of lidocaine treatment on frequency of cardiac arrhythmias, acute kidney injury, and hospitalization time in dogs with gastric dilatation volvulus.

PubMed

Bruchim, Yaron; Itay, Srugo; Shira, Ben-Halevy; Kelmer, Efrat; Sigal, Yudelecitch; Itamar, Aroch; Gilad, Segev

2012-08-01

To assess the efficacy of IV lidocaine in decreasing complication rate and improving the outcome in dogs with gastric dilatation volvulus (GDV). Prospective non-controlled study of 83 lidocaine-treated dogs with GDV compared to 47 untreated historical controls with GDV. University veterinary teaching hospital. One hundred and thirty client-owned dogs with naturally occurring GDV. Study group dogs were treated at presentation with lidocaine (2 mg/kg, IV bolus) followed by constant rate infusion (CRI) of 0.05 mg/kg/min for 24 h. Historical control dogs did not receive any lidocaine. There were no group differences in age, body weight, time lag from onset of clinical signs to presentation, rectal temperature and pulse rate at presentation, and proportion of gastric wall necrosis. The proportions of cardiac arrhythmias and acute kidney injury (AKI) were significantly (P< 0.001 and P = 0.045, respectively) lower in the lidocaine group (10/83 [12%] versus 18/47 [38.3%] and 3/83 [3.6] versus 0/47). Median hospitalization time period was shorter (P = 0.05) in the lidocaine group compared to the controls (median 48 h; range 24-360 h versus median 72 h; range 24-144 h, respectively). Early treatment with IV lidocaine bolus, followed by CRI of lidocaine for 24 h post presentation decreased the occurrence of cardiac arrhythmias, AKI and hospitalization time period significantly in lidocaine-treated dogs with GDV compared to untreated historical controls. Due to the nonblinded, placebo-uncontrolled, nonrandomized nature of the current study, further evaluation of the efficacy of lidocaine in dogs with GDV is warranted. © Veterinary Emergency and Critical Care Society 2012.

Home-based intermediate care program vs hospitalization: Cost comparison study.

PubMed

Armstrong, Catherine Deri; Hogg, William E; Lemelin, Jacques; Dahrouge, Simone; Martin, Carmel; Viner, Gary S; Saginur, Raphael

2008-01-01

To explore whether a home-based intermediate care program in a large Canadian city lowers the cost of care and to look at whether such home-based programs could be a solution to the increasing demands on Canadian hospitals. Single-arm study with historical controls. Department of Family Medicine at the Ottawa Hospital (Civic campus) in Ontario. Patients requiring hospitalization for acute care. Participants were matched with historical controls based on case-mix, most responsible diagnosis, and level of complexity. Placement in the home-based intermediate care program. Daily home visits from the nurse practitioner and 24-hour access to care by telephone. Multivariate regression models were used to estimate the effect of the program on 5 outcomes: length of stay in hospital, cost of care substituted for hospitalization (Canadian dollars), readmission for a related diagnosis, readmission for any diagnosis, and costs incurred by community home-care services for patients following discharge from hospital. The outcomes of 43 hospital admissions were matched with those of 363 controls. Patients enrolled in the program stayed longer in hospital (coefficient 3.3 days, P < .001), used more community care services following discharge (coefficient $729, P = .007), and were more likely to be readmitted to hospital within 3 months of discharge (coefficient 17%, P = .012) than patients treated in hospital. Total substituted costs of home-based care were not significantly different from the costs of hospitalization (coefficient -$501, P = .11). While estimated cost savings were not statistically significant, the limitations of our study suggest that we underestimated these savings. In particular, the economic inefficiencies of a small immature program and the inability to control for certain factors when selecting historical controls affected our results. Further research is needed to determine the economic effect of mature home-based programs.

A modern review of the operative management of chronic pancreatitis.

PubMed

King, Jonathan C; Abeywardina, Shannon; Farrell, James J; Reber, Howard A; Hines, O Joe

2010-10-01

Chronic pancreatitis is a debilitating disease resulting in pain, intestinal malabsorption, endocrine dysfunction, and poor quality of life (QoL). Our aim was to analyze surgical outcomes for patients with chronic pancreatitis. Data for patients undergoing operations for chronic pancreatitis between 1990 and 2009 were reviewed. Demographics, operative and perioperative data, and survival were catalogued. QoL was determined (Short Form 36 and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire + PAN-26) and compared with historical controls. The mean age was 51 +/- 2 years, 38 patients were male (53%), the most common indication was pain (71%), the etiology of pancreatitis often was alcohol, and most patients underwent a Whipple procedure (56%). Operative time was 316 +/- 17 minutes and blood loss was 363 +/- 75 mL. There were 34 complications in 30 patients (42%) and one death. QoL surveys were administered for 25 of 55 (45%) surviving patients at a mean follow-up of 72 +/- 16 months. Mean survival was 99 +/- 9 months, whereas 5- and 10-year survival were 86 and 75 per cent. QoL scores were uniformly better than historical controls. Our data demonstrate that operations for chronic pancreatitis can be performed with acceptable morbidity and mortality. Patients have excellent survival and improved QoL compared with historical controls. Surgery is an effective and durable treatment option for patients with chronic pancreatitis.

Evaluating the use of plerixafor in stem cell mobilisation - an economic analysis of the PHANTASTIC trial.

PubMed

Martin, Antony P; Richards, Sarah; Haycox, Alan; Houten, Rachel; McLeod, Claire; Braithwaite, Barbara; Clark, Jack O; Bell, Joanne; Clark, Richard E

2016-10-01

Plerixafor is an effective haematopoietic stem cell mobilising agent in candidates for autologous transplantation, including patients with myeloma and lymphoma. Here we compare 98 plerixafor recipients in the PHANTASTIC trial with 151 historic controls mobilised by conventional chemotherapy (each with granulocyte colony-stimulating factor, G-CSF). Seventy (71.4%) plerixafor-mobilised patients achieved the composite primary endpoint of ≥4 × 10(6) CD34+ cells kg(-1) in ≤2 aphereses and no clinically significant neutropenia, compared to 48 (31.8%) historic controls (P < 0.001), and this significant advantage was maintained in scenario analyses testing components of this composite endpoint. A patient-level cost analysis was undertaken for 249 patients, which included the cost of remobilising patients where initial mobilisation had failed. Combined mean treatment cost for plerixafor mobilised patients was £12,679 compared with £11,694 for historical controls. However, plerixafor produces an average saving of £3,828 per lymphoma patient but average cost increase by £5,245 per myeloma patient. The present data demonstrate cost-effectiveness for plerixafor as a first line mobilisation agent, certainly for lymphoma patients, where substantial resource savings and achievement of the primary endpoint are likely. J. Clin. Apheresis 31:434-442, 2016. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Intravenous thrombolysis guided by a telemedicine consultation system for acute ischaemic stroke patients in China: the protocol of a multicentre historically controlled study

PubMed Central

Yuan, Ziwen; Wang, Bo; Li, Feijiang; Wang, Jing; Zhi, Jin; Luo, Erping; Liu, Zhirong; Zhao, Gang

2015-01-01

Introduction The rate of intravenous thrombolysis with tissue-type plasminogen activator or urokinase for stroke patients is extremely low in China. It has been demonstrated that a telestroke service may help to increase the rate of intravenous thrombolysis and improve stroke care quality in local hospitals. The aim of this study, also called the Acute Stroke Advancing Program, is to evaluate the effectiveness and safety of decision-making concerning intravenous thrombolysis via a telemedicine consultation system for acute ischaemic stroke patients in China. Methods and analysis This is a multicentre historically controlled study with a planned enrolment of 300 participants in each of two groups. The telestroke network consists of one hub hospital and 14 spoke hospitals in underserved regions of China. The usual stroke care quality in the spoke hospitals without guidance from the hub hospital will be used as the historical control. The telemedicine consultation system is an interactive, two-way, wireless, audiovisual system accessed on portable devices. The primary outcome is the percentage of patients treated with intravenous thrombolysis within 4.5 h of stroke onset. Ethics and dissemination The project has been approved by the Institutional Review Board of Xijing Hospital. The results will be published in scientific journals and presented to local government and relevant institutes. Trial registration number NCT02088346 (12 March 2014). PMID:25979867

A clinical assessment of the anterior eye in arc welders.

PubMed

Doughty, Michael J; Oblak, Emil

2005-11-01

Corneal irradiation with high doses of ultraviolet-B (UVB) has been shown to damage the corneal endothelium in animals. Human occupational exposure to ultraviolet radiation (UVR) in welding is considered a risk for endothelial damage but the evidence for such an effect is limited. External eye photographs and non-contact specular micrographs (Topcon SP2000-P) were obtained from 102 white males aged between 32 and 62 years, 51 being arc welders (with 24 +/- 7 years experience) and 51 office workers. Most welders reported repeated occupational exposure to UVR (that is, welder's 'flashes'). Welders reported a higher level of ocular symptoms and a higher prevalence of pingueculae (47 versus 12 per cent), but only one case with pterygium. The average endothelial cell areas were the same in welders and office workers (398 +/- 55 microm(2) versus 400 +/- 56 microm(2); p = 0.868) as were the endothelial cell density (ECD) values (2,555 +/- 342 cells/mm(2) versus 2,541 +/- 308 cells/mm(2); p = 0.825). ECD decreased with years of welding experience (p < 0.01) but not faster than the decrease in ECD due to age. Repeated occupational ultraviolet radiation exposure through welding is not associated with any obvious differences in the corneal endothelium. No differences were observed in either ECD or cell polymegethism. Despite the periodic welding flashes, the exposure levels are below those needed to cause damage to the corneal endothelium.

Development of a second-generation novel UVR sensor for the quantification of the light field at the anterior ocular surface

NASA Astrophysics Data System (ADS)

Fleming, David; Walsh, James E.; Moore, Linda; Bergmanson, Jan P. G.; McMahon, David

2005-06-01

Research has shown in recent years that acute and cumulative exposure to excessive ultraviolet radiation (UVR) can cause a range of degenerative ocular conditions such as pterygium, photokeratitis and pinguecula. The increase in natural solar UVR as a result of the depletion of the ozone layer has led to a greater awareness of the adverse effects of UVR on the anterior ocular surface tissues. The relevance of this lies in the fact that these tissues are not immune to photodamage and that there is selective absorption of UVR by conjunctival and corneal tissue in the anterior ocular surface. Therefore, there is a demand for more precise quantification and localisation of UVR incidence at the anterior ocular surface. A novel solar blind photodiode sensor array has been designed, constructed and tested for this purpose. The emphasis of the measurements made by this sensor system is the acquisition of real time, field based surveys of the ocular UVR light field in a broad range of insolation environments. These data will then provide a thorough database of UVR irradiances that can be related to induced damage of anterior ocular tissue. Results to date show the first measured, in-vivo, absolute UVR levels on the eye, the corresponding relative field across the eye and the presence of nasal-temporal biases that exist.

The effect of ultraviolet radiation on the cornea - experimental study.

PubMed

Golu, Andreea; Gheorghişor, Irina; Bălăşoiu, A T; Baltă, Fl; Osiac, E; Mogoantă, L; Bold, Adriana

2013-01-01

Ultraviolet (UV) radiation in high doses may have harmful effects on the eye. The sources of UV radiation are the sun, as well as some artificial sources such as UV lamps or voltaic arcs. Chronic exposure to UV can cause damage to the anterior pole of the eye, ranging from minor (pterygium) to serious photokeratitis. In our study, we applied a UV dose of 6.5 J/cm(2) in the wavelength range of 290-400 nm, for five consecutive days per rat anterior pole of the eye. Seven days after the last dose of radiation, the animals were sacrificed, harvesting both the irradiated and the non-irradiated eye. Histological and immunohistochemical examination of the lesions revealed that the greatest damage to the epithelium was recorded prior to and 2/3 of the remaining corneal stroma. The epithelial lesions we found varied from pseudokeratosis and detachment of the Bowman epithelium membrane to deep epithelial necrosis. Within the corneal stroma, we observed the formation of interstitial edema with disruption of the collagen structure. We also noticed the presence of an inflammatory infiltrate composed mainly of lymphocytes and CD68+ and CD163+ macrophages, as well as the occurrence of vascular devices. These consisted of angiogenesis capillaries with structured wall composed mainly of endothelial CD34+ precursor cells and a basal membrane rich in collagen IV fibers.

Development of a low cost UV index datalogger and comparison between UV index sensors

NASA Astrophysics Data System (ADS)

Gomes, L. M.; Ventura, L.

2018-02-01

Ultraviolet radiation (UVR) is the part of radiation emitted by the Sun, with range between 280 nm and 400 nm, and that reaches the Earth's surface. The UV rays are essential to the human because it stimulates the production of vitamin D but this radiation may be related to several health problems, including skin cancer and ocular diseases like pterygium, photokeratitis, cataract and more. To inform people about UV radiation, it is adopted the Ultraviolet Index (UVI). This UVI consists in a measure of solar UV radiation level, which contributes to cause sunburn on skin, also known as Erythema, and is indicated as an integer number between 1 and 14, associated to categories from low to extreme respectively. The aim of this work was to develop a low cost UVI datalogger capable of measuring three different UVI sensors simultaneously, record their data with timestamp and serve the measures online through a dedicated server, so general public can access their data and see the current UV radiation conditions. We also compared three different UVI sensors (SGlux UV cosine, Skye SKU440 and SiLabs SI1145) between them and with meteorological models during a period of months to verify their compliance. With five months data, we could verify the sensors working characteristics and decide which among them are the most suitable for research purposes.

A Comparison Study of Conjunctiva Disorders in Technical and Administrative Sawmill Workers in Nigeria

PubMed Central

Njinaka, Itiyafa; Uhumwangho, Odarosa M; Edema, Omolabake T; Dawodu, Oseluese A; Omoti, Afekhide E

2011-01-01

Background: Workers in the sawmilling industry are at risk of various ocular hazards as a direct result of the sawmilling processes. The aim of this study was to determine the pattern of conjunctival disorders between technical and administrative sawmill workers in Benin, Nigeria. Methods: A cross-sectional study was performed on sawmill workers in Benin, Nigeria, between January and May 2009, with the aid of pre-tested questionnaires. Ocular examination was performed on all subjects. Data obtained were recorded and analysed using SPSS version 13. Results: A total of 553 sawmill workers were studied, among whom 449 (81.2%) and 104 (18.8%) were technical and administrative workers, respectively. There were 496 (89.7%) males and 57 (10.3%) females. The age range was 15–80 years, with a mean of 38.9 years (SD 12.8). Pingueculum was found in 127 (23%) workers, among whom 122 (27.2%) were technical workers and 5 (4.8%) were administrative workers. Pterygium was present in 65 (11.8%) workers, among whom 64 (14.3%) were technical workers and 1 (1%) was an administrative worker. Seven (1.6%) technical workers used protective eyewear; 2 (0.4%) wore this protective eyewear regularly. Conclusion: Technical sawmill workers are at risk of developing conjunctival disorders, which result from chronic ocular irritation. This can be prevented by the provision of protective eye devices in the workplace. PMID:22135600

A comparison study of conjunctiva disorders in technical and administrative sawmill workers in Nigeria.

PubMed

Njinaka, Itiyafa; Uhumwangho, Odarosa M; Edema, Omolabake T; Dawodu, Oseluese A; Omoti, Afekhide E

2011-07-01

Workers in the sawmilling industry are at risk of various ocular hazards as a direct result of the sawmilling processes. The aim of this study was to determine the pattern of conjunctival disorders between technical and administrative sawmill workers in Benin, Nigeria. A cross-sectional study was performed on sawmill workers in Benin, Nigeria, between January and May 2009, with the aid of pre-tested questionnaires. Ocular examination was performed on all subjects. Data obtained were recorded and analysed using SPSS version 13. A total of 553 sawmill workers were studied, among whom 449 (81.2%) and 104 (18.8%) were technical and administrative workers, respectively. There were 496 (89.7%) males and 57 (10.3%) females. The age range was 15-80 years, with a mean of 38.9 years (SD 12.8). Pingueculum was found in 127 (23%) workers, among whom 122 (27.2%) were technical workers and 5 (4.8%) were administrative workers. Pterygium was present in 65 (11.8%) workers, among whom 64 (14.3%) were technical workers and 1 (1%) was an administrative worker. Seven (1.6%) technical workers used protective eyewear; 2 (0.4%) wore this protective eyewear regularly. Technical sawmill workers are at risk of developing conjunctival disorders, which result from chronic ocular irritation. This can be prevented by the provision of protective eye devices in the workplace.

Knowledge, attitude and practice regarding solar ultraviolet exposure among medical university students in Northeast China.

PubMed

Gao, Qian; Liu, Guangcong; Liu, Yang

2014-11-01

To assess the knowledge, attitudes and practices regarding the health effects of ultraviolet radiation (UVR) and sun exposure among medical university students in Northeast China, 385 subjects were investigated on October 2013 using a self-administered multiple-choice questionnaire. Most of the subjects knew the effects of UVR on skin cancer (95.6%) and sunburn (92.2%), but fewer knew of the eye damage that can result from UVR (27.8% cataract and 3.1% pterygium). Correspondingly, the main purpose of adopting sun protection was considered to be 'preventing sunburn' (55.4%), but 'preventing eye damage' was the least (1.8%). In actual behaviour, the eyes received the least protection as well. Although knowing the effects of UVR on vitamin D synthesis (87.3%), 66.8% of participants never or seldom increased sun exposure. Compared to men, women were more likely to reduce sun exposure (P<0.001). Only a small fraction of subjects (6.6%) thought that tanning was attractive. Considering the response variability to UVR in people with different skin colours, different sun protection programs should be provided. In China, especially in the North, the public should be educated to moderately increase sun exposure to maintain adequate vitamin D status while also protecting against eye damage from UVR. Copyright © 2014 Elsevier B.V. All rights reserved.

[Ultrasound biomicroscopy of conjunctival lesions].

