IDENTIFICATION OF CASO4 FORMED BY REACTION OF CAO AND SO2
The injection of calcium-based sorbents into coal-fired boilers for reaction with, and reduction in the levels of, sulfur dioxide (SO2) in the flue gas has undergone considerable research and development. Significant effort has also been made in developing models for the overall ...
ERIC Educational Resources Information Center
Bryan, Chris
2011-01-01
Education in post-apartheid South Africa has undergone considerable change in recent years and is seen as providing the key to reform and social transformation. However, despite many government policies designed to improve the quality of teaching and learning, education continues to present challenges, particularly within the area of professional…
Image Acquisition and Quality in Digital Radiography.
Alexander, Shannon
2016-09-01
Medical imaging has undergone dramatic changes and technological breakthroughs since the introduction of digital radiography. This article presents information on the development of digital radiography and types of digital radiography systems. Aspects of image quality and radiation exposure control are highlighted as well. In addition, the article includes related workplace changes and medicolegal considerations in the digital radiography environment. ©2016 American Society of Radiologic Technologists.
Primary care needs of patients who have undergone gender reassignment.
Sobralske, Mary
2005-04-01
The purpose of this article is to inform nurse practitioners (NPs) about the primary care needs of patients who have undergone gender reassignment, either by hormone therapy alone or in conjunction with surgery. Data sources used were mainly from a review of the literature about gender identity disorder and gender reassignment. Information was also gathered from several leading surgeons on gender reassignment surgical procedures and subsequent clinical considerations. There is very little written on the primary care clinical ramifications of transsexual patients and how clinicians can adapt their approaches to healthcare delivery to accommodate their special situations. Implications for practice include how an NP can adapt clinical practice approaches to provide for patients who have undergone gender reassignment. Changes that occur in the transsexual process may warrant noncustomary primary healthcare screening and examination.
Code of Federal Regulations, 2011 CFR
2011-01-01
... finance have undergone considerable growth and change in recent years. It is increasingly common, for... climate, United States banking organizations would be placed at a competitive disadvantage if their...
Code of Federal Regulations, 2013 CFR
2013-01-01
... finance have undergone considerable growth and change in recent years. It is increasingly common, for... climate, United States banking organizations would be placed at a competitive disadvantage if their...
Code of Federal Regulations, 2012 CFR
2012-01-01
... finance have undergone considerable growth and change in recent years. It is increasingly common, for... climate, United States banking organizations would be placed at a competitive disadvantage if their...
Code of Federal Regulations, 2014 CFR
2014-01-01
... finance have undergone considerable growth and change in recent years. It is increasingly common, for... climate, United States banking organizations would be placed at a competitive disadvantage if their...
PC-SPES (PDQ®)—Health Professional Version
PC-SPES has undergone considerable research looking at the anticancer properties, but results are inconclusive due contamination of PC-SPES. PC-SPES is not legally available in the United States. Get detailed information about PC-SPES in this clinician summary.
Code of Federal Regulations, 2010 CFR
2010-01-01
... finance have undergone considerable growth and change in recent years. It is increasingly common, for... climate, United States banking organizations would be placed at a competitive disadvantage if their...
In Situ Subtalar Arthrodesis for Posttraumatic Arthritis of the Calcaneus.
Probe, Robert
2016-08-01
One of the most frequent complications after intraarticular fracture of the calcaneus is the development of posttraumatic arthritis of the subtalar joint. If conservative measures fail in the treatment of this condition, consideration of arthrodesis should be given. This video depicts the preoperative assessment and surgical technique applied to one such 54-year-old patient who had undergone internal fixation of a calcaneal fracture 9 years before. Shown within the video is exposure of the subtalar joint through a lateral incision, joint preparation, and the application of stable fixation. Subtleties of exposure, osteogenesis maximization, and postoperative management are covered.
Lázaro-Martínez, José Luis; Aragón-Sánchez, Javier; Alvaro-Afonso, Francisco Javier; García-Morales, Esther; García-Álvarez, Yolanda; Molines-Barroso, Raúl Juan
2014-12-01
Foot ulcer recurrence is still an unresolved issue. Although several therapies have been described for preventing foot ulcers, the rates of reulcerations are very high. Footwear and insoles have been recommended as effective therapies that prevent the development of new ulcers; however, the majority of studies have analyzed their effects in terms of reducing peak plantar pressure rather than ulcer relapse. Knowledge of biomechanical considerations is low, in general, in the team approach to diabetic foot because heterogeneous professionals having competence in recurrence prevention are involved. Assessment of biomechanical alterations define a foot type position; examining foot structure and recording plantar pressure could help in appropriate insole and footwear prescription and design. Patient education and compliance should be taken into consideration for better therapy success. When patients suffer from rigid deformities or have undergone an amputation, surgical offloading should be considered as an alternative. © The Author(s) 2014.
Redefining Academic Identity in an Evolving Higher Education Landscape
ERIC Educational Resources Information Center
Flecknoe, Sharon J.; Choate, Julia K.; Davis, Elizabeth A.; Hodgson, Yvonne M.; Johanesen, Priscilla A.; Macaulay, Janet O.; Murphy, Kim; Sturrock, Wayne J.; Rayner, Gerry M.
2017-01-01
During a period of massive upheaval to the higher education sector, the traditional academic role has undergone considerable change. One element of these changes has been the broad introduction of Education-Focused (EF) or equivalent academic positions, which focus on educational excellence, with a requirement for high quality teaching and…
Couvreur, P
2001-07-01
Drug vectorization has undergone considerable development over the last few years. This review focuses on the intravenous route of administration. Colloid formulations allow a modulation of drug tissue distribution. Using liposomes and nanoparticles with unmodified surfaces, drugs can be targeted to macrophages of the reticulum endothelium system. When the liposomes or nanoparticles are covered with hydrophilic or flexible polymers, the vascular phase can be favored in order, for example, to facilitate selective extravasation at a tumor site. Therapeutic applications of these systems are presented. The development of "intelligent" vectors capable of modulating intracellular distribution of an active compounds is an equally interesting approach, for example pH-sensitive liposomes or nanoparticles decorated with folic acid capable of targeting intracellular cytoplasm.
Nuclear medicine and imaging research: Quantitative studies in radiopharmaceutical science
DOE Office of Scientific and Technical Information (OSTI.GOV)
Copper, M.; Beck, R.N.
1991-06-01
During the past three years the program has undergone a substantial revitalization. There has been no significant change in the scientific direction of this grant, in which emphasis continues to be placed on developing new or improved methods of obtaining quantitative data from radiotracer imaging studies. However, considerable scientific progress has been made in the three areas of interest: Radiochemistry, Quantitative Methodologies, and Experimental Methods and Feasibility Studies, resulting in a sharper focus of perspective and improved integration of the overall scientific effort. Changes in Faculty and staff, including development of new collaborations, have contributed to this, as has acquisitionmore » of additional and new equipment and renovations and expansion of the core facilities. 121 refs., 30 figs., 2 tabs.« less
The documentation and reintegration of a lost past
NASA Astrophysics Data System (ADS)
Balletti, C.; Brussa, N.; Gottardi, C.; Guerra, F.
2014-05-01
The paper describes how new digital methodologies can be used within the field of Cultural Heritage, not only with the aim of documenting the actual state of an architecture but to review the past transformations it has undergone, conserving and representing these histories as well. Over the last few years, the methodologies of acquisition and integrated representation for 3D patrimony documentation have developed and consolidated considerably: the possibilities of the digital realm can augment the understanding and the valorisation of a monument. The specific case offered in the present paper, the Scuola Vecchia della Misericordia in Venice, is a significant example. It suggests not only the theme of the "no longer existing" regarding its façade, which has undergone evident modifications, but also the recontextualization of a number of decorative elements, such as the bas-reliefs which once marked the entrance and are today conserved in the Victoria and Albert Museum, London. The described experience shows how integrated methodology, from high resolution laser scanning and photogrammetric survey to 3d modelling, can develop a reliably virtual diachronical reconstruction from different sources of an historical building. Geomatic tools combined with computer graphics provide a better understanding of building history through the use historical documents, playing a paramount role in preserving and valorizing the cultural and environmental heritage.
Rondet, Claire; Soler, Marion; Ringa, Virginie; Parizot, Isabelle; Chauvin, Pierre
2013-10-01
This study aims to investigate the association between social contact and social support and women's breast cancer screening (BCS) practices, taking their socioeconomic status (SES) into account. The SIRS survey was conducted in 2010 in the Paris metropolitan area among a representative sample of 3000 French-speaking adults. For the 784 women aged 50years or older with no history of breast cancer, multivariate logistic regressions and bootstrap methods were used to analyze the factors associated with never having undergone BCS. 6.5% of these women had never undergone BCS. In multivariate analysis, being older, having a low education level, having poor-quality health insurance, and having one or less than one social contact per 3-day period were significantly associated with never having undergone BCS during their lifetime, but the level of social support was not. The strength of the association with a low frequency of social contact tended to increase with age. This study analyzed the role of social contact in social inequalities in BCS practices in the Paris metropolitan area. Like SES, social integration and social isolation should be taken into consideration by public health professionals and practitioners when planning BCS programs and incentives. © 2013.
ERIC Educational Resources Information Center
Burton, Suzanne L.
2011-01-01
Strong school-university partnerships yield effective music teachers. However, music teacher preparation curriculum has undergone little reform over the years, resulting in a homogeneous P-12 curriculum. Encouraging preservice music teachers to consider cultural and pedagogical differences holds promise for changing music teacher preparation and…
Evaluating cardiac risk: exposure response analysis in early clinical drug development.
Grenier, Julie; Paglialunga, Sabina; Morimoto, Bruce H; Lester, Robert M
2018-01-01
The assessment of a drug's cardiac liability has undergone considerable metamorphosis by regulators since International Council for Harmonization of Technical Requirement for Pharmaceuticals for Human Use E14 guideline was introduced in 2005. Drug developers now have a choice in how proarrhythmia risk can be evaluated; the options include a dedicated thorough QT (TQT) study or exposure response (ER) modeling of intensive electrocardiogram (ECG) captured in early clinical development. The alternative approach of ER modeling was incorporated into a guidance document in 2015 as a primary analysis tool which could be utilized in early phase dose escalation studies as an option to perform a dedicated TQT trial. This review will describe the current state of ER modeling of intensive ECG data collected during early clinical drug development; the requirements with regard to the use of a positive control; and address the challenges and opportunities of this alternative approach to assessing QT liability.
Minari, Jusaku; Shirai, Tetsuya; Kato, Kazuto
2014-12-01
As evidenced by high-throughput sequencers, genomic technologies have recently undergone radical advances. These technologies enable comprehensive sequencing of personal genomes considerably more efficiently and less expensively than heretofore. These developments present a challenge to the conventional framework of biomedical ethics; under these changing circumstances, each research project has to develop a pragmatic research policy. Based on the experience with a new large-scale project-the Genome Science Project-this article presents a novel approach to conducting a specific policy for personal genome research in the Japanese context. In creating an original informed-consent form template for the project, we present a two-tiered process: making the draft of the template following an analysis of national and international policies; refining the draft template in conjunction with genome project researchers for practical application. Through practical use of the template, we have gained valuable experience in addressing challenges in the ethical review process, such as the importance of sharing details of the latest developments in genomics with members of research ethics committees. We discuss certain limitations of the conventional concept of informed consent and its governance system and suggest the potential of an alternative process using information technology.
Bioprosthetic Mesh in Abdominal Wall Reconstruction
Baumann, Donald P.; Butler, Charles E.
2012-01-01
Mesh materials have undergone a considerable evolution over the last several decades. There has been enhancement of biomechanical properties, improvement in manufacturing processes, and development of antiadhesive laminate synthetic meshes. The evolution of bioprosthetic mesh materials has markedly changed our indications and methods for complex abdominal wall reconstruction. The authors review the optimal properties of bioprosthetic mesh materials, their evolution over time, and their indications for use. The techniques to optimize outcomes are described using bioprosthetic mesh for complex abdominal wall reconstruction. Bioprosthetic mesh materials clearly have certain advantages over other implantable mesh materials in select indications. Appropriate patient selection and surgical technique are critical to the successful use of bioprosthetic materials for abdominal wall repair. PMID:23372454
Skeletal and dental considerations in orthodontic treatment mechanics: a contemporary view.
Nanda, Ravindra; Upadhyay, Madhur
2013-10-01
Orthodontics has undergone a paradigm shift in the last 40 years. There have been both technical and philosophical changes ushered by the development of new appliances, techniques, and by the explosion in the amount of research being conducted all around the world. However, the application of any new concept requires a firm understanding of the fundamentals of orthodontics. This paper presents a broad review of some fundamental concepts of treatment mechanics that enable us to bring about skeletal and dental correction of the presenting malocclusion. The basic concepts of facemask therapy, mechanics, and biology of tooth movement will be discussed with an insight into the challenges facing us in the future.
Strategies of treatment of pediatric hypertension.
Seikaly, Mouin G; Bahlawan-Seikaly, Sawsan
2010-01-01
Over the past two decades the attitudes of pediatric health care providers towards childhood hypertension, as a predictor of future development of hypertension in adults have undergone considerable conceptual change. Childhood hypertension has unique features that differentiate it from hypertension in adults. It is widely accepted that pediatric hypertension carries an increased risk for future cardiovascular morbidity and mortality. There is also a prevalent belief that therapeutic intervention at an early age may favorably modify the long-term outcome of hypertension. Despite its importance, childhood hypertension is understudied and several basic questions remain controversial. This article addresses several issues pertinent to the treatment of hypertension during childhood and discusses some of the newer pharmacological agents used in children.
Forest responses to changing climate: lessons from the past and uncertainty for the future
Donald H. DeHayes; George L., Jr. Jacobson; Paul G. Schaberg; Bruce Bongarten; Louis Iverson; Ann C. Dieffenbacher-Krall
2000-01-01
The earth's climate has undergone dramatic and long-term changes through natural processes many millennia before humans influenced global climate. Considerable evidence indicates that increasing concentrations of carbon dioxide and other greenhouse gases in the earth's atmosphere will lead to near-term warming, perhaps as much as 2 to 4°C in...
A Features-Based Approach for Teaching Singapore English
ERIC Educational Resources Information Center
Schaetzel, Kirsten; Lim, Beng Soon; Low, Ee Ling
2010-01-01
Research into Singapore English (SgE) has undergone many paradigm shifts from the 1970s to the present. This paper first begins with a consideration of how variation in the English language used in Singapore has been studied. It then identifies the two main varieties of English commonly described in Singapore, namely, Standard SgE (SSE) and…
Entrepreneurial and Vocational Education and Training: Lessons from Eastern and Central Europe
ERIC Educational Resources Information Center
Mitra, Jay; Matlay, Harry
2004-01-01
The social, economic and political systems of former communist countries have faced considerable changes since the late 1980s. Most countries in Eastern and Central Europe have undergone their own individual brand of transition from a centrally planned, command system to a more or less liberalized, Western-style market economy. Many observers…
How Do We Educate Teachers for Early Childhood Education: Early Childhood Educators in Japan.
ERIC Educational Resources Information Center
Ishigaki, Emiko
This paper discusses the organization of early childhood education and preschool education in Japan and describes how teachers are trained for positions in these schools. It is noted that the organization of such education in Japan has undergone considerable change since the first kindergarten was established in 1877. At that time the curriculum…
Second Language Teacher Education: Review of Recent Research on Practice
ERIC Educational Resources Information Center
Wright, Tony
2010-01-01
Second language teacher education (SLTE) has undergone considerable change over the past 25 years. The question of how language teaching is learnt and how programmes of professional preparation can contribute to this process now elicits quite different answers. A new agenda of theory and practice has emerged as SLTE has incorporated many of the…
ERIC Educational Resources Information Center
le Roux, Adré
2016-01-01
In an attempt to bring about a society in which individuals can realise their full potential, South African (SA) education has undergone fundamental reforms. However, despite these changes, the education system seems to remain hampered by ongoing systematic and institutional racism, and subsequent socio-economic structures of poverty and…
ERIC Educational Resources Information Center
Machado-Da-Silva, Fábio Nazareno; Meirelles, Fernando de Souza; Filenga, Douglas; Filho, Marino Brugnolo
2014-01-01
Distance learning has undergone great changes, especially since the advent of the Internet and communication and information technology. Questions have been asked following the growth of this mode of instructional activity. Researchers have investigated methods to assess the benefits of e-learning from a number of perspectives. This survey…
"I'm a Geek I Am": Academic Achievement and the Performance of a Studious Working-Class Masculinity
ERIC Educational Resources Information Center
Ward, Michael R. M.
2014-01-01
During the last few decades, the South Wales Valleys (UK) have undergone a considerable economic, social, cultural and political transformation, altering youth transitions from school to work. Drawing on a two and a half year ethnographic study, in the paper I concentrate on a group of academically successful young white working-class men aged…
ERIC Educational Resources Information Center
Ermenc, Klara Skubic; Vujisic Živkovic, Nataša; Spasenovic, Vera
2015-01-01
Over the previous decade, higher education in Slovenia and Serbia has undergone considerable reforms, influenced by the Bologna process and its agenda of competence and learning outcomes. In the context of these reforms, the aim of this research is to consider the question of the relationship between the theoretical and the practical education of…
Song, Heli; Liu, Qingyun; Xie, Yongshu
2018-02-15
As a promising low-cost solar energy conversion technique, dye-sensitized solar cells have undergone spectacular development since 1991. For practical applications, improvement of power conversion efficiency has always been one of the major research topics. Porphyrins are outstanding sensitizers endowed with strong sunlight harvesting ability in the visible region and multiple reaction sites available for functionalization. However, judicious molecular design in consideration of light-harvest, energy levels, operational dynamics, adsorption geometry and suppression of back reactions is specifically required for achieving excellent photovoltaic performance. This feature article highlights some of the recently developed porphyrin sensitizers, especially focusing on the systematic dye structure optimization approach in combination with coadsorption and cosensitization methods in pursuing higher efficiencies. Herein, we expect to provide more insights into the structure-performance correlation and molecular engineering strategies in a stepwise manner.
Drivers of change for lakewater clarity
Lawrence A. Baker; Johanna E. Schussler; Stephanie A. Snyder
2008-01-01
Lakes in the Upper Midwest have undergone extensive lakeshore development over the past 30 years, raising concerns about eutrophication. We examined 11 case study lakes in Minnesota that had undergone substantial shoreline development over the past 30 years to evaluate drivers of change in clarity. Relationships between current Secchi disk transparency (SDT) and the...
Olson-Kennedy, Johanna; Warus, Jonathan; Okonta, Vivian; Belzer, Marvin; Clark, Leslie F
2018-05-01
Transmasculine youth, who are assigned female at birth but have a gender identity along the masculine spectrum, often report considerable distress after breast development (chest dysphoria). Professional guidelines lack clarity regarding referring minors (defined as people younger than 18 years) for chest surgery because there are no data documenting the effect of chest surgery on minors. To examine the amount of chest dysphoria in transmasculine youth who had had chest reconstruction surgery compared with those who had not undergone this surgery. Using a novel measure of chest dysphoria, this cohort study at a large, urban, hospital-affiliated ambulatory clinic specializing in transgender youth care collected survey data about testosterone use and chest distress among transmasculine youth and young adults. Additional information about regret and adverse effects was collected from those who had undergone surgery. Eligible youth were 13 to 25 years old, had been assigned female at birth, and had an identified gender as something other than female. Recruitment occurred during clinical visits and via telephone between June 2016 and December 2016. Surveys were collected from participants who had undergone chest surgery at the time of survey collection and an equal number of youth who had not undergone surgery. Outcomes were chest dysphoria composite score (range 0-51, with higher scores indicating greater distress) in all participants; desire for chest surgery in patients who had not had surgery; and regret about surgery and complications of surgery in patients who were postsurgical. Of 136 completed surveys, 68 (50.0%) were from postsurgical participants, and 68 (50.0%) were from nonsurgical participants. At the time of the survey, the mean (SD) age was 19 (2.5) years for postsurgical participants and 17 (2.5) years for nonsurgical participants. Chest dysphoria composite score mean (SD) was 29.6 (10.0) for participants who had not undergone chest reconstruction, which was significantly higher than mean (SD) scores in those who had undergone this procedure (3.3 [3.8]; P < .001). Among the nonsurgical cohort, 64 (94%) perceived chest surgery as very important, and chest dysphoria increased by 0.33 points each month that passed between a youth initiating testosterone therapy and undergoing surgery. Among the postsurgical cohort, the most common complication of surgery was loss of nipple sensation, whether temporary (59%) or permanent (41%). Serious complications were rare and included postoperative hematoma (10%) and complications of anesthesia (7%). Self-reported regret was near 0. Chest dysphoria was high among presurgical transmasculine youth, and surgical intervention positively affected both minors and young adults. Given these findings, professional guidelines and clinical practice should consider patients for chest surgery based on individual need rather than chronologic age.
Socio-economic, dietary, activity, nutrition and body weight transitions in South Korea.
Lee, Soo-Kyung; Sobal, Jeffery
2003-10-01
Socio-economic development influences many factors that affect health, especially diet and nutrition. This investigation proposes that a system of transitions occur as societies develop, with socio-economic, physical activity, dietary, nutrition and body weight transitions operating in relationship with each other. This model of transitions was examined empirically using South Korea as an example of a nation that has undergone considerable changes. Data were drawn from published government reports: the Korean National Nutrition Survey and annual reports at the national level for the years between 1969 and 1993. The socio-economic transition was assessed by gross national product. The physical activity transition was assessed using annual proportions of the population involved in primary, secondary and tertiary industries, as well as the number of cars and driver's licences. The dietary transition was measured by plant and animal food consumption. The nutrition transition was assessed by percentages of energy from carbohydrate, protein and fat. The body weight transition was measured by body mass index calculated from the average height and weight of adolescents. Results revealed that the transitions were highly correlated as expected, with the socio-economic transition exhibiting major changes. South Koreans tended to decrease their physical activity and plant food consumption, and to increase animal food consumption, percentage of energy from dietary fat and body weight, in relationship to the socio-economic transition. Examining a system of transitions on a national level in one country that has undergone rapid economic development may provide a strategy for examining how such transitions operate in other nations.
ERIC Educational Resources Information Center
Bara, Francisco Esteban
2015-01-01
In recent years university education has undergone considerable change. In short, it appears to have adapted to the prevailing circumstances and it is even proving to be an essential resource in the optimization of professional, social, cultural, and economic concerns. All in all, the changes it has gone through have led to the achievement of…
Consideration of Wear Rates at High Velocity
2010-03-01
specimen retracted back into the test slipper. The amount of wear was analyzed by comparing the pretest and posttest specimen thicknesses and weights...and Design System (DADS) Model . . . . . . . . . . . . . . . . . . . . . . . 62 3.1.2 January 2008 Test Mission Raw DADS Data . . 64 3.1.3 DADS...The experimental high-speed test track at Holloman Air Force Base (AFB) has undergone many design innovations over a span of fifty years. One of the
Working channel endoscope in lumbar spine surgery.
Choi, G; Lee, S H; Deshpande, K; Choi, H
2014-06-01
Percutaneous endoscopic lumbar discectomy (PELD) is a well established modality in the treatment of patients with herniated lumbar discs. Since the time of its inception towards the end of 20th century, this technique has undergone significant modifications. With better understanding of the patho-anatomy and development of instrumentation the indications for PELD are on the rise. In the modern era of knowledge exchange there have been considerable variations among different endoscopic surgeons about classical indications and the implications of a particular technique pertaining to those indications. During last 15 years of experience in practicing endoscopic surgery, Choi has published many articles, regarding the techniques of PELD, across many scientific journals. In our practice there has been considerable shift from central debulking to discectomy to selective fragmentectomy. With further advancements the span of this technique is definitely on the rise. Here, we wish to share all the published data along with my current practice trends in more precise manner to help newer endoscopic spine surgeons understand the implications and limitations of a working channel endoscope in lumbar spine pathologies.
Noise reduction of a tilt-rotor aircraft including effects on weight and performance
NASA Technical Reports Server (NTRS)
Gibs, J.; Stepniewski, W. Z.; Spencer, R.; Kohler, G.
1973-01-01
Various methods for far-field noise reduction of a tilt-rotor acoustic signature and the performance and weight tradeoffs which result from modification of the noise sources are considered in this report. In order to provide a realistic approach for the investigation, the Boeing tilt-rotor flight research aircraft (Model 222), was selected as the baseline. This aircraft has undergone considerable engineering development. Its rotor has been manufactured and tested in the Ames full-scale wind tunnel. The study reflects the current state-of-the-art of aircraft design for far-field acoustic signature reduction and is not based solely on an engineering feasibility aircraft. This report supplements a previous study investigating reduction of noise signature through the management of the terminal flight trajectory.
Tian, Yaohua; Jian, Zhong; Xu, Beibei; Liu, Hui
2017-10-03
Comorbidities have considerable effects on survival outcomes. The primary objective of this retrospective study was to examine the association between age-adjusted Charlson comorbidity index (ACCI) score and postoperative in-hospital mortality in patients with digestive system cancer who have undergone surgical resection of their cancers. Using electronic hospitalization summary reports, we identified 315,464 patients who had undergone surgery for digestive system cancer in top-rank (Grade 3A) hospitals in China between 2013 and 2015. The Cox proportional hazard regression model was applied to evaluate the effect of ACCI score on postoperative mortality, with adjustments for sex, type of resection, anesthesia methods, and caseload of each healthcare institution. The postoperative in-hospital mortality rate in the study cohort was 1.2% (3,631/315,464). ACCI score had a positive graded association with the risk of postoperative in-hospital mortality for all cancer subtypes. The adjusted HRs for postoperative in-hospital mortality scores ≥ 6 for esophagus, stomach, colorectum, pancreas, and liver and gallbladder cancer were 2.05 (95% CI: 1.45-2.92), 2.00 (95% CI: 1.60-2.49), 2.54 (95% CI: 2.02-3.21), 2.58 (95% CI: 1.68-3.97), and 4.57 (95% CI: 3.37-6.20), respectively, compared to scores of 0-1. These findings suggested that a high ACCI score is an independent predictor of postoperative in-hospital mortality in Chinese patients with digestive system cancer who have undergone surgical resection.
Frank, Steven J; Rosenthal, David I; Petsuksiri, Janjira; Ang, K Kian; Morrison, William H; Weber, Randal S; Glisson, Bonnie S; Chao, K S Clifford; Schwartz, David L; Chronowski, Gregory M; El-Naggar, Adel K; Garden, Adam S
2010-11-15
Conventional therapy for cervical node squamous cell carcinoma metastases from an unknown primary can cause considerable toxicity owing to the volume of tissues to be irradiated. In the present study, hypothesizing that using intensity-modulated radiotherapy (IMRT) would provide effective treatment with minimal toxicity, we reviewed the outcomes and patterns of failure for head-and-neck unknown primary cancer at a single tertiary cancer center. We retrospectively reviewed the records of 52 patients who had undergone IMRT for an unknown primary at M.D. Anderson Cancer Center between 1998 and 2005. The patient and treatment characteristics were extracted and the survival rates calculated using the Kaplan-Meier method. Of the 52 patients, 5 presented with Stage N1, 11 with Stage N2a, 23 with Stage N2b, 6 with Stage N2c, 4 with Stage N3, and 3 with Stage Nx disease. A total of 26 patients had undergone neck dissection, 13 before and 13 after IMRT; 14 patients had undergone excisional biopsy and presented for IMRT without evidence of disease. Finally, 14 patients had received systemic chemotherapy. All patients underwent IMRT to targets on both sides of the neck and pharyngeal axis. The median follow-up time for the surviving patients was 3.7 years. The 5-year actuarial rate of primary mucosal tumor control and regional control was 98% and 94%, respectively. Only 3 patients developed distant metastasis with locoregional control. The 5-year actuarial disease-free and overall survival rate was 88% and 89%, respectively. The most severe toxicity was Grade 3 dysphagia/esophageal stricture, experienced by 2 patients. The results of our study have shown that IMRT can produce excellent outcomes for patients who present with cervical node squamous cell carcinoma metastases from an unknown head-and-neck primary tumor. Severe late complications were uncommon. Copyright © 2010 Elsevier Inc. All rights reserved.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Frank, Steven J., E-mail: sjfrank@mdanderson.or; Rosenthal, David I.; Petsuksiri, Janjira
2010-11-15
Purpose: Conventional therapy for cervical node squamous cell carcinoma metastases from an unknown primary can cause considerable toxicity owing to the volume of tissues to be irradiated. In the present study, hypothesizing that using intensity-modulated radiotherapy (IMRT) would provide effective treatment with minimal toxicity, we reviewed the outcomes and patterns of failure for head-and-neck unknown primary cancer at a single tertiary cancer center. Methods and Materials: We retrospectively reviewed the records of 52 patients who had undergone IMRT for an unknown primary at M.D. Anderson Cancer Center between 1998 and 2005. The patient and treatment characteristics were extracted and themore » survival rates calculated using the Kaplan-Meier method. Results: Of the 52 patients, 5 presented with Stage N1, 11 with Stage N2a, 23 with Stage N2b, 6 with Stage N2c, 4 with Stage N3, and 3 with Stage Nx disease. A total of 26 patients had undergone neck dissection, 13 before and 13 after IMRT; 14 patients had undergone excisional biopsy and presented for IMRT without evidence of disease. Finally, 14 patients had received systemic chemotherapy. All patients underwent IMRT to targets on both sides of the neck and pharyngeal axis. The median follow-up time for the surviving patients was 3.7 years. The 5-year actuarial rate of primary mucosal tumor control and regional control was 98% and 94%, respectively. Only 3 patients developed distant metastasis with locoregional control. The 5-year actuarial disease-free and overall survival rate was 88% and 89%, respectively. The most severe toxicity was Grade 3 dysphagia/esophageal stricture, experienced by 2 patients. Conclusion: The results of our study have shown that IMRT can produce excellent outcomes for patients who present with cervical node squamous cell carcinoma metastases from an unknown head-and-neck primary tumor. Severe late complications were uncommon.« less
Schoenherr, Jordan Richard; Hamstra, Stanley J
2016-08-01
Psychometrics has recently undergone extensive criticism within the medical education literature. The use of quantitative measurement using psychometric instruments such as response scales is thought to emphasize a narrow range of relevant learner skills and competencies. Recent reviews and commentaries suggest that a paradigm shift might be presently underway. We argue for caution, in that the psychometrics approach and the quantitative account of competencies that it reflects is based on a rich discussion regarding measurement and scaling that led to the establishment of this paradigm. Rather than reflecting a homogeneous discipline focused on core competencies devoid of consideration of context, the psychometric community has a history of discourse and debate within the field, with an acknowledgement that the techniques and instruments developed within psychometrics are heuristics that must be used pragmatically.
Human pheromones and sexual attraction.
Grammer, Karl; Fink, Bernhard; Neave, Nick
2005-02-01
Olfactory communication is very common amongst animals, and since the discovery of an accessory olfactory system in humans, possible human olfactory communication has gained considerable scientific interest. The importance of the human sense of smell has by far been underestimated in the past. Humans and other primates have been regarded as primarily 'optical animals' with highly developed powers of vision but a relatively undeveloped sense of smell. In recent years this assumption has undergone major revision. Several studies indicate that humans indeed seem to use olfactory communication and are even able to produce and perceive certain pheromones; recent studies have found that pheromones may play an important role in the behavioural and reproduction biology of humans. In this article we review the present evidence of the effect of human pheromones and discuss the role of olfactory cues in human sexual behaviour.
Chadwick, Jeanne J; Andrade, Leonardo F; Altice, Frederick L; Petry, Nancy M
2014-01-01
Routine testing is the cornerstone to identifying HIV, but not all substance abuse treatment patients have been tested. This study is a real-world evaluation of predictors of having never been HIV tested among patients initiating substance abuse treatment. Participants (N = 614) from six New England clinics were asked whether they had ever been HIV tested. Eighty-five patients (13.8%) reported having never been tested and were compared to those who had undergone testing. Clinic, male gender (adjusted odds ratio (AOR) = 1.91, 95% confidence interval (CI) = 1.07-3.41), and having fewer employment (AOR = 0.31; 95% CI = 0.11-0.88) and medical problems (AOR = 0.40, 95% CI = 0.17-0.99) were independently correlated with having never been HIV tested. Thus, there is still considerable room for improved testing strategies as a clinically significant minority of substance abuse patients have never undergone HIV testing when they initiate treatment.
Irreversible electroporation of locally advanced pancreatic neck/body adenocarcinoma
2015-01-01
Objective Irreversible electroporation (IRE) of locally advanced pancreatic adenocarcinoma of the neck has been used to palliate appropriate stage 3 pancreatic cancers without evidence of metastasis and who have undergone appropriate induction therapy. Currently there has not been a standardized reported technique for pancreatic mid-body tumors for patient selection and intra-operative technique. Patients Subjects are patients with locally advanced pancreatic adenocarcinoma of the body/neck who have undergone appropriate induction chemotherapy for a reasonable duration. Main outcome measures Technique of open IRE of locally advanced pancreatic adenocarcinoma of the neck/body is described, with the emphasis on intra-operative ultrasound and intra-operative electroporation management. Results The technique of open IRE of the pancreatic neck/body with bracketing of the celiac axis and superior mesenteric artery with continuous intraoperative ultrasound imaging and consideration of intraoperative navigational system is described. Conclusions IRE of locally advanced pancreatic adenocarcinoma of the body/neck is feasible for appropriate patients with locally advanced unresectable pancreatic cancer. PMID:26029461
Laparoscopic inguinal hernioplasty after robot-assisted laparoscopic radical prostatectomy.
Sakon, M; Sekino, Y; Okada, M; Seki, H; Munakata, Y
2017-10-01
To evaluate the efficacy and safety of laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair in patients who have undergone robot-assisted laparoscopic radical prostatectomy (RALP). From July 2014 to December 2016, TAPP inguinal hernia repair was conducted in 40 consecutive patients who had previously undergone RALP. Their data were retrospectively analyzed as an uncontrolled case series. The mean operation time in patients who had previously undergone RALP was 99.5 ± 38.0 min. The intraoperative blood loss volume was small, and the duration of hospitalization was 2.0 ± 0.5 days. No intraoperative complications or major postoperative complications occurred. During the average 11.2-month follow-up period, no patients who had previously undergone prostatectomy developed recurrence. Laparoscopic TAPP inguinal hernia repair after RALP was safe and effective. TAPP inguinal hernia repair may be a valuable alternative to open hernioplasty.
NASA Astrophysics Data System (ADS)
Correia, M. F.; da Silva Dias, M. A. F.; da Silva Aragão, M. R.
2006-11-01
Sobradinho Lake lies in the São Francisco River Basin, in one of the most arid regions in Northeastern Brazil, within a land stretch categorized as the Lower-middle São Francisco, situated at about 40 km away from the municipality of Petrolina (09°23'S 40°30'W) in the state of Pernambuco. The dam, in its full capacity, consists of a lake of approximately 4,214 km2; 280 km in length, the width of which varies from 5 to 50 km. The dam storage capacity is that of 34.1 billion m3 of water. Being situated in a semi-arid region, the dam brought about significant development to local irrigated agriculture. The caatinga ecosystem has, for that matter, undergone considerable changes. Statistical analysis techniques applied to data collected before and after the filling of the lake, made it possible both to make an assessment of the impact of the dam construction on the region meteorology and to diagnose the variability of such an impact on environmental conditions. Results showed that the dam has brought about considerable changes to regional meteorology. The alterations were observed to be more significant as regards atmospheric humidity and wind speed.
Numerical Estimation of the Curvature of Biological Surfaces
NASA Technical Reports Server (NTRS)
Todd, P. H.
1985-01-01
Many biological systems may profitably be studied as surface phenomena. A model consisting of isotropic growth of a curved surface from a flat sheet is assumed. With such a model, the Gaussian curvature of the final surface determines whether growth rate of the surface is subharmonic or superharmonic. These properties correspond to notions of convexity and concavity, and thus to local excess growth and local deficiency of growth. In biological models where the major factors controlling surface growth are intrinsic to the surface, researchers thus gained from geometrical study information on the differential growth undergone by the surface. These ideas were applied to an analysis of the folding of the cerebral cortex, a geometrically rather complex surface growth. A numerical surface curvature technique based on an approximation to the Dupin indicatrix of the surface was developed. A metric for comparing curvature estimates is introduced, and considerable numerical testing indicated the reliability of this technique.
Burt, J A; Coles, S; van Lavieren, H; Taylor, O; Looker, E; Samimi-Namin, K
2016-04-30
Oman contains diverse and abundant reef coral communities that extend along a coast that borders three environmentally distinct water bodies, with corals existing under unique and often stressful environmental conditions. In recent years Oman's reefs have undergone considerable change due to recurrent predatory starfish outbreaks, cyclone damage, harmful algal blooms, and other stressors. In this review we summarize current knowledge of the biology and status of corals in Oman, particularly in light of recent stressors and projected future threats, and examine current reef management practices. Oman's coral communities occur in marginal environmental conditions for reefs, and hence are quite vulnerable to anthropogenic effects. We recommend a focus on developing conservation-oriented coral research to guide proactive management and expansion of the number and size of designated protected areas in Oman, particularly those associated with critical coral habitat. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
Los Alamos radiation transport code system on desktop computing platforms
DOE Office of Scientific and Technical Information (OSTI.GOV)
Briesmeister, J.F.; Brinkley, F.W.; Clark, B.A.
The Los Alamos Radiation Transport Code System (LARTCS) consists of state-of-the-art Monte Carlo and discrete ordinates transport codes and data libraries. These codes were originally developed many years ago and have undergone continual improvement. With a large initial effort and continued vigilance, the codes are easily portable from one type of hardware to another. The performance of scientific work-stations (SWS) has evolved to the point that such platforms can be used routinely to perform sophisticated radiation transport calculations. As the personal computer (PC) performance approaches that of the SWS, the hardware options for desk-top radiation transport calculations expands considerably. Themore » current status of the radiation transport codes within the LARTCS is described: MCNP, SABRINA, LAHET, ONEDANT, TWODANT, TWOHEX, and ONELD. Specifically, the authors discuss hardware systems on which the codes run and present code performance comparisons for various machines.« less
Concepts of Cell Lineage in Mammalian Embryos.
Papaioannou, Virginia E
2016-01-01
Cell lineage is the framework for understanding cellular diversity, stability of differentiation, and its relationship to pluripotency. The special condition of in utero development in mammals has presented challenges to developmental biologists in tracing cell lineages but modern imaging and cell marking techniques have allowed the gradual elucidation of lineage relationships. Early experimental embryology approaches had limited resolution and relied of suboptimal cell markers and considerable disturbance to the embryos. Transgenic technology introduced genetic markers, particularly fluorescent proteins that, combined with sophisticated imaging modalities, greatly increase resolution and allow clonal analysis within lineages. The concept of cell lineage has also undergone evolution as it became possible to trace the lineage of cells based not only on their physical location or attributes but also on their gene expression pattern, thus opening up mechanistic lines of investigation into the determinants of cell lineage. © 2016 Elsevier Inc. All rights reserved.
Transsphenoidal surgery for pituitary tumours
Massoud, A; Powell, M; Williams, R; Hindmarsh, P; Brook, C
1997-01-01
Accepted 29 January 1997 OBJECTIVES—Transsphenoidal surgery (TSS) is the preferred method for the excision of pituitary microadenomas in adults. This study was carried out to establish the long term efficacy and safety of TSS in children. STUDY DESIGN—A 14 year retrospective analysis was carried out on 23 children (16 boys and seven girls), all less than 18 years of age, who had undergone TSS at our centre. RESULTS—Twenty nine transsphenoidal surgical procedures were carried out. The most common diagnosis was an adrenocorticotrophic hormone (ACTH) secreting adenoma (14 (61%) patients). The median length of follow up was 8.0 years (range 0.3-14.0 years). Eighteen (78%) patients were cured after the first procedure. No death was related to the operation. The most common postoperative complication was diabetes insipidus, which was transient in most patients. Other complications were headaches in two patients and cerebrospinal fluid leaks in two patients. De novo endocrine deficiencies after TSS in children were as follows: three (14%) patients developed panhypopituitarism, eight (73%) developed growth hormone insufficiency, three (14%) developed secondary hypothyroidism, and four (21%) developed gonadotrophin deficiency. Permanent ACTH deficiency occurred in five (24%) patients, though all patients received postoperative glucocorticoid treatment until dynamic pituitary tests were performed three months after TSS. CONCLUSIONS—TSS in children is a safe and effective treatment for pituitary tumours, provided it is performed by surgeons with considerable experience and expertise. Surgical complications are minimal. Postoperative endocrine deficit is considerable, but is only permanent in a small proportion of patients. • Transsphenoidal surgery is a safe and effective treatment for pituitary tumours in children • Transsphenoidal surgery should be performed by surgeons with considerable experience and expertise • Surgical complications of transsphenoidal surgery are minimal and endocrine deficit is permanent in only a small proportion of patients PMID:9196353
Incidence of ovarian cancer after hysterectomy: a nationwide controlled follow up.
Loft, A; Lidegaard, O; Tabor, A
1997-11-01
To estimate the risk of developing ovarian cancer after abdominal (total or subtotal) hysterectomy on benign indication. Prospective historical cohort study with 12.5 years of follow up. Denmark, nationwide. All Danish women (aged 0 to 99 years) having undergone hysterectomy with conservation of at least one ovary for a benign indication from 1977 to 1981 (n = 22,135). Follow up was conducted from 1977 to 1991. The reference group included all Danish women who had not undergone hysterectomy, age-standardised according to the hysterectomy group (n = 2,554,872). Registry data derived from the Danish National Register of Patients (diagnoses and operation codes) and the Civil Registration System (information about general population, including time of death). Incidence rate of ovarian cancer, lifetime risk of ovarian cancer, relative risk of ovarian cancer. Seventy-one women developed ovarian cancer on average 7.0 years after hysterectomy and 10,659 women in the reference group had ovarian cancer diagnosed after on average 6.4 years. The incidence rate of ovarian cancer was 0.27 per 1000 person-years in the group that had undergone hysterectomy and 0.34 per 1000 person-years in the general population (age-standardised). The extrapolated lifetime risk of developing ovarian cancer was 2.1% after hysterectomy and 2.7% in the general population (RR 0.78; 95% CI 0.60-0.96). The risk of ovarian cancer is lower among women who have undergone hysterectomy compared with those who have not. The protection seems to decrease with time.
Pahwa, Archna R.; Girotra, Mohit; Abrahm, Rtika Ryfka; Kathuria, Sachin; Sharma, Ajay
2014-01-01
Introduction. Congenital pelviureteric junction obstruction (PUJO) is one of the most common causes of hydronephrosis. Historically, open dismembered pyeloplasty has been considered the gold standard intervention for correcting PUJO. The aim of this study was to compare the surgical and functional outcomes of three different approaches, namely, open, conventional laparoscopy, and robotic pyeloplasty. Material and Methods. 60 patients underwent minimally invasive pyeloplasty (30 conventional laparoscopies and 30 robotics) for congenital PUJO at a tertiary health center in India. Demographic, perioperative, and postoperative data were prospectively collected and analyzed. The data of these patients were retrospectively compared with another cohort of 30 patients who had undergone open pyeloplasty. Results. There was significant difference in operative time, time to drain removal, hospital stay, pain score, and complications rate between open and minimally invasive pyeloplasty (P < 0.05). SFI was considerably lesser in robotic as compared to conventional laparoscopy. The success rate in OP, CLP, and RP was 93.33, 96.67, and 96.67%. Conclusion. Robotic pyeloplasty is safe, effective, and feasible. It is associated with significantly lesser operative time, lesser blood loss, less pain, shorter hospital stay, and fewer complications. It is also associated with considerably lesser surgeon fatigue as compared to conventional laparoscopy pyeloplasty. PMID:24624138
Irrgeher, Johanna; Prohaska, Thomas
2016-01-01
Analytical ecogeochemistry is an evolving scientific field dedicated to the development of analytical methods and tools and their application to ecological questions. Traditional stable isotopic systems have been widely explored and have undergone continuous development during the last century. The variations of the isotopic composition of light elements (H, O, N, C, and S) have provided the foundation of stable isotope analysis followed by the analysis of traditional geochemical isotope tracers (e.g., Pb, Sr, Nd, Hf). Questions in a considerable diversity of scientific fields have been addressed, many of which can be assigned to the field of ecogeochemistry. Over the past 15 years, other stable isotopes (e.g., Li, Zn, Cu, Cl) have emerged gradually as novel tools for the investigation of scientific topics that arise in ecosystem research and have enabled novel discoveries and explorations. These systems are often referred to as non-traditional isotopes. The small isotopic differences of interest that are increasingly being addressed for a growing number of isotopic systems represent a challenge to the analytical scientist and push the limits of today's instruments constantly. This underlines the importance of a metrologically sound concept of analytical protocols and procedures and a solid foundation of data processing strategies and uncertainty considerations before these small isotopic variations can be interpreted in the context of applied ecosystem research. This review focuses on the development of isotope research in ecogeochemistry, the requirements for successful detection of small isotopic shifts, and highlights the most recent and innovative applications in the field.
Rind, Esther; Jones, Andy
2014-05-01
At the population level, the prevalence of physical activity has declined considerably in many developed countries in recent decades. There is some evidence that areas exhibiting the lowest activity levels are those which have undergone a particularly strong transition away from employment in physically demanding occupations. We propose that processes of deindustrialization may be causally linked to unexplained geographical disparities in levels of physical activity. While the sociocultural correlates of physical activity have been well studied, and prior conceptual frameworks have been developed to explain more general patterns of activity, none have explicitly attempted to identify the components of industrial change that may impact physical activity. In this work we review the current literature on sociocultural correlates of health behaviors before using a case study centered on the United Kingdom to present a novel framework that links industrial change to declining levels of physical activity. We developed a comprehensive model linking sociocultural correlates of physical activity to processes associated with industrial restructuring and discuss implication for policy and practice. A better understanding of sociocultural processes may help to ameliorate adverse health consequences of employment decline in communities that have experienced substantial losses of manual employment.
Liu, Peng; Wen, Hui; Harich, Franziska K; He, Changhuan; Wang, Lanxin; Guo, Xianming; Zhao, Jianwei; Luo, Aidong; Yang, Hongpei; Sun, Xiao; Yu, Yang; Zheng, Shaobo; Guo, Jing; Li, Li; Zhang, Li
2017-08-03
Over the last 4 decades, China has undergone major economic development, resulting in considerable impacts on its wildlife populations and habitats. It is essential to quantify the conflict between development and conservation to assist with policy-making because forestry policies and market trends affected indirectly the distribution of Asian elephants. Here, we mapped the historical distribution of elephants versus human land use. Elephant distributions appear to occur in unbroken natural forests only. However, over the 40-year period, the distribution ranges have become smaller and fragmented, with natural forest area also declining by 16%. The monoculture of cash trees is encroaching on natural forests. Over the past 10 years, rubber plantations have become concentrated in the south, with extensive natural forests and scattered rubber farms being converted to tea plantations, due to changes in governmental policies and product prices. Through mapping the spatial changes in the distribution of rubber and tea plantations, our study is expected to help local managers to incorporate the needs of endangered elephants through creating space when planning plantations, especially in Xishuangbanna and the south part of Pu'er. In conclusion, restoring elephant habitat and establishing ecological corridors are critical for the survival of elephants in this region.
McDonagh, T J
1982-02-01
The practice of occupational medicine has undergone considerable change over the last decade. Increased awareness of potential health hazards associated with the workplace and its products and wastes, the interest of society and workers in these subjects, and related governmental regulation have resulted in expanded occupational health programs within industry. The occupational physician has become a key company resource in the optimal management of the business impacts of health-related issues. Health-related matters often have noteworthy business implications, and the occupational physician needs to spend considerable time as a manager in the planning, resourcing, implementation, evaluation, and stewardship of programs. Thus he is experiencing greater demands and often is inadequately prepared for this nonclinical, nonscientific role. Therefore, the preparation of occupational physicians to assume such managerial responsibilities needs to receive high priority. The physician must be willing to accept this challenge both to ensure the program's success and to retain a leadership position in occupational health programs.
Finken, Martijn J J; Zwaveling-Soonawala, Nitash; Walenkamp, Marie J E; Vulsma, Thomas; van Trotsenburg, A S Paul; Rotteveel, Joost
2011-01-01
It is not exactly known how many children develop the triphasic response (diabetes insipidus (DI)/hyponatremia/DI) immediately after surgery for childhood craniopharyngioma; neither is it known which factors predict this. We studied the occurrence of the triphasic response after primary surgery for craniopharyngioma in children, and aimed to identify possible predictors. Patients <18 years old who had undergone a primary craniopharyngioma resection between January 1990 and February 2010 in either of the 2 academic centers in Amsterdam were studied retrospectively. Twenty-one patients (5 males) fulfilled the inclusion criteria. Median age at surgery was 9.1 (range: 4.0-15.1) years. Six patients developed a triphasic response (29%). Of all factors, only the duration of surgery was found to be a predictor of a triphasic response: 8.5 (6.0-11.0) versus 4.6 (3.5-11.5) h in patients who did not develop a triphasic response (p = 0.03). After primary surgery for a craniopharyngioma, a considerable number of patients develop a triphasic response in the regulation of the sodium and water balance. This is predicted by (factors associated with) a longer duration of surgery. Other predictors could not be identified, which may be due to the small sample size. Copyright © 2011 S. Karger AG, Basel.