PubMed

Buchwald, Hans-Jürgen; Müller, Andreas; Spraul, Christoph W; Lang, Gerhard K

2003-01-01

The value of ultrasound biomicroscopy in the diagnosis of conjunctival lesions is not well established. For the examination of conjunctival lesions, we used an ultrasound biomicroscope (Humphrey, Zeiss, Oberkochen) with a high frequency transducer (30 MHz). Between January 2000 and August 2001, 28 patients (16 female, 12-male) with conjunctival lesions, aged 9 to 81 years, were available for this study. Histological examination of the excised tissue displayed the presence of a compound naevus (8/28), cysts (6/28), inflammatory processes (3/28), granulomatous processes (2/28), lymphomas (2/28), foreign bodies (2/28), a pterygium (2/28), a malignant melanoma (1/28), a primary acquired melanosis (1/28), and a conjunctival amyloidosis (1/28). Using ultrasound biomicroscopy we were able to demonstrate a cystic tumour in the six patients (21 %) with a cyst of the conjunctiva. In patients suffering from solid tumours of the conjunctiva the definite diagnosis could not be made with ultrasound biomicroscopy alone. The eight patients with compound naevus displayed a somewhat heterogeneous sonographic structure within the tumour. In the patient with a foreign body we were able to demonstrate posterior shadowing of the underlying tissue. For evaluation of conjunctival lesions caused by a cyst or a solid tumour, ultrasound biomicroscopy may be an additional diagnostic tool, e. g. for assessing the margins of the tumour. However, up to now it is not possible to differentiate between different lesions solely by means of ultrasonography.

Automated lamellar therapeutic keratoplasty with fibrin adhesive in the treatment of anterior corneal opacities.

PubMed

Hashemi, Hassan; Dadgostar, Alhan

2011-06-01

To assess the visual outcome of using fibrin adhesive in automated lamellar therapeutic keratoplasty with a microkeratome in the treatment of anterior corneal opacities. In this prospective noncomparative clinical trial, surgery was done on 10 eyes belonging to 9 patients with anterior stromal opacity (macular dystrophy, spheroidal degeneration, scarring because of advanced recurrent pterygium, refractive surgery, or trauma). Depending on the depth of the opacity, a 130- or 250-μm flap was removed from the recipient cornea using a microkeratome. Then, a thin layer of fibrin adhesive was spread over the bed, and a lenticule with the same thickness, created from the donor cornea, was positioned in place. After allowing the glue to set for about 5 minutes, a bandage contact lens was placed over the cornea, which was removed 7-10 days postoperatively. All corneas healed properly, and none required suturing or reoperation. During the follow-up period, no inflammation or rejection was observed. The donor cornea and the donor-recipient interface remained clear in all cases. The mean of best contact lens-corrected visual acuity improved from 1.14 ± 0.53 to 0.51 ± 0.23 in the logarithm of the minimum angle of resolution scale. The fibrin glue can provide safe and effective attachment needed in automated lamellar therapeutic keratectomy and obviates the need for suturing. However, it requires improvement for easier and safer use in ophthalmology.

Evaluation of CAESAR-Lisflood as a tool for modelling river channel change and floodplain sediment residence times.

NASA Astrophysics Data System (ADS)

Feeney, Christopher; Smith, Hugh; Chiverrell, Richard; Hooke, Janet; Cooper, James

2017-04-01

Sediment residence time represents the duration of particle storage, from initial deposition to remobilisation, within reservoirs such as floodplains. Residence time influences rates of downstream redistribution of sediment and associated contaminants and is a useful indicator of landform stability and hence, preservation potential of alluvial archives of environmental change. River channel change controls residence times, reworking sediments via lateral migration, avulsion and incision through floodplain deposits. As reworking progresses, the floodplain age distribution is 'updated', reflecting the time since 'older' sediments were removed and replaced with 'younger' ones. The relationship between ages and the spatial extents they occupy can be used to estimate the average floodplain sediment residence times. While dating techniques, historic maps and remote sensing can reconstruct age distributions from historic reworking, modelling provides advantages, including: i) capturing detailed river channel changes and resulting floodplain ages over longer timescales and higher resolutions than from historic mapping, and ii) control over inputs to simulate hypothetical scenarios to investigate the effects of different environmental drivers on residence times. CAESAR-Lisflood is a landform evolution model capable of simulating variable channel width, divergent flow, and both braided and meandering planforms. However, the model's ability to accurately simulate channel changes requires evaluation if it is to be useful for quantitative evaluation of floodplain sediment residence times. This study aims to simulate recent historic river channel changes along ten 1 km reaches in northern England. Simulation periods were defined by available overlapping historic map and mean daily flow datasets, ranging 27-39 years. LiDAR-derived 2 m DEMs were modified to smooth out present-day channels and burn in historic channel locations. To reduce run times, DEMs were resampled to coarser resolutions based on the size of the channel and historic rate of lateral channel migration. Separate pre-defined coarse and finer channel bed and floodplain grain size distributions were used, respectively, in combination with constructed reach DEMs for model simulations. Calibration was performed by modifying selected parameters to obtain best fits between observed and modelled channel planforms. Initial simulations suggest the model can broadly reproduce observed planform change and is comparable in terms of channel sinuosities and the mean radius of curvature. As such, CAESAR-Lisflood may provide a useful tool for evaluating floodplain sediment residence times under environmental change scenarios.

Active case finding of tuberculosis: historical perspective and future prospects

PubMed Central

Golub, J. E.; Mohan, C. I.; Comstock, G. W.; Chaisson, R. E.

2015-01-01

SUMMARY Despite a history of remarkable scientific achievements in microbiology and therapeutics, tuberculosis (TB) continues to pose an extraordinary threat to human health. Case finding and treatment of TB disease are the principal means of controlling transmission and reducing incidence. This review presents a historical perspective of active case finding (ACF) of TB, detailing case detection strategies that have been used over the last century. This review is divided into the following sections: mass radiography, house-to-house surveys, out-patient case detection, enhanced case finding, high-risk populations and cost-effectiveness. The report concludes with a discussion and recommendations for future case finding strategies. Understanding the strengths and weaknesses of these methods will help inform and shape ACF as a TB control policy in the twenty-first century. PMID:16333924

Public policies on healthcare-associated infections: a Brazil and UK case study.

PubMed

Padoveze, Maria Clara; Melo, Sara; Bishop, Simon; Poveda, Vanessa de Brito; Fortaleza, Carlos Magno Castelo Branco

2017-12-11

To summarize the historical events and drivers underlying public policy for the prevention and control of healthcare-associated infections in Brazil and in the United Kingdom. In doing so, the article aims to identify lessons and recommendations for future development of public policy. The analysis is based on a historical overview of national healthcare-associated infections programs taken from previously published sources. Findings highlight how the development of healthcare-associated infections prevention and control policies followed similar trajectories in Brazil and the United Kingdom. This can be conceptualized around four sequential phases: Formation, Consolidation, Standardization, and Monitoring and Evaluation. However, while we identified similar phases of development in Brazil and the United Kingdom, it can be seen that the former entered each stage around 20 years after the latter.

Prolonged elevated body mass index in preschool children after the Great East Japan Earthquake.

PubMed

Isojima, Tsuyoshi; Yokoya, Susumu; Ono, Atsushi; Kato, Noriko; Tanaka, Toshiaki; Yokomichi, Hiroshi; Yamagata, Zentaro; Tanaka, Soichiro; Matsubara, Hiroko; Ishikuro, Mami; Kikuya, Masahiro; Chida, Shoichi; Hosoya, Mitsuaki; Kuriyama, Shinichi; Kure, Shigeo

2017-09-01

The Great East Japan Earthquake followed by tsunamis and the Fukushima Daiichi Nuclear Power Plant (NPP) accident caused catastrophic damage. The effects of the disaster on the growth of affected children are of great concern but remain unknown. The subject group was derived from two Japanese nationwide retrospective cohorts (historical control and exposure groups, respectively). The exposure group experienced the disaster at 47-59 months of age. We analyzed longitudinal changes in standard deviation score (SDS) for height and body mass index (BMI) using normal Japanese children's standards. Moreover, we analyzed the details of the affected children in Fukushima using Fukushima-specific growth charts established with the historical control data to clarify any indirect effect of the disaster on growth. Affected children in Fukushima had significantly higher BMI SDS than the historical control group (difference, 0.13; 95% CI: 0.044-0.21, P = 0.0029) and the regional controls (difference, 0.14; 95% CI: 0.074-0.20, P < 0.0001) 1.5 years after the disaster. Similar sustained increases in BMI SDS were also found with Fukushima-specific growth charts, but the phenomenon was detected only in boys. Notably, the BMI SDS of affected children who lived near the NPP had been increasing after the disaster, whereas those in distant areas had not changed. In contrast, height SDS had not changed throughout the analysis. Prolonged elevated BMI SDS was detected only in affected children in Fukushima. This phenomenon may be explained by an indirect effect of the NPP accident. © 2017 Japan Pediatric Society.

The effect of a calcium phosphate mouth rinse on (chemo) radiation induced oral mucositis in head and neck cancer patients: a prospective study.

PubMed

Stokman, M A; Burlage, F R; Spijkervet, F K L

2012-08-01

Promising results of a calcium phosphate (CP) mouth rinse on reduced severity of oral mucositis have been reported. The aim of this study was to determine the effect of a CP mouth rinse on the frequency, duration and severity of (chemo) radiation induced oral mucositis in patients with head-neck cancer. patients with oral malignancies, treated with (chemo) radiotherapy, were included. Patients rinsed four times a day with a CP mouth rinse. Patients not willing to rinse with the CP mouth rinse served as control. Mucositis was scored according to the WHO score at baseline and twice a week during the full course of (chemo) radiotherapy. Patient's self-reported mouth-throat soreness (MTS) was evaluated at the same time interval using a diary in the CP mouth rinse group. The outcomes on MTS were compared with a historical control group. Fifty-two patients were analysed: 25 CP mouth rinse group, 11 control group and 16 historical group. There was no significant difference between the CP group and control group on development and severity of oral mucositis. No significant difference was found for subjective outcomes on MTS between the CP group and the historical group. The CP mouth rinse seems to have no influence on the frequency, duration and severity of oral mucositis during (chemo) radiation in patients with head and neck cancer. A trend to develop less MTS for drinking and eating was found when applying the CP mouth rinse. © 2012 John Wiley & Sons A/S.

Evidence-based control of canine rabies: a critical review of population density reduction

PubMed Central

Morters, Michelle K; Restif, Olivier; Hampson, Katie; Cleaveland, Sarah; Wood, James L N; Conlan, Andrew J K

2013-01-01

Control measures for canine rabies include vaccination and reducing population density through culling or sterilization. Despite the evidence that culling fails to control canine rabies, efforts to reduce canine population density continue in many parts of the world. The rationale for reducing population density is that rabies transmission is density-dependent, with disease incidence increasing directly with host density. This may be based, in part, on an incomplete interpretation of historical field data for wildlife, with important implications for disease control in dog populations. Here, we examine historical and more recent field data, in the context of host ecology and epidemic theory, to understand better the role of density in rabies transmission and the reasons why culling fails to control rabies. We conclude that the relationship between host density, disease incidence and other factors is complex and may differ between species. This highlights the difficulties of interpreting field data and the constraints of extrapolations between species, particularly in terms of control policies. We also propose that the complex interactions between dogs and people may render culling of free-roaming dogs ineffective irrespective of the relationship between host density and disease incidence. We conclude that vaccination is the most effective means to control rabies in all species. PMID:23004351

Outlier detection in contamination control

NASA Astrophysics Data System (ADS)

Weintraub, Jeffrey; Warrick, Scott

2018-03-01

A machine-learning model is presented that effectively partitions historical process data into outlier and inlier subpopulations. This is necessary in order to avoid using outlier data to build a model for detecting process instability. Exact control limits are given without recourse to approximations and the error characteristics of the control model are derived. A worked example for contamination control is presented along with the machine learning algorithm used and all the programming statements needed for implementation.

Expanded R&D by Jet-engine-steering Revolution

NASA Astrophysics Data System (ADS)

Gal-Or, Benjamin

2017-11-01

Since 1987 [1,2,3,4,5] the global jet engine community is facing the historical fact that jet engine steering is gradually replacing canards and the common, often dangerous and obsolete, aerodynamic-only flight control - a fact that (i) has already affected the defense-industrial complex in the US, Russia, China, Japan, S-Korea and India, (ii) has integrated the traditional jet-engine components R&D with advanced aero-electro-physics, stealth technology, thrust vectoring aerodynamics and material science. Moreover, this military revolution is historically due to expand into the civil transport jets domain, [6,7,8,9]. The historical aim of the JES-Revolution remains the same: Replace the common, stall-spin sensitive canards [6] and Aerodynamic-Only-Obsolete-Flight Control ("AOOF Control"). Invented about 100 years ago for propeller-driven air vehicles, it has already been partially replaced for failure to function in WVR-combat post-stall domain, and for the following reasons: In comparison with complete Tail-Less, Canard-Less, Stealth-JES (Figure 5 and References [1,2,3,4,5,6]), the common AOOF Control increases drag, weight, fuel consumption, complexity, cost, and reduces flight safety, stealth, [Low Detectability] and provides zero post-stall, WVR air combat capability while its CANARDS KILL LD & REDUCE JES. Examples of stealth fighter aircraft that have already replaced canards and AOOF-Control where JES provides at least 64 to 0 KILL-RATIO advantage over AOOF-Controlled conventional fighter aircraft: The U.S. JES F-22 and, apparently, the Russian JES-Su-T-50 & 35S, China 2016-J-31, Indian HAL AMCA & FGFA, Japanese JES IHHI ATD-X, S-Korean JES KF-X. Cf. X-44 in Figure 5. Consequently, the jet engine is no longer defined as providing only brute force forward. Instead, it successfully competes with and wins over the wrong, dominating AOOF-Control, at least as a backup flight control whose sole factual domain is currently a well-established, primary flight controller RE any post-stall, super-agility, [2,3,4,5,6,7,8,9].

Golden Algae Control: Efficacy of Hydraulic Manipulations in Coves of Lake Granbury

DTIC Science & Technology

2013-04-01

19  Bee Creek (cove A, from below...Analysis of historical data ...................................................................................................... 21  Cove A ( Bee ...34  Bee Creek (cove A, from above

Factors Contributing to Self Control for Incarcerated Youth

ERIC Educational Resources Information Center

Winquist, Trancita

2010-01-01

This study was conducted to examine characteristics contributing to high self control for incarcerated youth. Subjects include fifty youth (8 females and 42 males) ages 14 through 18 incarcerated for at least 60 days. Data on subjects' responses from a validated measure (Grasmick et. al. Scale, 1993) and data from historical records, STAR reading…

Utilization of pyrosequencing to monitor the microbiome dynamics of probiotic treated poultry (Gallus gallus domesticus) during downstream poultry processing

USDA-ARS?s Scientific Manuscript database

Antibiotic growth promoters that have been historically employed to control pathogens and increase the rate of animal development for human consumption are currently banned in many countries. Probiotics have been proposed as an alternative to control pathogenic bacteria. Traditional culture method...

Historical review of C-5A lift distribution control systems

NASA Technical Reports Server (NTRS)

Disney, T. E.; Eckholdt, D. C.

1976-01-01

Analytical and experimental development work on various load alleviation systems for the C-5A is reviewed to trace the development of the technical and hardware concepts to the present time. Variations in system objectives, means of implementation and effects on loads and airplane performance, stability and control are discussed.

Racial Isolation, Poverty, and the Limits of Local Control in Oakland

ERIC Educational Resources Information Center

Noguera, Pedro A.

2004-01-01

Historically, schools in the United States have been governed at the local level by elected school boards, and finances have been raised primarily through local property taxes. While local control theoretically allows for greater responsiveness to local concerns, it does not take into account the vast inequality among and between communities in…

Get the Federal Government out of Education? That Wasn't the Founding Fathers' Vision

ERIC Educational Resources Information Center

Jennings, Jack

2011-01-01

During the 2010 election campaign, Senator Rand Paul from Kentucky demanded the dismantling of the U.S. Department of Education. "I am against any federal funding or control of education," he said. "Historically, education was funded and controlled locally" (Strauss, 2010). Another new Republican senator, Mike Lee from…

Family Planning in Sweden. Fact Sheets on Sweden.

ERIC Educational Resources Information Center

Swedish Inst., Stockholm.

This fact sheet explores attitudes in Sweden toward sexuality and childbirth from a historical perspective. After describing the strict social control over abortion and contraception in place 100 years ago, and the gradual easing of those controls in response to the low birth rate, the paper goes on to discuss the 1974 Abortion Act, which…

A multiyear quality control study of alpha-track radon monitors.

PubMed

Pearson, M D; Martz, D E; George, J L; Langner, G H

1992-01-01

Quality control exposures of commercial alpha-track radon monitors have been conducted approximately weekly at the U.S. Department of Energy (DOE) Grand Junction Projects Office since early 1987 in support of DOE remedial action programs. The results of these exposures provide a historical record of the comparative performances of these radon monitors.

Teaching and "Women's Work": A Comparative Historical and Ideological Analysis.

ERIC Educational Resources Information Center

Apple, Michael W.

1985-01-01

The fact that most elementary school teachers are female provides a key to understanding why there are often attempts by state bureaucrats, industry, and academics to control the curricular and teaching practices in classrooms. It also explains why these externally derived controls are often transformed by teachers once they are in their…

Method and apparatus for reducing rotor blade deflections, loads, and/or peak rotational speed

DOEpatents

Moroz, Emilian Mieczyslaw; Pierce, Kirk Gee

2006-10-17

A method for reducing at least one of loads, deflections of rotor blades, or peak rotational speed of a wind turbine includes storing recent historical pitch related data, wind related data, or both. The stored recent historical data is analyzed to determine at least one of whether rapid pitching is occurring or whether wind speed decreases are occurring. A minimum pitch, a pitch rate limit, or both are imposed on pitch angle controls of the rotor blades conditioned upon results of the analysis.

Mercy killing without consent. Historical comments on a controversial issue.

PubMed

Lauter, H; Meyer, J E

1982-02-01

In recent discussions on euthanasia the question about mercy killing without consent of mentally ill persons has turned up, particularly in cases of hopeless suffering among senile or chronically insane patients. Possible analogies to the actions under the German Nazi-regimen and relations to the concept of Social Darwinism with suggestions about active eugenic control as propagated in the early part of this century are outlined in a historical review. The implications and obvious dangers of misuse of any such kind of active euthanasia in psychiatry are discussed on this background.

Dendrochemical assessment of mercury releases from a pond and dredged-sediment landfill impacted by a chlor-alkali plant.

PubMed

Maillard, François; Girardclos, Olivier; Assad, Mohamad; Zappelini, Cyril; Pérez Mena, Julia Maria; Yung, Loïc; Guyeux, Christophe; Chrétien, Stéphane; Bigham, Gary; Cosio, Claudia; Chalot, Michel

2016-07-01

Although current Hg emissions from industrial activities may be accurately monitored, evidence of past releases to the atmosphere must rely on one or more environmental proxies. We used Hg concentrations in tree cores collected from poplars and willows to investigate the historical changes of Hg emissions from a dredged sediment landfill and compared them to a nearby control location. Our results demonstrated the potential value of using dendrochemistry to record historical Hg emissions from past industrial activities. Copyright © 2016 Elsevier Inc. All rights reserved.

Advancing the management and control of typhoid fever: a review of the historical role of human challenge studies.

PubMed

Waddington, Claire S; Darton, Thomas C; Woodward, William E; Angus, Brian; Levine, Myron M; Pollard, Andrew J

2014-05-01

Typhoid infection causes considerable morbidity and mortality worldwide, particularly in settings where lack of clean water and inadequate sanitation facilitate disease spread through faecal-oral transmission. Improved understanding of the pathogenesis, immune control and microbiology of Salmonella Typhi infection can help accelerate the development of improved vaccines and diagnostic tests necessary for disease control. S. Typhi is a human-restricted pathogen; therefore animal models are limited in their relevance to human infection. During the latter half of the 20th century, induced human infection ("challenge") studies with S. Typhi were used effectively to assess quantitatively the human host response to challenge and to measure directly the efficacy of typhoid vaccines in preventing clinical illness. Here, the findings of these historic challenge studies are reviewed, highlighting the pivotal role that challenge studies have had in improving our understanding of the host-pathogen interaction, and illustrating issues relevant to modern typhoid challenge model design. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

The role of vaccination in risk mitigation and control of Newcastle disease in poultry.

PubMed

Mayers, Jo; Mansfield, Karen L; Brown, Ian H

2017-10-20

Newcastle disease is regarded as one of the most important avian diseases throughout the world and continues to be a threat and economic burden to the poultry industry. With no effective treatment, poultry producers rely primarily on stringent biosecurity and vaccination regimens to control the spread of this devastating disease. This concise review provides an historical perspective of Newcastle disease vaccination and how fundamental research has paved the way for the development of instrumental techniques which are still in use today. Although vaccination programmes have reduced the impact of clinical disease, they have historically been ineffective in controlling the spread of virulent viruses and therefore do not always offer an adequate solution to the world's food security problems. However, the continued development of novel vaccine technology and improved biosecurity measures through education may offer a solution to help reduce the global threat of Newcastle disease on the poultry industry. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

[Notes on childhood and theory: a Latin American approach].

PubMed

Bustelo Graffigna, Eduardo

2012-12-01

This work seeks to introduce and examine different historically relevant theories and propose certain frameworks that allow for the development of a Latin American theoretical approach based in a new discourse regarding childhood and adolescence. In order to undertake the creation of this Latin American approach, understanding the category of childhood as a social and historical construction, the work draws upon the contributions of structuralism (in particular, childhood as a permanent category, its relational dimension with regards to adulthood and its historical and intercultural dimension) and Foucault and Deleuze's concept of the society of control associated with the category of domination, an essential aspect of Latin American thought. The text was presented as a speech in the V World Congress for the Rights of Children and Adolescents held in San Juan, Argentina, from October 15-19, 2012.

Contaminant exposure and potential effects on terrestrial vertebrates residing in the National Capital Region network and Mid-Atlantic network

USGS Publications Warehouse

Rattner, B.A.; Ackerson, B.K.

2006-01-01

Based upon these and other findings, ecotoxicological monitoring and research investigations of terrestrial vertebrates are warranted at several National Parks. These include Shenandoah National Park, Richmond National Battlefield, Chesapeake & Ohio Canal National Historic Park, Valley Forge National Historic Park, Hopewell Furnace National Historic Site, Monocacy National Battlefield, and Harpers Ferry National Historic Park. The types of investigations vary according to the species present at these parks and potential contaminant threats, but should focus on contemporary use pesticides and herbicides, polychlorinated biphenyls, mercury, lead, and perhaps, emerging contaminants including antibiotics, flame retardants, pharmaceuticals, and surfactants. Other management recommendations include additional training for natural resource staff members in the area of ecotoxicology, inclusion of terrestrial vertebrate contaminant monitoring and the Contaminant Assessment Process (U.S. Geological Survey Biomonitoring of Environmental Status and Trends Project) into the National Park Service Vital Signs Program, development of protocols for hand ling and toxicological analysis of dead or seemingly affected wildlife, consideration of some alternative methods and compounds for pest management and weed control, and use of non-toxic fishing tackle by visitors. 

Newly Digitized Historical Climate Data of the German Bight and the Southern Baltic Sea Coasts

NASA Astrophysics Data System (ADS)

Röhrbein, Dörte; Tinz, Birger; von Storch, Hans

2015-04-01

The detection of historical climate information plays an important role with regard to the discussion on climate change, particularly on storminess. The German Meteorological Service houses huge archives of historical handwritten journals of weather observations. A considerable number of original observation sheets from stations along the coast of the German Bight and the southern Baltic Sea exists which has been until recently almost unnoticed. These stations are called signal stations and are positioned close to the shore. However, for this region meteorological observation data of 128 stations exist from 1877 to 1999 and are partly digitized. In this study we show an analysis of firstly newly digitized wind and surface air pressure data of 15 stations from 1877 to 1939 and we also present a case study of the storm surge at the coast of the southern Baltic Sea in December 1913. The data are quality controlled by formal, climatological, temporal and consistency checks. It is shown that these historical climate data are usable in consistency and quality for further investigations on climate change, e.g. as input for regional and global reanalysis.

Documented historical landslide dams from around the world

USGS Publications Warehouse

Costa, John E.; Schuster, Robert L.

1991-01-01

This data compilation consists of dBase IV1 data files of the location, date, triggering mechanism, kind, size, failure time and mechanism, breach dimensions, subsequent controls, materials, and references for 463 historical landslide dams and associated natural reservoirs that have been recorded throughout the World. The data base presented in this report is a compilation of information on the characteristics of 463 landslide dams from around the World. It forms a basis on which to assess potential threats from existing landslide dams, or newly-formed landslide dams. The data base includes only landslide dams that have formed in historical times - that is, those formed during times when humans were able to record their occurrence, and the information transferred through various means of written and/or oral documentation. There have been far more prehistoric landslide dams about which relatively little is known. None of these is included in this data base. The focus on historical landslide dams allows insights into this natural process that will aid in understanding their role as a significant geologic process in recent Earth history.

Green Remediation Best Management Practices: Soil Vapor Extraction & Air Sparging

EPA Pesticide Factsheets

Historically, approximately one-quarter of Superfund source control projects have involved soil vapor extraction (SVE) to remove volatile organic compounds (VOCs) sorbed to soil in the unsaturated (vadose) zone.

Prevention of dimethylsulfoxide-related nausea and vomiting by prophylactic administration of ondansetron for patients receiving autologous cryopreserved peripheral blood stem cells.

PubMed

Eisenberg, Seth; Wickline, Mihkaila; Linenberger, Michael; Gooley, Ted; Holmberg, Leona

2013-05-01

To evaluate the effectiveness of ondansetron for the prevention of nausea and vomiting from dimethylsulfoxide (DMSO) during autologous stem cell transplantation (ASCT) infusion. Nonrandomized cohort using historical control. Comprehensive cancer center outpatient infusion department. 50 patients receiving ASCT in the outpatient setting. Patients were assessed for nausea and vomiting on their infusion day using the Multinational Association of Supportive Care in Cancer Antiemesis Tool (MAT) at arrival, pre-ASCT infusion, pre-ondansetron administration, prior to the first bag, and after each bag of stem cells. A standard script was used to ensure consistency. Ondansetron, 16 mg IV, was administered 30-90 minutes prior to each ASCT infusion. Number and volume of stem cells bags, as well as infusion rate and emesis episodes, were recorded. Nausea scores and vomiting episodes were compared to historical data. Subjectivity of nausea, potential Hawthorne Effect. Forty-five percent of patients had an MAT score greater than 2 on arrival, decreasing to 18% after receiving ondansetron before the first bag. Twenty-four percent had MAT increases of more than two points by infusion end compared to 58% in the historic control group. Eighteen percent of patients vomited compared to 28% of historic controls. The administration of 16 mg of IV ondansetron significantly reduced DMSO-related nausea and episodes of vomiting in patients receiving ASCT. Prophylactic administration of ondansetron had a positive effect on reducing nausea symptoms and episodes of vomiting during ASCT infusions. These results prompted a change in clinical practice. More research is required to determine whether the inclusion of other antiemetic agents would provide even greater benefit. To date, no other published studies have explored the benefits of premedicating patients with ondansetron prior to ASCT infusions. This study is the first to establish efficacy of ondansetron for an unlabeled indication. These results may pave the way for future research in decreasing nausea and vomiting in this setting.

Clinical utility of the Prostate Health Index (phi) for biopsy decision management in a large group urology practice setting.

PubMed

White, Jay; Shenoy, B Vittal; Tutrone, Ronald F; Karsh, Lawrence I; Saltzstein, Daniel R; Harmon, William J; Broyles, Dennis L; Roddy, Tamra E; Lofaro, Lori R; Paoli, Carly J; Denham, Dwight; Reynolds, Mark A

2018-04-01

Deciding when to biopsy a man with non-suspicious DRE findings and tPSA in the 4-10 ng/ml range can be challenging, because two-thirds of such biopsies are typically found to be benign. The Prostate Health Index (phi) exhibits significantly improved diagnostic accuracy for prostate cancer detection when compared to tPSA and %fPSA, however only one published study to date has investigated its impact on biopsy decisions in clinical practice. An IRB approved observational study was conducted at four large urology group practices using a physician reported two-part questionnaire. Physician recommendations were recorded before and after receiving the phi test result. A historical control group was queried from each site's electronic medical records for eligible men who were seen by the same participating urologists prior to the implementation of the phi test in their practice. 506 men receiving a phi test were prospectively enrolled and 683 men were identified for the historical control group (without phi). Biopsy and pathological findings were also recorded for both groups. Men receiving a phi test showed a significant reduction in biopsy procedures performed when compared to the historical control group (36.4% vs. 60.3%, respectively, P < 0.0001). Based on questionnaire responses, the phi score impacted the physician's patient management plan in 73% of cases, including biopsy deferrals when the phi score was low, and decisions to perform biopsies when the phi score indicated an intermediate or high probability of prostate cancer (phi ≥36). phi testing significantly impacted the physician's biopsy decision for men with tPSA in the 4-10 ng/ml range and non-suspicious DRE findings. Appropriate utilization of phi resulted in a significant reduction in biopsy procedures performed compared to historical patients seen by the same participating urologists who would have met enrollment eligibility but did not receive a phi test.

Optimizing Blood Transfusion Practices Through Bundled Intervention Implementation in Patients With Gynecologic Cancer Undergoing Laparotomy.

PubMed

Wallace, Sumer K; Halverson, Jessica W; Jankowski, Christopher J; DeJong, Stephanie R; Weaver, Amy L; Weinhold, Megan R; Borah, Bijan J; Moriarty, James P; Cliby, William A; Kor, Daryl J; Higgins, Andrew A; Otto, Hilary A; Dowdy, Sean C; Bakkum-Gamez, Jamie N

2018-05-01

To examine blood transfusion practices and develop a standardized bundle of interventions to address the high rate of perioperative red blood cell transfusion among patients with ovarian and endometrial cancer. This was a retrospective cohort study. Our primary aim was to determine whether an implemented bundled intervention was associated with a reduction in perioperative red blood cell transfusions among cases of laparotomy for cancer. Secondary aims included comparing perioperative demographic, surgical, complication, and cost data. Interventions included blood transfusion practice standardization using American Society of Anesthesiologists guidelines, an intraoperative hemostasis checklist, standardized intraoperative fluid status communication, and evidence-based use of tranexamic acid. Prospective data from women undergoing laparotomy for ovarian or endometrial cancer from September 28, 2015, to May 31, 2016, defined the study cohort and were compared with historical controls (September 1, 2014, to September 25, 2015). Outcomes were compared in the full unadjusted cohorts and in propensity-matched cohorts. In the intervention and historical cohorts, respectively, 89 and 184 women underwent laparotomy for ovarian cancer (n=74 and 152) or advanced endometrial cancer (n=15 and 32). Tranexamic acid was administered in 54 (60.7%) patients. The perioperative transfusion rate was lower for the intervention group compared with historical controls (18.0% [16/89] vs 41.3% [76/184], P<.001), a 56.4% reduction. This improvement in the intervention group remained significant after propensity matching (16.2% [13/80] vs 36.2% [29/80], P=.004). The hospital readmission rate was also lower for the intervention group compared with historical controls (1.1% [1/89] vs 12.5% [23/184], P=.002); however, this improvement did not attain statistical significance after propensity matching (1.2% [1/80] vs 7.5% [6/80], P=.12). Cost analysis demonstrated that this intervention was cost-neutral during index hospitalization plus 30-day follow-up. Application of a standardized bundle of evidence-based interventions was associated with reduced blood use in our gynecologic oncology practice.

Perfection and complexity in the lower Brazos River

NASA Astrophysics Data System (ADS)

Phillips, Jonathan D.

2007-11-01

The "perfect landscape" concept is based on the notion that any specific geomorphic system represents the combined, interacting effects of a set of generally applicable global laws and a set of geographically and historically contingent local controls. Because the joint probability of any specific combination of local and global controls is low, and the local controls are inherently idiosyncratic, the probability of existence of any given landscape is vanishingly small. A perfect landscape approach to geomorphic complexity views landscapes as circumstantial, contingent outcomes of deterministic laws operating in a specific environmental and historical context. Thus, explaining evolution of complex landscapes requires the integration of global and local approaches. Because perfection in this sense is the most important and pervasive form of complexity, the study of geomorphic complexity is not restricted to nonlinear dynamics, self-organization, or any other aspects of complexity theory. Beyond what can be achieved via complexity theory, the details of historical and geographic contexts must be addressed. One way to approach this is via synoptic analyses, where the relevant global laws are applied in specific situational contexts. A study of non-acute tributary junctions in the lower Brazos River, Texas illustrates this strategy. The application of generalizations about tributary junction angles, and of relevant theories, does not explain the unexpectedly high occurrence or the specific instances of barbed or straight junctions in the study area. At least five different causes for the development of straight or obtuse junction angles are evident in the lower Brazos. The dominant mechanism, however, is associated with river bank erosion and lateral channel migration which encroaches on upstream-oriented reaches of meandering tributaries. Because the tributaries are generally strongly incised in response to Holocene incision of the Brazos, the junctions are not readily reoriented to the expected acute angle. The findings are interpreted in the context of nonlinear divergent evolution, geographical and historical contingency, synoptic frameworks for generalizing results, and applicability of the dominant processes concept in geomorphology.

Modelling historical changes in the force-of-infection of Chagas disease to inform control and elimination programmes: application in Colombia

PubMed Central

Nouvellet, Pierre; Conteh, Lesong; Vera, Mauricio Javier; Angulo, Victor Manuel; Dib, Juan Carlos; Parra -Henao, Gabriel Jaime; Basáñez, María Gloria

2017-01-01

Background WHO's 2020 milestones for Chagas disease include having all endemic Latin American countries certified with no intradomiciliary Trypanosoma cruzi transmission, and infected patients under care. Evaluating the variation in historical exposure to infection is crucial for assessing progress and for understanding the priorities to achieve these milestones. Methods Focusing on Colombia, all the available age-structured serological surveys (undertaken between 1995 and 2014) were searched and compiled. A total of 109 serosurveys were found, comprising 83 742 individuals from rural (indigenous and non-indigenous) and urban settings in 14 (out of 32) administrative units (departments). Estimates of the force-of-infection (FoI) were obtained by fitting and comparing three catalytic models using Bayesian methods to reconstruct temporal and spatial patterns over the course of three decades (between 1984 and 2014). Results Significant downward changes in the FoI were identified over the course of the three decades, and in some specific locations the predicted current seroprevalence in children aged 0–5 years is <1%. However, pronounced heterogeneity exists within departments, especially between indigenous, rural and urban settings, with the former exhibiting the highest FoI (up to 66 new infections/1000 people susceptible/year). The FoI in most of the indigenous settings remain unchanged during the three decades investigated. Current prevalence in adults in these 15 departments varies between 10% and 90% depending on the dynamics of historical exposure. Conclusions Assessing progress towards the control of Chagas disease requires quantifying the impact of historical exposure on current age-specific prevalence at subnational level. In Colombia, despite the evident progress, there is a marked heterogeneity indicating that in some areas the vector control interventions have not been effective, hindering the possibility of achieving interruption by 2020. A substantial burden of chronic cases remains even in locations where serological criteria for transmission interruption may have been achieved, therefore still demanding diagnosis and treatment interventions. PMID:29147578

Living on the edge: reconstructing the genetic history of the Finnish wolf population

PubMed Central

2014-01-01

Background Many western European carnivore populations became almost or completely eradicated during the last ~200 years, but are now recovering. Extirpation of wolves started in Finland in the 19th century, and for more than 150 years the population size of wolves has remained small. To investigate historical patterns of genetic variation, we extracted DNA from 114 wolf samples collected in zoological museums over the last ~150 years. Fifteen microsatellite loci were used to look at genotypic variation in this historical sample. Additionally, we amplified a 430 bp sequence of mtDNA control region from the same samples. Contemporary wolf samples (N = 298) obtained after the population recovery in the mid-1990s, were used as a reference. Results Our analyses of mtDNA revealed reduced variation in the mtDNA control region through the loss of historical haplotypes observed prior to wolf declines. Heterozygosity at autosomal microsatellite loci did not decrease significantly. However, almost 20% of microsatellite alleles were unique to wolves collected before the 1960s. The genetic composition of the population changed gradually with the largest changes occurring prior to 1920. Half of the oldest historical samples formed a distinguishable genetic cluster not detected in the modern-day Finnish or Russian samples, and might therefore represent northern genetic variation lost from today’s gene pool. Point estimates of Ne were small (13.2 and 20.5) suggesting population fragmentation. Evidence of a genetic population bottleneck was also detected. Conclusions Our genetic analyses confirm changes in the genetic composition of the Finnish wolf population through time, despite the geographic interconnectivity to a much larger population in Russia. Our results emphasize the need for restoration of the historical connectivity between the present wolf populations to secure long-term viability. This might be challenging, however, because the management policies between Western and Eastern Europe often differ greatly. Additionally, wolf conservation is still a rather controversial issue, and anthropogenic pressure towards wolves remains strong. PMID:24678616

Application of Decision Tree to Obtain Optimal Operation Rules for Reservoir Flood Control Considering Sediment Desilting-Case Study of Tseng Wen Reservoir

NASA Astrophysics Data System (ADS)

ShiouWei, L.