Biddle, Adrian; Gammon, Luke; Fazil, Bilal; Mackenzie, Ian C
2013-01-01
CD44 is commonly used as a cell surface marker of cancer stem-like cells in epithelial tumours, and we have previously demonstrated the existence of two different CD44(high) cancer stem-like cell populations in squamous cell carcinoma, one having undergone epithelial-to-mesenchymal transition and the other maintaining an epithelial phenotype. Alternative splicing of CD44 variant exons generates a great many isoforms, and it is not known which isoforms are expressed on the surface of the two different cancer stem-like cell phenotypes. Here, we demonstrate that cancer stem-like cells with an epithelial phenotype predominantly express isoforms containing the variant exons, whereas the cancer stem-like cells that have undergone an epithelial-to-mesenchymal transition down-regulate these variant isoforms and up-regulate expression of the standard CD44 isoform that contains no variant exons. In addition, we find that enzymatic treatments used to dissociate cells from tissue culture or fresh tumour specimens cause destruction of variant CD44 isoforms at the cell surface whereas expression of the standard CD44 isoform is preserved. This results in enrichment within the CD44(high) population of cancer stem-like cells that have undergone an epithelial-to-mesenchymal transition and depletion from the CD44(high) population of cancer stem-like cells that maintain an epithelial phenotype, and therefore greatly effects the characteristics of any cancer stem-like cell population isolated based on expression of CD44. As well as effecting the CD44(high) population, enzymatic treatment also reduces the percentage of the total epithelial cancer cell population staining CD44-positive, with potential implications for studies that aim to use CD44-positive staining as a prognostic indicator. Analyses of the properties of cancer stem-like cells are largely dependent on the ability to accurately identify and assay these populations. It is therefore critical that consideration be given to use of multiple cancer stem-like cell markers and suitable procedures for cell isolation in order that the correct populations are assayed.
Socolovsky, Mariano; Martins, Roberto S; Di Masi, Gilda; Bonilla, Gonzalo; Siqueira, Mario G
2014-12-01
Body mass index (BMI) has recently been identified as a predictor of outcomes following reconstructive surgery of shoulder palsies. In this study, we sought to determine if the same holds true for the reconstruction of elbow flexion. Forty patients who had undergone partial ulnar-to-biceps nerve transfer (Oberlin's procedure) for shoulder palsy were assessed and compared against 18 previously reported patients who had undergone reconstruction for elbow palsies. The British Medical Research Council (BMRC) scale and an index dividing shoulder abduction strength in the affected arm by healthy arm were recorded. All patients had undergone surgery within 12 months of injury and had ≥ 12 months of follow-up. M4 or M3 biceps strength was obtained in 90 % of patients. Final strength on the affected side averaged 5.8 kg, versus 20.2 kg on the normal side, for a mean recovery index score of 0.30. In this sample of 40 patients, BMI did not predict percentage strength or BMRC grade recovery. Neither did age, number of roots involved, the affected side, nor time to surgery. Comparing patients with elbow versus shoulder reconstruction, there were no differences, except that patients undergoing Oberlin's procedure had a statistically longer duration of time between injury and surgical repair (7.4 vs 5.1 months, p < 0.006). Our data suggest that proximal muscle re-innervation is functionally more dependent upon BMI than distal re-innervation, likely because proximal muscles must support the weight of the entire extremity, while more distal muscles do not. BMI should be taken into consideration when planning surgery.
Markham, Larry W; Knecht, Sandra K; Daniels, Stephen R; Mays, Wayne A; Khoury, Philip R; Knilans, Timothy K
2004-11-01
Often, the lack of systemic arterial hypertension and the lack of a resting arm-leg blood pressure gradient are used to assess the adequacy of the anatomic result after intervention for coarctation of the aorta (CoA). Some patients with no arm-leg gradient at rest may develop a gradient with exercise, leading caregivers to question the success of the repair. It is not clear what the prevalence is of patients who have undergone a successful intervention for CoA and have no arm-leg gradient at rest but develop a significant gradient with exercise and which factors may predict the development of an arm-leg gradient with exercise. This study evaluates the prevalence and predictors of an exercise-induced arm-leg gradient in subjects who have undergone an apparently successful intervention for CoA.
Puras-Gil, A M; López-Cousillas, A
1999-01-01
It is obvious that technology has contributed throughout history to the development of the different sciences. In this article, we define the concept of Pathology as a medical speciality, and we explain its influence in a hospital, considering very different fields such as education, research, quality control, hospital information, and patient care. This speciality has undergone a considerable evolution, to which technological innovation has undoubtedly contributed. As a basic discipline, it is of great importance in pre and post-graduate training, in the medical education at the hospital or outside it, and in the fields previously mentioned. Its relation with other disciplines such us Chemistry, (fixation and dyeing), Physics (mechanical devices), Mathematics (algorithms, morphometry, statistics...) and Telecommunications (telepathology, image analysis...) is examined and their contribution to Pathology is evaluated. We are also aware of contributions made by Pathology to technological innovation in the evaluation of different diagnostic methods or in the recent therapeutic technologies based on Radiotherapy, Hyperthermia, laser, prothesis, etc.; where histological examination provides accurate information about the therapeutic capacity or side-effects, or the rejection reactions caused, aiding the research to obtain adequate results.
Recuero-Checa, Maria A; Sharma, Manu; Lau, Constance; Watkins, Paul A; Gaydos, Charlotte A; Dean, Deborah
2016-03-18
The obligate-intracellular pathogen Chlamydia trachomatis (Ct) has undergone considerable genome reduction with consequent dependence on host biosynthetic pathways, metabolites and enzymes. Long-chain acyl-CoA synthetases (ACSLs) are key host-cell enzymes that convert fatty acids (FA) into acyl-CoA for use in metabolic pathways. Here, we show that the complete host ACSL family [ACSL1 and ACSL3-6] translocates into the Ct membrane-bound vacuole, termed inclusion, and remains associated with membranes of metabolically active forms of Ct throughout development. We discovered that three different pharmacologic inhibitors of ACSL activity independently impede Ct growth in a dose-dependent fashion. Using an FA competition assay, host ACSLs were found to activate Ct branched-chain FAs, suggesting that one function of the ACSLs is to activate Ct FAs and host FAs (recruited from the cytoplasm) within the inclusion. Because the ACSL inhibitors can deplete lipid droplets (LD), we used a cell line where LD synthesis was switched off to evaluate whether LD deficiency affects Ct growth. In these cells, we found no effect on growth or on translocation of ACSLs into the inclusion. Our findings support an essential role for ACSL activation of host-cell and bacterial FAs within the inclusion to promote Ct growth and development, independent of LDs.
Lin, Wenzhi; Karczmarski, Leszek; Xia, Jia; Zhang, Xiyang; Yu, Xinjian; Wu, Yuping
2016-10-19
Over the past few thousand years, human development and population expansion in southern China have led to local extirpation and population contraction of many terrestrial animals. At what extent this early human-induced environmental change has also affected coastal marine species remains poorly known. We investigated the demographic history of the Indo-Pacific humpback dolphin (Sousa chinensis) in the Pearl River Delta (PRD); an obligatory inshore species known for its susceptibility to anthropogenic impacts in one of China's most developed coastal regions. Although the deltaic evolution of PRD has been influenced by climate since the Holocene, ~74% reduction of the dolphin's effective population size occurred within the last 2000 years, consistent with ~61% habitat contraction during this period. This considerable and recent population contraction may have been due to land use practices and deforestation in the upper/middle Pearl River region, all leading to increasing sedimentation rate in the estuarine area. As anthropogenic impacts within the drainage of Pearl River affected a vast area, coastal dolphins and large terrestrial mammals in southern China may share a similar demographic history, whilst the demographic and biogeographic history of the PRD humpback dolphins may be symptomatic of similar processes that this species may have undergone elsewhere in the region.
[Counterfeit medicines: a growing threat].
Barbereau, S
2006-12-01
The medical drug market has undergone considerable transformation in recent years. Like other products, medicines have been affected by globalization. Free trade policies have had a number of negative effects including a reduction in quality control not only for some products but also for raw materials and finished products. The global environment has also created conditions conducive to counterfeit medicines. The term counterfeit medicine is defined differently from one country to another in terms of quality, legality and fraudulent intent. This situation prompted the WHO to propose the following definition: "A counterfeit medicine is one which is deliberately and fraudulently mislabeled with respect to identity and/or source. Counterfeiting can apply to both branded and generic products and counterfeit products may include products with the correct ingredients or with the wrong ingredients, without active ingredients, with insufficient active ingredients or with fake packaging." Weak pharmaceutical regulation often compounded by widespread corruption in developing countries has greatly facilitated the development of this illicit market with harmful and costly effects on public health. Due to the lack of pharmocovigilance accidents involving use of counterfeit drugs go unreported. For this reason it is not possible to measure the economic impact. While counterfeiting has become a major threat in developing countries, it also affects industrialized countries. Fraudulent behavior occurs all over the world.
Saudi Continuous Professional Development and Leadership Skills Awareness
ERIC Educational Resources Information Center
Alsughayyer, Arwa
2016-01-01
Higher education in Saudi Arabia has undergone major reforms over the past decade. Investment in leadership development has received particular focus by policymakers. Little is known about leaders and their participations in professional development (PD) programs and effective leadership skills. Therefore, this study examined, using a quantitative…
Hubble Space Telescope: Faint object spectrograph instrument handbook. Version 1.1
NASA Technical Reports Server (NTRS)
Ford, Holland C. (Editor)
1990-01-01
The Faint Object Spectrograph (FOS) has undergone substantial rework since the 1985 FOS Instrument Handbook was published, and we are now more knowledgeable regarding the spacecraft and instrument operations requirements and constraints. The formal system for observation specification has also evolved considerably, as the GTO programs were defined in detail. This supplement to the FOS Instrument Handbook addresses the important aspects of these changes, to facilitate proper selection and specification of FOS observing programs. Since the Handbook was published, the FOS red detector has been replaced twice, first with the best available spare in 1985 (which proved to have a poor, and steadily degrading red response), and later with a newly developed Digicon, which exhibits a high, stable efficiency and a dark-count rate less than half that of its predecessors. Also, the FOS optical train was realigned in 1987-88 to eliminate considerable beam-vignetting losses, and the collimators were both removed and recoated for greater reflectivity. Following the optics and detector rework, the FOS was carefully recalibrated (although only ambient measurements were possible, so the far-UV characteristics could not be re-evaluated directly). The resulting efficiency curves, including improved estimates of the telescope throughput, are shown. A number of changes in the observing-mode specifications and addition of several optional parameters resulted as the Proposal Instructions were honed during the last year. Target-brightness limitations, which have only recently been formulated carefully, are described. Although these restrictions are very conservative, it is imperative that the detector safety be guarded closely, especially during the initial stages of flight operations. Restrictions on the use of the internal calibration lamps and aperture-illumination sources (TA LEDs), also resulting from detector safety considerations, are outlined. Finally, many changes have been made to the instructions for target acquisition specification.
Aluminum: Approaching the new millennium
NASA Astrophysics Data System (ADS)
Øye, H. A.; Mason, N.; Peterson, R. D.; Richards, N. E.; Rooy, E. L.; Stevens McFadden, F. J.; Zabreznik, R. D.; Williams, F. S.; Wagstaff, R. B.
1999-02-01
During the past 100 years, aluminum has developed into a staple of the manufacturing industry. The industry has undergone successive revolutions in consumption, smelter location, and pricing. Now, it faces more change as products mature, new markets struggle to develop, and technology advances further.
Emollient treatment of atopic dermatitis: latest evidence and clinical considerations
Kung, Jeng Sum Charmaine; Ng, Wing Gi Gigi; Leung, Ting Fan
2018-01-01
Aim To review current classes of emollients in the market, their clinical efficacy in atopic dermatitis (AD) and considerations for choice of an emollient. Methods PubMed Clinical Queries under Clinical Study Categories (with Category limited to Therapy and Scope limited to Narrow) and Systematic Reviews were used as the search engine. Keywords of ‘emollient or moisturizer’ and ‘atopic dermatitis’ were used. Overview of findings Using the keywords of ‘emollient’ and ‘atopic dermatitis’, there were 105 and 36 hits under Clinical Study Categories (with Category limited to Therapy and Scope limited to Narrow) and Systematic Reviews, respectively. Plant-derived products, animal products and special ingredients were discussed. Selected proprietary products were tabulated. Conclusions A number of proprietary emollients have undergone trials with clinical data available on PubMed-indexed journals. Most moisturizers showed some beneficial effects, but there was generally no evidence that one moisturizer is superior to another. Choosing an appropriate emollient for AD patients would improve acceptability and adherence for emollient treatment. Physician’s recommendation is the primary consideration for patients when selecting a moisturizer/emollient; therefore, doctors should provide evidence-based information about these emollients. PMID:29692852
NASA Technical Reports Server (NTRS)
Butler, Carolyn; Spencer, Randall
1988-01-01
The improvement of computer hardware and software of the NASA Multipurpose Differential Absorption Lidar (DIAL) system is documented. The NASA DIAL system has undergone development and experimental deployment at NASA/Langley Res. Center for the remote measurement of atmospheric trace gas concentrations from ground and aircraft platforms. A viable DIAL system was developed capable of remotely measuring O3 and H2O concentrations from an aircraft platform. The DIAL Data Acquisition System (DAS) has undergone a number of improvements also. Due to the participation of the DIAL in the Global Tropospheric Experiment, modifications and improvements of the system were tested and used both in the lab and in air. Therefore, this is an operational manual for the DIAL DAS.
Goluch-Koniuszy, Zuzanna
2010-01-01
This research was aimed at evaluation of the method of nutrition in the children aged 13 during the period of pubertal spurt who had their body mass, body weight and this values led to calculation of BMI indicator which was related to centile distribution of children from Warszawa. From the group 1464 children selected 79 persons (5.4% the whole of investigated) with BMI < or = 5 percentile with underweight and considerable underweight. Their menus of three chosen at random weekdays were obtained. Analysis of the nutrition method of children with underweight and considerable underweight showed low energy value of the diet, cellulose, mineral components (K, Ca, Mg) also liquids deficiency at simultaneously occurrent the general and animal protein, the fat, the cholesterol, mineral components (Na, P, Fe, Cu, Zn), vitamins A, C, E (girls) and from the group B. The children have undergone a special pro health education in the form "live" workshop.
The structure and evolution of ancient impact basins on Mars
NASA Technical Reports Server (NTRS)
Schultz, P. H.; Schultz, R. A.; Rogers, J.
1982-01-01
It is pointed out that characteristic styles of degradation and modification of obvious Martian basins make it possible to recognize more subtle expressions. This approach is seen as providing not only additional basins to the existing inventory but also fundamental clues for initial impact basin structure and stratigraphy. It also reveals the long-lasting influence of basin formation on the crust of Mars in spite of extensive erosion and resurfacing. Consideration is given to five clear examples of modified impact basins, and regions around each that have undergone similar processes (fracturing, collapse, channeling) are delineated. These processes among the different basins are then compared, and similar zones of modification are correlated with concentric basin rings. Consideration is then given to the implications of these observations for current models of basin formation and to the role of impact basins in controlling regional tectonics. The results indicate that large multiring impact scars leave a major but sometimes subtle imprint on the geologic structure of stable crustal regions on Mars.
Basic MR relaxation mechanisms and contrast agent design.
De León-Rodríguez, Luis M; Martins, André F; Pinho, Marco C; Rofsky, Neil M; Sherry, A Dean
2015-09-01
The diagnostic capabilities of magnetic resonance imaging (MRI) have undergone continuous and substantial evolution by virtue of hardware and software innovations and the development and implementation of exogenous contrast media. Thirty years since the first MRI contrast agent was approved for clinical use, a reliance on MR contrast media persists, largely to improve image quality with higher contrast resolution and to provide additional functional characterization of normal and abnormal tissues. Further development of MR contrast media is an important component in the quest for continued augmentation of diagnostic capabilities. In this review we detail the many important considerations when pursuing the design and use of MR contrast media. We offer a perspective on the importance of chemical stability, particularly kinetic stability, and how this influences one's thinking about the safety of metal-ligand-based contrast agents. We discuss the mechanisms involved in MR relaxation in the context of probe design strategies. A brief description of currently available contrast agents is accompanied by an in-depth discussion that highlights promising MRI contrast agents in the development of future clinical and research applications. Our intention is to give a diverse audience an improved understanding of the factors involved in developing new types of safe and highly efficient MR contrast agents and, at the same time, provide an appreciation of the insights into physiology and disease that newer types of responsive agents can provide. © 2015 Wiley Periodicals, Inc.
"Basic MR Relaxation Mechanisms & Contrast Agent Design"
De León-Rodríguez, Luis M.; Martins, André F.; Pinho, Marco; Rofsky, Neil; Sherry, A. Dean
2015-01-01
The diagnostic capabilities of magnetic resonance imaging (MRI) have undergone continuous and substantial evolution by virtue of hardware and software innovations and the development and implementation of exogenous contrast media. Thirty years since the first MRI contrast agent was approved for clinical use, a reliance on MR contrast media persists largely to improve image quality with higher contrast resolution and to provide additional functional characterization of normal and abnormal tissues. Further development of MR contrast media is an important component in the quest for continued augmentation of diagnostic capabilities. In this review we will detail the many important considerations when pursuing the design and use of MR contrast media. We will offer a perspective on the importance of chemical stability, particularly kinetic stability, and how this influences one's thinking about the safety of metal-ligand based contrast agents. We will discuss the mechanisms involved in magnetic resonance relaxation in the context of probe design strategies. A brief description of currently available contrast agents will be accompanied by an in-depth discussion that highlights promising MRI contrast agents in development for future clinical and research applications. Our intention is to give a diverse audience an improved understanding of the factors involved in developing new types of safe and highly efficient MR contrast agents and, at the same time, provide an appreciation of the insights into physiology and disease that newer types of responsive agents can provide. PMID:25975847
Isotopic evidence of nitrate sources and denitrification in the Mississippi River, Illinois
Panno, S.V.; Hackley, Keith C.; Kelly, W.R.; Hwang, H.-H.
2006-01-01
Anthropogenic nitrate (NO3-) within the Mississippi-Atchafalaya River basin and discharge to the Gulf of Mexico has been linked to serious environmental problems. The sources of this NO 3- have been estimated by others using mass balance methods; however, there is considerable uncertainty in these estimates. Part of the uncertainty is the degree of denitrification that the NO3- has undergone. The isotopic composition of NO3- in the Mississippi River adjacent to Illinois and tile drain (subsurface drain) discharge in agricultural areas of east-central Illinois was examined using N and O isotopes to help identify the major sources of NO 3- and assess the degree of denitrification in the samples. The isotopic evidence suggests that most of the NO3- in the river is primarily derived from synthetic fertilizers and soil organic N, which is consistent with published estimates of N inputs to the Mississippi River. The 1:2 relationship between ??18O and ??15N also indicate that, depending on sample location and season, NO3- in the river and tile drains lias undergone significant denitrification, ranging from about 0 to 55%. The majority of the denitrification appears to have occurred before discharge into the Mississippi River. ?? ASA, CSSA, SSSA.
Santurtún, Ana; Riancho, José A; Santurtún, Maite; Richard, Carlos; Colorado, M Mercedes; García Unzueta, Mayte; Zarrabeitia, María T
2017-09-01
Biological samples from patients who have undergone allogeneic hematopoietic stem cell transplantation (HSCT) constitute a challenge for individual identification. In this study we analyzed the genetic profiles (by the amplification of 15 autosomic STRs) of HSCT patients found in different types of samples (blood, hair and urine) that may be the source of DNA in civil or criminal forensic cases. Our results show that while in hair follicles the donor component was not detected in any patient, thus being a reliable source of biological material for forensic identification, mixed chimerism was detected in urine samples from all patient, and no correlation was found between the time elapsed from the transplant and the percentage of chimerism. These results certainly have practical implications if the urine is being considered as a source of DNA for identification purposes in HSTC patients. Moreover, taking into consideration that chimerism was found not only in patients with leukocyturia (given the hematopoietic origin of leukocytes, this was expected), but also in those without observable leukocytes in the sediment, we conclude that an alternative source or sources of donor DNA must be implicated. Copyright © 2017 The Chartered Society of Forensic Sciences. Published by Elsevier B.V. All rights reserved.
Laboratory medicine in France. A jeopardized situation.
Valdiguié, P M; de Graeve, J S; Guerre, J P
1997-11-06
The expenses for health care in France have risen considerably during the present decade, ranking third after USA and Canada in the Western world. In spite of the very low cost of laboratory medicine (2.4% of the total expenditure in 1995), clinical laboratories have undergone a severe squeeze, due to two limiting factors; a decrease in the ordering of laboratory tests from private physicians and a reduction in the total expenses for laboratory services from the Social Security. Consequently, there has been unemployment of technical and secretarial staff and severe restriction in investment for buying new equipment. However, hospital laboratories will manage to assume their challenge in developing robotics, automation, molecular pathology techniques and expert systems. Private laboratories, in spite of their efforts to follow the technological advances in automation, will survive thanks to consolidation of regional networks that operate in a cooperative rather than competitive mode. Therefore, the challenge will be not in the adaptation of clinical laboratories, but in the limitation of overspending at the national level and in modification of the behaviour of irresponsible citizens accustomed to spending freely on health care services.
Anaphylactic reactions presenting with hypertension.
Solmazgul, Emrullah; Kutlu, Ali; Dogru, Salim; Ozalper, Veysel; Cetindagli, Ibrahim; Sezer, Ogun; Salmanoglu, Musa; Kilic, Erol; Karabacak, Ercan; Ozturk, Sami
2016-01-01
Although a few case reports about hypertensive anaphylaxis (HA) are available in the present literature, there is no study about the prevalence of HA. In this study, we review our cases with anaphylaxis presenting with hypertension and ascertain its prevalence. The documents of the patients who had anaphylactic reactions after the procedures performed for the diagnosis and treatment of allergic diseases in GATA Haydarpasa Clinic of Allergy and Immunology between January 2010 and December 2014 were retrospectively reviewed. Within the study period, 324 patients had undergone 4332 procedures in which 62 of them had developed anaphylaxis. During the procedures, the rate of anaphylaxis was found to be 1.43 %. The rate of HA among the anaphylaxis patients was 12.9 % (8 of 62 patients). During treatments, 2 patients received adrenaline injections without any adverse reaction. HA may be seen at a considerable rate during an anaphylactic reaction. Anaphylaxis and hypertension can be recovered by adrenaline injection when required. According to the best of our knowledge, this study is the first original study about the prevalence of HA in English-language medical literature.
An assessment of Qatar's coral communities in a regional context.
Burt, John A; Smith, Edward G; Warren, Christopher; Dupont, Jennifer
2016-04-30
Qatar's once extensive coral communities have undergone considerable change in recent decades. We quantitatively surveyed three coral assemblages in Qatar to assess current status, and compared these against 14 sites in Bahrain and the United Arab Emirates to evaluate Qatar in a larger biogeographic context. Umm Al-Arshan had the highest species richness of 17 sites examined in the southern Arabian Gulf, as well as the highest coral cover and the only Acropora observed on sites in Qatar. Coral cover and richness were more modest at Fuwayrit and Al-Ashat, reflecting greater impacts from earlier stress events. Two distinct communities were identified across the southern Gulf, with Umm Al-Arshan clustering with high-cover, mixed merulinid/poritid assemblages that were less impacted by earlier bleaching and long-term stress, while Fuwayrit and Al-Ashat grouped with a lower-cover, stress-tolerant community characteristic of more extreme environments in the southern Gulf. We recommend implementation of a nation-wide baseline assessment of coral communities to guide development of an MPA network and long-term coral monitoring program for Qatar. Copyright © 2015 Elsevier Ltd. All rights reserved.
Adult Learning in Executive Development Programs
ERIC Educational Resources Information Center
Wuestewald, Todd
2016-01-01
Executive development programs (EDPs) have undergone significant change since their introduction in the early 20th century. As an adjunct or alternative to traditional education, EDPs are considered an efficient means of imparting critical, functional, and social-behavior skills to current and future organizational leaders. Consequently, such…
Sustainable Development, Systems Thinking and Professional Practice
ERIC Educational Resources Information Center
Martin, Stephen
2008-01-01
This article explores the impact of the sustainable development (SD) agenda on the occupational and professional needs of those who have undergone educational and training programmes in the environmental field either at the undergraduate or the postgraduate level or through relevant professional institutions' continuing professional development…
Lin, Shih-Yi; Lin, Cheng-Li; Chang, Chao-Hsiang; Wu, His-Chin; Wang, I-Kuan; Chou, Che-Yi; Liang, Ji-An
2017-01-01
Background The outcomes of upper tract urothelial carcinoma (UTUC) receiving radical nephroureterectomy were usually limited to small sample size, case-control studies, and often focused on cancer progression. Risk of acute myocardial infarction (AMI) in these patients was never investigated. Results The overall incidences of AMI were 3.39, 1.44, and 1.70 per 10,000 person-years in the radical nephroureterectomy, nonnephroureterectomy, and non-UTUC cohorts, respectively. Multivariable Cox proportional hazard regression analysis revealed a significantly higher AMI risk in the radical nephroureterectomy cohort [adjusted HR (aHR) = 1.83, 95% confidence interval (CI) = 1.08–3.11], compared with non-UTUC cohorts. The risk of mortality were the highest in patients with UTUC who had undergone radical nephroureterectomy [adjusted HR (aHR) = 5.37, 95% confidence interval (CI) = 4.80–6.02]. Materials and Methods From the Taiwan National Health Insurance claims data, 1,359 patients with UTUC who had undergone radical nephroureterectomy and 3,154 patients with UTUC who had undergone nephron sparing surgery and were newly diagnosed between 2000 and 2010 were identified. For each patient, 4 individuals without UTUC were randomly selected and frequency matched by age, sex, and diagnosis year. Conclusions Patients with UTUC who have undergone radical nephroureterectomy are at a higher risk of developing AMI, compared with those receiving nephron sparing surgery. PMID:29108329
Advances in Games Technology: Software, Models, and Intelligence
ERIC Educational Resources Information Center
Prakash, Edmond; Brindle, Geoff; Jones, Kevin; Zhou, Suiping; Chaudhari, Narendra S.; Wong, Kok-Wai
2009-01-01
Games technology has undergone tremendous development. In this article, the authors report the rapid advancement that has been observed in the way games software is being developed, as well as in the development of games content using game engines. One area that has gained special attention is modeling the game environment such as terrain and…
Structural considerations for fabrication and mounting of the AXAF HRMA optics
NASA Technical Reports Server (NTRS)
Cohen, Lester M.; Cernoch, Larry; Mathews, Gary; Stallcup, Michael
1990-01-01
A methodology is described which minimizes optics distortion in the fabrication, metrology, and launch configuration phases. The significance of finite element modeling and breadboard testing is described with respect to performance analyses of support structures and material effects in NASA's AXAF X-ray optics. The paper outlines the requirements for AXAF performance, optical fabrication, metrology, and glass support fixtures, as well as the specifications for mirror sensitivity and the high-resolution mirror assembly. Analytical modeling of the tools is shown to coincide with grinding and polishing experiments, and is useful for designing large-area polishing and grinding tools. Metrological subcomponents that have undergone initial testing show evidence of meeting force requirements.
Mycobacterium leprae: genes, pseudogenes and genetic diversity
Singh, Pushpendra; Cole, Stewart T
2011-01-01
Leprosy, which has afflicted human populations for millenia, results from infection with Mycobacterium leprae, an unculturable pathogen with an exceptionally long generation time. Considerable insight into the biology and drug resistance of the leprosy bacillus has been obtained from genomics. M. leprae has undergone reductive evolution and pseudogenes now occupy half of its genome. Comparative genomics of four different strains revealed remarkable conservation of the genome (99.995% identity) yet uncovered 215 polymorphic sites, mainly single nucleotide polymorphisms, and a handful of new pseudogenes. Mapping these polymorphisms in a large panel of strains defined 16 single nucleotide polymorphism-subtypes that showed strong geographical associations and helped retrace the evolution of M. leprae. PMID:21162636
Yoon, Hyung-In
2016-10-01
This report is to present the treatment procedure and clinical considerations of prosthodontic management of a patient who had undergone a partial mandibulectomy and fibular free flap surgery. A 59-year-old man with a squamous cell carcinoma received a partial mandibular resection. Microsurgical reconstruction with a fibular free flap surgery and implant-supported zirconia-fixed prosthesis produced by computer-aided manufacturing led to successful results for the oral rehabilitation of mandibular defects. The implant-supported zirconia-fixed prosthesis can be recommended for use in patients with mandibulectomy and fibular free flaps. Close cooperation between the surgeon and the prosthodontist is mandatory for the satisfaction of the patient.
Biddle, Adrian; Gammon, Luke; Fazil, Bilal; Mackenzie, Ian C.
2013-01-01
CD44 is commonly used as a cell surface marker of cancer stem-like cells in epithelial tumours, and we have previously demonstrated the existence of two different CD44high cancer stem-like cell populations in squamous cell carcinoma, one having undergone epithelial-to-mesenchymal transition and the other maintaining an epithelial phenotype. Alternative splicing of CD44 variant exons generates a great many isoforms, and it is not known which isoforms are expressed on the surface of the two different cancer stem-like cell phenotypes. Here, we demonstrate that cancer stem-like cells with an epithelial phenotype predominantly express isoforms containing the variant exons, whereas the cancer stem-like cells that have undergone an epithelial-to-mesenchymal transition down-regulate these variant isoforms and up-regulate expression of the standard CD44 isoform that contains no variant exons. In addition, we find that enzymatic treatments used to dissociate cells from tissue culture or fresh tumour specimens cause destruction of variant CD44 isoforms at the cell surface whereas expression of the standard CD44 isoform is preserved. This results in enrichment within the CD44high population of cancer stem-like cells that have undergone an epithelial-to-mesenchymal transition and depletion from the CD44high population of cancer stem-like cells that maintain an epithelial phenotype, and therefore greatly effects the characteristics of any cancer stem-like cell population isolated based on expression of CD44. As well as effecting the CD44high population, enzymatic treatment also reduces the percentage of the total epithelial cancer cell population staining CD44-positive, with potential implications for studies that aim to use CD44-positive staining as a prognostic indicator. Analyses of the properties of cancer stem-like cells are largely dependent on the ability to accurately identify and assay these populations. It is therefore critical that consideration be given to use of multiple cancer stem-like cell markers and suitable procedures for cell isolation in order that the correct populations are assayed. PMID:23437366
Thinking Skill Education and Transformational Progress in Malaysia
ERIC Educational Resources Information Center
Othman, Nooraini; Mohamad, Khairul Azmi
2014-01-01
This paper intends to highlight the issues in thinking skills development and efforts made in addressing these issues in Malaysia. The education system in Malaysia has undergone a huge transformational progress particularly in the field related to the development of thinking skill. Traditionally, thinking skill was not specifically cultivated in…
Stages of Gender Education in Canadian Secondary Schools
ERIC Educational Resources Information Center
Zhukovskyi, Vasyl; Kostiuk, Olha
2015-01-01
The article deals with the issue of educational preconditions of gender education formation and development in Canadian secondary schools. On the basis of conducted scientific and pedagogical literature analysis it has been determined that gender education has undergone three main stages and is currently developing during its fourth, modern…
Enhancing Young Graduates' Intention towards Entrepreneurship Development in Malaysia
ERIC Educational Resources Information Center
Mohamed, Zainalabidin; Rezai, Golnaz; Shamsudin, Mad Nasir; Mahmud, Muhammad Mu'az
2012-01-01
Purpose: The purpose of this paper is to evaluate the effectiveness of the Basic Student Entrepreneurial Programme (BSEP) among local university graduates who have undergone the training programme in entrepreneurship development. Design/methodology/approach: In total, 410 respondents who had participated in BSEP were interviewed with a structural…
The impact of European harmonisation on Norwegian drug policy.
Norris, P
1998-01-01
Although not a member of the European Union (EU), Norway is part of the European internal market as a result of the European economic area (EEA) agreement. Before 1994, Norway had a distinctive set of arrangements for the licensing and distribution of medicines. Many of these have undergone considerable change as a result of European harmonisation. This paper describes the previous arrangements and the impact of European harmonisation on them. Significant changes have been made to the Norwegian marketing authorisation system because of the loss of the 'need clause' and changes in price control. These are described and an attempt is made to evaluate their impact. The development of parallel importing and the introduction of private wholesaling companies have led to the development of new players in the Norwegian drug market and an increase in competition both within and between levels of the pharmaceutical distribution chain. New co-operatives have also arisen to increase the negotiating power of purchasers, particularly hospitals. Further significant changes are likely to occur in the Norwegian pharmaceutical sector in the future. The Norwegian case study provides an opportunity to look at the impact of European harmonisation on a particular set of regulatory arrangements and sheds light on the difficulty of implementing European policy in a national setting.
Recuero-Checa, Maria A.; Sharma, Manu; Lau, Constance; Watkins, Paul A.; Gaydos, Charlotte A.; Dean, Deborah
2016-01-01
The obligate-intracellular pathogen Chlamydia trachomatis (Ct) has undergone considerable genome reduction with consequent dependence on host biosynthetic pathways, metabolites and enzymes. Long-chain acyl-CoA synthetases (ACSLs) are key host-cell enzymes that convert fatty acids (FA) into acyl-CoA for use in metabolic pathways. Here, we show that the complete host ACSL family [ACSL1 and ACSL3–6] translocates into the Ct membrane-bound vacuole, termed inclusion, and remains associated with membranes of metabolically active forms of Ct throughout development. We discovered that three different pharmacologic inhibitors of ACSL activity independently impede Ct growth in a dose-dependent fashion. Using an FA competition assay, host ACSLs were found to activate Ct branched-chain FAs, suggesting that one function of the ACSLs is to activate Ct FAs and host FAs (recruited from the cytoplasm) within the inclusion. Because the ACSL inhibitors can deplete lipid droplets (LD), we used a cell line where LD synthesis was switched off to evaluate whether LD deficiency affects Ct growth. In these cells, we found no effect on growth or on translocation of ACSLs into the inclusion. Our findings support an essential role for ACSL activation of host-cell and bacterial FAs within the inclusion to promote Ct growth and development, independent of LDs. PMID:26988341
Early Childhood Education and Care in China: History, Current Trends and Challenges
ERIC Educational Resources Information Center
Qi, Xiaofei; Melhuish, Edward C.
2017-01-01
This paper reviews the development of early childhood education and care (ECEC) in China. The historical context from 1900 is summarised, and then developments from the 1980s up to the present kindergarten expansion movement, starting in 2010, are covered in detail. The review shows that ECEC development in China has undergone great changes both…
Continuity and Change in the Development of Moral Education in Botswana
ERIC Educational Resources Information Center
Matemba, Yonah H.
2010-01-01
This article traces the development of moral education (ME) in Botswana from pre-colonial times to the present day. It shows how during this time ME has undergone three distinct phases of development, each emphasising a particular ideology. In pre-colonial times ME was offered as part of indigenous education in the home and community, both…
The Relationship Between Female Genital Cutting and Obstetric Fistulas
Browning, Andrew; Allsworth, Jenifer E.; Wall, L. Lewis
2013-01-01
Objective To evaluate any association between female genital cutting and vesicovaginal fistula formation during obstructed labor. Methods A comparison was made between 255 fistula patients who had undergone Type I or Type II female genital cutting and 237 patients who had not undergone such cutting. Women were operated on at the Barhirdar Hamlin Fistula Centre in Ethiopia. Data points used in the analysis included age, parity, length of labor, labor outcome (stillbirth or not), type of fistula, site, size and scarring of fistula, outcomes of surgery (fistula closed, persistent incontinence with closed fistula, urinary retention with overflow, site, size, and scarring of any rectovaginal fistula and operation outcomes, as well as specific methods employed during the operation (utilization of a graft or not, application of a pubococcygeal or similar autologous sling, vaginoplasty, catheterization of ureters, and flap reconstruction of vagina). Primary outcomes were site of genitourinary fistula and persistent incontinence despite successful fistula closure. Results The only statistically significant differences between the two groups (p = 0.05) was a slightly greater need to place ureteral catheters at the time of surgery in women who had not undergone a genital cutting operation, and slightly higher use of a pubococcygeal sling at the time of fistula repair and a slightly longer length of labor (by 0.3 of a day) in women who had undergone genital cutting. Conclusion Type I and Type II female genital cutting are not independent causative factors in the development of obstetric fistulas from obstructed labor. PMID:20177289
de Thomasson, E; Guingand, O; Terracher, R; Mazel, C
2001-09-01
We conducted a retrospective study to assess morbidity and mortality in patients undergoing revision total hip arthroplasty (THA) procedures. Perioperative complications were recorded in 181 revision procedures (162 patients) performed between January 1995 and March 1999 (117 bipolar revisions and 64 acetabular isolated revisions). There were 86 complications (68 patients) leading to 21 new revisions. About half (50/86) were related to the surgical procedure (dislocation, femoral fracture, infection.). Life-threatening complications (3.6%) ended in patient death in 1.6% of the cases. Complications were more frequent in patients with an ASA score=3 (p<0.01) or aged over 75 years (p<0.05). Age was also predictive of femoral misalignment and fracture (p<0.05). Dislocations (8.8%) were observed more frequently in patients who had undergone more than 2 procedures prior to the revision (p<0.05) (4.8% of the dislocations in patients undergoing a first revision procedure and 14.3% in the others). In addition, peroperative blood loss and duration of the procedure were significantly greater in case of bipolar replacement than for isolated acetabular replacement (sigma > 1.96). Our experience and data in the literature point to the important age factor in the development of complications. Preservation of a well-fixed femoral component does not appear to worsen prognosis and leads to fewer complications than bipolar changes. The decision to revise a THA must take into consideration the functional impairment but also the risks inherent in revision procedures, particularly in old patients who have undergone several procedures. Revising the acetabular component alone can be an interesting option if the femoral component remains well-fixed although our follow-up is insufficient to determine whether this attitude provides better long-term outcome than complete biopolar revision. Better patient selection and improved operative technique, in particular in femur preparation, should help reduce morbidity and mortality in this type of procedure.
Guidelines: Intellectual Disabilities in Educational Settings
ERIC Educational Resources Information Center
North Dakota Department of Public Instruction, 2013
2013-01-01
The field of special education, and specifically the area of intellectual disabilities, has undergone dramatic changes in terminology, evaluation practices, service delivery models, expectations for learning, career development, and independent living opportunities. "Guidelines: Intellectual Disabilities in Educational Settings" is…
Milgrom, Sarah A; Nieto, Yago; Pinnix, Chelsea C; Smith, Grace L; Wogan, Christine F; Rondon, Gabriela; Medeiros, L Jeffrey; Kebriaei, Partow; Dabaja, Bouthaina S
2016-07-28
Patients who undergo allogeneic stem cell transplantation and subsequent radiation therapy uncommonly develop graft-versus-host disease within the irradiated area. We quantified the incidence of this complication, which is a novel contribution to the field. From 2010 to 2014, 1849 patients underwent allogeneic stem cell transplantation, and 41 (2 %) received radiation therapy afterward. Of these, two patients (5 %) developed graft-versus-host disease within the irradiated tissues during or immediately after radiation therapy. The first patient is a 37-year-old white man who had Hodgkin lymphoma; he underwent allogeneic stem cell transplantation from a matched unrelated donor and received radiation therapy for an abdominal and pelvic nodal recurrence. After 28.8 Gy, he developed grade 4 gastrointestinal graft-versus-host disease, refractory to tacrolimus and steroids, but responsive to pentostatin and photopheresis. The other patient is a 24-year-old white man who had acute leukemia; he underwent allogeneic stem cell transplantation from a matched related donor and received craniospinal irradiation for a central nervous system relapse. After 24 cobalt Gy equivalent, he developed severe cutaneous graft-versus-host disease, sharply delineated within the radiation therapy field, which was responsive to tacrolimus and methylprednisolone. We conclude that graft-versus-host disease within irradiated tissues is an uncommon but potentially serious complication that may follow radiation therapy in patients who have undergone allogeneic stem cell transplantation. Clinicians must be aware of this complication and prepared with strategies to mitigate risk. Patients who have undergone allogeneic stem cell transplantation represent a unique population that may offer novel insight into the pathways involved in radiation-related inflammation.
Complications after type one thyroplasty: is day-case surgery feasible?
Bray, D; Young, J P; Harries, M L
2008-07-01
Isshiki type one medialisation thyroplasty is an accepted treatment for a unilateral immobile vocal fold. It can also be performed simultaneously as a bilateral procedure in patients with severe bowing of the vocal folds (e.g. presbyphonia). The objectives of this study were to assess the incidence and timing of post-operative complications, and to evaluate whether patients undergoing this operation could, in future, be treated as day cases. A retrospective analysis was undertaken of 57 consecutive patients who had undergone a type one thyroplasty (52 unilateral and five bilateral) at a tertiary referral centre between April 2003 and April 2006. Post-operative improvement in the voice (measured subjectively, perceptually and quantitatively) was considered to constitute a successful outcome. Any complications were documented. Fifty-seven patients who had undergone laryngeal framework surgery were recruited from the study database. All of these patients had undergone either unilateral or bilateral type one medialisation thyroplasty but no arytenoid surgery. Thirty-seven were male (65 per cent) and 20 female (35 per cent), and there was left-sided predominance (74 per cent). All patients were discharged the morning following afternoon surgery (i.e. within 24 hours). Complications occurred in four patients (7 per cent). One patient, who was taking warfarin, developed a post-operative haematoma which resolved with conservative treatment. Two patients (both of whom had undergone revision thyroplasty) developed a wound infection three days post-operatively, which resolved with antibiotics. One patient returned with hoarseness five months post-operatively, after an initially successful result. This patient had previously received radiotherapy for early glottic carcinoma, and the Silastic implant was eroding through the mucosa. This was subsequently removed under general anaesthesia. No patients developed complications leading to airway compromise. The only complications in this series were in patients taking anticoagulation medication, undergoing revision surgery, or in whom the laryngeal tissue was atrophic or absent. Careful patient selection to exclude any of the above should reduce the risk of complications. The authors would therefore advocate type one thyroplasty for unilateral or bilateral vocal fold paralysis as a suitable procedure for day-case surgery within our department.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Koshy, Matthew, E-mail: mkoshy@radonc.uchicago.edu; Department of Radiation Oncology, University of Illinois at Chicago, Chicago, IL; Rich, Shayna E.
2012-02-01
Purpose: Concerns regarding long-term toxicities have led some to withhold radiotherapy (RT) for the treatment of Stage I and II Hodgkin's disease (HD). The present study was undertaken to assess the use of RT for HD and its effect on overall survival and the development of secondary malignancies. Methods and Materials: The present study included data from the Surveillance, Epidemiology, and End Results database from patients aged {>=}20 years who had been diagnosed with Stage I or II HD between 1988 and 2006. Overall survival was estimated using the Kaplan-Meier method, and the Cox multivariate regression model was used tomore » analyze trends. Results: A total of 12,247 patients were selected, and 51.5% had received RT. The median follow-up for the present cohort was 4.9 years, with 21% of the cohort having >10 years of follow-up. Between 1988 and 1991, 62.9% had undergone RT, but between 2004 and 2006, only 43.7% had undergone RT (p < .001). The 5-year overall survival rate was 76% for patients who had not received RT and 87% for those who had (p < .001). The hazard ratio adjusted for other variables in the regression model showed that patients who had not undergone RT (hazard ratio, 1.72; 95% confidence interval, 1.72-2.02) was associated with significantly worse survival compared with patients who had received RT. The actuarial rate of developing a second malignancy was 14.6% vs. 15.0% at 15 years for those who had and had not undergone RT, respectively (p = .089). Conclusions: The present study is one of the largest studies to examine the role of RT for Stage I and II HD. Our results revealed a survival benefit with the addition of RT with no increase in the development of secondary malignancies compared with patients who had not received RT. Furthermore, the present nationwide study revealed a >20% absolute decrease in the use of RT from 1988 to 2006.« less
Histological evaluation of the equine larynx after unilateral laser-assisted ventriculocordectomy.
Robinson, P; Williams, K J; Sullins, K E; Arnoczky, S P; Stick, J A; Robinson, N E; de Feijter-Rupp, H; Derksen, F J
2007-05-01
Trans-endoscopic laser surgery, such as unilateral laser-assisted ventriculocordectomy (LVC), has gained popularity in the treatment of RLN because a laryngotomy incision or general anaesthesia are not required. However, removal of the vocal fold and ventricle takes considerable laser energy and could cause collateral tissue damage, including injury to the adjacent laryngeal cartilages. To document the histological effects of laser surgery on laryngeal tissues in horses that have undergone LVC for the treatment of laryngeal hemiplegia (LH). Six horses were used: 4 with experimentally induced LH that had subsequently undergone LVC 6 months prior to euthanasia; and, 2 horses were used as controls. One of the control horses with naturally occurring LH was used to study the effect of neuropathy alone, whereas the other was subjected to euthanasia immediately following LVC to evaluate the acute effect of laser surgery. Using a band saw, each larynx was sectioned transversely at 5 mm intervals and evaluated histologically. Acutely, LVC caused thermal damage to adjacent soft tissues but did not affect the histology of the laryngeal cartilages. Six months after LVC, laryngeal cartilages were histologically normal and there was squamous metaplasia of the repaired laryngeal mucosa, resulting in restitution of the mucosal integrity. Using a diode laser in contact fashion at 20 W, LVC can be used to remove the laryngeal vocal fold and ventricle without causing laryngeal cartilage damage. Laryngeal chondritis is an unlikely consequence of LVC.
United States state-level population estimates: Colonization to 1999
David P. Coulson; Linda Joyce
2003-01-01
The U.S. landscape has undergone substantial changes since Europeans first arrived. Many land use changes are attributable to human activity. Historical data concerning these changes are frequently limited and often difficult to develop. Modeling historical land use changes may be neccessary. We develop annual population series from first European settlement to 1999...
ERIC Educational Resources Information Center
Simonton, Dean Keith
2013-01-01
Although the theory that creativity requires blind variation and selective retention (BVSR) is now more than a half-century old, only recently has BVSR theory undergone appreciable conceptual development, including formal three-parameter definitions of both creativity and sightedness. In this article, these new developments are for the first time…
History and Development of Instructional Technology and Media in Social Work Education
ERIC Educational Resources Information Center
Shorkey, Clayton T.; Uebel, Michael
2014-01-01
Since the mid-20th century, instructional technologies and educational media in social work education have undergone significant development with the goals of improving learning and performance and enhancing access. This growth has been marked by technical advances in hardware and by innovations in media, or so-called soft formats. Current…
Research in Vocational Education and Training
ERIC Educational Resources Information Center
Winch, Christopher
2012-01-01
Research into Vocational Education and Training (VET) has undergone major developments in the last 60 years. This is particularly true of the last 30 years. The rising political, social and economic priority of VET has been principally responsible for this development. However, it is also true to say that some of the disciplines of education have…
ERIC Educational Resources Information Center
Garabedian, Todd E.
2004-01-01
U.S. patent laws have undergone many changes in recent years, both through Congress and the courts. This article summarizes recent developments relating to judicial decisions, legislative initiatives, and patent office policy, and provides some practical advice relating to administration of intellectual property. As illustrated by the latest…
Who Am I Now? Accommodating New Higher Education Diversity in Supplemental Instruction
ERIC Educational Resources Information Center
Couchman, Judith A.
2008-01-01
Supplemental Instruction (SI) has undergone many adaptations over its 35 year history as it has evolved to meet new developments in higher education while still maintaining its "original genetic code" (Martin and Blanc, 1995). During this time there have been some additions to its theoretical base to accommodate these developments.…
Teachers' Evaluation of Professional Development in Support of National Reforms
ERIC Educational Resources Information Center
Gökmenoglu, Tuba; Clark, Christopher M.
2015-01-01
As in many other nations, the Turkish education system has undergone many significant curricular and structural reforms in the last decade. This study was designed to learn from teachers about the quality of professional development programs that were designed to support national reforms. Ten years into a period of intensive national reform,…
Student Aid: Who Benefits Now?
ERIC Educational Resources Information Center
King, Jacqueline E.
1996-01-01
The annual survey by the College Board of student financial aid traces development of a system that has grown dramatically, is now dominated by federal student loan programs, and has undergone a long-term shift in purpose from creating access for the disadvantaged to broadening choice and convenience for the middle class. These developments have…
Extended Plate and Beam Wall System: Concept Investigation and Initial Evaluation
DOE Office of Scientific and Technical Information (OSTI.GOV)
Wiehagen, J.; Kochkin, V.
A new and innovative High-R wall design, referred to as the Extended Plate & Beam (EP&B), is under development. The EP&B system uniquely integrates foam sheathing insulation with wall framing such that wood structural panels are installed exterior of the foam sheathing, enabling the use of standard practices for installation of drainage plane, windows and doors, claddings, cavity insulation, and the standard exterior foam sheathing installation approach prone to damage of the foam during transportation of prefabricated wall panels. As part of the ongoing work, the EP&B wall system concept has undergone structural verification testing and has been positively vettedmore » by a group of industry stakeholders. Having passed these initial milestone markers, the advanced wall system design has been analyzed to assess cost implications relative to other advanced wall systems, undergone design assessment to develop construction details, and has been evaluated to develop representative prescriptive requirements for the building code. This report summarizes the assessment steps conducted to-date and provides details of the concept development.« less
Extended Plate and Beam Wall System: Concept Investigation and Initial Evaluation
DOE Office of Scientific and Technical Information (OSTI.GOV)
Wiehagen, J.; Kochkin, V.