2014-12-01

Reservoirs are the most important water resources facilities in Taiwan.However,due to the steep slope and fragile geological conditions in the mountain area,storm events usually cause serious debris flow and flood,and the flood then will flush large amount of sediment into reservoirs.The sedimentation caused by flood has great impact on the reservoirs life.Hence,how to operate a reservoir during flood events to increase the efficiency of sediment desilting without risk the reservoir safety and impact the water supply afterward is a crucial issue in Taiwan. 　Therefore,this study developed a novel optimization planning model for reservoir flood operation considering flood control and sediment desilting,and proposed easy to use operating rules represented by decision trees.The decision trees rules have considered flood mitigation,water supply and sediment desilting.The optimal planning model computes the optimal reservoir release for each flood event that minimum water supply impact and maximum sediment desilting without risk the reservoir safety.Beside the optimal flood operation planning model,this study also proposed decision tree based flood operating rules that were trained by the multiple optimal reservoir releases to synthesis flood scenarios.The synthesis flood scenarios consists of various synthesis storm events,reservoir's initial storage and target storages at the end of flood operating. 　Comparing the results operated by the decision tree operation rules(DTOR) with that by historical operation for Krosa Typhoon in 2007,the DTOR removed sediment 15.4% more than that of historical operation with reservoir storage only8.38×106m3 less than that of historical operation.For Jangmi Typhoon in 2008,the DTOR removed sediment 24.4% more than that of historical operation with reservoir storage only 7.58×106m3 less than that of historical operation.The results show that the proposed DTOR model can increase the sediment desilting efficiency and extend the reservoir life.

7 CFR 3565.9 - Compliance with federal requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... regulation. (c) Clean Air Act and Water Pollution Control Act Requirements. For any contract, all applicable... Water Act; Executive Order 11738; and EPA regulations at part 32, of title 40. (d) Historic preservation...

7 CFR 3565.9 - Compliance with federal requirements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... regulation. (c) Clean Air Act and Water Pollution Control Act Requirements. For any contract, all applicable... Water Act; Executive Order 11738; and EPA regulations at part 32, of title 40. (d) Historic preservation...

Historical inability to control Aedes aegypti as a main contributor of fast dispersal of chikungunya outbreaks in Latin America.

PubMed

Fernández-Salas, Ildefonso; Danis-Lozano, Rogelio; Casas-Martínez, Mauricio; Ulloa, Armando; Bond, J Guillermo; Marina, Carlos F; Lopez-Ordóñez, Teresa; Elizondo-Quiroga, Armando; Torres-Monzón, Jorge A; Díaz-González, Esteban E

2015-12-01

The arrival of chikungunya fever (CHIKF) in Latin American countries has been expected to trigger epidemics and challenge health systems. Historically considered as dengue-endemic countries, abundant Aedes aegypti populations make this region highly vulnerable to chikungunya virus (CHIKV) circulation. This review describes the current dengue and CHIKF epidemiological situations, as well as the role of uncontrolled Ae. aegypti and Aedes albopictus vectors in spreading the emerging CHIKV. Comments are included relating to the vector competence of both species and failures of surveillance and vector control measures. Dengue endemicity is a reflection of these abundant and persistent Aedes populations that are now spreading CHIKV in the Americas. This article forms part of a symposium in Antiviral Research on "Chikungunya discovers the New World." Copyright © 2015 Elsevier B.V. All rights reserved.

Command, Control and Communications Capabilities Enabling 21st Century Missions, a Historical Perspective

NASA Technical Reports Server (NTRS)

Waterman, Robert D.; Rice, Herbert D.; Waterman, Susan J.

2010-01-01

Command, Control and Communications (CCC) has evolved through the years from simple switches, dials, analogue hardwire networks and lights to a modern computer based digital network. However there are two closely coupled pillars upon which a CCC system is built. The first, is that technology drives the pace of advancement. The second is that a culture that fosters resistance to change can limit technological advancements in the CCC system. While technology has advanced at a tremendous rate throughout the years, the change in culture has moved slowly. This paper will attempt to show through a historical perspective where specific design decisions for early CCC systems have erroneously evolved into general requirements being imposed on later systems. Finally this paper will provide a glimpse into the future directions envisioned for CCC capabilities that will enable 21st century missions.

Comparison of the efficacy and cost effectiveness of pre-emptive therapy as directed by CMV antigenemia and prophylaxis with ganciclovir in lung transplant recipients.

PubMed

Kelly, J; Hurley, D; Raghu, G

2000-04-01

CMV disease remains a major complication of lung transplantation and attempts to prevent it have met with marginal success. In a previous study we documented that universal prophylaxis did not prevent CMV disease but merely delayed it, and was very costly. We compared the efficacy and cost of pre-emptive therapy with ganciclovir, guided by CMV antigenemia, to that of historic controls that received universal prophylaxis with ganciclovir. CMV antigenemia assay was done routinely and pre-emptive therapy was initiated if greater than 25 CMV positive cells per 100,000 polymorphonuclear cells were found. Nineteen patients were enrolled; 6 of of whom received 12 courses of pre-emptive therapy. The incidence of CMV disease was 26% compared to 38% for the historical controls (p = 0.51). None of the patients that received pre-emptive therapy developed CMV disease following that therapy. Antigenemia failed to predict disease in 5 patients that developed it, and thus it is unknown if pre-emptive therapy could have prevented it. There was no mortality in either the study patients or historic controls directly related to CMV. The net savings with pre-emptive therapy was $2569 per patient. We conclude that pre-emptive therapy with ganciclovir is as safe and effective as universal prophylaxis in preventing CMV disease in lung transplant recipients, and is less expensive. The appropriate surveillance technique and timing remain to be determine to optimize the efficacy of pre-emptive therapy.

Proof of Principle of Ocular sparing in dogs with sinonasal tumors treated with intensity-modulated radiation therapy

PubMed Central

Lawrence, Jessica A.; Forrest, Lisa J.; Turek, Michelle M.; Miller, Paul E.; Mackie, T. Rockwell; Jaradat, Hazim A.; Vail, David M.; Dubielzig, Richard R.; Chappell, Richard; Mehta, Minesh P.

2010-01-01

Intensity modulated radiation therapy (IMRT) allows optimization of radiation dose delivery to complex tumor volumes with rapid dose drop-off to surrounding normal tissues. A prospective study was performed to evaluate the concept of conformal avoidance using IMRT in canine sinonasal cancer. The potential of IMRT to improve clinical outcome with respect to acute and late ocular toxicity was evaluated. Thirty-one dogs with sinonasal cancer were treated definitively with IMRT using helical tomotherapy and/or dynamic multileaf collimator (DMLC) delivery. Ocular toxicity was evaluated prospectively and compared to a comparable group of historical controls treated with conventional two-dimensional radiotherapy (2D-RT) techniques. Treatment plans were devised for each dog using helical tomotherapy and DMLC that achieved the target dose to the planning treatment volume and limited critical normal tissues to the prescribed dose-volume constraints. Overall acute and late toxicities were limited and minor, detectable by an experienced observer. This was in contrast to the profound ocular morbidity observed in the historical control group treated with 2D-RT. Overall median survival for IMRT treated and 2D treated dogs was 420 days and 411 days, respectively. Compared with conventional techniques, IMRT reduced dose delivered to eyes and resulted in bilateral ocular sparing in the dogs reported herein. These data provide proof-of-principle that conformal avoidance radiotherapy can be delivered through high conformity IMRT, resulting in decreased normal tissue toxicity as compared to historical controls treated with 2D-RT. PMID:20973393

Anthropocene streams and base-level controls from historic dams in the unglaciated mid-Atlantic region, USA

USGS Publications Warehouse

Merritts, Dorothy; Walter, Robert; Rahnis, Michael; Hartranft, Jeff; Cox, Scott; Gellis, Allen; Potter, Noel; Hilgartner, William; Langland, Michael; Manion, Lauren; Lippincott, Caitlin; Siddiqui, Sauleh; Rehman, Zain; Scheid, Chris; Kratz, Laura; Shilling, Andrea; Jenschke, Matthew; Datin, Katherine; Cranmer, Elizabeth; Reed, Austin; Matuszewski, Derek; Voli, Mark; Ohlson, Erik; Neugebauer, Ali; Ahamed, Aakash; Neal, Conor; Winter, Allison; Becker, Steven

2011-01-01

Recently, widespread valley-bottom damming for water power was identified as a primary control on valley sedimentation in the mid-Atlantic US during the late seventeenth to early twentieth century. The timing of damming coincided with that of accelerated upland erosion during post-European settlement land-use change. In this paper, we examine the impact of local drops in base level on incision into historic reservoir sediment as thousands of ageing dams breach. Analysis of lidar and field data indicates that historic milldam building led to local base-level rises of 2-5 m (typical milldam height) and reduced valley slopes by half. Subsequent base-level fall with dam breaching led to an approximate doubling in slope, a significant base-level forcing. Case studies in forested, rural as well as agricultural and urban areas demonstrate that a breached dam can lead to stream incision, bank erosion and increased loads of suspended sediment, even with no change in land use. After dam breaching, key predictors of stream bank erosion include number of years since dam breach, proximity to a dam and dam height. One implication of this work is that conceptual models linking channel condition and sediment yield exclusively with modern upland land use are incomplete for valleys impacted by milldams. With no equivalent in the Holocene or late Pleistocene sedimentary record, modern incised stream-channel forms in the mid-Atlantic region represent a transient response to both base-level forcing and major changes in land use beginning centuries ago. Similar channel forms might also exist in other locales where historic milling was prevalent.

15. DETAIL INTERIOR VIEW OF CONTROL HOUSE FOR NAVIGATION LOCK ...

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

15. DETAIL INTERIOR VIEW OF CONTROL HOUSE FOR NAVIGATION LOCK #1. Photograph Nos. OR-11-D-16 through OR-11-D-27 are photocopies of photographs. Original historic photographs are located at the Bonneville Powerhouse, Bonneville, Oregon. - Bonneville Project, Navigation Lock No. 1, Oregon shore of Columbia River near first Powerhouse, Bonneville, Multnomah County, OR

Law of Mass Communications: Freedom and Control of Print and Broadcast Media. Third Edition.

ERIC Educational Resources Information Center

Nelson, Harold L.; Teeter, Dwight L., Jr.

This book is divided into three major sections: principles and development of freedom of expression, rights in conflict with free expression, and communications law and the public interest. Specific areas covered in the two chapters of the first section are freedom and control and a historical background of freedom of expression. The second…

From Communist Control to "Glastnost" and Back?: Media Freedom and Control in the Former Soviet Union.

ERIC Educational Resources Information Center

Ferguson, Denise P.

1998-01-01

Frames the role of public relations in a self-governing society. Discusses three environmental factors that affect the practice of socially responsible public relations. Reviews the historical media philosophy of eastern Europe and the former Soviet Union. Examines media practice occurring during the region's transformation and implications for…

Tribally Controlled Colleges: Making Good Medicine. American Indian Studies, Volume 3.

ERIC Educational Resources Information Center

Stein, Wayne J.

This book traces the development of tribally controlled colleges (TCC), placing them in a historical context within Native American higher education and within the junior and community college movement. It examines the first 10 years of the movement, focusing in particular on six TCC's and the American Indian Higher Education Consortium (AIHEC),…

Military Control over War News: The Implications of the Persian Gulf.

ERIC Educational Resources Information Center

Cooper, Stephen

1996-01-01

Notes that news coverage of warfare poses a problem for political systems with a free press, such as the United States. Reports that the military's controls over newsgathering during the Persian Gulf War set off a controversy still smoldering during the Haiti occupation of 1994. Examines the legal, historical, and technological aspects of the…

Successful when Given the Opportunity: Investigating Gender Representation and Success Rates of Interscholastic Athletic Directors

ERIC Educational Resources Information Center

Pedersen, Paul M.; Whisenant, Warren A.

2005-01-01

Historically, males have almost exclusively controlled sport (Cashmore, 2000). While this control has been evident on the playing field (Sage, 1998) and in the media's coverage of sport (Kinkema & Harris, 1998), it has also been prevalent in all levels of administration positions in sport (Coakley, 2001). In intercollegiate athletics, the…

Strand I - Physical Health; Disease Prevention and Control for Grades 4-6.

ERIC Educational Resources Information Center

New York State Education Dept., Albany. Bureau of Elementary Curriculum Development.

This health curriculum guide, intended for use with children in grades four through six, sees man's struggle to discover new knowledge for the prevention and control of disease in historical perspective. The contents of the guide are presented in outline form and cover the nature of disease, the history of disease, modern approaches to disease…

The History of Injury Control and the Epidemiology of Child and Adolescent Injuries.

ERIC Educational Resources Information Center

Grossman, David C.

2000-01-01

Presents a historical overview of injury control and prevention in the United States and offers a summary of current knowledge about the importance of different causes of childhood injury, looking at risk and protective factors that have a bearing on preventive efforts. Injury remains the most important cause of death and disability for children…

Patterns and controls on historical channel change in the Willamette River, Oregon, USA

Treesearch

Jennifer Rose Wallick; Gordon E. Grant; Stephen T. Lancaster; John P. Bolte; Roger P. Denlinger

2007-01-01

Distinguishing human impacts on channel morphology from the natural behaviour of fluvial systems is problematic for large river basins. Large river basins, by virtue of their size, typically encompass wide ranges of geology and landforms resulting in diverse controls on channel form. They also inevitably incorporate long and complex histories of overlapping human and...

Statistical Process Control. Impact and Opportunities for Ohio.

ERIC Educational Resources Information Center

Brown, Harold H.

The first purpose of this study is to help the reader become aware of the evolution of Statistical Process Control (SPC) as it is being implemented and used in industry today. This is approached through the presentation of a brief historical account of SPC, from its inception through the technological miracle that has occurred in Japan. The…

Controlling the Black School-Age Male: Psychotropic Medications and the Circumvention of Public Law 94-142 and Section 504

ERIC Educational Resources Information Center

Fitzgerald, Terence D.

2009-01-01

Public schools have historically embedded mechanisms for control within their policies and procedures through a variety of means. This article investigates a moderately sized integrated public school system in an upscale to low socioeconomic Big Ten university community in Illinois. Through descriptive measures, the author examines the racial…

Newly discovered bio-control agents kill Sparganothis and cranberry fruitworm: Preliminary data on native nematode species

USDA-ARS?s Scientific Manuscript database

Historically, two of the most destructive insect pests in Wisconsin have been the Cranberry Fruitworm (CFW) and the Sparganothis Fruitworm (SFW). Once they’ve hatched, controlling them is a lot like “trench warfare,” where we throw various weapons at the enemy, but most of them miss. Many Wisconsin ...

A comprehensive intervention following the clinical pathway of eating and swallowing disorder in the elderly with dementia: historically controlled study.

PubMed

Arahata, Masahisa; Oura, Makoto; Tomiyama, Yuka; Morikawa, Naoe; Fujii, Hatsue; Minani, Shinji; Shimizu, Yukihiro

2017-07-14

Eating problems in patients with advanced dementia are strongly associated with their deteriorating survival. Food and drink intake in people with dementia may be supported by specific interventions, but the effectiveness of such interventions is backed by almost no evidence. However, comprehensive geriatric assessment (CGA) might potentially clarify the etiology of decreased oral intake in people with dementia; thus improving their clinical outcomes. This study was a single-arm, non-randomized trial that included historically controlled patients for comparison. We defined elderly patients with both severely decreased oral intake depending on artificial hydration and/or nutrition (AHN) and dementia as "Eating and Swallowing Disorder of the Elderly with Dementia (ESDED)". In the intervention group, participants received CGA through the original clinical pathway with multidisciplinary interventions. This was followed by individualized therapeutic interventions according to assessment of the etiology of their eating problems. During the intervention period (between 1st April 2013 and 31st March 2015), 102 cases of ESDED were enrolled in the study and 90 patients had completed receiving CGA. Conversely, 124 ESDED patient controls were selected from the same hospital enrolled during the historical period (between 1st April 2011 and 31st March 2012). Most participants in both groups were bedridden with severe cognitive impairment. For the intervention group, an average of 4.3 interventional strategies was recommended per participant after CGA. Serological tests, diagnostic imaging and other diagnostic examinations were much more frequently performed in the intervention group. Recovery rate from ESDED in the intervention group was significantly higher than that in the historical group (51% v.s. 34%, respectively, P = 0.02). The 1-year AHN-free survival in the intervention group was significantly higher than that in the historical group (28% v.s. 15%, respectively, P = 0.01). No significant difference between the two groups was found for 1-year overall survival (37% v.s. 28%, respectively, P = 0.08). Use of CGA with multidisciplinary interventions could improve the functional status of eating and allow elderly patients with severe eating problems and dementia to survive independently without the need for AHN. ISRCTN57646445 , this trial was retrospectively registered on 8th December 2015.

Modeling physical and biogeochemical controls over carbon accumulation in a boreal forest soil

USGS Publications Warehouse

Carrasco, J.J.; Neff, J.C.; Harden, J.W.

2006-01-01

Boreal soils are important to the global C cycle owing to large C stocks, repeated disturbance from fire, and the potential for permafrost thaw to expose previously stable, buried C. To evaluate the primary mechanisms responsible for both short- and long-term C accumulation in boreal soils, we developed a multi-isotope (12,14C) Soil C model with dynamic soil layers that develop through time as soil organic matter burns and reaccumulates. We then evaluated the mechanisms that control organic matter turnover in boreal regions including carbon input rates, substrate recalcitrance, soil moisture and temperature, and the presence of historical permafrost to assess the importance of these factors in boreal C accumulation. Results indicate that total C accumulation is controlled by the rate of carbon input, decomposition rates, and the presence of historical permafrost. However, unlike more temperate ecosystems, one of the key mechanisms involved in C preservation in boreal soils examined here is the cooling of subsurface soil layers as soil depth increases rather than increasing recalcitrance in subsurface soils. The propagation of the 14C bomb spike into soils also illustrates the importance of historical permafrost and twentieth century warming in contemporary boreal soil respiration fluxes. Both 14C and total C simulation data also strongly suggest that boreal SOM need not be recalcitrant to accumulate; the strong role of soil temperature controls on boreal C accumulation at our modeling test site in Manitoba, Canada, indicates that carbon in the deep organic soil horizons is probably relatively labile and thus subject to perturbations that result from changing climatic conditions in the future. Copyright 2006 by the American Geophysical Union.

Cryptococcal meningitis management in Tanzania with strict schedule of serial lumber punctures using intravenous tubing sets: an operational research study.