2015-08-01
A new and innovative High-R wall design, referred to as the Extended Plate & Beam (EP&B), is under development. The EP&B system uniquely integrates foam sheathing insulation with wall framing such that wood structural panels are installed exterior of the foam sheathing, enabling the use of standard practices for installation of drainage plane, windows and doors, claddings, cavity insulation, and the standard exterior foam sheathing installation approach prone to damage of the foam during transportation of prefabricated wall panels. As part of the ongoing work, the EP&B wall system concept has undergone structural verification testing and has been positively vettedmore » by a group of industry stakeholders. Having passed these initial milestone markers, the advanced wall system design has been analyzed to assess cost implications relative to other advanced wall systems, undergone design assessment to develop construction details, and has been evaluated to develop representative prescriptive requirements for the building code. This report summarizes the assessment steps conducted to-date and provides details of the concept development.« less
Present Status of Medical Education in Poland
Selzer, Arthur
1965-01-01
In the past few years medical education in Poland has undergone considerable change, particularly at the graduate and postgraduate levels, and has shown increasing Western influences. On the negative side, a physician who was trained in pre-war Poland and is now in the United States, noted mass production of physicians with modest clinical facilities and the preponderance of didactic lecturing over semi-individual instruction—conditions rather characteristic of most European medical schools. On the positive side were well-informed, up-to-date faculties and the thoughtful planning and organization of graduate and postgraduate medical education. The overall impression was a favorable one, but the system of schooling and of evaluation of students' work made it possible for indifferent students to progress to licensure. PMID:14288146
PRESENT STATUS OF MEDICAL EDUCATION IN POLAND.
SELZER, A
1965-04-01
In the past few years medical education in Poland has undergone considerable change, particularly at the graduate and postgraduate levels, and has shown increasing Western influences. On the negative side, a physician who was trained in pre-war Poland and is now in the United States, noted mass production of physicians with modest clinical facilities and the preponderance of didactic lecturing over semi-individual instruction-conditions rather characteristic of most European medical schools. On the positive side were well-informed, up-to-date faculties and the thoughtful planning and organization of graduate and postgraduate medical education. The overall impression was a favorable one, but the system of schooling and of evaluation of students' work made it possible for indifferent students to progress to licensure.
Aeromedical transport: its hidden problems.
Parsons, C. J.; Bobechko, W. P.
1982-01-01
Air transport can move patients safely and rapidly over long distances. However, changes in altitude can have disastrous effects because diminished ambient air pressure may allow gases in closed spaces and tissues to expand rapidly. Even pressurized commercial aircraft do not maintain sea-level pressure: cabin pressures equal to those at yp to 8000 ft may be experienced, diminishing oxygen tension in proportion. Air transport is absolutely contraindicated for patients with untreated pneumothorax, gas gangrene, or air trapped in the cranium and those who have recently undergone abdominal surgery. Special considerations including a planned low-altitude flight are warrented for patients who are anemic, in respiratory or cardiac distress, or immobilized in casts, or who have been engaged in underwater diving immediately before the flight. Images FIG. 1 PMID:7059899
NASA Technical Reports Server (NTRS)
Stuart, J. J.; Brown, S. J.; Beeman, R. W.; Denell, R. E.; Spooner, B. S. (Principal Investigator)
1993-01-01
The Abdominal gene is a member of the single homeotic complex of the beetle, Tribolium castaneum. An integrated developmental genetic and molecular analysis shows that Abdominal is homologous to the abdominal-A gene of the bithorax complex of Drosophila. abdominal-A mutant embryos display strong homeotic transformations of the anterior abdomen (parasegments 7-9) to PS6, whereas developmental commitments in the posterior abdomen depend primarily on Abdominal-B. In beetle embryos lacking Abdominal function, parasegments throughout the abdomen are transformed to PS6. This observation demonstrates the general functional significance of parasegmental expression among insects and shows that the control of determinative decisions in the posterior abdomen by homeotic selector genes has undergone considerable evolutionary modification.
Khoury, Mitri; Sim, Geok Choo; Harao, Michiko; Radvanyi, Laszlo; Amini, Behrang; Benjamin, Robert S; Pisters, Peter W T; Pollock, Raphael E; Tseng, William W
2015-01-01
Liposarcomas are soft tissue sarcomas of adipocyte origin. We describe a case of a dedifferentiated retroperitoneal liposarcoma with an unusual presentation on recurrence as a large, multicystic tumour. The patient was a 72-year-old woman who had undergone multiple treatments including two prior resections. For her most recent locoregional disease recurrence, the patient was offered surgical debulking for symptom palliation. At this operation, performed after two cycles of chemotherapy, the tumour cyst fluid was analysed and found to have a predominance of immune cells with no identifiable malignant cells. This case and the results of our tumour cyst fluid analysis raise several interesting considerations for the management of this unique situation in a rare disease. PMID:26156843
Khoury, Mitri; Sim, Geok Choo; Harao, Michiko; Radvanyi, Laszlo; Amini, Behrang; Benjamin, Robert S; Pisters, Peter W T; Pollock, Raphael E; Tseng, William W
2015-07-08
Liposarcomas are soft tissue sarcomas of adipocyte origin. We describe a case of a dedifferentiated retroperitoneal liposarcoma with an unusual presentation on recurrence as a large, multicystic tumour. The patient was a 72-year-old woman who had undergone multiple treatments including two prior resections. For her most recent locoregional disease recurrence, the patient was offered surgical debulking for symptom palliation. At this operation, performed after two cycles of chemotherapy, the tumour cyst fluid was analysed and found to have a predominance of immune cells with no identifiable malignant cells. This case and the results of our tumour cyst fluid analysis raise several interesting considerations for the management of this unique situation in a rare disease. 2015 BMJ Publishing Group Ltd.
Stuart, J J; Brown, S J; Beeman, R W; Denell, R E
1993-01-01
The Abdominal gene is a member of the single homeotic complex of the beetle, Tribolium castaneum. An integrated developmental genetic and molecular analysis shows that Abdominal is homologous to the abdominal-A gene of the bithorax complex of Drosophila. abdominal-A mutant embryos display strong homeotic transformations of the anterior abdomen (parasegments 7-9) to PS6, whereas developmental commitments in the posterior abdomen depend primarily on Abdominal-B. In beetle embryos lacking Abdominal function, parasegments throughout the abdomen are transformed to PS6. This observation demonstrates the general functional significance of parasegmental expression among insects and shows that the control of determinative decisions in the posterior abdomen by homeotic selector genes has undergone considerable evolutionary modification.
Evaluating Causes of Ecological Impairments in the Estuaries of Ukraine
Ukrainian estuaries have not undergone a systematic evaluation of the causes of ecological impairments caused by anthropogenic contamination. The objective of this evaluation is to use recently developed diagnostic tools to determine the causes of benthic ecological impairments. ...
Master Curriculum Guide in Economics. A Framework for Teaching the Basic Concepts. Second Edition.
ERIC Educational Resources Information Center
Saunders, Phillip; And Others
Intended for curriculum developers, this revised Framework presents a set of basic concepts for teaching K-12 economics. The revision reflects the change and development which the field of economics has undergone and includes improvements suggested by users of the first edition. The purpose of teaching economics is to impart a general…
School-Based Curriculum Development in Career and Technical Education in Taiwan, Republic of China.
ERIC Educational Resources Information Center
Wu, Robert T. Y.
In Taiwan, technological and vocational education (TVE) the equivalent of career and technical education in the United States has undergone several political and social changes and is poised for applying school-based curriculum development (SBCD). Three reasons for adopting SBCD are planning of an integrated curriculum, concept of student-centered…
Hox3/zen and the evolution of extraembryonic epithelia in insects.
Schmidt-Ott, Urs; Rafiqi, Ab Matteen; Lemke, Steffen
2010-01-01
Insects have undergone dramatic evolutionary changes in extraembryonic development, which correlate with changes in the expression of the class-3 Hox gene zen. Here, we review the evolution of this gene in insects and point out how changes in zen expression may have affected extraembryonic development at the morphological and the genetic level.
Cerwenka, Susanne; Nieder, Timo O; Cohen-Kettenis, Peggy; De Cuypere, Griet; Haraldsen, Ira R Hebold; Kreukels, Baudewijntje P C; Richter-Appelt, Hertha
2014-01-01
A transsexual course of development that starts before puberty (early onset) or during or after puberty, respectively (late onset), may lead to diverse challenges in coping with sexual activity. The authors explored the sexual behavior of 380 adult male-to-female and female-to-male individuals diagnosed according to DSM-IV-TR criteria who had not yet undergone gender-confirming interventions. Data originated from the European Network for the Investigation of Gender Incongruence Initiative, conducted in Belgium, Germany, The Netherlands, and Norway. Information on outcome variables was collected using self-administered questionnaires at first clinical presentation. Compared with late-onset male-to-females, early-onset individuals tended to show sexual attraction toward males more frequently (50.5%), involve genitals less frequently in partner-related sexual activity, and consider penile sensations and orgasm as more negative. Early-onset female-to-males predominantly reported sexual attraction toward females (84.0%), whereas those with a late-onset more frequently showed other sexual attractions (41.7%). The study (a) shows that early- and late-onset male-to-females differ considerably with regard to coping strategies involving their body during sexual relations and (b) reveals initial insights into developmental pathways of late-onset female-to-males.
Boron Nitride Nanotubes Synthesized by Pressurized Reactive Milling Process
NASA Technical Reports Server (NTRS)
Hurst, Janet B.
2004-01-01
Nanotubes, because of their very high strength, are attractive as reinforcement materials for ceramic matrix composites (CMCs). Recently there has been considerable interest in developing and applying carbon nanotubes for both electronic and structural applications. Although carbon nanotubes can be used to reinforce composites, they oxidize at high temperatures and, therefore, may not be suitable for ceramic composites. Boron nitride, because it has a higher oxidation resistance than carbon, could be a potential reinforcement material for ceramic composites. Although boron nitride nanotubes (BNnT) are known to be structurally similar to carbon nanotubes, they have not undergone the same extensive scrutiny that carbon nanotubes have experienced in recent years. This has been due to the difficulty in synthesizing this material rather than lack of interest in the material. We expect that BNnTs will maintain the high strength of carbon nanotubes while offering superior performance for the high-temperature and/or corrosive applications of interest to NASA. At the NASA Glenn Research of preparing BN-nTs were investigated and compared. These include the arc jet process, the reactive milling process, and chemical vapor deposition. The most successful was a pressurized reactive milling process that synthesizes BN-nTs of reasonable quantities.
Chemical transfers along slowly eroding catenas developed on granitic cratons in southern Africa
Khomo, Lesego; Bern, Carleton R.; Hartshorn, Anthony S.; Rogers, Kevin H.; Chadwick, Oliver A.
2013-01-01
A catena is a series of distinct but co-evolving soils arrayed along a slope. On low-slope, slowly eroding catenas the redistribution of mass occurs predominantly as plasma, the dissolved and suspended constituents in soil water. We applied mass balance methods to track how redistribution via plasma contributed to physical and geochemical differentiation of nine slowly eroding (~ 5 mm ky− 1) granitic catenas. The catenas were arrayed in a 3 × 3 climate by relief matrix and located in Kruger National Park, South Africa. Most of the catenas contained at least one illuviated soil profile that had undergone more volumetric expansion and less mass loss, and these soils were located in the lower halves of the slopes. By comparison, the majority of slope positions were eluviated. Soils from the wetter climates (550 and 730 mm precipitation yr− 1) generally had undergone greater collapse and lost more mass, while soils in the drier climate (470 mm yr− 1) had undergone expansion and lost less mass. Effects of differences in catena relief were less clear. Within each climate zone, soil horizon mass loss and strain were correlated, as were losses of most major elements, illustrating the predominant influence of primary mineral weathering. Nevertheless, mass loss and volumetric collapse did not become extreme because of the skeleton of resistant primary mineral grains inherited from the granite. Colloidal clay redistribution, as traced by the ratio of Ti to Zr in soil, suggested clay losses via suspension from catena eluvial zones. Thus illuviation of colloidal clays into downslope soils may be crucial to catena development by restricting subsurface flow there. Our analysis provides quantitative support for the conceptual understanding of catenas in cratonic landscapes and provides an endmember reference point in understanding the development of slowly eroding soil landscapes.
Heird, William C
2007-02-01
More than 90% of women in developing countries and 50 to 90% of women in industrialized countries now initiate breast-feeding, a marked improvement from 25 y ago. The duration of breast-feeding has lengthened, but fewer than 35% of infants worldwide are still exclusively breast-fed at 4 mo of age. Considerable progress has also been made in combating infant malnutrition. In 1980, 47% of under-5-y-old children in developing countries were stunted. This percentage declined to 29% in 2005. Major advances in formula use and composition include the introduction of formulas tailored to the perceived needs of low-birth-weight infants and the development of fortifiers to overcome the nutritional deficits of human milk for the preterm infant. More recently, postdischarge formulas were introduced and are now being used widely, often in combination with breast-feeding. Formulas for term infants also have undergone a number of changes in the past 25 y to better reproduce the composition of human milk and/or the response of the breast-fed infant. The use of whey-predominant rather than casein-predominant formulas has increased, as has the use of iron-fortified formulas. Cow's milk is introduced into the infant's diet much later than 25 y ago. Despite the progress that has been made in promoting breast-feeding and in the quality of infant formulas, further improvements in the duration of breast-feeding and in the composition of infant formulas are needed.
UK guidelines on oesophageal dilatation in clinical practice
Sami, Sarmed S; Haboubi, Hasan N; Ang, Yeng; Boger, Philip; Bhandari, Pradeep; de Caestecker, John; Griffiths, Helen; Haidry, Rehan; Patel, Praful; Paterson, Stuart; Ragunath, Krish; Watson, Peter; Siersema, Peter D; Attwood, Stephen E
2018-01-01
These are updated guidelines which supersede the original version published in 2004. This work has been endorsed by the Clinical Services and Standards Committee of the British Society of Gastroenterology (BSG) under the auspices of the oesophageal section of the BSG. The original guidelines have undergone extensive revision by the 16 members of the Guideline Development Group with representation from individuals across all relevant disciplines, including the Heartburn Cancer UK charity, a nursing representative and a patient representative. The methodological rigour and transparency of the guideline development processes were appraised using the revised Appraisal of Guidelines for Research and Evaluation (AGREE II) tool. Dilatation of the oesophagus is a relatively high-risk intervention, and is required by an increasing range of disease states. Moreover, there is scarcity of evidence in the literature to guide clinicians on how to safely perform this procedure. These guidelines deal specifically with the dilatation procedure using balloon or bougie devices as a primary treatment strategy for non-malignant narrowing of the oesophagus. The use of stents is outside the remit of this paper; however, for cases of dilatation failure, alternative techniques—including stents—will be listed. The guideline is divided into the following subheadings: (1) patient preparation; (2) the dilatation procedure; (3) aftercare and (4) disease-specific considerations. A systematic literature search was performed. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool was used to evaluate the quality of evidence and decide on the strength of recommendations made. PMID:29478034
An overview of mineral dust modeling over East Asia
NASA Astrophysics Data System (ADS)
Chen, Siyu; Huang, Jianping; Qian, Yun; Zhao, Chun; Kang, Litai; Yang, Ben; Wang, Yong; Liu, Yuzhi; Yuan, Tiangang; Wang, Tianhe; Ma, Xiaojun; Zhang, Guolong
2017-08-01
East Asian dust (EAD) exerts considerable impacts on the energy balance and climate/climate change of the earth system through its influence on solar and terrestrial radiation, cloud properties, and precipitation efficiency. Providing an accurate description of the life cycle and climate effects of EAD is therefore critical to better understanding of climate change and socioeconomic development in East Asia and even worldwide. Dust modeling has undergone substantial development since the late 1990s, associated with improved understanding of the role of EAD in the earth system. Here, we review the achievements and progress made in recent decades in terms of dust modeling research, including dust emissions, long-range transport, radiative forcing (RF), and climate effects of dust particles over East Asia. Numerous efforts in dust/EAD modeling have been directed towards furnishing more sophisticated physical and chemical processes into the models on higher spatial resolutions. Meanwhile, more systematic observations and more advanced retrieval methods for instruments that address EAD related science issues have made it possible to evaluate model results and quantify the role of EAD in the earth system, and to further reduce the uncertainties in EAD simulations. Though much progress has been made, large discrepancies and knowledge gaps still exist among EAD simulations. The deficiencies and limitations that pertain to the performance of the EAD simulations referred to in the present study are also discussed.
Using fiberglass volumes for VPI of superconductive magnetic systems’ insulation
DOE Office of Scientific and Technical Information (OSTI.GOV)
Andreev, I. S.; Bezrukov, A. A.; Pischugin, A. B.
2014-01-29
The paper describes the method of manufacturing fiberglass molds for vacuum pressure impregnation (VPI) of high-voltage insulation of superconductive magnetic systems (SMS) with epoxidian hot-setting compounds. The basic advantages of using such vacuum volumes are improved quality of insulation impregnation in complex-shaped areas, and considerable cost-saving of preparing VPI of large-sized components due to dispensing with the stage of fabricating a metal impregnating volume. Such fiberglass vacuum molds were used for VPI of high-voltage insulation samples of an ITER reactor’s PF1 poloidal coil. Electric insulation of these samples has successfully undergone a wide range of high-voltage and mechanical tests atmore » room and cryogenic temperatures. Some results of the tests are also given in this paper.« less
William Hughes; Mary Freeman; Elliott Jones; John Jones; Jacob Lafontaine; Jaime Painter; Lynn Torak; Steve Walsh
2016-01-01
In Grant Parish, LA, increases in overstory basal area, canopy cover, and development of understory woody plants reduce over the last 50 years, the Apalachicola-Chattahoochee- Flint (ACF) Basin in Alabama, Florida, and Georgia has undergone extensive development of water resources for municipal and industrial supplies, power generation, and agriculture. Concurrent with...
ERIC Educational Resources Information Center
Hentges, Francoise; Hill, Jonathan; Bishop, Dorothy V. M.; Goodacre, Tim; Moss, Tony; Murray, Lynne
2011-01-01
Background: Our previous investigation showed that infants with cleft lip who had undergone late (three-month) surgical repair (but not those with early, neonatal, repair) had significantly poorer cognitive development at 18 months than a group of unaffected control children. These differences were mediated by the quality of early mother-infant…
Study of Motives of Chinese Business English Development Based on the Theory of Human Capital
ERIC Educational Resources Information Center
Meichang, Ouyang; Wenzhong, Zhu; Dan, Liu
2017-01-01
Business English in China has evolved into a cross-disciplinary program from ESP, with more than 1000 universities having set the program of business English in bachelor, master or doctor degree levels. In general, it has undergone a rapid development and enjoyed a more and more social recognition. This paper tries to uncover the underlying…
ERIC Educational Resources Information Center
Villani, Alberto; Dias, Valeria Silva; Valadares, Juarez Melgaco
2010-01-01
Over the last 50 years a new research area, science education research, has arisen and undergone singular development worldwide. In the specific case of Brazil, research in science education first appeared systematically 40 years ago, as a consequence of an overall renovation in the field of science education. This evolution was also related to…
ERIC Educational Resources Information Center
Hirani, Shela Akbar Ali
2014-01-01
Pakistan is a developing country with the second highest infant and child mortality rates in South Asia. During the past years this region has undergone several humanitarian emergencies that have negatively affected all the aspects of health and development of young children. During these emergencies relief camps are set up by governmental and…
Nevins, Alan J; Cymerman, Jerome J
2015-06-01
An enhanced revision of the revitalization endodontic technique for immature teeth with apical periodontitis has been described. It includes the addition of collagen-hydroxyapatite scaffold to the currently practiced revascularization technique. Four cases treated in series are presented in this report, 1 case involving 2 teeth. Periapical diagnoses of immature teeth included "asymptomatic apical periodontitis," "symptomatic apical periodontitis," and "acute apical abscess." Additionally, 1 fully developed tooth that had undergone root canal treatment that failed had a periapical diagnosis of acute apical abscess. An established revascularization protocol was used for all teeth. In addition to stimulating blood clots, all teeth were filled with collagen-hydroxyapatite scaffolds. Periapical radiolucencies healed in all teeth, and diffuse radiopacity developed within the coronal portions of canal spaces. Root development with root lengthening occurred in the immature nonvital maxillary premolar that had not undergone prior treatment. The technique of adding a collagen-hydroxyapatite scaffold to the existing revitalization protocol has been described in which substantial hard tissue repair has occurred. This may leave teeth more fully developed and less likely to fracture. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
STORM WATER MANAGEMENT MODEL USER'S MANUAL VERSION 5.0
The EPA Storm Water Management Model (SWMM) is a dynamic rainfall-runoff simulation model used for single event or long-term (continuous) simulation of runoff quantity and quality from primarily urban areas. SWMM was first developed in 1971 and has undergone several major upgrade...
Youk, Shin-Young; Lee, Jee-Ho; Heo, Seong-Joo; Roh, Hyun-Ki; Park, Eun-Jin; Shin, Im Hee
2014-01-01
PURPOSE This study aims to investigate the degree of subjective pain and the satisfaction of patients who have undergone an implant treatment using a computer-guided template. MATERIALS AND METHODS A survey was conducted for 135 patients who have undergone implant surgery with and without the use of the computer-guided template during the period of 2012 and 2013 in university hospitals, dental hospitals and dental clinics that practiced implant surgery using the computer-guided template. Likert scale and VAS score were used in the survey questions, and the independent t-test and One-Way ANOVA were performed (α=.05). RESULTS The route that the subjects were introduced to the computer-guided implant surgery using a surgical template was mostly advices by dentists, and the most common reason for which they chose to undergo such surgery was that it was accurate and safe. Most of them gave an answer that they were willing to recommend it to others. The patients who have undergone the computer-guided implant surgery felt less pain during the operation and showed higher satisfaction than those who have undergone conventional implant surgery. Among the patients who have undergone computer-guided implant surgery, those who also had prior experience of surgery without a computer-guided template expressed higher satisfaction with the former (P<.05). CONCLUSION In this study, it could be seen that the patients who have undergone computer-guided implant surgery employing a surgical template felt less pain and had higher satisfaction than those with the conventional one, and the dentist's description could provide the confidence about the safety of surgery. PMID:25352962
The report discusses EPA's On-Road Diesel Emissions Characterization Facility, which has been collecting real-world gaseous emissions data for the past 6 years. It has recently undergone extensive modifications to enhance its particulate matter (PM) measurement capabilities, with...
ERIC Educational Resources Information Center
Kubalíková, Andrea; Kacian, Adrian
2016-01-01
This article analyzes the present status of continuing professional development of teachers (CPD) in Slovakia in the post-communist era. During 25 years of democracy in Slovak society, the system of education has undergone several formal reforms, mainly in the area of legislation. As the analysis demonstrates, CPD in Slovakia still follows the…
Fracture of fusion mass after hardware removal in patients with high sagittal imbalance.
Sedney, Cara L; Daffner, Scott D; Stefanko, Jared J; Abdelfattah, Hesham; Emery, Sanford E; France, John C
2016-04-01
As spinal fusions become more common and more complex, so do the sequelae of these procedures, some of which remain poorly understood. The authors report on a series of patients who underwent removal of hardware after CT-proven solid fusion, confirmed by intraoperative findings. These patients later developed a spontaneous fracture of the fusion mass that was not associated with trauma. A series of such patients has not previously been described in the literature. An unfunded, retrospective review of the surgical logs of 3 fellowship-trained spine surgeons yielded 7 patients who suffered a fracture of a fusion mass after hardware removal. Adult patients from the West Virginia University Department of Orthopaedics who underwent hardware removal in the setting of adjacent-segment disease (ASD), and subsequently experienced fracture of the fusion mass through the uninstrumented segment, were studied. The medical records and radiological studies of these patients were examined for patient demographics and comorbidities, initial indication for surgery, total number of surgeries, timeline of fracture occurrence, risk factors for fracture, as well as sagittal imbalance. All 7 patients underwent hardware removal in conjunction with an extension of fusion for ASD. All had CT-proven solid fusion of their previously fused segments, which was confirmed intraoperatively. All patients had previously undergone multiple operations for a variety of indications, 4 patients were smokers, and 3 patients had osteoporosis. Spontaneous fracture of the fusion mass occurred in all patients and was not due to trauma. These fractures occurred 4 months to 4 years after hardware removal. All patients had significant sagittal imbalance of 13-15 cm. The fracture level was L-5 in 6 of the 7 patients, which was the first uninstrumented level caudal to the newly placed hardware in all 6 of these patients. Six patients underwent surgery due to this fracture. The authors present a case series of 7 patients who underwent surgery for ASD after a remote fusion. These patients later developed a fracture of the fusion mass after hardware removal from their previously successfully fused segment. All patients had a high sagittal imbalance and had previously undergone multiple spinal operations. The development of a spontaneous fracture of the fusion mass may be related to sagittal imbalance. Consideration should be given to reimplanting hardware for these patients, even across good fusions, to prevent spontaneous fracture of these areas if the sagittal imbalance is not corrected.