PubMed

Meda, John; Kalluvya, Samuel; Downs, Jennifer A; Chofle, Awilly A; Seni, Jeremiah; Kidenya, Benson; Fitzgerald, Daniel W; Peck, Robert N

2014-06-01

Cryptococcal meningitis (CM) has a mortality rate of ∼70% among HIV-infected adults in low-income countries. Controlling intracranial pressure (ICP) is essential in CM, but it is difficult in low-income countries because manometers and practical ICP management protocols are lacking. As part of a continuous quality improvement project, our Tanzanian hospital initiated a new protocol for ICP management for CM. All adult inpatients with CM are included in a prospective patient registry. At the time of analysis, this registry included data from 2 years before the initiation of this new ICP management protocol and for a 9-month period after. ICP was measured at baseline and at days 3, 7, and 14 by both manometer and intravenous (IV) tubing set. All patients were given IV fluconazole according to Tanzanian treatment guidelines and were followed until 30 days after admission. Among adult inpatients with CM, 32 of 35 patients (91%) had elevated ICP on admission. Cerebrospinal fluid pressure measurements using the improvised IV tubing set demonstrated excellent agreement (r = 0.96) with manometer measurements. Compared with historical controls, the new ICP management protocol was associated with a significant reduction in 30-day mortality (16/35 [46%] vs. 48/64 [75%] in historical controls; hazard ratio = 2.1 [95% CI: 1.1 to 3.8]; P = 0.018]. Increased ICP is almost universal among HIV-infected adults admitted with CM in Tanzania. Intensive ICP management with a strict schedule of serial lumbar punctures reduced in-hospital mortality compared with historical controls. ICP measurement with IV tubing sets may be a good alternative in resource-limited health facilities where manometers are not available.

Plasma rich in growth factors membrane as coadjuvant treatment in the surgery of ocular surface disorders.

PubMed

Sanchez-Avila, Ronald M; Merayo-Lloves, Jesús; Riestra, Ana C; Berisa, Silvia; Lisa, Carlos; Sánchez, José Alfonso; Muruzabal, Francisco; Orive, Gorka; Anitua, Eduardo

2018-04-01

To evaluate the safety and efficacy of the surgical use of plasma rich in growth factors fibrin membrane (mPRGF) in different ocular surface pathologies.Fifteen patients with different corneal and conjunctival diseases were included in the study. Patients were grouped according to the use of mPRGF as graft (corneal and/or conjunctival) or dressing; they were also grouped according to the surgical subgroup of intervention (persistent corneal ulcer [PCU], keratoplasty, superficial keratectomy, corneal perforation, and pterygium). Best corrected visual acuity, intraocular pressure (IOP), inflammation control time (ICT), mPRGF AT (PRGF membrane absorption time), and the healing time of the epithelial defect (HTED) were evaluated throughout the clinical follow-up time. Safety assessment was also performed reporting all adverse events.mPRGF showed a total closure of the defect in 13 of 15 patients (86.7%) and a partial closure in 2 patients (13.3%). The mean follow-up time was 11.1 ± 4.2 (4.8-22.8) months, the mean ICT was 2.5 ± 1.1 (1.0-4.0) months, the mean mPRGF AT was 12.4 ± 2.0 (10.0-16.0) days, and for the global HTED the mean was 2.9 ± 1.2 (1-4.8) months. Results showed an improvement in BCVA in all patients, with an overall improvement of 2.9 in Vision Lines. The BCVA significantly improved (P < .05) in the groups of corneal graft and dressing. In the PCU subgroup (6 patients), the healing time of epithelial defect was significantly reduced (P < .05) in patients treated only with the mPRGF in comparison to those which mPRGF therapy was associated to the amniotic membrane. The IOP remained stable (P > .05) throughout the clinical follow-up time. No adverse events were reported after mPRGF use.The mPRGF is effective and safe as coadjuvant treatment in surgeries related with ocular surface disorders, being an alternative to the use of amniotic membrane. The mPRGF accelerates tissue regeneration after ocular surface surgery thus minimizing inflammation and fibrosis.

A perspective of laminar-flow control. [aircraft energy efficiency program

NASA Technical Reports Server (NTRS)

Braslow, A. L.; Muraca, R. J.

1978-01-01

A historical review of the development of laminar flow control technology is presented with reference to active laminar boundary-layer control through suction, the use of multiple suction slots, wind-tunnel tests, continuous suction, and spanwise contamination. The ACEE laminar flow control program is outlined noting the development of three-dimensional boundary-layer codes, cruise-noise prediction techniques, airfoil development, and leading-edge region cleaning. Attention is given to glove flight tests and the fabrication and testing of wing box designs.

Evidence-based control of canine rabies: a critical review of population density reduction.

PubMed

Morters, Michelle K; Restif, Olivier; Hampson, Katie; Cleaveland, Sarah; Wood, James L N; Conlan, Andrew J K

2013-01-01

Control measures for canine rabies include vaccination and reducing population density through culling or sterilization. Despite the evidence that culling fails to control canine rabies, efforts to reduce canine population density continue in many parts of the world. The rationale for reducing population density is that rabies transmission is density-dependent, with disease incidence increasing directly with host density. This may be based, in part, on an incomplete interpretation of historical field data for wildlife, with important implications for disease control in dog populations. Here, we examine historical and more recent field data, in the context of host ecology and epidemic theory, to understand better the role of density in rabies transmission and the reasons why culling fails to control rabies. We conclude that the relationship between host density, disease incidence and other factors is complex and may differ between species. This highlights the difficulties of interpreting field data and the constraints of extrapolations between species, particularly in terms of control policies. We also propose that the complex interactions between dogs and people may render culling of free-roaming dogs ineffective irrespective of the relationship between host density and disease incidence. We conclude that vaccination is the most effective means to control rabies in all species. © 2012 The Authors. Journal of Animal Ecology © 2012 British Ecological Society.

Detention basin alternative outlet design study.

DOT National Transportation Integrated Search

2016-10-01

This study examines the outlets structures CDOT has historically employed to drain water quality treatment detention basins and flood control basins, presents two new methods of metering the water quality capture volume (WQCV), namely 1) the Elliptic...

The characteristic of the earthquake damage in Kyoto during the historical period

NASA Astrophysics Data System (ADS)

Nishiyama, Akihito

2017-04-01

The Kyoto city is located in the northern part of the Kyoto basin, central Japan and has a history of more than 1200 years. Kyoto has long been populated area with many buildings, and the center of politics, economics and culture of Japan. Due to historical large earthquakes, the Kyoto city was severely damaged such as collapses of buildings and human casualties. In the historical period, the Kyoto city has experienced six damaging large earthquake of 976, 1185, 1449, 1596, 1662 and 1830. Among them, Kyoto has experienced three damaging large earthquakes from the end of the 16th century to the middle of the 19th century, when the urban area was being expanded. All of these earthquakes are considered to be not the earthquakes in the Kyoto basin but inland earthquakes occurred in the surrounding area. The earthquake damage in Kyoto during the historical period is strongly controlled by ground conditions and earthquakes resistance of buildings rather than distance from the estimated source fault. To better estimate seismic intensity based on building damage, it is necessary to consider the state of buildings (e.g., elapsed years since established, histories of repairs and/or reinforcements, building structures) as well as the strength of ground shakings. By considering the strength of buildings at the time of an earthquake occurrence, the seismic intensity distribution due to historical large earthquakes can be estimated with higher reliability than before. The estimated seismic intensity distribution map for such historical earthquakes can be utilized for developing the strong ground motion prediction in the Kyoto basin.

Use of computational fluid dynamics in optimization of natural smoke ventilation from a historical shopping mall - Case study

NASA Astrophysics Data System (ADS)

Krajewski, Grzegorz; Wegrzyński, Wojciech

2018-01-01

In this paper, the Authors present results of a complex case study, in which a natural smoke ventilation system was introduced into a historical mall Koszyki Market Hall located in the centre of Warsaw. As historical authorities protected the building, the only solution possible was to use a natural system - known for deficient performance in façade applications. To maximise the performance of the smoke control system, a Computational Wind Engineering exercise was performed. The goal was to find the most difficult wind attack angles, and optimise the performance at these conditions. Once the wind influence was known, a transient analysis was performed that included the growth of the fire within the building, as well as a numerical evacuation study. The resulting system was immune to the wind effects, and provided safe evacuation to users of the building, even in difficult wind conditions.

Exposures to diesel exhaust in the International Brotherhood of Teamsters, 1950-1990.

PubMed

Bailey, Chad R; Somers, Joseph H; Steenland, Kyle

2003-01-01

A prior case-control study found a positive, monotonic exposure-response relationship between exposure to diesel exhaust and lung cancer among decedents of the Central States Conference of the International Brotherhood of Teamsters. In response to critiques of the Teamsters' exposure estimates by the Health Effects Institute's Diesel Epidemiology Panel, historical exposures and associated uncertainties are investigated here. Historic diesel exhaust exposures are predicted as a function of heavy-duty diesel truck emissions, increasing use of diesel engines, and occupational elemental carbon (EC) measurements taken during the late 1980s and early 1990s. EC from diesel and nondiesel sources is distinguished in light of recent studies indicating a substantial contribution of gasoline vehicles to ambient EC. Monte Carlo sampling is used to characterize exposure distributions. The methodology used in this article-a probabilistic model for historical exposure assessment-is novel.

[Going into the 21st century: should one dream or act?].

PubMed

Coosemans, M

1991-01-01

A historical review of vector control is made. Despite the available tools, vector borne diseases are still a priority in Public Health. Magic tools, like DDT, were often misused. Adapted strategies and structures for vector control are now required. Progress will mainly result from research and evaluation done in the framework of vector control programmes. Discovery of new tools will find in these operational programmes a point of fall for their application.

Environmental Assessment for Terminal Area Improvements, Charleston International Airport

DTIC Science & Technology

2011-11-17

Resources and/or USFWS . 7. An erosion and sedimentation control plan that includes the use of construction controls to prevent degradation of water...CCAA property and surrounding lands were historically used for phosphate fertilizer mining. Prior to the development of this property as an airport...number of zoning classifications which control land use within the city limits. The Airport is in an area zoned as "Light Industrial District" a

137. Photographic copy of historic photo, April 14, 1936 (original ...

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

137. Photographic copy of historic photo, April 14, 1936 (original print filed in Record Group 115, National Archives, Washington, D.C.). AFTER EXAMINATION OF ALL THE FEATURES OF THE GATE AND CONTROL, AND DUE TO THE PERFECT OPERATION THE GATE WAS RAISED TO MAXIMUM HEIGHT. IT IS SHOWN HERE SOME SEVEN OR EIGHT FEET ABOVE WATER LEVEL COMPLETELY SHUTTING OFF THE FLOW OF THE RIVER. EXAMINATION OF THE INTERIOR OF THE OUTLET TUNNEL WAS CONDUCTED. NO DAMAGE COULD BE DISCOVERED AND TESTS OF THE RING GATE CONTINUED. - Owyhee Dam, Across Owyhee River, Nyssa, Malheur County, OR

Patient Groups and the Construction of the Patient-Consumer in Britain: An Historical Overview

PubMed Central

MOLD, ALEX

2010-01-01

This article presents an historical overview of the changing meaning of the patient-consumer, and specifically the role played by patient groups in constructing the patient as consumer. It is argued that patient groups were central to the formation of the patient-consumer, but as health consumerism was taken on by the state, they lost control of this figure. Competing understandings of what it meant to be a patient-consumer developed, a shift that raises further questions about the unity of claims made in the name of the patient-consumer. PMID:20798768

Patient Groups and the Construction of the Patient-Consumer in Britain: An Historical Overview.

PubMed

Mold, Alex

2010-10-01

This article presents an historical overview of the changing meaning of the patient-consumer, and specifically the role played by patient groups in constructing the patient as consumer. It is argued that patient groups were central to the formation of the patient-consumer, but as health consumerism was taken on by the state, they lost control of this figure. Competing understandings of what it meant to be a patient-consumer developed, a shift that raises further questions about the unity of claims made in the name of the patient-consumer.

A Database Design for the Brazilian Air Force Military Personnel Control System.

DTIC Science & Technology

1987-06-01

GIVEN A RECNum GET MOVING HISTORICAL". 77 SEL4 PlC X(70) VALUE ". 4. GIVEN A RECNUM GET NOMINATION HISTORICAL". 77 SEL5 PIC X(70) VALUE it 5. GIVEN A...WHERE - "°RECNUM = :RECNUM". 77 SQL-SEL3-LENGTH PIC S9999 VALUE 150 COMP. 77 SQL- SEL4 PIC X(150) VALUE "SELECT ABBREV,DTNOM,DTEXO,SITN FROM...NOMINATION WHERE RECNUM 77 SQL- SEL4 -LENGTH PIC S9999 VALUE 150 COMP. 77 SQL-SEL5 PIC X(150) VALUE "SELECT ABBREVDTDES,DTWAIVER,SITD FROM DESIG WHERE RECNUM It

Genetic affinities among the historical provinces of Romania and Central Europe as revealed by an mtDNA analysis.

PubMed

Cocoş, Relu; Schipor, Sorina; Hervella, Montserrat; Cianga, Petru; Popescu, Roxana; Bănescu, Claudia; Constantinescu, Mihai; Martinescu, Alina; Raicu, Florina

2017-03-07

As a major crossroads between Asia and Europe, Romania has experienced continuous migration and invasion episodes. The precise routes may have been shaped by the topology of the territory and had diverse impacts on the genetic structure of mitochondrial DNA (mtDNA) in historical Romanian provinces. We studied 714 Romanians from all historical provinces, Wallachia, Dobrudja, Moldavia, and Transylvania, by analyzing the mtDNA control region and coding markers to encompass the complete landscape of mtDNA haplogroups. We observed a homogenous distribution of the majority of haplogroups among the Romanian provinces and a clear association with the European populations. A principal component analysis and multidimensional scaling analysis supported the genetic similarity of the Wallachia, Moldavia, and Dobrudja groups with the Balkans, while the Transylvania population was closely related to Central European groups. These findings could be explained by the topology of the Romanian territory, where the Carpathian Arch played an important role in migration patterns. Signals of Asian maternal lineages were observed in all Romanian historical provinces, indicating gene flow along the migration routes through East Asia and Europe. Our current findings based on the mtDNA analysis of populations in historical provinces of Romania suggest similarity between populations in Transylvania and Central Europe, supported both by the observed clines in haplogroup frequencies for several European and Asian maternal lineages and MDS analyses.

Home-based intermediate care program vs hospitalization

PubMed Central

Armstrong, Catherine Deri; Hogg, William E.; Lemelin, Jacques; Dahrouge, Simone; Martin, Carmel; Viner, Gary S.; Saginur, Raphael

2008-01-01

OBJECTIVE To explore whether a home-based intermediate care program in a large Canadian city lowers the cost of care and to look at whether such home-based programs could be a solution to the increasing demands on Canadian hospitals. DESIGN Single-arm study with historical controls. SETTING Department of Family Medicine at the Ottawa Hospital (Civic campus) in Ontario. PARTICIPANTS Patients requiring hospitalization for acute care. Participants were matched with historical controls based on case-mix, most responsible diagnosis, and level of complexity. INTERVENTIONS Placement in the home-based intermediate care program. Daily home visits from the nurse practitioner and 24-hour access to care by telephone. MAIN OUTCOME MEASURES Multivariate regression models were used to estimate the effect of the program on 5 outcomes: length of stay in hospital, cost of care substituted for hospitalization (Canadian dollars), readmission for a related diagnosis, readmission for any diagnosis, and costs incurred by community home-care services for patients following discharge from hospital. RESULTS The outcomes of 43 hospital admissions were matched with those of 363 controls. Patients enrolled in the program stayed longer in hospital (coefficient 3.3 days, P < .001), used more community care services following discharge (coefficient $729, P = .007), and were more likely to be readmitted to hospital within 3 months of discharge (coefficient 17%, P = .012) than patients treated in hospital. Total substituted costs of home-based care were not significantly different from the costs of hospitalization (coefficient -$501, P = .11). CONCLUSION While estimated cost savings were not statistically significant, the limitations of our study suggest that we underestimated these savings. In particular, the economic inefficiencies of a small immature program and the inability to control for certain factors when selecting historical controls affected our results. Further research is needed to determine the economic effect of mature home-based programs. PMID:18208958

Early crisis nontechnical skill teaching in residency leads to long-term skill retention and improved performance during crises: A prospective, nonrandomized controlled study.

PubMed

Doumouras, Aristithes G; Engels, Paul T

2017-07-01

Medical error is common in crises, and the majority of observed errors are nontechnical in nature. The long-term impact of teaching crisis nontechnical skills to residents has not been evaluated. The objective of this study was to determine the effect of simulation-based teaching of crisis nontechnical skills compared to controls one year after initial teaching. This was a prospective study using both historical controls and a before-and-after methodology to evaluate the effect of a high-fidelity simulation curriculum that used crisis resource management principles to teach nontechnical skills. Postgraduate year 2 and 3 residents were invited to take part in a prospective training course over 2 years. The primary outcome was leader performance evaluated by expert raters using the previously validated 7-point Ottawa Global Rating Scale. Overall, 23 residents performed 30 simulations over the 2 years with the intervention group of 7 residents being assessed in both years. After adjustment, the postgraduate year 3 intervention group who received training the previous year had significantly higher overall performance scores than all postgraduate year 2 scores (1.09 95% confidence interval 0.70-1.47, P < .001) and the historical postgraduate year 3 cohort who received no prior training (1.20, 95% confidence interval 0.37-2.03, P = .005). There was no decay of skills noted over the course of the study. Postgraduate year 3 residents who had prior training had significantly improved crisis performance compared to historical postgraduate year 3 controls and untrained postgraduate year 2 residents. There were no significant differences between the crisis performance of postgraduate year 2 residents and the untrained postgraduate year 3 controls. This confirms the beneficial effect and long-term retention after crisis nontechnical skill training. Copyright © 2016 Elsevier Inc. All rights reserved.

Taking People's History Back to the People: An Approach to Making History Popular, Relevant, and Intellectual

ERIC Educational Resources Information Center

Lempert, David H

2013-01-01

This article takes the educational vision of people's history an additional step, combining it with experiential approaches to democratic education that have developed over the past century and presenting the tools for students and adults to take control of their own historical study, control their heritage, and personalize the study of…

Landscape and Residential Variables Associated with Plague-Endemic Villages in the West Nile Region of Uganda

PubMed Central

MacMillan, Katherine; Enscore, Russell E.; Ogen-Odoi, Asaph; Borchert, Jeff N.; Babi, Nackson; Amatre, Gerald; Atiku, Linda A.; Mead, Paul S.; Gage, Kenneth L.; Eisen, Rebecca J.

2011-01-01

Plague, caused by the bacteria Yersinia pestis, is a severe, often fatal disease. This study focuses on the plague-endemic West Nile region of Uganda, where limited information is available regarding environmental and behavioral risk factors associated with plague infection. We conducted observational surveys of 10 randomly selected huts within historically classified case and control villages (four each) two times during the dry season of 2006 (N = 78 case huts and N = 80 control huts), which immediately preceded a large plague outbreak. By coupling a previously published landscape-level statistical model of plague risk with this observational survey, we were able to identify potential residence-based risk factors for plague associated with huts within historic case or control villages (e.g., distance to neighboring homestead and presence of pigs near the home) and huts within areas previously predicted as elevated risk or low risk (e.g., corn and other annual crops grown near the home, water storage in the home, and processed commercial foods stored in the home). The identified variables are consistent with current ecologic theories on plague transmission dynamics. This preliminary study serves as a foundation for future case control studies in the area. PMID:21363983

Sweat chloride concentrations in children with Idiopathic Nephrotic Syndrome.

PubMed

Guglani, Lokesh; Moir, Devin; Jain, Amrish

2016-01-01

Idiopathic Nephrotic Syndrome (INS) has been believed to cause a false positive elevation of sweat chloride concentrations, as measured by the sweat test. Sweat tests were done for 11 children with acute onset INS at admission and again while they were in remission, with results being compared to normal historical controls. The initial sweat chloride concentration for 10 patients was normal (mean16.7 ± 11.02 mmol/L) and 1 patient had inadequate collection. This latter patient and two others were excluded during follow-up because of diagnoses other than INS. Sweat test results for the eight INS patients during follow up remained unchanged when they were in remission (16.94 ± 7.88 mmol/L; P = 0.98; Wilcoxon Matched-Pairs Signed Rank Test). In comparing sweat chloride concentrations from INS patients to those from 20 historical control subjects, we found no significant differences (Mann-Whitney Test; initial vs. control P = 0.643; follow up vs. control P = 0.806). INS does not cause a false positive sweat test. Further studies should be done to objectively assess the conditions that have been reported to affect sweat chloride concentrations. © 2015 Wiley Periodicals, Inc.

Spontaneous Findings in the Eyes of Cynomolgus Monkeys ( Macaca fascicularis) of Mauritian Origin.

PubMed

Woicke, Jochen; Haile, Solomon; Mysore, Jagannatha; Peden, W Michael; Lejeune, Typhaine; Sanderson, Thomas; Brodie, Thomas

2018-04-01

Spontaneous findings noted in the eyes of Mauritian cynomolgus monkeys are described and descriptions are supplemented with illustrations. Findings observed after extensive histopathologic examinations (20 to 44 sections per eye) from 20 control, 17 treatment-naive stock monkeys, and 2 findings noted in drug-treated monkeys that were considered to be spontaneous are included. Also included are findings from 361 control monkeys of routine toxicity studies performed at our laboratories, for most of which a standard histopathological examination of 1 section per eye was conducted. Common observations in monkeys examined extensively and in historical controls were limited to lymphocytic or mononuclear cell infiltrations of the uvea and/or conjunctiva/sclera and, less commonly observed, melanocytoma of the ciliary body or iris. Findings noted only in monkeys examined extensively consisted of inflammation of the conjunctiva, ora serrata cysts, glial nodules, focal degeneration of the retina, cystoid degeneration of the central retina, ballooning degeneration of the ciliary epithelium, cyst of the ciliary body, and decreased pigmentation of the retinal pigment epithelium. Changes recorded only in historical controls included retinal atrophy and nuclear displacement in the retina. Lesions are discussed and compared with pertinent literature.

50 CFR 622.17 - South Atlantic golden crab controlled access.

Code of Federal Regulations, 2010 CFR

2010-10-01

... the northern zone. Selection will be made from the list of historical participants in the South... vessel by returning an existing permit or permits to the RA with an application for a permit for the...

CONNECTICUT DEP PROPERTY

EPA Science Inventory

This is a 1:24,000-scale datalayer of property owned and maintained by the Connecticut Department of Environmental Protection. It is a polygon Shapefile that includes state fish hatcheries, flood control areas, historic preserves, natural area preserves, state forests, state par...

EPA's National Stormwater Calculator (Poster)

EPA Science Inventory

This poster will demonstrate how EPA's National Stormwater Calculator works. The National Stormwater Calculator (SWC) estimates the amount of stormwater runoff generated from a site under different development and control scenarios over a long period of historical rainfall. The a...

Generation of Combat Power by Insurgents: An Historical Analysis

DTIC Science & Technology

2013-06-13

the concept of operations. Transportation incorporates military, commercial, and multinational assets. Transportation includes motor , rail, air...and water modes. Transportation nodes include motor , rail, air, and water terminal operations. Transportation also includes movement control and

Interlingua: An Interlanguage.

ERIC Educational Resources Information Center

Tinsley, Royal L., Jr.

This paper presents the historical background and practical applications of "Interlingua," a language system of common words derived from four control languages. Interlingua and "Esperanto," another artificial language, are compared, emphasizing that international, cross-cultural communication is best served, not by the…

Mobile Source Mitigation Opportunities

EPA Science Inventory

For Frank Princiotta’s book, Global Climate Change—The Technology Challenge The objective of this chapter is to review this history, focusing initially on the historical growth patterns and the resulting environmental consequences; then on the current control efforts around the ...

The Right to Regulate

NASA Technical Reports Server (NTRS)

Vittek, J. F.

1972-01-01

An introduction to the historical and constitutional framework of industry regulation by local and Federal Governments is presented. Problems of the confiscation of private property without due process, government control and the rights and duties of the regulated industry are discussed.

[Discourses and practices concerning the social participation process in health education activities: community mobilization in the PCDEN/PE. Programa de Controle das Doenças Endêmicas do Nordeste/Pernambuco].

PubMed

Acioli, M D; de Carvalho, E F

1998-01-01

This study analyzes and compares several social participation concepts in health education processes to practical experiences with schistosomiasis prevention measures under the Northeast Endemic Disease Control Program (Brazilian Ministry of Health/World Bank, 1987). Using qualitative methods, institutional documents and discourses were interpreted (Sucam, FNS, and Ministry of Health). A field study was also performed (using interviews with community-based health agents and the general population) in the Zona da Mata region of Pernambuco (a historically endemic area for schistosomiasis), focused in the county of Amaraji. Comparing discourses and educational practices, we found factors that explain respective points of convergence and divergence, as well as elements linked to the social and historical process of the target population which systematically limit the efficacy of such educational measures.

Effects of Holocene climate change on the historical demography of migrating sharp-shinned hawks (Accipiter striatus velox) in North America.

PubMed

Hull, Joshua M; Girman, Derek J

2005-01-01

DNA sequences of the mitochondrial control region were analysed from 298 individual sharp-shinned hawks (Accipiter striatus velox) sampled at 12 different migration study sites across North America. The control region proved to be an appropriate genetic marker for identification of continental-scale population genetic structure and for determining the historical demography of population units. These data suggest that sharp-shinned hawks sampled at migration sites in North America are divided into distinct eastern and western groups. The eastern group appears to have recently expanded in response to the retreat of glacial ice at the end of the last glacial maximum. The western group appears to have been strongly effected by the Holocene Hypsithermal dry period, with molecular evidence indicating the most recent expansion following this mid-Holocene climatic event 7000-5000 years before present.

Historical Contingency in Controlled Evolution

NASA Astrophysics Data System (ADS)

Schuster, Peter

2014-12-01

A basic question in evolution is dealing with the nature of an evolutionary memory. At thermodynamic equilibrium, at stable stationary states or other stable attractors the memory on the path leading to the long-time solution is erased, at least in part. Similar arguments hold for unique optima. Optimality in biology is discussed on the basis of microbial metabolism. Biology, on the other hand, is characterized by historical contingency, which has recently become accessible to experimental test in bacterial populations evolving under controlled conditions. Computer simulations give additional insight into the nature of the evolutionary memory, which is ultimately caused by the enormous space of possibilities that is so large that it escapes all attempts of visualization. In essence, this contribution is dealing with two questions of current evolutionary theory: (i) Are organisms operating at optimal performance? and (ii) How is the evolutionary memory built up in populations?

Survey of eye practitioners' preference of diagnostic tests and treatment modalities for dry eye in Ghana.

PubMed

Asiedu, Kofi; Kyei, Samuel; Ayobi, Benedict; Agyemang, Frank Okyere; Ablordeppey, Reynolds Kwame

2016-12-01

This study sought to provide an evidence-based profile of the diagnosis, treatment and knowledge or opinions on dry eye among optometrists and ophthalmologists in Ghana. This was a cross-sectional survey RESULTS: The responses of 162 participants are included in the analysis. The most commonly used test to diagnosed dry eye disease was tear break-up time followed by patient history. The most common symptom doctors heard from dry eye patients were burning sensation followed by foreign body sensation. The most often prescribed first- line treatment for dry eye was aqueous-based artificial tears followed by lipid-based artificial tears. Most practitioners considered meibomian gland dysfunction as the most common cause of dry eye followed by pterygium. The most often used test to guide or gauge therapeutic effect is patient history followed closely by tear break-up time. Most practitioners reported that 10%-20% of all their patients they see in a day are diagnosed of dry eye. This study showed tear break up time was the main test majority of practitioners in Ghana used to diagnose dry eye but patient history was the main test used to gauge therapeutic effect over time. Burning sensation was the commonest symptom practitioners heard from dry eye patients whilst artificial tears was their main and first-line treatment for dry eye. Copyright © 2016 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

POSSIBILITIES OF SHIELDING OF SENSITIVE PORTIONS OF THE EYE DURING BETA IRRADIATION (Sr$sup 90$) (in German)

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

Vollmar, R.

A small adhesive glass capsule with a removable 0.5-mm thick layer of Pb is used for protection of the sensitive portions of the eye (cornea, lens, etc.) during Sr/sup 90/ BETA irradiation. The capsule need not be fitted optically to the eye surface. Bremstrahlung from the Pb amounts to less than 1% of the 500- r single dose applied during 25 sec with a 40 mC/cm/sup 2/ applicator. Radiation losses between the applicator and the eye surface are minimal. The method has been used to reduce vascular invasion of the cornea and cloudiness of transplants, marginal ulcerations in senile degeneration,more » chronic lymphocytic conjunctival hyperplasia, growing conjunctival nevus in children, and conjunctival melanoma. A combined treatment of the conjunctival bulba and tarsi was used for diseased conditions such as chronic lymphocytic conjunctival hyperplasia or laminar melanosis of the conjunctiva. Large capsules with portions of the edges removed are utilized for segmental irradiation of pterygium to avoid damage and appearance of late radiation effects in other portions of the eye. A large assortment of eye capsules is necessary to provide for the wide variety of sizes of individual conjunctiva. Use of eye capsules avoids damage to the lens that may otherwise receive as much as 10% of the surface beta dosage. This could bring about cataract formation as a later radiation injury. (BBB)« less

[Development of a monitor for quantifying personal eye exposure to visible and ultraviolet radiation and its application in epidemiology].

PubMed

Eto, Norihito; Tsubota, Kazuo; Tanaka, Taichiro; Nishiwaki, Yuji

2013-01-01

Eye diseases including cataract, keratitis and pterygium have been reported to be sun-exposure-related. The association between macular degeneration and blue light has also been discussed. Moreover, it is hypothesized that retinal exposure to blue light may influence the human circadian rhythm. However, no monitoring devices exist that can measure eye exposure to visible and ultraviolet (UV) radiation over time. To measure the exact dose at specific times, we have developed a novel sensing system (ray-sensing glass system: RaySeG). RaySeG can continuously measure and record the composition and intensity of light with a time-stamped system. Subjects wearing RaySeG were instructed to walk under various light conditions such as indoor and outdoor. RaySeG consists of two sensors embedded in the eyeglasses. These sensors are for UV (260-400 nm), visible lights (red, 615 nm; green, 540 nm; and blue, 465 nm: peak wavelength for each). The total weight of the system is about 100 g, and the size is comparable to that of a digital audio player. The system continuously recorded changes in visible and UV light exposure under various conditions. After accuracy validation, further experiments with a larger number of subjects are required. Our final goal is to apply the system to evaluating personal eye exposure to UV and visible light in epidemiological studies of eye diseases and circadian rhythm abnormality.

Microvascular endothelial function and severity of primary open angle glaucoma.

PubMed

Bukhari, S M I; Kiu, K Y; Thambiraja, R; Sulong, S; Rasool, A H G; Liza-Sharmini, A T

2016-12-01

PurposeThe role of microvascular endothelial dysfunction on severity of primary open angle glaucoma (POAG) was investigated in this study.Patients and methodsA prospective cohort study was conducted. One hundred and fourteen ethnically Malay patients (114 eyes) with POAG treated at the eye clinic of Hospital University Sains Malaysia between April 2012 and December 2014 were recruited. Patients aged between 40 and 80 years with two consecutive reliable and reproducible Humphrey visual field 24-2 analyses were selected. Patients who were diagnosed with any other type of glaucoma, previous glaucoma-filtering surgery, or other surgeries except uncomplicated cataract and pterygium surgery were excluded. Humphrey visual field analysis 24-2 was used to stratify the severity of glaucoma using Advanced Glaucoma Intervention Study (AGIS) score at the time of recruitment. Microvascular endothelial function was assessed using Laser Doppler fluximetry and iontophoresis. Iontophoresis process with acetylcholine (ACh) and sodium nitroprusside (SNP) was used to measure microvascular endothelium-dependent and -independent vasodilatation, respectively.ResultsBased on the AGIS score, 55 patients showed mild glaucoma, with 29 moderate and 30 severe. There was statistically significant difference in microvascular endothelial function (ACh% and ACh max ) between mild and moderate POAG cases (P=0.023) and between mild and severe POAG cases (P<0.001). There was negative correlation between microvascular endothelial function and severity of POAG (r=-0.457, P<0.001).ConclusionMicrovascular endothelial dysfunction may have a role in influencing the severity of POAG in Malay patients.

Cryopreserved Ultra-Thick Human Amniotic Membrane for Conjunctival Surface Reconstruction After Excision of Conjunctival Tumors.

PubMed

Tanaka, Thais S; Demirci, Hakan

2016-04-01

Cryopreserved ultra-thick human amniotic membrane (AM) is used for glaucoma surgery. We evaluated the use of cryopreserved ultra-thick human AM for conjunctival surface reconstruction after excision of a conjunctival tumor. We retrospectively reviewed the medical records of 28 patients who underwent conjunctival surface reconstruction with cryopreserved ultra-thick human AM after excision of the tumor. The AM was secured to the surrounding conjunctiva and underlying sclera with interrupted 8-0 Vicryl sutures. Clinical data regarding demographics, diagnosis, size and location of conjunctival tumors, patient outcome, and complications were gathered. Of 28 patients, 6 (21.4%) had malignant melanoma, 4 (14.3%) had squamous cell carcinoma, 6 (21.4%) had conjunctival intraepithelial neoplasia, 1 (3.6%) had sebaceous carcinoma, 1 (3.6%) had mucoepidermoid carcinoma, 1 (3.6%) had conjunctival intraepithelial dysplasia, 5 (17.9%) had pterygium, 2 (7.1%) had compound nevus, 1 (3.6%) had a large epithelial inclusion cyst, and 1 (3.6%) patient had a granuloma. The mean area of graft size was 156 ± 120 mm2. Postoperatively, the graft was well tolerated with no failure, discomfort, or dehiscence. During the 17-month mean follow-up, symblepharon, which was clinically nonsignificant, developed in 3 (11%) patients and partial stem cell deficiency was noted in 5 (18%) patients. Cryopreserved ultra-thick human AM is a well-tolerated, effective graft material that is easy to handle. It is a viable alternative for conjunctival surface reconstruction after excision of a conjunctival tumor.

A Survey of Distributed Optimization and Control Algorithms for Electric Power Systems

DOE PAGES

Molzahn, Daniel K.; Dorfler, Florian K.; Sandberg, Henrik; ...

2017-07-25

Historically, centrally computed algorithms have been the primary means of power system optimization and control. With increasing penetrations of distributed energy resources requiring optimization and control of power systems with many controllable devices, distributed algorithms have been the subject of significant research interest. Here, this paper surveys the literature of distributed algorithms with applications to optimization and control of power systems. In particular, this paper reviews distributed algorithms for offline solution of optimal power flow (OPF) problems as well as online algorithms for real-time solution of OPF, optimal frequency control, optimal voltage control, and optimal wide-area control problems.

A Survey of Distributed Optimization and Control Algorithms for Electric Power Systems

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

Molzahn, Daniel K.; Dorfler, Florian K.; Sandberg, Henrik

Historically, centrally computed algorithms have been the primary means of power system optimization and control. With increasing penetrations of distributed energy resources requiring optimization and control of power systems with many controllable devices, distributed algorithms have been the subject of significant research interest. Here, this paper surveys the literature of distributed algorithms with applications to optimization and control of power systems. In particular, this paper reviews distributed algorithms for offline solution of optimal power flow (OPF) problems as well as online algorithms for real-time solution of OPF, optimal frequency control, optimal voltage control, and optimal wide-area control problems.

Caspian sea-level changes during the last millennium: historical and geological evidence from the south Caspian Sea

NASA Astrophysics Data System (ADS)

Naderi Beni, A.; Lahijani, H.; Mousavi Harami, R.; Arpe, K.; Leroy, S. A. G.; Marriner, N.; Berberian, M.; Andrieu-Ponel, V.; Djamali, M.; Mahboubi, A.; Reimer, P. J.

2013-07-01

Historical literature may constitute a valuable source of information to reconstruct sea-level changes. Here, historical documents and geological records have been combined to reconstruct Caspian sea-level (CSL) changes during the last millennium. In addition to a comprehensive literature review, new data from two short sediment cores were obtained from the south-eastern Caspian coast to identify coastal change driven by water-level changes and to compare the results with other geological and historical findings. The overall results indicate a high-stand during the Little Ice Age, up to -21 m (and extra rises due to manmade river avulsion), with a -28 m low-stand during the Medieval Climate Anomaly, while presently the CSL stands at -26.5 m. A comparison of the CSL curve with other lake systems and proxy records suggests that the main sea-level oscillations are essentially paced by solar irradiance. Although the major controller of the long-term CSL changes is driven by climatological factors, the seismicity of the basin creates local changes in base level. These local base-level changes should be considered in any CSL reconstruction.

Caspian Sea level changes during the last millennium: historical and geological evidences from the south Caspian Sea

NASA Astrophysics Data System (ADS)

Naderi Beni, A.; Lahijani, H.; Mousavi Harami, R.; Arpe, K.; Leroy, S. A. G.; Marriner, N.; Berberian, M.; Andrieu-Ponel, V.; Djamali, M.; Mahboubi, A.