Pursuing Harmony and Fairness in Education
ERIC Educational Resources Information Center
Dongping, Yang
2006-01-01
In 2005, there was a transition in China, in which public policy toward education underwent a systemwide change. In this article, the author explores the educational development in China and examines reforms concerning educational issues that were of intense concern to society. In recent years, Chinese education at all levels has undergone massive…
ERIC Educational Resources Information Center
Randall, G. Kevin
2012-01-01
In the past 40 years, individuals' close relationships, marriages, and families have undergone dramatic changes. The development and maintenance of strong interpersonal relationships, particularly close romantic relationships, are known to associate strongly and positively with physiological and psychological measures of well-being across the…
Identification of food and beverage spoilage yeasts from DNA sequence analyses
USDA-ARS?s Scientific Manuscript database
Detection, identification, and classification of yeasts has undergone a major transformation in the last decade and a half following application of gene sequence analyses and genome comparisons. Development of a database (barcode) of easily determined DNA sequences from domains 1 and 2 (D1/D2) of th...
Mormon Clients' Experiences of Conversion Therapy: The Need for a New Treatment Approach
ERIC Educational Resources Information Center
Beckstead, A. Lee; Morrow, Susan L.
2004-01-01
Perspectives were gathered of 50 Mormon individuals who had undergone counseling to change their sexual orientation. The data were analyzed using the constant comparative method and participant verification, thereby developing a grounded theory. A model emerged that depicted participants' intrapersonal and interpersonal motivations for seeking…
Teacher Education and "Politics of Humanity"
ERIC Educational Resources Information Center
Waghid, Y.
2011-01-01
Since the demise of apartheid education, the development of policy in relation to teacher education in South Africa has undergone major adjustments. By far the most poignant conceptual and pragmatic change that teacher education has been subjected to points towards the cultivation of teachers who can enact their professions as democratic citizens.…
ERIC Educational Resources Information Center
Russell, Jennifer Lin
2011-01-01
The impermeability of schooling to reform is a frequent conclusion of studies of educational organizations, but historical accounts suggest that kindergartens have undergone significant transformation. Once a transitional year emphasizing child development, kindergarten now marks the beginning of formal academic instruction. Guided by…
Identifying Priorities for Post-Secondary Education in Qatar. Research Brief
ERIC Educational Resources Information Center
Stasz, Cathleen; Eide, Eric R.; Martorell, Francisco; Salem, Hanine; Constant, Louay; Goldman, Charles A.; Moini, Joy S.; Nadareishvili, Vazha
2007-01-01
Although Qatar has improved its post-secondary educational opportunities, the country's efforts have not undergone a broad strategic review. This study analyzed the extent to which the current offerings can meet the country's future needs and identified priorities for developing further educational options. Researchers found that Qataris' current…
Character Education/Formation in Catholic Schools (K-12).
ERIC Educational Resources Information Center
Marine, Robert A.
Noting that character formation within Catholic education has undergone several changes over the last 10 years, this paper examines character education and character formation as they are currently implemented in Catholic elementary and secondary schools. Section 1 of the paper considers the definition of character, and traces the development of…
Recent Developments in Young-Earth Creationist Geology
ERIC Educational Resources Information Center
Heaton, Timothy H.
2009-01-01
Young-earth creationism has undergone a shift in emphasis toward building of historical models that incorporate Biblical and scientific evidence and the acceptance of scientific conclusions that were formerly rejected. The RATE Group admitted that massive amounts of radioactive decay occurred during earth history but proposed a period of…
Reprint 1987: Research Administration in a Time of Change
ERIC Educational Resources Information Center
Brandt, Edward N.
2017-01-01
The field of biomedical research has undergone several changes in recent years. These include increased funding, the rapid development in scientific knowledge which speeds up the obsolescence of equipment, facilities and knowledge and the growing complexity of scientific problems. Research administrators can take steps to address these changes…
Conditions for Linking School Mathematics and Moral Education: A Case Study
ERIC Educational Resources Information Center
Falkenberg, Thomas; Noyes, Andrew
2010-01-01
In recent years the mathematics education research community has undergone a "social turn" towards a greater interest in the values and broader educational purposes of mathematics education, including issues of social justice and citizenship education. Building on these developing interests, this paper presents a conceptual framework…
Internships: Tapping into China's Next Generation of Talent
ERIC Educational Resources Information Center
Rose, Philip
2013-01-01
At the current juncture of China's economic development, the mismatch between the supply of university graduates and contemporary organizations' staffing demands is becoming increasingly evident. Thus, student participation in internships and their use by organizations, as means to recruit and select graduate talent in China has undergone rapid…
Convergent and Divergent Validity of the Learning Transfer System Inventory
ERIC Educational Resources Information Center
Holton, Elwood F., III; Bates, Reid A.; Bookter, Annette I.; Yamkovenko, V. Bogdan
2007-01-01
The Learning Transfer System Inventory (LTSI) was developed to identify a select set of factors with the potential to substantially enhance or inhibit transfer of learning to the work environment. It has undergone a variety of validation studies, including construct, criterion, and crosscultural studies. However, the convergent and divergent…
Situated Legitimacy: Deliberative Arenas and the New Rural Governance
ERIC Educational Resources Information Center
Connelly, Steve; Richardson, Tim; Miles, Tim
2006-01-01
Rural governance in the UK and elsewhere has undergone far-reaching changes, as partnerships and other collaborative approaches have emerged to address the challenges of rural sustainable development. The legitimacy of this "new rural governance" is purportedly grounded in deliberation between stakeholders, but this is problematic--it is…
Newman, Jason; Costantino, Peter; Moche, Jason
2003-11-01
We present 3 cases in which a unilateral pericranial flap was used to repair defects in the medial orbital and upper lateral nasal areas. All three patients had undergone previous excision of malignant tumors from the upper septum and ethmoid areas. Postoperatively, they all received radiation and then developed wound breakdown with fistula formation, particularly in the area of the incisional site. All 3 patients had undergone previous unsuccessful repair of the fistula. Closure of such fistulas requires well-vascularized nonradiated tissue, which can be provided by a unilateral pericranial flap. This flap is flexible, thin, and well suited to the sinonasal area. Use of this flap avoids the need for a paramedian forehead or other musculocutaneous flap. Cosmetic results were excellent, and there have been no flap breakdowns or complications to date.
Misgav-Ladach cesarean section: general consideration.
Fatusić, Zlatan; Hudić, Igor; Musić, Asim
2011-03-01
Among obstetric techniques, cesarean section seemed to represent a well-defined procedure and significant advances in this intervention were considered to be unlikely. However, obstetric surgery has recently undergone many improvements. In 1972, Joel-Cohen presented a new method for transverse incision of the abdomen. This method, with some modifications, was integrated into the Misgav-Ladach cesarean section. The philosophy of this technique is to cause the least possible damage to tissues, to refrain from superfluous steps, and to make the intervention the simplest possible. Advantages of this method are lower incidence of fever and urinary tract infection, reduced use of antibiotics and narcotics, faster re-establishment of normal bowel function, shorter maternal hospital stay and less postoperative adhesion formation. The Misgav-Ladach method of cesarean section is suitable for emergency and elective procedures, justifying its use in daily routine.
GENERAL VIEW, LOOKING SOUTHEAST FROM THE INTERSECTION OF CECIL B. ...
GENERAL VIEW, LOOKING SOUTHEAST FROM THE INTERSECTION OF CECIL B. MOORE (FORMERLY COLUMBIA) AVENUE AND FIFTEENTH STREET. THE PHILADELPHIA REAL ESTATE RECORD AND BUILDERS GUIDE OBSERVED IN ITS JANUARY 3, 1887 ISSUE THAT COLUMBIA AVENUE IN THE PAST TWO YEARS HAS SHOWN CONSIDERABLE IMPROVEMENT, FURTHER ADDING, WITHIN THE PAST 12 MONTHS COLUMBIA AVENUE BETWEEN BROAD & 23RD HAS UNDERGONE SOME VERY GREAT CHANGES, AT LEAST 50 OF THE PRIVATE DWELLINGS HAVE BEEN TURNED INTO STORES. THE THREE-STORY COMMERCIAL BLOCK ON THE SOUTHEAST CORNER OF COLUMBIA AND FIFTEENTH WAS NOT A CONVERSION; HOWEVER, IT STILL CONTRIBUTED TO COLUMBIA AVENUES 1880S TRANSFORMATION FROM RESIDENTIAL THOROUGHFARE INTO NORTH PHILADELPHIAS PREMIER SHOPPING CORRIDOR. - 1400 Block Cecil B. Moore Avenue (Stores), South side of Cecil B. Moore Avenue between Carlisle & Fifteenth Streets, Philadelphia, Philadelphia County, PA
Spatially explicit modeling of particulate nutrient flux in Large global rivers
NASA Astrophysics Data System (ADS)
Cohen, S.; Kettner, A.; Mayorga, E.; Harrison, J. A.
2017-12-01
Water, sediment, nutrient and carbon fluxes along river networks have undergone considerable alterations in response to anthropogenic and climatic changes, with significant consequences to infrastructure, agriculture, water security, ecology and geomorphology worldwide. However, in a global setting, these changes in fluvial fluxes and their spatial and temporal characteristics are poorly constrained, due to the limited availability of continuous and long-term observations. We present results from a new global-scale particulate modeling framework (WBMsedNEWS) that combines the Global NEWS watershed nutrient export model with the spatially distributed WBMsed water and sediment model. We compare the model predictions against multiple observational datasets. The results indicate that the model is able to accurately predict particulate nutrient (Nitrogen, Phosphorus and Organic Carbon) fluxes on an annual time scale. Analysis of intra-basin nutrient dynamics and fluxes to global oceans is presented.
Large-scale fluctuations in the diffusive decomposition of solid solutions
NASA Astrophysics Data System (ADS)
Karpov, V. G.; Grimsditch, M.
1995-04-01
The concept of an instability in the classic Ostwald ripening theory with respect to compositional fluctuations is suggested. We show that small statistical fluctuations in the precipitate phase lead to gigantic Coulomb-like fluctuations in the solute concentration which in turn affect the ripening. As a result large-scale fluctuations in both the precipitate and solute concentrations appear. These fluctuations are characterized by amplitudes of the order of the average values of the corresponding quantities and by a space scale L~(na)-1/2 which is considerably greater than both the average nuclear radius and internuclear distance. The Lifshitz-Slyozov theory of ripening is shown to remain locally applicable, over length scales much less than L. The implications of these findings for elastic light scattering in solid solutions that have undergone Ostwald ripening are considered.
Bañuelos Andrío, Luis; Rodríguez Caravaca, Gil; Argüelles Pintos, Miguel; Mitjavilla Casanova, Mercedes
2014-01-01
To analyze the rate of axillary recurrences (AR) in patients with early breast cancer who had not undergone an axillary node dissection (ALND) because of a negative sentinel lymph node biopsy (SLNB). The study includes 173 patients operated on for breast cancer and selective node biopsy. In 32 patients the SLNB was positive and undergone subsequent ALND. We followed up 141 patients with negative SLNB without LDN, with a median follow up of 55 months (range 74-36). The detection rate of SLN was of 99.42%. After a median follow-up of 4.5 years, there were no axillary recurrences. Two patients developed local recurrence, other two patients developed distant metastases and four patients developed a metachronous tumor. Four patients died, none of them because of breast cancer. The results obtained support the SLNB as an accurate technique in the axillary stratification of patients with breast cancer, offering in the cases of negative SLNB a safe axillary control after 4.5 year follow-up. Copyright © 2013 Elsevier España, S.L.U. and SEMNIM. All rights reserved.
Genome-wide detection and characterization of positive selection in human populations.
Sabeti, Pardis C; Varilly, Patrick; Fry, Ben; Lohmueller, Jason; Hostetter, Elizabeth; Cotsapas, Chris; Xie, Xiaohui; Byrne, Elizabeth H; McCarroll, Steven A; Gaudet, Rachelle; Schaffner, Stephen F; Lander, Eric S; Frazer, Kelly A; Ballinger, Dennis G; Cox, David R; Hinds, David A; Stuve, Laura L; Gibbs, Richard A; Belmont, John W; Boudreau, Andrew; Hardenbol, Paul; Leal, Suzanne M; Pasternak, Shiran; Wheeler, David A; Willis, Thomas D; Yu, Fuli; Yang, Huanming; Zeng, Changqing; Gao, Yang; Hu, Haoran; Hu, Weitao; Li, Chaohua; Lin, Wei; Liu, Siqi; Pan, Hao; Tang, Xiaoli; Wang, Jian; Wang, Wei; Yu, Jun; Zhang, Bo; Zhang, Qingrun; Zhao, Hongbin; Zhao, Hui; Zhou, Jun; Gabriel, Stacey B; Barry, Rachel; Blumenstiel, Brendan; Camargo, Amy; Defelice, Matthew; Faggart, Maura; Goyette, Mary; Gupta, Supriya; Moore, Jamie; Nguyen, Huy; Onofrio, Robert C; Parkin, Melissa; Roy, Jessica; Stahl, Erich; Winchester, Ellen; Ziaugra, Liuda; Altshuler, David; Shen, Yan; Yao, Zhijian; Huang, Wei; Chu, Xun; He, Yungang; Jin, Li; Liu, Yangfan; Shen, Yayun; Sun, Weiwei; Wang, Haifeng; Wang, Yi; Wang, Ying; Xiong, Xiaoyan; Xu, Liang; Waye, Mary M Y; Tsui, Stephen K W; Xue, Hong; Wong, J Tze-Fei; Galver, Luana M; Fan, Jian-Bing; Gunderson, Kevin; Murray, Sarah S; Oliphant, Arnold R; Chee, Mark S; Montpetit, Alexandre; Chagnon, Fanny; Ferretti, Vincent; Leboeuf, Martin; Olivier, Jean-François; Phillips, Michael S; Roumy, Stéphanie; Sallée, Clémentine; Verner, Andrei; Hudson, Thomas J; Kwok, Pui-Yan; Cai, Dongmei; Koboldt, Daniel C; Miller, Raymond D; Pawlikowska, Ludmila; Taillon-Miller, Patricia; Xiao, Ming; Tsui, Lap-Chee; Mak, William; Song, You Qiang; Tam, Paul K H; Nakamura, Yusuke; Kawaguchi, Takahisa; Kitamoto, Takuya; Morizono, Takashi; Nagashima, Atsushi; Ohnishi, Yozo; Sekine, Akihiro; Tanaka, Toshihiro; Tsunoda, Tatsuhiko; Deloukas, Panos; Bird, Christine P; Delgado, Marcos; Dermitzakis, Emmanouil T; Gwilliam, Rhian; Hunt, Sarah; Morrison, Jonathan; Powell, Don; Stranger, Barbara E; Whittaker, Pamela; Bentley, David R; Daly, Mark J; de Bakker, Paul I W; Barrett, Jeff; Chretien, Yves R; Maller, Julian; McCarroll, Steve; Patterson, Nick; Pe'er, Itsik; Price, Alkes; Purcell, Shaun; Richter, Daniel J; Sabeti, Pardis; Saxena, Richa; Schaffner, Stephen F; Sham, Pak C; Varilly, Patrick; Altshuler, David; Stein, Lincoln D; Krishnan, Lalitha; Smith, Albert Vernon; Tello-Ruiz, Marcela K; Thorisson, Gudmundur A; Chakravarti, Aravinda; Chen, Peter E; Cutler, David J; Kashuk, Carl S; Lin, Shin; Abecasis, Gonçalo R; Guan, Weihua; Li, Yun; Munro, Heather M; Qin, Zhaohui Steve; Thomas, Daryl J; McVean, Gilean; Auton, Adam; Bottolo, Leonardo; Cardin, Niall; Eyheramendy, Susana; Freeman, Colin; Marchini, Jonathan; Myers, Simon; Spencer, Chris; Stephens, Matthew; Donnelly, Peter; Cardon, Lon R; Clarke, Geraldine; Evans, David M; Morris, Andrew P; Weir, Bruce S; Tsunoda, Tatsuhiko; Johnson, Todd A; Mullikin, James C; Sherry, Stephen T; Feolo, Michael; Skol, Andrew; Zhang, Houcan; Zeng, Changqing; Zhao, Hui; Matsuda, Ichiro; Fukushima, Yoshimitsu; Macer, Darryl R; Suda, Eiko; Rotimi, Charles N; Adebamowo, Clement A; Ajayi, Ike; Aniagwu, Toyin; Marshall, Patricia A; Nkwodimmah, Chibuzor; Royal, Charmaine D M; Leppert, Mark F; Dixon, Missy; Peiffer, Andy; Qiu, Renzong; Kent, Alastair; Kato, Kazuto; Niikawa, Norio; Adewole, Isaac F; Knoppers, Bartha M; Foster, Morris W; Clayton, Ellen Wright; Watkin, Jessica; Gibbs, Richard A; Belmont, John W; Muzny, Donna; Nazareth, Lynne; Sodergren, Erica; Weinstock, George M; Wheeler, David A; Yakub, Imtaz; Gabriel, Stacey B; Onofrio, Robert C; Richter, Daniel J; Ziaugra, Liuda; Birren, Bruce W; Daly, Mark J; Altshuler, David; Wilson, Richard K; Fulton, Lucinda L; Rogers, Jane; Burton, John; Carter, Nigel P; Clee, Christopher M; Griffiths, Mark; Jones, Matthew C; McLay, Kirsten; Plumb, Robert W; Ross, Mark T; Sims, Sarah K; Willey, David L; Chen, Zhu; Han, Hua; Kang, Le; Godbout, Martin; Wallenburg, John C; L'Archevêque, Paul; Bellemare, Guy; Saeki, Koji; Wang, Hongguang; An, Daochang; Fu, Hongbo; Li, Qing; Wang, Zhen; Wang, Renwu; Holden, Arthur L; Brooks, Lisa D; McEwen, Jean E; Guyer, Mark S; Wang, Vivian Ota; Peterson, Jane L; Shi, Michael; Spiegel, Jack; Sung, Lawrence M; Zacharia, Lynn F; Collins, Francis S; Kennedy, Karen; Jamieson, Ruth; Stewart, John
2007-10-18
With the advent of dense maps of human genetic variation, it is now possible to detect positive natural selection across the human genome. Here we report an analysis of over 3 million polymorphisms from the International HapMap Project Phase 2 (HapMap2). We used 'long-range haplotype' methods, which were developed to identify alleles segregating in a population that have undergone recent selection, and we also developed new methods that are based on cross-population comparisons to discover alleles that have swept to near-fixation within a population. The analysis reveals more than 300 strong candidate regions. Focusing on the strongest 22 regions, we develop a heuristic for scrutinizing these regions to identify candidate targets of selection. In a complementary analysis, we identify 26 non-synonymous, coding, single nucleotide polymorphisms showing regional evidence of positive selection. Examination of these candidates highlights three cases in which two genes in a common biological process have apparently undergone positive selection in the same population:LARGE and DMD, both related to infection by the Lassa virus, in West Africa;SLC24A5 and SLC45A2, both involved in skin pigmentation, in Europe; and EDAR and EDA2R, both involved in development of hair follicles, in Asia.
Predictors of perioperative blood loss in total joint arthroplasty.
Park, Jai Hyung; Rasouli, Mohammad R; Mortazavi, S M Javad; Tokarski, Anthony T; Maltenfort, Mitchell G; Parvizi, Javad
2013-10-02
UPDATE The print version of this article has errors that have been corrected in the online version of this article. In the Materials and Methods section, the sentence that reads as "During the study period, our institution offered preoperative autologous blood donation to all patients who were scheduling for total joint arthroplasty with a hemoglobin level of no less than 11 mg/dL or a hematocrit level of at least 33%." in the print version now reads as "During the study period, our institution offered preoperative autologous blood donation to all patients who were scheduling for total joint arthroplasty with a hemoglobin level of no less than 11 g/dL or a hematocrit level of at least 33%." in the online version. In Table III, the footnote that reads as "The values are given as the estimate and the standard error in milligrams per deciliter." in the print version now reads as "The values are given as the estimate and the standard error in grams per deciliter." in the online version. Despite advances in surgical and anesthetic techniques, lower-extremity total joint arthroplasty is associated with considerable perioperative blood loss. As predictors of perioperative blood loss and allogenic blood transfusion have not yet been well defined, the purpose of this study was to identify clinical predictors for perioperative blood loss and allogenic blood transfusion in patients undergoing total joint arthroplasty. From 2000 to 2008, all patients undergoing unilateral primary total hip or knee arthroplasty who met the inclusion criteria were enrolled in the study. Perioperative blood loss was calculated with use of a previously validated formula. The predictors of perioperative blood loss and allogenic blood transfusion were identified in a multivariate analysis. Eleven thousand three hundred and seventy-three patients who underwent total joint arthroplasty, including 4769 patients who underwent total knee arthroplasty and 6604 patients who underwent total hip arthroplasty, were evaluated. Multivariate analysis indicated that an increase in blood loss was associated with being male (263.59 mL in male patients who had undergone total hip arthroplasty and 233.60 mL in male patients who had undergone total knee arthroplasty), a Charlson Comorbidity Index of >3 (293.99 mL in patients who had undergone total hip arthroplasty and 167.96 mL in patients who had undergone total knee arthroplasty), and preoperative autologous blood donation (593.51 mL in patients who had undergone total hip arthroplasty and 592.30 mL in patients who had undergone total knee arthroplasty). In patients who underwent total hip arthroplasty, regional anesthesia compared with general anesthesia reduced the amount of blood loss. The risk of allogenic blood transfusion increased with the amount of blood loss in the patients who underwent total hip arthroplasty (odds ratio, 1.43 [95% confidence interval, 1.40 to 1.46]) and the patients who underwent total knee arthroplasty (odds ratio, 1.47 [95% confidence interval, 1.42 to 1.51]), but the risk of blood transfusion increased with the Charlson Comorbidity Index only in patients who underwent total knee arthroplasty (odds ratio, 3.2 [95% confidence interval, 1.99 to 5.15]). The risk of allogenic blood transfusion decreased with preoperative autologous blood donation in patients who underwent total hip arthroplasty (odds ratio, 0.01 [95% confidence interval, 0.01 to 0.02]) and patients who underwent total knee arthroplasty (odds ratio, 0.02 [95% confidence interval, 0.01 to 0.03]). This study identified some clinical predictors for blood loss in patients undergoing total joint arthroplasty that we believe can be used for implementing more effective blood conservation strategies. Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Signorello, L B; Kennedy, J A; Richmond, R A; Sieu, K L; Blot, W J; Harrison, D C
2001-03-01
The risk of fracture of Björk-Shiley convexo-concave (BSCC) prosthetic heart valves has resulted in consideration of prophylactic explantation and replacement for patients with high-risk valves. Little information exists on perceived quality of life, health status, and serious morbidity among BSCC patients, including those who have undergone explantation. Self-administered questionnaires were completed by a cohort of 585 BSCC patients who participated in an X-ray imaging study to detect precursors to valve fracture up to seven years (average 3.9 years) previously. Responses from 31 explant patients were contrasted with those from 554 BSCC patients in whom explant surgery was not attempted. Perceived quality of life and health status and risk of hospitalization after participating in the imaging study varied considerably among patients, but on average tended not to differ significantly between those with and without explants. A slightly greater proportion of explantees tended to report both improved health status and high rates of heart attack and pacemaker implantation. The health status of these patients was, in general, considerably worse than previously reported among valve implant patients. Over half the cohort were hospitalized during follow up, and half were unable to walk up more than one flight of stairs without shortness of breath. The less than optimal health status of most BSCC patients and relatively high rates of morbidity should be taken into account when considering potential explantation of the valves.
UKPMC: a full text article resource for the life sciences.
McEntyre, Johanna R; Ananiadou, Sophia; Andrews, Stephen; Black, William J; Boulderstone, Richard; Buttery, Paula; Chaplin, David; Chevuru, Sandeepreddy; Cobley, Norman; Coleman, Lee-Ann; Davey, Paul; Gupta, Bharti; Haji-Gholam, Lesley; Hawkins, Craig; Horne, Alan; Hubbard, Simon J; Kim, Jee-Hyub; Lewin, Ian; Lyte, Vic; MacIntyre, Ross; Mansoor, Sami; Mason, Linda; McNaught, John; Newbold, Elizabeth; Nobata, Chikashi; Ong, Ernest; Pillai, Sharmila; Rebholz-Schuhmann, Dietrich; Rosie, Heather; Rowbotham, Rob; Rupp, C J; Stoehr, Peter; Vaughan, Philip
2011-01-01
UK PubMed Central (UKPMC) is a full-text article database that extends the functionality of the original PubMed Central (PMC) repository. The UKPMC project was launched as the first 'mirror' site to PMC, which in analogy to the International Nucleotide Sequence Database Collaboration, aims to provide international preservation of the open and free-access biomedical literature. UKPMC (http://ukpmc.ac.uk) has undergone considerable development since its inception in 2007 and now includes both a UKPMC and PubMed search, as well as access to other records such as Agricola, Patents and recent biomedical theses. UKPMC also differs from PubMed/PMC in that the full text and abstract information can be searched in an integrated manner from one input box. Furthermore, UKPMC contains 'Cited By' information as an alternative way to navigate the literature and has incorporated text-mining approaches to semantically enrich content and integrate it with related database resources. Finally, UKPMC also offers added-value services (UKPMC+) that enable grantees to deposit manuscripts, link papers to grants, publish online portfolios and view citation information on their papers. Here we describe UKPMC and clarify the relationship between PMC and UKPMC, providing historical context and future directions, 10 years on from when PMC was first launched.
NASA Astrophysics Data System (ADS)
Ma, Chaoyang; Cao, Yongge; Shen, Xiaofei; Wen, Zicheng; Ma, Ran; Long, Jiaqi; Yuan, Xuanyi
2017-07-01
Nowadays, major commercial w-LEDs fabricated by the traditionally gold-wire-welding packaging technology have undergone considerable development as indoor/outdoor lighting sources due to its high-energy utilization efficiency, long service life, environmental friendliness, and excellent chromatic stability. While, new generation applications in projections, automotive lighting, street lighting, plaza lighting, and high-end general lighting need further improvements in power handling and light extraction. Herein, transparent Ce:YAG glass-ceramics (GCs) phosphor was prepared by low-temperature co-sintering polycrystalline Ce:YAG phosphor powder and home-made PbO-B2O3-ZnO-SiO2 glass powder. Thereafter, the flip-chip (FC) w-LEDs were fabricated with the GCs phosphor plates and FC blue chips. The GCs-based FC w-LEDs show not only excellent heat- and humidity-resistance characteristics, but also superior optical performances with an LE of 112.8 lm/W, a CRI of 71.2, a CCT of 6103 K as well as a chromaticity coordinate of (0.3202, 0.3298), under a high operation current of 400 mA. The technology route will open a practically commercial feasible approach to achieve excellent performances for advanced high-power FC w-LEDs.
Patlewicz, Grace; Casati, Silvia; Basketter, David A; Asturiol, David; Roberts, David W; Lepoittevin, Jean-Pierre; Worth, Andrew P; Aschberger, Karin
2016-12-01
Predictive testing to characterize substances for their skin sensitization potential has historically been based on animal tests such as the Local Lymph Node Assay (LLNA). In recent years, regulations in the cosmetics and chemicals sectors have provided strong impetus to develop non-animal alternatives. Three test methods have undergone OECD validation: the direct peptide reactivity assay (DPRA), the KeratinoSens™ and the human Cell Line Activation Test (h-CLAT). Whilst these methods perform relatively well in predicting LLNA results, a concern raised is their ability to predict chemicals that need activation to be sensitizing (pre- or pro-haptens). This current study reviewed an EURL ECVAM dataset of 127 substances for which information was available in the LLNA and three non-animal test methods. Twenty eight of the sensitizers needed to be activated, with the majority being pre-haptens. These were correctly identified by 1 or more of the test methods. Six substances were categorized exclusively as pro-haptens, but were correctly identified by at least one of the cell-based assays. The analysis here showed that skin metabolism was not likely to be a major consideration for assessing sensitization potential and that sensitizers requiring activation could be identified correctly using one or more of the current non-animal methods. Published by Elsevier Inc.
Biomaterials and Advanced Technologies for Hemostatic Management of Bleeding.
Hickman, DaShawn A; Pawlowski, Christa L; Sekhon, Ujjal D S; Marks, Joyann; Gupta, Anirban Sen
2018-01-01
Bleeding complications arising from trauma, surgery, and as congenital, disease-associated, or drug-induced blood disorders can cause significant morbidities and mortalities in civilian and military populations. Therefore, stoppage of bleeding (hemostasis) is of paramount clinical significance in prophylactic, surgical, and emergency scenarios. For externally accessible injuries, a variety of natural and synthetic biomaterials have undergone robust research, leading to hemostatic technologies including glues, bandages, tamponades, tourniquets, dressings, and procoagulant powders. In contrast, treatment of internal noncompressible hemorrhage still heavily depends on transfusion of whole blood or blood's hemostatic components (platelets, fibrinogen, and coagulation factors). Transfusion of platelets poses significant challenges of limited availability, high cost, contamination risks, short shelf-life, low portability, performance variability, and immunological side effects, while use of fibrinogen or coagulation factors provides only partial mechanisms for hemostasis. With such considerations, significant interdisciplinary research endeavors have been focused on developing materials and technologies that can be manufactured conveniently, sterilized to minimize contamination and enhance shelf-life, and administered intravenously to mimic, leverage, and amplify physiological hemostatic mechanisms. Here, a comprehensive review regarding the various topical, intracavitary, and intravenous hemostatic technologies in terms of materials, mechanisms, and state-of-art is provided, and challenges and opportunities to help advancement of the field are discussed. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
UKPMC: a full text article resource for the life sciences
McEntyre, Johanna R.; Ananiadou, Sophia; Andrews, Stephen; Black, William J.; Boulderstone, Richard; Buttery, Paula; Chaplin, David; Chevuru, Sandeepreddy; Cobley, Norman; Coleman, Lee-Ann; Davey, Paul; Gupta, Bharti; Haji-Gholam, Lesley; Hawkins, Craig; Horne, Alan; Hubbard, Simon J.; Kim, Jee-Hyub; Lewin, Ian; Lyte, Vic; MacIntyre, Ross; Mansoor, Sami; Mason, Linda; McNaught, John; Newbold, Elizabeth; Nobata, Chikashi; Ong, Ernest; Pillai, Sharmila; Rebholz-Schuhmann, Dietrich; Rosie, Heather; Rowbotham, Rob; Rupp, C. J.; Stoehr, Peter; Vaughan, Philip
2011-01-01
UK PubMed Central (UKPMC) is a full-text article database that extends the functionality of the original PubMed Central (PMC) repository. The UKPMC project was launched as the first ‘mirror’ site to PMC, which in analogy to the International Nucleotide Sequence Database Collaboration, aims to provide international preservation of the open and free-access biomedical literature. UKPMC (http://ukpmc.ac.uk) has undergone considerable development since its inception in 2007 and now includes both a UKPMC and PubMed search, as well as access to other records such as Agricola, Patents and recent biomedical theses. UKPMC also differs from PubMed/PMC in that the full text and abstract information can be searched in an integrated manner from one input box. Furthermore, UKPMC contains ‘Cited By’ information as an alternative way to navigate the literature and has incorporated text-mining approaches to semantically enrich content and integrate it with related database resources. Finally, UKPMC also offers added-value services (UKPMC+) that enable grantees to deposit manuscripts, link papers to grants, publish online portfolios and view citation information on their papers. Here we describe UKPMC and clarify the relationship between PMC and UKPMC, providing historical context and future directions, 10 years on from when PMC was first launched. PMID:21062818
Introducing Gross Pathology to Undergraduate Medical Students in the Dissecting Room
ERIC Educational Resources Information Center
Wood, Andrew; Struthers, Kate; Whiten, Susan; Jackson, David; Herrington, C. Simon
2010-01-01
Pathology and anatomy are both sciences that contribute to the foundations of a successful medical career. In the past decade, medical education has undergone profound changes with the development of a core curriculum combined with student selected components. There has been a shift from discipline-based teaching towards problem-based learning.…
ERIC Educational Resources Information Center
Dong, Ting
2009-01-01
The assessment and structure of personality traits and small group learning during classroom discussions are both research fields that have undergone fast development in the past few decades. However, very few studies have investigated the relationship between individual personality characteristics and performance in discussions, especially with…
TOC/DOC: "It Has Changed the Way I Do Science".
ERIC Educational Resources Information Center
Douglas, Kimberly; Roth, Dana L.
1997-01-01
Describes a user-based automated service developed at the California Institute of Technology that combines access to journal article databases with an in-house document delivery system. TOC/DOC (Tables of Contents/Document Delivery) has undergone a conceptual change from a catalog of locally-held journal articles to a broader, more retrospective…
ERIC Educational Resources Information Center
Kranitz, Gina; Hart, Kenneth R.
As an institution having undergone many changes over the past 13 years in the Maricopa Community College District, Paradise Valley Community College (PVCC) in Arizona has developed and implemented its strategic planning process, institutional effectiveness and student outcomes assessment model, and resource allocation (budget) process over the…
Research Timeline: Form-Focused Instruction and Second Language Acquisition
ERIC Educational Resources Information Center
Nassaji, Hossein
2016-01-01
This article provides a timeline of research on form-focused instruction (FFI). Over the past 40 years, research on the role of instruction has undergone many changes. Much of the early research concentrated on determining whether formal instruction makes any difference in the development of learner language. This question was motivated in part by…
Leadership for Effective Teacher Training Transfer in Kuwaiti Secondary Schools
ERIC Educational Resources Information Center
Winokur, Ilene K.; Sperandio, Jill
2017-01-01
This article reports on the findings of a study undertaken to examine the links between leadership practices of a transformational nature and the transfer of teacher training in the public high schools in Kuwait. The participants in the study were teachers who had undergone mandated professional development (PD) aimed at improving teaching…
Interactions between dietary n-3 fatty acids and genetic variants and risk of disease
USDA-ARS?s Scientific Manuscript database
Nutritional genomics has undergone rapid development and the concept is now very popular with the general public. Therefore, there is increasing demand for knowledge on adapting dietary composition to the genome. Our aim has been to undertake a systematic review so as to find out the level of eviden...
Vocationally Oriented Language Learning Revisited
ERIC Educational Resources Information Center
Vogt, Karin; Kantelinen, Ritva
2013-01-01
Vocationally oriented language learning (VOLL) is often seen as a part of English for Specific Purposes/Language for Specific Purposes (ESP/LSP), which it is not in every case. The diverging characteristics and lines of development that these two branches of ELT have undergone are outlined and contrasted. Then, a discussion of the added value of a…
Implications for VocED of Changing Work Arrangements.
ERIC Educational Resources Information Center
Hawke, Geof
The definition of work has undergone a massive transition within the last decade, and this trend has major implications for vocational education. Earlier ideas of work included that it was full-time, permanent, and for life; in addition, work provided opportunities for career development, a clearly-defined employer-worker relationship, and clear…
English for Business Communication
ERIC Educational Resources Information Center
Bhatia, Vijay K.; Bremner, Stephen
2012-01-01
The concept of Business English has undergone some major shifts in the last few years because of a number of developments, such as advances in genre theory and the coming together of English for Business Purposes and Business Communication, inspired by the realization that there is a gap to be bridged between the academy and the globalized…
The Magellan Project: Developing Global Citizens through Independent Study Abroad
ERIC Educational Resources Information Center
Haring-Smith, Tori
2011-01-01
In January 2005, when this author became president of Washington & Jefferson College (W&J), one of her first initiatives was to expand the international program. A private, residential liberal arts college about 25 miles outside of Pittsburgh, W&J had undergone a period of significant growth, with enrollment increasing from 1,000 to…
Synchromeshing (Teacher) Education and the Economy in Australia: Panacean or Problematic.
ERIC Educational Resources Information Center
Burke, Clarrie
The position adopted in this paper is developed in the context of literature relating to the politics and policies which are transforming Australian school and teacher education. The public education system in Australia has undergone rapid change and restructuring with the goal of national reconstruction and international competitiveness through…
The 2014 Bowman Lecture—Bowman's and Bruch's: a tale of two membranes during the laser revolution
Marshall, J
2015-01-01
To describe the historical evolution of the role of lasers in effecting therapeutic changes in the four acellular membranes of the eye. Over the past 50 years, iterative developments have been instituted in lasers used for various forms of eye surgery predominately on the basis of data generated in early experiments in the 1960s to determine thresholds for damage and their incorporation in codes of practice for laser safety. The evolutionary steps are described. Excimer laser technology resulted in the generation of the new field of laser refractive surgery with over 40 million individuals now having undergone procedures such as photorefractive keratectomy and LASIK. Developments in lasers used for various forms of retinal surgery have undergone changes involving shorter and shorter pulse durations together with changes in beam energy distribution with implications for potential intervention in AMD prophylactically. Lasers have made a major impact on surgical treatment on all four acellular membranes of the eye but particularly Bowman's membrane in refractive surgery, where it has been demonstrated that it can be removed without significant consequences for eye health or vision. PMID:25567376
Developments in hydrogenation technology for fine-chemical and pharmaceutical applications.
Machado, R M; Heier, K R; Broekhuis, R R
2001-11-01
The continuous innovation in hydrogenation technology is testimony to its growing importance in the manufacture of specialty and fine chemicals. New developments in equipment, process intensification and catalysis represent major themes that have undergone recent advances. Developments in chiral catalysis, methods to support and fix homogeneous catalysts, novel reactor and mixing technology, high-throughput screening, supercritical processing, spectroscopic and electrochemical online process monitoring, monolithic and structured catalysts, and sonochemical activation methods illustrate the scope and breadth of evolving technology applied to hydrogenation.
A perspective perception on the applications of light-emitting diodes.
Nair, Govind B; Dhoble, S J
2015-12-01
Light-emitting diodes (LEDs) continue to penetrate the global market; their pervasiveness clearly being felt in such diverse fields as technological, socio-economic and commercial interests. The multi-billion dollar LED market is shared by various segments, including office and household lighting, street lighting, the automobile industry, traffic signals, backlighting for hand-held devices, indoor and outdoor signs and indicators, medicine, communication systems, crop cultivation using artificial light and many more. The technological development of LEDs has undergone many phases in different parts of the world. From the early discovery of luminescence to the invention of highly efficient organic LEDs, researchers have worked with the prime purpose of improving the performance of luminaires. The need to infuse the market with more efficient and cheaper products has been prevalent from the start. LEDs are a result of this uncontrolled desire of researchers to develop superior products that would displace existing products in the market. To understand what led to the current prominence of LEDs, we give a brief historical overview of the field followed by a thorough discussion of the positive features of LEDs. This work includes the basic requirements, advantages and disadvantages of LEDs in a variety of applications. A brief description of the diverse applications of LED in fields such as lighting, indicators and displays, farming, medicine and communication is given. Considerable importance is placed on discussing the possible difficulties that must be overcome before using LEDs in commercial applications. Copyright © 2015 John Wiley & Sons, Ltd.
Living on a knife edge-the daily struggle of coping with symptomatic cardiac arrhythmias.
Withers, Kathleen L; Wood, Kathryn A; Carolan-Rees, Grace; Patrick, Hannah; Lencioni, Mauro; Griffith, Michael
2015-06-24
In 2010 a retrospective audit was undertaken to assess the viability of using PROMs in patients with symptomatic cardiac arrhythmias having undergone percutaneous arrhythmia ablation. A response rate of 74 % was achieved, with finding suggesting that arrhythmia patients reported a significant impact on their work, social and family life. To conduct a qualitative cross sectional survey to understand patients' perspectives of how cardiac arrhythmias affect their daily lives, as part of a program to develop a Patient Reported Outcome Measure (PROM). Twenty five patients aged 18 or over, diagnosed with a variety of symptomatic cardiac arrhythmias referred for a cardiac ablation procedure took part in cognitive interviews. These aimed to inform the development of a patient reported outcome measure and to determine factors important to this patient group. Common themes were identified using content analysis. Participants reported that symptoms of their arrhythmia caused them considerable problems and impacted adversely on their quality of life in many ways. This extended through daily routine, work and social activities and also to friends and family, with fear and anxiety being significant factors for most responders. Patients felt their illness was poorly understood, even by health professionals, and often reported that they felt isolated, lacking support and information. Symptomatic cardiac arrhythmias are a source of debilitating and life limiting symptoms, having a negative impact on quality of life. Symptoms and related complications are relevant across different arrhythmia substrates and patient groups. The study is registered on the Clinical Trials website, Identifier NCT01672528.
Get Active Orlando: changing the built environment to increase physical activity.
McCreedy, Malisa; Leslie, Jill G
2009-12-01
Active Living by Design's Get Active Orlando partnership (GAO) focused on downtown Orlando's Community Redevelopment Area, including the Parramore Heritage District, home to many low-income and ethnically diverse residents, including many seniors. The area had undergone substantial development, and GAO aimed to incorporate active living considerations into the city's changing landscape. Get Active Orlando conducted a baseline survey of all streets, sidewalks, and bicycle lanes in the project area and identified a sequence of plans and policies in which to incorporate changes identified in the assessment. To create more immediate opportunities for active living, the partnership initiated a senior walking program, a bicycle refurbishment and giveaway program, and community bicycle-riding events, and led a social-marketing campaign that emphasized simple lifestyle changes. Get Active Orlando influenced adoption of public policies supporting active living in Orlando, including the Downtown Transportation Plan, Streetscape Guidelines, Design Standards Review Checklist, and growth management policies. Establishment of the Mayor's Advisory Council on Active Living is testament to the heightened significance of active living in Orlando. Initial assessment data served as a strong platform for policy change. Creating connections across disciplines including land-use planning, transportation, public health, and economic development allowed GAO to secure substantial policy change to influence design of the built environment. Engaging community members, including youth, as leaders was an important factor in program success. The physical environment in Orlando's Community Redevelopment Area is beginning to change as a reflection of a new policy framework designed to support active living.
Generic tacrolimus in solid organ transplantation.
Taube, D; Jones, G; O'Beirne, J; Wennberg, L; Connor, A; Rasmussen, A; Backman, L
2014-05-01
The availability of a wide range of immunosuppressive therapies has revolutionized the management of patients who have undergone solid organ transplantation (SOT). However, the cost of immunosuppressive drugs remains high. This situation has led to the development of generic equivalents, which are similar in quality, safety, and efficacy to their approved innovator drugs. There are data available for three generic brands, tacrolimus (Intas), tacrolimus (PharOS), and tacrolimus (Sandoz). Bioequivalence has been demonstrated for generic tacrolimus (Sandoz) within a narrow therapeutic range to its innovator tacrolimus drug (Prograf) in both healthy volunteers and kidney transplant patients. Clinical experience with this generic tacrolimus formulation has also been established in both de novo and conversion patients who have undergone kidney and liver transplantation, as well as in conversion of other SOT patients, including lung and heart recipients. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Ha, Seo-In; Kim, Kyunghee; Kim, Ji-Su
2016-10-01
After oesophagectomy, anatomical changes and loss of function induce various symptoms that may affect quality of life (QoL) in oesophageal cancer patients. The purpose of this study was to identify the factors influencing QoL in Korean patients who have undergone oesophageal cancer surgery. This was a cross-sectional study of a convenience sample consisting of 120 surgery patients with oesophageal cancer. We used the EORTC QLQ-C30 and EORTC QLQ-OES18 to measure participants' oesophageal cancer-related symptoms and QoL. Multiple regression analyses were applied to analyse to the relationship between cancer-related symptoms and QoL. The average score of oesophageal cancer-related symptoms was 19.28 points, and the most common symptom was reflux. The mean score for global health status/QoL was 60.55. There were significant differences in the functional and symptom subscales according to financial burden, operation type (procedure), and treatment period. Dysphagia most affected global health status/QoL, and eating problems most affected the functional and symptom subscales. Dysphagia and eating problems were confirmed to be the most common symptoms affecting the QoL of patients who had undergone oesophageal cancer surgery. These results can be used to aid in the development of strategies to better manage symptoms in these patients. Copyright © 2016 Elsevier Ltd. All rights reserved.
Parasites of freshwater fishes in North America: why so neglected?
Scholz, Tomáš; Choudhury, Anindo
2014-02-01
Fish parasitology has a long tradition in North America and numerous parasitologists have contributed considerably to the current knowledge of the diversity and biology of protistan and metazoan parasites of freshwater fishes. The Journal of Parasitology has been essential in disseminating this knowledge and remains a significant contributor to our understanding of fish parasites in North America as well as more broadly at the international level. However, with a few exceptions, the importance of fish parasites has decreased during the last decades, which is reflected in the considerable decline of funding and corresponding decrease of attention paid to these parasites in Canada and the United States of America. After the 'golden age' in the second half of the 20th Century, fish parasitology in Canada and the United States went in a new direction, driven by technology and a shift in priorities. In contrast, fish parasitology in Mexico has undergone rapid development since the early 1990s, partly due to extensive international collaboration and governmental funding. A critical review of the current data on the parasites of freshwater fishes in North America has revealed considerable gaps in the knowledge of their species composition, host specificity, life cycles, evolution, phylogeography, and relationships with their fish hosts. As to the key question, "Why so neglected?" this is probably because: (1) fish parasites are not in the forefront due to their lesser economic importance; (2) there is little funding for this kind of research, especially if a practical application is not immediately apparent; and (3) of shifting interests and a shortage of key personalities to train a new generation (they switched to marine habitats or other fields). Some of the opportunities for future research are outlined, such as climate change and cryptic species diversity. A significant problem challenging future research seems to be the loss of trained and experienced fish parasitologists. This has 2 major ramifications: the loss of expertise in identifying organisms that other biologists (e.g., ecologists, molecular biologists, evolutionists) work with, and an incomplete comprehension of ecosystem structure and function in the face of climate change, emerging diseases, and loss of biodiversity.
The Importance of Developmental Science for Aging Research
ERIC Educational Resources Information Center
Wurm, Susanne; Ziegelmann, Jochen P.; Tesch-Römer, Clemens
2012-01-01
In this essay we argue that our societal and individual beliefs about aging can have an influence on the aging process. We give a brief illustration how life-span developmental theories have undergone a process of development themselves in the last years. Hereby it is essential that old age is conceptualized as a result of a lifelong aging process…
Just-in-Time Teaching, Just-in-Need Learning: Designing towards Optimized Pedagogical Outcomes
ERIC Educational Resources Information Center
Killi, Steinar; Morrison, Andrew
2015-01-01
Teaching methods are constantly being changed, new ones are developed and old methods have undergone a renaissance. Two main approaches to teaching prevail: a) lecture-based and project-based and b) an argumentative approach to known knowledge or learning by exploration. Today, there is a balance between these two approaches, and they are more…
USDA-ARS?s Scientific Manuscript database
Detection, identification, and classification of yeasts have undergone a major transformation in the last decade and a half following application of gene sequence analyses and genome comparisons. Development of a database (barcode) of easily determined DNA sequences from domains 1 and 2 (D1/D2) of t...
The Devolution of 20th Century Presidential Campaign Rhetoric: A Call for "Rhetorical Service."
ERIC Educational Resources Information Center
Heinemann, Robert L.
Over the course of the 20th century, American Presidential campaign rhetoric has undergone various metamorphoses. Most of these changes can be traced to developments in technology and media. Furthermore, many of these changes have had the unfortunate effect of undermining a rational choice of the electorate, and thus threaten our democracy. Like…
Curriculum Change and Development of Chinese Social Science Education since 1980s.
ERIC Educational Resources Information Center
Zhao, Yali
China's opening to the world and economic reform in the late 1970s led to tremendous progress in Chinese education. Social science education, has traditionally assumed the most important task of cultivating responsible citizens. It has undergone remarkable changes in quantity and quality as a result of the change of the social and economic…
Evolution and Revolution in Artificial Intelligence in Education
ERIC Educational Resources Information Center
Roll, Ido; Wylie, Ruth
2016-01-01
The field of Artificial Intelligence in Education (AIED) has undergone significant developments over the last twenty-five years. As we reflect on our past and shape our future, we ask two main questions: What are our major strengths? And, what new opportunities lay on the horizon? We analyse 47 papers from three years in the history of the…
ERIC Educational Resources Information Center
Muller, Uta
Librarianship has undergone a radical change in recent years, which will be continued in the future. Whereas previously the administration of media was most important, nowadays an ever increasing willingness to provide a service is required. In addition to the essential restructuring of libraries, a generational change is taking place within the…
Qualifications and the Professional Preparation and Development of Art Museum Educators
ERIC Educational Resources Information Center
Ebitz, David
2005-01-01
Art museums in the United States have undergone profound changes since the 1980s. Have the qualifications and professional preparation of art museum educators changed as well? This article focuses on these qualifications from five points of view: a) the changing context of art museums in transition from object-centered to visitor-centered…
Characteristics of the Teaching of Citizenship and Patriotism to Upper-Grade Students
ERIC Educational Resources Information Center
Pronina, E. I.