2013-03-01

Historical literature may constitute a valuable source of information to reconstruct sea level changes. Here, historical documents and geological records have been combined to reconstruct Caspian sea-level (CSL) changes during the last millennium. In addition to a literature survey, new data from two short sediment cores were obtained from the south-eastern Caspian coast to identify coastal change driven by water-level changes. Two articulated bivalve shells from the marine facies were radiocarbon dated and calibrated to establish a chronology and to compare them with historical findings. The overall results indicate a high-stand during the Little Ice Age, up to -19 m, with a -28 m low-stand during the Medieval Climate Anomaly, while presently the CSL stands at -26.5 m. A comparison of the CSL curve with other lake systems and proxy records suggests that the main sea-level oscillations are essentially paced by solar irradiance. Although the major controller of the long-term CSL changes is driven by climatological factors, the seismicity of the basin could create locally changes in base level. These local base-level changes should be considered in any CSL reconstruction.

Hierarchical Commensurate and Power Prior Models for Adaptive Incorporation of Historical Information in Clinical Trials

PubMed Central

Hobbs, Brian P.; Carlin, Bradley P.; Mandrekar, Sumithra J.; Sargent, Daniel J.

2011-01-01

Summary Bayesian clinical trial designs offer the possibility of a substantially reduced sample size, increased statistical power, and reductions in cost and ethical hazard. However when prior and current information conflict, Bayesian methods can lead to higher than expected Type I error, as well as the possibility of a costlier and lengthier trial. This motivates an investigation of the feasibility of hierarchical Bayesian methods for incorporating historical data that are adaptively robust to prior information that reveals itself to be inconsistent with the accumulating experimental data. In this paper, we present several models that allow for the commensurability of the information in the historical and current data to determine how much historical information is used. A primary tool is elaborating the traditional power prior approach based upon a measure of commensurability for Gaussian data. We compare the frequentist performance of several methods using simulations, and close with an example of a colon cancer trial that illustrates a linear models extension of our adaptive borrowing approach. Our proposed methods produce more precise estimates of the model parameters, in particular conferring statistical significance to the observed reduction in tumor size for the experimental regimen as compared to the control regimen. PMID:21361892

Stroke declines from third to fourth leading cause of death in the United States: historical perspective and challenges ahead.

PubMed

Towfighi, Amytis; Saver, Jeffrey L

2011-08-01

Stroke recently declined from the third to the fourth leading cause of death in the United States, its first rank transition among sources of American mortality in nearly 75 years. This is a narrative review supplemented by new analyses of Centers for Disease Control and Prevention National Vital Statistics Reports from 1931 to 2008. Historically, stroke transitioned from the second to the third leading cause of death in the United States in 1937, but stroke death rates were essentially stable from 1930 to 1960. Then a long, great decline began, moderate in the 1960s, precipitous in the 1970s and 1980s, and moderate again in the 1990s and 2000s. By 2008, age-adjusted annual death rates from stroke were three fourths less than the historic 1931 to 1960 norm (40.6 versus 175.0 per 100,000). Total actual stroke deaths in the United States declined from a high of 214,000 in 1973 to 134,000 in 2008. Improved stroke prevention, through control of hypertension, hyperlipidemia, and tobacco, contributed most greatly to the mortality decline with a lesser but still substantial contribution of improved acute stroke care. Persisting challenges include race-ethnicity, sex, and geographic disparities in stroke mortality; the burden of stroke disability; the expanding obesity epidemic and aging of the US population; and the epidemic of cerebrovascular disease in low- and middle-income countries worldwide. The recent rank decline of stroke among leading causes of American death is testament to a half century of societal progress in cerebrovascular disease prevention and acute care. Renewed commitments are needed to preserve and broaden this historic achievement.

Fine Surface Control of Flexible Space Mirrors Using Adaptive Optics and Robust Control

DTIC Science & Technology

2009-03-01

an AO system not only increases complexity but also lends itself to coupling between actuators. Whereas historically, control laws treated AO...adaptive optic in large ground based AO systems is treated as a static system with no dynamics. In the case of a deformable mirror, it is assumed... astigmatism , and so on. As with any series expansion, the more terms used, the more accurate the approximation will be. For this research, 21 Zernike

New from the Old - Measuring Coastal Cliff Change with Historical Oblique Aerial Photos

NASA Astrophysics Data System (ADS)

Warrick, J. A.; Ritchie, A.

2016-12-01

Oblique aerial photographs are commonly collected to document coastal landscapes. Here we show that these historical photographs can be used to develop topographic models with Structure-from-Motion (SfM) photogrammetric techniques if adequate photo-to-photo overlaps exist. Focusing on the 60-m high cliffs of Fort Funston, California, photographs from the California Coastal Records Project were combined with ground control points to develop topographic point clouds of the study area for five years between 2002 and 2010. Uncertainties in the results were assessed by comparing SfM-derived point clouds with airborne lidar data, and the differences between these data were related to the number and spatial distribution of ground control points used in the SfM analyses. With six or more ground control points the root mean squared error between the SfM and lidar data was less than 0.3 m (minimum = 0.18 m) and the mean systematic error was consistently less than 0.10 m. Because of the oblique orientation of the imagery, the SfM-derived point clouds provided coverage on vertical to overhanging portions of the cliff, and point densities from the SfM techniques averaged between 17 and 161 points/m2 on the cliff face. The time-series of topographic point clouds revealed many topographic changes, including landslides, rockfalls and the erosion of landslide talus along the Fort Funston beach. Thus, we concluded that historical oblique photographs, such as those generated by the California Coastal Records Project, can provide useful tools for mapping coastal topography and measuring coastal change.

Roles of sunlight and natural ventilation for controlling infection: historical and current perspectives.

PubMed

Hobday, R A; Dancer, S J

2013-08-01

Infections caught in buildings are a major global cause of sickness and mortality. Understanding how infections spread is pivotal to public health yet current knowledge of indoor transmission remains poor. To review the roles of natural ventilation and sunlight for controlling infection within healthcare environments. Comprehensive literature search was performed, using electronic and library databases to retrieve English language papers combining infection; risk; pathogen; and mention of ventilation; fresh air; and sunlight. Foreign language articles with English translation were included, with no limit imposed on publication date. In the past, hospitals were designed with south-facing glazing, cross-ventilation and high ceilings because fresh air and sunlight were thought to reduce infection risk. Historical and recent studies suggest that natural ventilation offers protection from transmission of airborne pathogens. Particle size, dispersal characteristics and transmission risk require more work to justify infection control practices concerning airborne pathogens. Sunlight boosts resistance to infection, with older studies suggesting potential roles for surface decontamination. Current knowledge of indoor transmission of pathogens is inadequate, partly due to lack of agreed definitions for particle types and mechanisms of spread. There is recent evidence to support historical data on the effects of natural ventilation but virtually none for sunlight. Modern practice of designing healthcare buildings for comfort favours pathogen persistence. As the number of effective antimicrobial agents declines, further work is required to clarify absolute risks from airborne pathogens along with any potential benefits from additional fresh air and sunlight. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Outcomes from a Computer-Assisted Intervention Simultaneously Targeting Cannabis and Tobacco Use

PubMed Central

Lee, Dustin C.; Budney, Alan J.; Brunette, Mary F.; Hughes, John R.; Etter, Jean-Francois; Stanger, Catherine

2015-01-01

BACKGROUND Cannabis users frequently report concurrent tobacco use, and tobacco use is associated with poorer outcomes during treatment for cannabis use disorders (CUD). Interventions that simultaneously target both tobacco and cannabis use disorders may enhance cessation outcomes for either or both substances. METHODS This study evaluated an intervention integrating highly effective treatments for cannabis and tobacco use disorders. Thirty-two participants meeting diagnostic criteria for CUD and reporting daily tobacco use were enrolled in a 12-week computer-assisted behavioral treatment for CUD. Participants were encouraged to participate in a tobacco intervention that included a computer-assisted behavioral treatment tailored for tobacco and cannabis co-users, and nicotine-replacement therapy (NRT). Cannabis and tobacco outcomes were evaluated using descriptive statistics and were compared to a historical control group that received treatment for CUD but not tobacco. RESULTS Participants achieved 3.6 ± 4.3 consecutive weeks of cannabis abstinence, which was comparable to the historical control group (3.1 ± 4.4). A majority of the sample (78%) completed at least one tobacco module and 44% initiated NRT. Over half (56%) initiated tobacco quit attempts, and 28% were tobacco abstinent for at least two consecutive weeks. Participants showed greater reduction in tobacco use (cigarettes per day) than the historical control group, but differences in tobacco abstinence rates during the final month of treatment were not statistically significant (12.5% vs 4%). CONCLUSION Findings suggest that providing a tobacco intervention during treatment for CUD is feasible and may positively impact tobacco use without negatively affecting cannabis use outcomes. PMID:26307942

Low locoregional recurrence rates in patients treated after 2000 with doxorubicin based chemotherapy, modified radical mastectomy, and post-mastectomy radiation

PubMed Central

Greenbaum, Michael P.; Strom, Eric A.; Allen, Pamela K.; Perkins, George H.; Oh, Julia L.; Tereffe, Welela; Yu, Tse-Kuan; Buchholz, Thomas A.; Woodward, Wendy. A.

2011-01-01

Purpose To determine the rate of locoregional recurrence (LRR) associated with modern tri-modality therapy. Methods We retrospectively reviewed data from 291 consecutive PMRT patients treated from 1999 to 2001. These patients were compared to an historical group of 313 patients treated from 1979 to 1988 who had fluoroscopic simulation and contour-generated 2D planning. 1999–2001 spans the adoption of CT simulators for breast radiation therapy and a comparison was made between patients simulated before and after the implementation of CT simulation. Five-year actuarial rates for LRR, distal metastasis (DM), and overall survival (OS) between the pre and post CT simulation cohorts were compared as well. Results Compared to a 2D planned historic control, the combined contemporary patients had improved outcomes at 5 years for all endpoints studied; LRR 3.0% vs. 11.5%, DM 29.2% vs. 39.2%, and OS 79.2% vs. 70.6% (p = 0.0004, 0.0052, 0.0012, respectively). Significant factors in a multivariate analysis for LRR were: advanced T-stage (RR = 2.14, CI = 1.11–4.11, p = 0.023), and percent positive nodes (RR = 1.01, CI = 1.00–1.02, p = 0.012). The comparison of the pre and post CT-simulated PMRT patients (1999–2001) found no significant difference in any endpoint. Conclusions The rate of locoregional control for PMRT patients treated with modern radiotherapy is outstanding and has improved significantly compared to historical controls. PMID:20227126

Explosive activity associated with the growth of volcanic domes

USGS Publications Warehouse

Newhall, C.G.; Melson, W.G.

1983-01-01

Domes offer unique opportunities to measure or infer the characteristics of magmas that, at domes and elsewhere, control explosive activity. A review of explosive activity associated with historical dome growth shows that: 1. (1) explosive activity has occurred in close association with nearly all historical dome growth; 2. (2) whole-rock SiO2 content, a crude but widely reported indicator of magma viscosity, shows no systematic relationship to the timing and character of explosions; 3. (3) the average rate of dome growth, a crude indicator of the rate of supply of magma and volatiles to the near-surface enviornment, shows no systematic relationship to the timing or character of explosions; and 4. (4) new studies at Arenal and Mount St. Helens suggest that water content is the dominant control on explosions from water-rich magmas, whereas the crystal content and composition of the interstitial melt (and hence magma viscosity) are equally or more important controls on explosions from water-poor magmas. New efforts should be made to improve current, rather limited techniques for monitoring pre-eruption volatile content and magma viscosity, and thus the explosive potential of magmas. ?? 1983.

Alberta's and Ontario's liquor boards: why such divergent outcomes?

PubMed

Bird, Malcolm G

2010-01-01

The provinces of Alberta and Ontario have chosen very different methods to distribute alcoholic beverages: Alberta privatized the Alberta Liquor Control Board (ALCB) in 1993 and established a private market to sell beverage alcohol, while Ontario, in stark contrast, opted to retain and expand the Liquor Control Board of Ontario (LCBO). This article examines the reasons for the divergent policy choices made by Ralph Klein and Mike Harris' Conservative governments in each province. The article draws on John Kingdon's “multiple streams decision-making model,” to examine the mindsets of the key decision-makers, as well as “historical institutionalism,” to organize the pertinent structural, historical and institutional variables that shaped the milieu in which decision-makers acted. Unique, province-specific political cultures, histories, institutional configurations (including the relative influence of a number of powerful actors), as well as the fact that the two liquor control boards were on opposing trajectories towards their ultimate fates, help to explain the different decisions made by each government. Endogenous preference construction in this sector, furthermore, implies that each system is able to satisfy all relevant stakeholders, including consumers.

78 FR 46931 - Intent To Hold North Dakota Task Force Meeting as Established by the Missouri River Protection...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-02

... a long-term strategy to improve conservation, protect recreation from sedimentation, improve water quality, improve erosion control, and protect historic and cultural sites along the Missouri River in...

Leadership Theories.

ERIC Educational Resources Information Center

Sferra, Bobbie A.; Paddock, Susan C.

This booklet describes various theoretical aspects of leadership, including the proper exercise of authority, effective delegation, goal setting, exercise of control, assignment of responsibility, performance evaluation, and group process facilitation. It begins by describing the evolution of general theories of leadership from historic concepts…

Predictive powertrain control using powertrain history and GPS data

DOEpatents

Weslati, Feisel; Krupadanam, Ashish A

2015-03-03

A method and powertrain apparatus that predicts a route of travel for a vehicle and uses historical powertrain loads and speeds for the predicted route of travel to optimize at least one powertrain operation for the vehicle.

The Road to a New Unified Command

DTIC Science & Technology

2008-01-01

The Directorate of Command, Control, Communications, and Computers (C4) Systems is chartered with information architecture (including in Africa...Friday afternoon cinema presentations where a documentary or feature film covering an African historic event was played, followed by dialogue

Aspects of quality insurance in digitizing historical climate data in Germany

NASA Astrophysics Data System (ADS)

Mächel, H.; Behrends, J.; Kapala, A.

2010-09-01

This contribution presents some of the problems and offers solutions regarding the digitization of historical meteorological data, and explains the need for verification and quality control. For the assessment of changes in climate extremes, long-term and complete observational records with a high temporal resolution are needed. However, in most countries, including Germany, such climate data are rare. Therefore, in 2005, the German Weather Service launched a project to inventory and digitize historical daily climatic records in cooperation with the Meteorological Institute of the University of Bonn. Experience with Optical Character Recognition (OCR) show that it is only of very limited use, as even printed tables (e.g. yearbooks) are not sufficiently recognized (10-20% error). In hand-written records, the recognition rate is about 50%. By comparing daily and monthly values, it is possible to auto-detect errors, but they can not be automatically corrected, since there is often more than one error per month. These erroneous data must then be controlled manually on an individual basis, which is significantly more error-prone than direct manual input. Therefore, both precipitation and climate station data are digitized manually. The time required to digitize one year of precipitation data (including the recording of daily precipitation amount and type, snow amount and type, and weather events such as thunder storms, fog, etc.) is equivalent to about five hours for one year of data. This involves manually typing, reformatting and quality control of the digitized data, as well as creating a digital photograph. For climate stations with three observations per day, the working time is 30-50 hours for one year of data, depending on the number of parameters and the condition of the documents. Several other problems occur when creating the digital records from historical observational data, some of which are listed below. Older records often used varying units and different conventions. For example, a value of 100 was added to the observed temperatures to avoid negative values. Furthermore, because standardization of the observations was very low when measurements began up to 200 years ago, the data often reflect a greater part of non-climatic influences. Varying daily observation times make it difficult to calculate a representative daily value. Even unconventional completed tables cost labor and requires experienced and trained staff. Data homogenization as well as both manual and automatic quality control may address some of these problems.

In the Shadow of Coal: How Large-Scale Industries Contributed to Present-Day Regional Differences in Personality and Well-Being.

PubMed

Obschonka, Martin; Stuetzer, Michael; Rentfrow, Peter J; Shaw-Taylor, Leigh; Satchell, Max; Silbereisen, Rainer K; Potter, Jeff; Gosling, Samuel D

2017-11-20

Recent research has identified regional variation of personality traits within countries but we know little about the underlying drivers of this variation. We propose that the Industrial Revolution, as a key era in the history of industrialized nations, has led to a persistent clustering of well-being outcomes and personality traits associated with psychological adversity via processes of selective migration and socialization. Analyzing data from England and Wales, we examine relationships between the historical employment share in large-scale coal-based industries (coal mining and steam-powered manufacturing industries that used this coal as fuel for their steam engines) and today's regional variation in personality and well-being. Even after controlling for possible historical confounds (historical energy supply, education, wealth, geology, climate, population density), we find that the historical local dominance of large-scale coal-based industries predicts today's markers of psychological adversity (lower Conscientiousness [and order facet scores], higher Neuroticism [and anxiety and depression facet scores], lower activity [an Extraversion facet], and lower life satisfaction and life expectancy). An instrumental variable analysis, using the historical location of coalfields, supports the causal assumption behind these effects (with the exception of life satisfaction). Further analyses focusing on mechanisms hint at the roles of selective migration and persisting economic hardship. Finally, a robustness check in the U.S. replicates the effect of the historical concentration of large-scale industries on today's levels of psychological adversity. Taken together, the results show how today's regional patterns of personality and well-being (which shape the future trajectories of these regions) may have their roots in major societal changes underway decades or centuries earlier. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Assessment of national strategies for control of high pathogenicity avian influenza and low pathogenicity notifiable avian influenza in poultry, with emphasis on vaccines and vaccination

USDA-ARS?s Scientific Manuscript database

Twenty-nine distinct epizootics of highly pathogenic avian influenza (HPAI) have occurred since 1959. The H5N1 HPAI panzootic affecting Asia, Africa and Eastern Europe has been the largest among these, affecting poultry and/or wild birds in 63 countries. Historically, control strategies have focus...

Antidoping control in Brazil: history, current situation, and prospects for the 2014 World Cup and the 2016 Olympic Games.

PubMed

Santos, Marcos Antonio Pereira dos; Silva, Alexandre Sérgio; Ribeiro, Sergio Luiz Galan; Santos, Azenildo Moura

2014-07-01

Brazil will soon host two major sporting events: the 2014 World Cup and the 2016 Summer Olympic Games. Given the importance of antidoping control during these competitions, it is important that the scientific community receive a status update on antidoping control in Brazil. In this brief communication, the authors present the status of antidoping control in Brazil from an historical perspective, both the benefits and difficulties to be faced by antidoping control during these events, and the legacy resulting from the efficacy of the drug testing performed during these competitions.

Principles and Practices for Quality Assurance and Quality Control

USGS Publications Warehouse

Jones, Berwyn E.

1999-01-01

Quality assurance and quality control are vital parts of highway runoff water-quality monitoring projects. To be effective, project quality assurance must address all aspects of the project, including project management responsibilities and resources, data quality objectives, sampling and analysis plans, data-collection protocols, data quality-control plans, data-assessment procedures and requirements, and project outputs. Quality control ensures that the data quality objectives are achieved as planned. The historical development and current state of the art of quality assurance and quality control concepts described in this report can be applied to evaluation of data from prior projects.

Democracy is a historical urgency

NASA Astrophysics Data System (ADS)

Synek, Miroslav

2015-03-01

Survival of humanity, on this planet, may depend, heavily, on coping with advancing technology of nuclear missiles. Let us consider critical alternatives of powerful governments: democracy, as an alternative to dictatorship. Democracy is based on free elections, as a government of the people, by the people and for the people. Democracy is a historical urgency, in the age of inter-continental nuclear missiles, computerized on a push-button, conceivably controllable by a very powerful, miscalculating and/or insane, dictator, capable of producing global nuclear holocaust, on our entire planet. Diplomacy, together with supporting activities, should be utilized, to help, in important steps, at this time, for achieving democracy in critical areas.

The Detection and Attribution Model Intercomparison Project (DAMIP v1.0)contribution to CMIP6

DOE PAGES

Gillett, Nathan P.; Shiogama, Hideo; Funke, Bernd; ...

2016-10-18

Detection and attribution (D&A) simulations were important components of CMIP5 and underpinned the climate change detection and attribution assessments of the Fifth Assessment Report of the Intergovernmental Panel on Climate Change. The primary goals of the Detection and Attribution Model Intercomparison Project (DAMIP) are to facilitate improved estimation of the contributions of anthropogenic and natural forcing changes to observed global warming as well as to observed global and regional changes in other climate variables; to contribute to the estimation of how historical emissions have altered and are altering contemporary climate risk; and to facilitate improved observationally constrained projections of futuremore » climate change. D&A studies typically require unforced control simulations and historical simulations including all major anthropogenic and natural forcings. Such simulations will be carried out as part of the DECK and the CMIP6 historical simulation. In addition D&A studies require simulations covering the historical period driven by individual forcings or subsets of forcings only: such simulations are proposed here. Key novel features of the experimental design presented here include firstly new historical simulations with aerosols-only, stratospheric-ozone-only, CO2-only, solar-only, and volcanic-only forcing, facilitating an improved estimation of the climate response to individual forcing, secondly future single forcing experiments, allowing observationally constrained projections of future climate change, and thirdly an experimental design which allows models with and without coupled atmospheric chemistry to be compared on an equal footing.« less

The Detection and Attribution Model Intercomparison Project (DAMIP v1.0) contribution to CMIP6

NASA Astrophysics Data System (ADS)

Gillett, Nathan P.; Shiogama, Hideo; Funke, Bernd; Hegerl, Gabriele; Knutti, Reto; Matthes, Katja; Santer, Benjamin D.; Stone, Daithi; Tebaldi, Claudia

2016-10-01

Detection and attribution (D&A) simulations were important components of CMIP5 and underpinned the climate change detection and attribution assessments of the Fifth Assessment Report of the Intergovernmental Panel on Climate Change. The primary goals of the Detection and Attribution Model Intercomparison Project (DAMIP) are to facilitate improved estimation of the contributions of anthropogenic and natural forcing changes to observed global warming as well as to observed global and regional changes in other climate variables; to contribute to the estimation of how historical emissions have altered and are altering contemporary climate risk; and to facilitate improved observationally constrained projections of future climate change. D&A studies typically require unforced control simulations and historical simulations including all major anthropogenic and natural forcings. Such simulations will be carried out as part of the DECK and the CMIP6 historical simulation. In addition D&A studies require simulations covering the historical period driven by individual forcings or subsets of forcings only: such simulations are proposed here. Key novel features of the experimental design presented here include firstly new historical simulations with aerosols-only, stratospheric-ozone-only, CO2-only, solar-only, and volcanic-only forcing, facilitating an improved estimation of the climate response to individual forcing, secondly future single forcing experiments, allowing observationally constrained projections of future climate change, and thirdly an experimental design which allows models with and without coupled atmospheric chemistry to be compared on an equal footing.

Advances in control of wheat rusts

USDA-ARS?s Scientific Manuscript database

This chapter provides a summary of recent advances in wheat rust research. Although the emphasis is on recent developments, some historical context is provided. Critical concepts in studying the wheat rusts are pathogen and host genetics, host-pathogen interactions, epidemiology and management strat...

Evaluation of Louisiana's statistically based quality control and acceptance specifications for asphaltic concrete : final report.

DOT National Transportation Integrated Search

1998-09-01

In 1971, the Louisiana Department of Transportation and Development initiated a statistically based specification system for asphaltic concrete using historically generated data. A Materials Test Data (MATT) reporting system was also started to archi...

The Better Mousetrap...Can Be Built by Engineers.

ERIC Educational Resources Information Center

McBride, Matthew

2003-01-01

Describes the growth of the INSPEC database developed by the Institution of Electrical Engineers. Highlights include an historical background of its growth from "Science Abstracts"; production methods, including computerization; indexing, including controlled (thesaurus-based), uncontrolled, chemical, and numerical indexing; and the…

Geographic information systems in corn rootworm management

USDA-ARS?s Scientific Manuscript database

Corn rootworms (Diabrotica spp. Coleoptera: Chrysomelidae) are serious pests of corn (Zea mays) in the United States and Europe. Control measures for corn rootworms (CRW) were historically based upon chemical pesticides and crop rotation. Pesticide use created environmental and economic concerns. In...

U.S. EPA’s Role in Watershed Management

EPA Science Inventory

This presentation provides some historical background on the evolution and application of rulemaking associated primarily with the control and treatment of wet-weather flow in the urban environment. It presents, as an example, an overview of the stormwater regulation program for...

ATRAZINE AND REPRODUCTIVE FUNCTION: MODE AND MECHANISM OF ACTION STUDIES

EPA Science Inventory

Atrazine, a chlorotriazine herbicide, is used to control annual grasses and broadleaf weeds. In this review, we summarize our laboratory's work evaluating the neuroendocrine toxicity of atrazine (and related chlorotriazines) from an historic perspective. We provide the rationale ...

Patterns and Controls of Erosion along the Elson Lagoon Coastline, Barrow, Alaska (2003-2016)

NASA Astrophysics Data System (ADS)

Tweedie, C. E.; Escarzaga, S. M.; Cody, R. P.; Manley, W. F.; Gaylord, A. G.; Aiken, Q.; Lopez, A. F.; Aguirre, A.; George, C.; Nelson, L.; Brown, J.

2016-12-01

With arctic warming and the combined effect of decreased summer sea ice extent, longer fetch for wave propagation, warmer sea surface and ground temperature, and longer periods of open water; the propensity for increased arctic coastal erosion rates and land-ocean sediment inputs to increase has been recognized for some time. In this study, we report on coastal erosion trends along a 11km stretch of coastline adjacent to the Barrow Environmental Observatory (BEO) where the position of the 2-4 meter high coastal bluff has been monitored annually with survey grade differential GPS (dGPS). Modern and historic erosion trends can be viewed through interactive web mapping applications at http://barrowmapped.org/. Rates of aerial and volumetric erosion losses averaged 0.7-2.8 meters and 0.8-3.5 cubic meters per meter of coast per year from 2003-2015 for each of the four coastal sections monitored. These losses equate to losses to the atmosphere and/or inputs to lagoon waters 53-220kgC per meter of coast per year. Such aerial losses are lower than from other areas of the Beaufort Sea coast that lack protective barrier islands, but 25-30% higher than historic decadal-scale change rates estimated for this section of coastline. However, regression analyses indicate no significant change to the rate of erosion during the past 13 years. Historic hotspots of erosion remained modern hotspots of erosion, and increases in modern erosion rates were greatest for sections of coast where historically high rates of erosion have been recorded. Regionally, the Elson Lagoon study area shows some of the highest rates of erosion for the Barrow Peninsula, which are generally 2-3 times mean annual erosion rates recorded for the Chukchi Sea Coastline near Barrow. Regression tree analysis used to isolate the relative importance of different biophysical controls of erosion differ between analyses run for aerial and volumetric losses along the Elson Lagoon Coast. These analyses also highlight key differences in controls between sampling periods with high/low wind-wave activity. In particular, analyses show the important influence of wave energy, land cover type, and landscape geomorphic history on modern coastal erosion dynamics.

RITA--Registry of Industrial Toxicology Animal data: the application of historical control data for Leydig cell tumors in rats.

PubMed

Nolte, Thomas; Rittinghausen, Susanne; Kellner, Rupert; Karbe, Eberhard; Kittel, Birgit; Rinke, Matthias; Deschl, Ulrich

2011-11-01

Historical data for Leydig cell tumors from untreated or vehicle treated rats from carcinogenicity studies collected in the RITA database are presented. Examples are given for analyses of these data for dependency on variables considered to be of possible influence on the spontaneous incidence of Leydig cell tumors. In the 7453 male rats available for analysis, only one case of a Leydig cell carcinoma was identified. The incidence of Leydig cell adenomas differed markedly between strains. High incidences of close to 100% have been found in F344 rats, while the mean incidence was 4.2% in Sprague-Dawley rats and 13.7% in Wistar rats. Incidences in Wistar rats were highly variable, primarily caused by different sources of animals. Mean incidences per breeder varied from 2.8 to 39.9%. Analyses for the dependency on further parameters have been performed in Wistar rats. In breeders G and I, the Leydig cell tumor incidence decreased over the observation period and with increasing mean terminal body weight. The incidence of Leydig cell tumors increased with mean age at necropsy and was higher in studies with dietary admixture compared to gavage studies. These parameters had no effect on Leydig cell tumor incidence in breeders A and B. Animals from almost all breeders had a considerably higher mean age at necropsy when bearing a Leydig cell adenoma than animals without a Leydig cell adenoma. Studies with longitudinal trimming of the testes had a higher incidence than studies with transverse trimming. The observed dependencies and breeder differences are discussed and explanations are given. Consequences for the use of historical control data are outlined. With the retrospective analyses presented here we were able to confirm the published features of Leydig cell adenomas and carcinomas. This indicates that the RITA database is a valuable tool for analyses of tumors for their biological features. Furthermore, it demonstrates that the RITA database is highly beneficial for the definition of reliable historical control data for carcinogenicity studies on a scientifically solid basis. Copyright © 2010 Elsevier GmbH. All rights reserved.

The development of the Final Approach Spacing Tool (FAST): A cooperative controller-engineer design approach

NASA Technical Reports Server (NTRS)

Lee, Katharine K.; Davis, Thomas J.

1995-01-01

Historically, the development of advanced automation for air traffic control in the United States has excluded the input of the air traffic controller until the need of the development process. In contrast, the development of the Final Approach Spacing Tool (FAST), for the terminal area controller, has incorporated the end-user in early, iterative testing. This paper describes a cooperative between the controller and the developer to create a tool which incorporates the complexity of the air traffic controller's job. This approach to software development has enhanced the usability of FAST and has helped smooth the introduction of FAST into the operational environment.

River-ice break-up/freeze-up: a review of climatic drivers, historical trends and future predictions

NASA Astrophysics Data System (ADS)

Prowse, T. D.; Bonsal, B. R.; Duguay, C. R.; Lacroix, M. P.

2007-10-01

River ice plays a fundamental role in biological, chemical and physical processes that control freshwater regimes of the cold regions. Moreover, it can have enormous economic implications for river-based developments. All such activities and processes can be modified significantly by any changes to river-ice thickness, composition or event timing and severity. This paper briefly reviews some of the major hydraulic, mechanical and thermodynamic processes controlling river-ice events and how these are influenced by variations in climate. A regional and temporal synthesis is also made of the observed historical trends in river-ice break-up/freeze-up occurrence from the Eurasian and North American cold regions. This involves assessment of several hydroclimatic variables that have influenced past trends and variability in river-ice break-up/freeze-up dates including air-temperature indicators (e.g. seasonal temperature, 0°C isotherm dates and various degree-days) and large-scale atmospheric circulation patterns or teleconnections. Implications of future climate change on the timing and severity of river-ice events are presented and discussed in relation to the historical trends. Attention is drawn to the increasing trends towards the occurrence of mid-winter break-up events that can produce especially severe flood conditions but prove to be the most difficult type of event to model and predict.

Emergency abdominal aortic aneurysm repair with a preferential endovascular strategy: mortality and cost-effectiveness analysis.

PubMed

Kapma, Marten R; Groen, Henk; Oranen, Bjorn I; van der Hilst, Christian S; Tielliu, Ignace F; Zeebregts, Clark J; Prins, Ted R; van den Dungen, Jan J; Verhoeven, Eric L

2007-12-01

To assess mortality and treatment costs of a new management protocol with preferential use of emergency endovascular aneurysm repair (eEVAR) for acute abdominal aortic aneurysm (AAA). From September 2003 until February 2005, 49 consecutive patients (45 men; mean age 71 years) with acute AAA were entered into a prospective study of a new management protocol that featured preferential use of eEVAR (n=18); patients with unsuitable anatomy or who were hemodynamically unstable underwent open repair (n=31). Mortality data and costs of treatment were compared in this mixed prospective group to a historical control group consisting of 147 patients (128 men; mean age 71 years) who underwent open repair from January 1998 to December 2001. All direct medical costs were included from the moment of admission until discharge from the hospital. Mortality in the mixed prospective group (18%) was lower than in the historical control group (31%), but the difference did not reach statistical significance (p=0.099). The mean total cost in the mixed prospective group was 17,164 euro compared to 21,084 euro in the historical open repair group (p=0.255). A preferential eEVAR protocol for acute AAA can decrease mortality and does not increase overall costs during initial treatment, but larger studies are needed to determine if these trends are statistically significant.

Tobacco as a social currency: cigarette gifting and sharing in China.

PubMed

Rich, Zachary C; Xiao, Shuiyuan

2012-03-01

China produces and consumes more tobacco than any other country in the world and as such is at the forefront of the world tobacco epidemic. Many studies have recently emerged that directly or indirectly reference the acts of giving and sharing cigarettes as a major contributor to China's high tobacco usage. The goal of this report is to review relevant literature relating to sharing and gifting cigarettes as well as provide useful historic and cultural contexts. Important differences between the act of giving individual cigarettes and the gifting of packaged cigarettes are explored as well as explanations for how both these practices have influenced current tobacco control efforts. Available Chinese and English sources on gifting and sharing cigarettes in China published between 1991 and 2011 were reviewed and discussed with a cultural and historical background. The practices of gifting and sharing cigarettes strongly contribute to smoking initiation as well as failure to quit smoking among Chinese males. Historical and cultural roots have reinforced these practices and hampered efforts to reduce tobacco use in China. Traditional tobacco control efforts should be combined with culture-specific approaches to reduce tobacco usage in China. The regular exchange of cigarettes normalizes smoking across society and promotes tobacco's acceptability. Great efforts should be taken not only to minimize these practices among males but also to discourage their adoption by females.

A multi-site evaluation of innovative approaches to increase tuberculosis case notification: summary results.

PubMed

Creswell, Jacob; Sahu, Suvanand; Blok, Lucie; Bakker, Mirjam I; Stevens, Robert; Ditiu, Lucica

2014-01-01

Globally, TB notifications have stagnated since 2007, and sputum smear positive notifications have been declining despite policies to improve case detection. We evaluate results of 28 interventions focused on improving TB case detection. We measured additional sputum smear positive cases treated, defined as the intervention area's increase in case notification during the project compared to the previous year. Projects were encouraged to select control areas and collect historical notification data. We used time series negative binomial regression for over-dispersed cross-sectional data accounting for fixed and random effects to test the individual projects' effects on TB notification while controlling for trend and control populations. Twenty-eight projects, 19 with control populations, completed at least four quarters of case finding activities, covering a population of 89.2 million. Among all projects sputum smear positive (SS+) TB notifications increased 24.9% and annualized notification rates increased from 69.1 to 86.2/100,000 (p = 0.0209) during interventions. Among the 19 projects with control populations, SS+TB case notifications increased 36.9% increase while in the control populations a 3.6% decrease was observed. Fourteen (74%) of the 19 projects' SS+TB notification rates in intervention areas increased from the baseline to intervention period when controlling for historical trends and notifications in control areas. Interventions were associated with large increases in TB notifications across many settings, using an array of interventions. Many people with TB are not reached using current approaches. Different methods and interventions tailored to local realities are urgently needed.

New Opportunities of Low-Cost Photogrammetry for Culture Heritage Preservation

NASA Astrophysics Data System (ADS)

Shults, R.

2017-05-01

In the paper, the questions of using the technologies of low-cost photogrammetry in combination with the additional capabilities of modern smartphones are considered. The research was carried out on the example of documenting the historical construction of the II World War - the Kiev Fortified Region. Brief historical information about the object of research is given. The possibilities of using modern smartphones as measuring instruments are considered. To get high-quality results, the camera of the smartphone was calibrated. The calibration results were used in the future to perform 3D modeling of defense facilities. Photographing of three defense structures in a different state: destroyed, partially destroyed and operating was carried out. Based on the results of photography using code targets, 3D object models were constructed. To verify the accuracy of the 3D modelling, control measurements of the lines between the code targets at the objects were performed. The obtained results are satisfying, and the technology considered in the paper can be recommended for use in performing archaeological and historical studies.

Reconstruction of the 1945 Wieringermeer Flood

NASA Astrophysics Data System (ADS)

Hoes, O. A. C.; Hut, R. W.; van de Giesen, N. C.; Boomgaard, M.

2013-03-01

The present state-of-the-art in flood risk assessment focuses on breach models, flood propagation models, and economic modelling of flood damage. However, models need to be validated with real data to avoid erroneous conclusions. Such reference data can either be historic data, or can be obtained from controlled experiments. The inundation of the Wieringermeer polder in the Netherlands in April 1945 is one of the few examples for which sufficient historical information is available. The objective of this article is to compare the flood simulation with flood data from 1945. The context, the breach growth process and the flood propagation are explained. Key findings for current flood risk management addresses the importance of the drainage canal network during the inundation of a polder, and the uncertainty that follows from not knowing the breach growth parameters. This case study shows that historical floods provide valuable data for the validation of models and reveal lessons that are applicable in current day flood risk management.