2012-01-01
Adolescents develop a sense of citizenship through the influence of the institutions of their socialization--the family, the school, the mass media, and so on. In the past few years, these institutions, along with all of Russian society, have undergone a transition to a new phase by "shock therapy," which brought about crisis phenomena…
School Improvements in Abu Dhabi, United Arab Emirates: Asking the "Expert Witnesses"
ERIC Educational Resources Information Center
Dickson, Martina
2013-01-01
Government schools in Abu Dhabi, as part of wide-scale educational reforms undertaken in the whole of the United Arab Emirates, have undergone massive school improvement developments over the past seven years. Over the course of these years, the reality of student life for those in government schools has been widely altered. This research explores…
Syntactic Development in Children with Hemispherectomy: The I-, D-, And C-Systems
ERIC Educational Resources Information Center
Curtiss, S.; Schaeffer, J.
2005-01-01
This study reports on functional morpheme (I, D, and C) production in the spontaneous speech of five pairs of children who have undergone hemispherectomy, matching each pair for etiology and age at symptom onset, surgery, and testing. Our results show that following left hemispherectomy (LH), children evidence a greater error rate in the use of…
ERIC Educational Resources Information Center
Joseph, Dawn; van Niekerk, Caroline
2007-01-01
Music Education, as well as cultural and musical identities are all being renegotiated, post-Apartheid, within the so-called "newer" rather than the commonly known "new" South Africa. The developing situation with certain minority groups is particularly interesting. Education in general has undergone much change since the first…
Picture Books and the Digital World: Educators Making Informed Choices
ERIC Educational Resources Information Center
Yokota, Junko; Teale, William H.
2014-01-01
The book publishing industry in general and picture book materials for children in particular have undergone rapid and profound changes in recent years with the developments in the digital realm. As a result, teachers, school librarians, and literacy researchers have been largely left to their own devices to figure out basic questions related to…
Rural Education and Urbanization: Experiences and Struggles in China since the Late 1970s
ERIC Educational Resources Information Center
Xu, Shuqin; Law, Wing-Wah
2015-01-01
China has adopted an unbalanced policy for economic development to improve its domestic economy and international competitiveness for more than three decades. During this process, rural education has undergone a series of reforms. With reference to compulsory education, this article argues that rural education in China is a pragmatic instrument…
ERIC Educational Resources Information Center
Robbins, Lynn A.
Navajo participation in labor unions and Navajo labor relations have undergone rapid and fundamental changes since the development of industry around Lake Powell and on Black Mesa. Early attempts to unionize Navajo workers met with stiff resistance from employees and the Navajo Tribal Council. Union entry into the Navajo Reservation was viewed as…
Postdoctorals vs. Non-Postdoctorals: Career Performance Differentials Within Academic Medicine.
ERIC Educational Resources Information Center
Fribush, Stuart L.; Larson, Thomas A.
The research methodology developed in this paper was intended to shed some light on the question of career performance differentials within academic medicine between persons who have undergone postdoctoral training and those who have not. Compared were two groups of medical school faculty members (including M. D.'s and Ph.D.'s). One group included…
Between the "Local" and the "Global": South African Geography after Apartheid
ERIC Educational Resources Information Center
Mather, Charles
2007-01-01
South Africa's higher education system has undergone significant change since the end of apartheid. A central theme in the debates on higher education transformation has been the tension between the global imperatives of development and the need for universities to respond to the legacy of apartheid. This paper explores this tension by considering…
The Korean National Curriculum for Physical Education: A Shift from Edge to Central Subject
ERIC Educational Resources Information Center
Lee, Ki-Cheon; Cho, Soon-Mook
2014-01-01
Background: Within the last half century, the Korean national curriculum has undergone seven periods of reform, each at intervals of just 6-8 years. The most recent "seventh curriculum" was developed in 1997, and implemented in schools from 2001. Continual curriculum change has been driven by national and social needs, keeping in line…
DOE Office of Scientific and Technical Information (OSTI.GOV)
Schoenfeld, Jonathan D., E-mail: jdschoenfeld@partners.org; Sher, David J.; Norris, Charles M.
Purpose: To analyze the recent single-institution experience of patients with salivary gland tumors who had undergone adjuvant intensity-modulated radiotherapy (IMRT), with or without concurrent chemotherapy. Patients and Methods: We performed a retrospective analysis of 35 salivary gland carcinoma patients treated primarily at the Dana-Farber Cancer Institute between 2005 and 2010 with surgery and adjuvant IMRT. The primary endpoints were local control, progression-free survival, and overall survival. The secondary endpoints were acute and chronic toxicity. The median follow-up was 2.3 years (interquartile range, 1.2-2.8) among the surviving patients. Results: The histologic types included adenoid cystic carcinoma in 15 (43%), mucoepidermoid carcinomamore » in 6 (17%), adenocarcinoma in 3 (9%), acinic cell carcinoma in 3 (9%), and other in 8 (23%). The primary sites were the parotid gland in 17 (49%), submandibular glands in 6 (17%), tongue in 4 (11%), palate in 4 (11%), and other in 4 (11%). The median radiation dose was 66 Gy, and 22 patients (63%) received CRT. The most common chemotherapy regimen was carboplatin and paclitaxel (n = 14, 64%). A trend was seen for patients undergoing CRT to have more adverse prognostic factors, including Stage T3-T4 disease (CRT, n = 12, 55% vs. n = 4, 31%, p = .29), nodal positivity (CRT, n = 8, 36% vs. n = 1, 8%, p = .10), and positive margins (n = 13, 59% vs. n = 5, 38%, p = .30). One patient who had undergone CRT developed an in-field recurrence, resulting in an overall actuarial 3-year local control rate of 92%. Five patients (14%) developed distant metastases (1 who had undergone IMRT only and 4 who had undergone CRT). Acute Grade 3 mucositis, esophagitis, and dermatitis occurred in 8%, 8%, and 8% (1 each) of IMRT patients and in 18%, 5%, and 14% (4, 1, and 3 patients) of the CRT group, respectively. No acute Grade 4 toxicity occurred. The most common late toxicity was Grade 1 xerostomia (n = 8, 23%). Conclusions: Treatment of salivary gland malignancies with postoperative IMRT was well tolerated with a high rate of local control. Chemoradiotherapy resulted in excellent local control in a subgroup of patients with adverse prognostic factors and might be warranted in select patients.« less
Subjective stress factors in centrifuge training for military aircrews.
Lin, Pei-Chun; Wang, Jenhung; Li, Shih-Chin
2012-07-01
This study investigates stress-influence factors perceived by military aircrews undergoing centrifuge training, which lowers the incidence of G-induced loss of consciousness (G-LOC) for the crews of high-performance combat aircrafts. We used questionnaires to assess the subjective stress-influence factors of crews undergoing centrifuge training. Professionals in aviation physiology identified attributes measuring the perceived stress induced by centrifuge training, which were segmented into three constructs by factor analysis, theory lecture, centrifuge equipment, and physical fitness. Considerable interpenetration was discernible between these factors and military rank, age, length of service, flight hours accrued, and type of aircraft piloted. Identifying and quantifying the perceived stressors experienced in human-use centrifuge training enables aviators, astronauts, and air forces of the world to determine which constructs perceptibly increase or alleviate the perceived stress undergone by trainees when partaking in centrifuge training. Copyright © 2011 Elsevier Ltd and The Ergonomics Society. All rights reserved.
Enzmann, Peter-Joachim; Castric, Jeannette; Bovo, Giuseppe; Thiery, Richard; Fichtner, Dieter; Schütze, Heike; Wahli, Thomas
2010-02-24
The fish pathogenic rhabdovirus infectious hematopoietic necrosis virus (IHNV) causes substantial losses in European aquaculture. IHNV was first detected in Europe in 1987 and has since undergone considerable spread. Phylogenetic analyses of the full G-gene sequences of 73 isolates obtained from 4 countries in Europe (France, n = 18; Italy, 9; Switzerland, 4; Germany, 42) enable determination of the evolution of the virus in Europe since the first detection, and identification of characteristic changes within the G-genes of European strains. Further, the database allows us to analyse the pathways of distribution in Europe over time. The results suggest that in most of the recent cases, spread of IHNV was related to trade of infected fish. The data further demonstrate that knowledge of the sequence is required to determine the source of infections in farms.
Onodera, Ken; Noda, Masafumi; Okada, Yoshinori; Kondo, Takashi
2013-01-01
A 31-year old female patient in the ninth week of pregnancy complained of chest pain and dyspnoea. The patient had experienced an episode of spontaneous pneumothorax on the left side at the age of 20 and had undergone chest tube drainage. Her medical history was unremarkable and she had no history of smoking. She had no family history of pulmonary disease. Thoracic radiography showed a pneumothorax on the right side. The patient underwent chest tube drainage in the thoracic space. When surgical intervention for continuous air leakage was unavoidable, we selected video-assisted thoracic surgery under local and epidural anaesthesia in consideration of her general condition. We conclude that awake surgical intervention is applicable in selected patients with pneumothorax in pregnancy and is particularly useful in those in whom general anaesthesia is best avoided. PMID:23670703
A tactual pilot aid for the approach-and-landing task: Inflight studies
NASA Technical Reports Server (NTRS)
Gilson, R. D.; Fenton, R. E.
1973-01-01
A pilot aid -- a kinesthetic-tactual compensatory display -- for assisting novice pilots in various inflight situations has undergone preliminary inflight testing. The efficacy of this display, as compared with two types of visual displays, was evaluated in both a highly structured approach-and-landing task and a less structured test involving tight turns about a point. In both situations, the displayed quantity was the deviation (alpha sub 0 - alpha) in angle at attack from a desired value alpha sub 0. In the former, the performance with the tactual display was comparable with that obtained using a visual display of (alpha sub 0 - alpha), while in the later, substantial improvements (reduced tracking error (55%), decreased maximum altitude variations (67%), and decreased speed variations (43%)), were obtained using the tactual display. It appears that such a display offers considerable potential for inflight use.
NASA Technical Reports Server (NTRS)
Parkinson, Claire L.; Zukor, Dorothy J. (Technical Monitor)
2000-01-01
The Arctic Ocean is the smallest of the Earth's four major oceans, covering 14x10(exp 6) sq km located entirely within the Arctic Circle (66 deg 33 min N). It is a major player in the climate of the north polar region and has a variable sea ice cover that tends to increase its sensitivity to climate change. Its temperature, salinity, and ice cover have all undergone changes in the past several decades, although it is uncertain whether these predominantly reflect long-term trends, oscillations within the system, or natural variability. Major changes include a warming and expansion of the Atlantic layer, at depths of 200-900 m, a warming of the upper ocean in the Beaufort Sea, a considerable thinning (perhaps as high as 40%) of the sea ice cover, a lesser and uneven retreat of the ice cover (averaging approximately 3% per decade), and a mixed pattern of salinity increases and decreases.
Oral Anticoagulant Use After Bariatric Surgery: A Literature Review and Clinical Guidance.
Martin, Karlyn A; Lee, Craig R; Farrell, Timothy M; Moll, Stephan
2017-05-01
Bariatric surgery may alter the absorption, distribution, metabolism, or elimination (disposition) of orally administered drugs via changes to the gastrointestinal tract anatomy, body weight, and adipose tissue composition. As some patients who have undergone bariatric surgery will need therapeutic anticoagulation for various indications, appropriate knowledge is needed regarding anticoagulant drug disposition and resulting efficacy and safety in this population. We review general considerations about oral drug disposition in patients after bariatric surgery, as well as existing literature on oral anticoagulation after bariatric surgery. Overall, available evidence on therapeutic anticoagulation is very limited, and individual drug studies are necessary to learn how to safely and effectively use the direct oral anticoagulants. Given the sparsity of currently available data, it appears most prudent to use warfarin with international normalized ratio monitoring, and not direct oral anticoagulants, when full-dose anticoagulation is needed after bariatric surgery. Copyright © 2017 Elsevier Inc. All rights reserved.
Shifts in fisheries management: adapting to regime shifts
King, Jacquelynne R.; McFarlane, Gordon A.; Punt, André E.
2015-01-01
For many years, fisheries management was based on optimizing yield and maintaining a target biomass, with little regard given to low-frequency environmental forcing. However, this policy was often unsuccessful. In the last two to three decades, fisheries science and management have undergone a shift towards balancing sustainable yield with conservation, with the goal of including ecosystem considerations in decision-making frameworks. Scientific understanding of low-frequency climate–ocean variability, which is manifested as ecosystem regime shifts and states, has led to attempts to incorporate these shifts and states into fisheries assessment and management. To date, operationalizing these attempts to provide tactical advice has met with limited success. We review efforts to incorporate regime shifts and states into the assessment and management of fisheries resources, propose directions for future investigation and outline a potential framework to include regime shifts and changes in ecosystem states into fisheries management.
Greaver, Laura; Eskridge, Hannah; Teagle, Holly F B
2017-06-13
The purpose of this clinical report is to present case studies of children who are nontraditional candidates for cochlear implantation because they have significant residual hearing in 1 ear and to describe outcomes and considerations for their audiological management and habilitation. Case information is presented for 5 children with profound hearing loss in 1 ear and normal or mild-to-moderate hearing loss in the opposite ear and who have undergone unilateral cochlear implantation. Pre- and postoperative assessments were performed per typical clinic routines with modifications described. Postimplant habilitation was customized for each recipient using a combination of traditional methods, newer technologies, and commercial materials. The 5 children included in this report are consistent users of their cochlear implants and demonstrate speech recognition in the implanted ear when isolated from the better hearing ear. Candidacy criteria for cochlear implantation are evolving. Children with single-sided deafness or asymmetric hearing loss who have traditionally not been considered candidates for cochlear implantation should be evaluated on a case-by-case basis. Audiological management of these recipients is not vastly different compared with children who are traditional cochlear implant recipients. Assessment and habilitation techniques must be modified to isolate the implanted ear to obtain accurate results and to provide meaningful therapeutic intervention.
Clinical privileges for laparoscopic surgery.
Albrink, M H; Rosemurgy, A S
1993-06-01
Laparoscopic cholecystectomy has undergone an explosive growth. Its benefits to patients--shortened recovery time and less pain--became immediately obvious. The procedure's development and adaptation have largely been devised and implemented by ingenious and creative private practitioners, not the typical mode of introduction. Most or many new procedures in the past evolved from academic institutions after laboratory and then clinical trials. With rapid development and acceptance has come an additional new burden among medical practitioners: credentialing and granting clinical privileges.
Quality plan for a product line.
Lanza, M L; Binus, G K; McMillan, F J
1997-12-01
Continuous Quality improvement (CQI) has undergone radical change as health care facilities merge, expand, and modify their existing services. CQI has shifted from a centralized position in health care organizations, to unit based, to product lines. This paper describes one product line's endeavors to develop a Quality Plan to direct CQI activities. One particular strength of our innovation is that the Quality Plan was developed with attention to the important balance of interdisciplinary cooperation and maintenance of appropriate discipline boundaries.
Language assessment of children with severe liver disease in a public service in Brazil
de-Paula, Erica Macêdo; Porta, Gilda; Tannuri, Ana Cristina Aoun; Tannuri, Uenis; Befi-Lopes, Debora Maria
2017-01-01
OBJECTIVE: The aim of this research was to compare language development (expressive and receptive skills) in children awaiting liver transplantation with that of children who have already undergone the surgical procedure. METHODS: An observational, descriptive, cross-sectional study was conducted with 76 children divided into groups, as follows: 31 children who were candidates for liver transplantation (Group 1; G1), 45 children who had already undergone liver transplantation (Group 2; G2), and a control group (CG) of 60 healthy, normally developing children. Health status information was gathered, and the Test of Early Language Development (TELD)-3 was used to assess language skills. Family household monthly income data were also gathered using a specific questionnaire. RESULTS: G1 had poorer language performance compared with G2 and the CG. G2 had lower language performance when compared with the CG. However, when considering the TELD-3 standard scores, G2 had scores within normal limits. The regression analysis indicated age as a risk factor for language deficits in Group 1 and family income as a risk factor for language deficits in G2. CONCLUSIONS: The results suggested that children with chronic liver disease have delays in language development. Transplanted children have linguistic performance within normal limits, but their scores tended to be lower than the CG. PMID:28658434
Development of excess skin and request for body-contouring surgery in postbariatric adolescents.
Staalesen, Trude; Olbers, Torsten; Dahlgren, Jovanna; Fagevik Olsén, Monika; Flodmark, Carl-Erik; Marcus, Claude; Elander, Anna
2014-10-01
Little is known about the development of excess skin and requests for body-contouring surgery after bariatric surgery in adolescents. Forty-seven of 86 adolescents that had undergone gastric bypass surgery answered two questionnaires regarding excess skin and requests for and performed body-contouring surgery. An objective assessment of the amount of excess skin was also performed. The results were compared to earlier results from postbariatric adults. The most common overall problem in adolescents was the feeling of having an unattractive body (91 percent). The most common locations for developing excess skin were the upper arms and thighs according to the measurements. Five of 47 adolescents had undergone body-contouring surgery, and 88 percent of the others desired one or more body-contouring operations. Correlations were found between the objectively measured excess skin and the subjectively experienced amount of excess skin. Correlations were also found between the measured excess skin and the experienced discomfort of excess skin for the abdomen, breast/chest, upper arms, and chin. The authors' results indicate that bariatric surgery in adolescents often leads to severe problems associated with excess skin in both sexes. Thus, the commonly held belief that young people do not develop excess skin to the same extent as adults is strongly questioned. Health care professionals must address the current imbalance between requests for and the performance of body-contouring surgery in adolescents. Therapeutic, IV.
Montgomery, S.L.; Chidsey, T.C.; Eby, D.E.; Lorenz, D.M.; Culham, W.E.
1999-01-01
Productive carbonate buildups of Pennsylvanian age in the southern Paradox basin, Utah, contain up to 200 million bbl remaining oil potentially recoverable by enhanced recovery methods. These buildups comprise over 100 satellite fields to the giant Greater Aneth field, where secondary recovery operations thus far have been concentrated. Several types of satellite buildups exist and produce oil from the Desert Creek zone of the Paradox Formation. Many of the relevant fields have undergone early abandonment; wells in Desert Creek carbonate mounds commonly produce at very high initial rates (>1000 bbl/day) and then suffer precipitous declines. An important new study focused on the detailed characterization of five separate reservoirs has resulted in significant information relevant to their future redevelopment. Completed assessment of Anasazi field suggests that phylloid algal mounds, the major productive buildup type in this area, consist of ten separate lithotypes and can be described in terms of a two-level reservoir system with an underlying high-permeability mound-core interval overlain by a lower permeability but volumetrically larger supramound (mound capping) interval. Reservoir simulations and related performance predictions indicate that CO2 flooding of these reservoirs should have considerable success in recovering remaining oil reserves.Productive carbonate buildups of Pennsylvanian age in the southern Paradox basin, Utah, contain up to 200 million bbl remaining oil potentially recoverable by enhanced recovery methods. These buildups comprise over 100 satellite fields to the giant Greater Aneth field, where secondary recovery operations thus far have been concentrated. Several types of satellite buildups exist and produce oil from the Desert Creek zone of the Paradox Formation. Many of the relevant fields have undergone early abandonment; wells in Desert Creek carbonate mounds commonly produce at very high initial rates (>1000 bbl/day) and then suffer precipitous declines. An important new study focused on the detailed characterization of five separate reservoirs has resulted in significant information relevant to their future redevelopment. Completed assessment of Anasazi field suggests that phylloid algal mounds, the major productive buildup type in this area, consist of ten separate lithotypes and can be described in terms of a two-level reservoir system with an underlying high-permeability mound-core interval overlain by a lower permeability but volumetrically larger supramound (mound capping) interval. Reservoir simulations and related performance predictions indicate that CO2 flooding of these reservoirs should have considerable success in recovering remaining oil reserves.
Charles B. Sims; Donald G. Hodges; Del Scruggs
2004-01-01
Rural economies in many parts of the United States have undergone significant changes over the past two decades. Faltering economies historically based on traditional economic sectors like agriculture and manufacturing are transitioning to retail and service sectors to support growth. One example of such an industry is resource-based recreation and tourism. Tourists...
A Snapshot of State Regulatory Framework Development in Elementary and Secondary Online Education
ERIC Educational Resources Information Center
Stedrak, Luke J.; Rose, Amanda L.
2015-01-01
With the advent and growth of elementary and secondary online education in the United States, teaching and learning has undergone radical change with unimagined alternatives to traditional brick-and-mortar classrooms, and online education is here to stay. Law and policy in some states has lagged behind the emergence of online K-12 education. The…
USSR Report, International Affairs.
1986-09-22
evolution ; by the beginning of the imperialist epoch they were not colonies as a rule, but they were lagging behind in their development and for...Metis population) and resource potential; they have undergone an extensive evolution from patriarchy to capitalist modernization deformed by foreign...territories of these countries for their own purposes—as "hotels," which attract foreign tourists , as locations for corporate and bank headquarters
USDA-ARS?s Scientific Manuscript database
Beach Plum Prunus maritima Marshall 1785 not Wangenh. 1787 (Rosaceae) represents both a new crop under development and an under-acknowledged host plant for several Lepidoptera rthat have undergone declines in the Northeastern USA. The Coastal Heathland Cutworm Abagrotis nefascia (Smith) and the Dune...
1988-01-29
Hungarian founders are the Microelectronics Enterprise and the Communications Technology Cooperative. The Soviet founders are the Union of Nauchniy Centr...selection, growing and breeding of new plant and animal species, and the development of manufacturing technology for the food industry. Direct...the reforms our economy still has not undergone a rapid enough technological modernization. We have, for example, failed to make any progress in the
Histological evolution of pleuroparenchymal fibroelastosis
Hirota, Takako; Yoshida, Yuji; Kitasato, Yasuhiko; Yoshimi, Michihiro; Koga, Takaomi; Tsuruta, Nobuko; Minami, Masato; Harada, Taishi; Ishii, Hiroshi; Fujita, Masaki; Nabeshima, Kazuki; Nagata, Nobuhiko; Watanabe, Kentaro
2015-01-01
Aims To investigate the histological evolution in the development of pleuroparenchymal fibroelastosis (PPFE). Methods and results We examined four patients who had undergone surgical lung biopsy twice, or who had undergone surgical lung biopsy and had been autopsied, and in whom the histological diagnosis of the first biopsy was not PPFE, but the diagnosis of the second biopsy or of the autopsy was PPFE. The histological patterns of the first biopsy were cellular and fibrotic interstitial pneumonia, cellular interstitial pneumonia (CIP) with organizing pneumonia, CIP with granulomas and acute lung injury in cases 1, 2, 3, and 4, respectively. Septal elastosis was already present in the non-specific interstitial pneumonia-like histology of case 1, but a few additional years were necessary to reach consolidated subpleural fibroelastosis. In case 3, subpleural fibroelastosis was already present in the first biopsy, but only to a small extent. Twelve years later, it was replaced by a long band of fibroelastosis. The septal inflammation and fibrosis and airspace organization observed in the first biopsies were replaced by less cellular subpleural fibroelastosis within 3–12 years. Conclusions Interstitial inflammation or acute lung injury may be an initial step in the development of PPFE. PMID:25234959
Medical education in Japan: a challenge to the healthcare system.
Suzuki, Yasuyuki; Gibbs, Trevor; Fujisaki, Kazuhiko
2008-01-01
In response to a change in health and societal need, the system of medical education in Japan has undergone major reform within the last two decades. Although the general health status of Japanese citizens ranks amongst the highest in the world, a rapidly increasingly elderly population, a social insurance system in crisis and a decrease in the number of practicing physicians is severely affecting this enviable position. To compensate, the Government has reversed its previous decision to reduce the number of doctors. Concomitantly, public opinion is changing to that of support and sympathy for the practicing physician. In order to produce a new breed of future doctors, Japanese medical education has undergone major reform: problem-based learning and clinical skills development has been instituted in most medical schools, more rigid assessment methods, ensuring competency and fitness to practice have been introduced, and there has been an increase in purposeful clinical attachments with a hands-on approach rather than a traditional observation model. A new postgraduate residency programme, introduced in 2004, hopes to improve general competency levels, while medical schools throughout the country are paying attention to modern medical education and faculty development.
Results of arthroscopic joint debridement in different stages of chondromalacia of the knee joint.
Krüger, T; Wohlrab, D; Birke, A; Hein, W
2000-01-01
A retrospective study was performed of 161 patients who had undergone arthroscopic operation for chondromalacia of the knee joint. After an average follow-up period of 40 (range 10-72) months, patients with severe articular cartilage lesions who had undergone articular lavage alone showed significantly poorer results (P < 0.001). With the same stage of chondromalacia and having undergone the same surgical procedure, younger patients showed better results than older patients. The more effective interruption of the circulus vitiosus during the development of degenerative joint diseases is the primary cause for better results achieved by mechanical debridement of the joint for patients suffering from grade 2 or higher. According to the literature, aggressive subchondral abrasion in severely degenerated knees does not show any benefits. Apparently, the success of the therapy depends to a great extent on the inferiority of the potential degenerative regenerate (lack of capacity of intrinsic regeneration of the hyaline cartilage) as well as on the grade and the progression of chondromalacia. Almost every second patient suffering from grade 4 chondromalacia complained of recurrent pain 1 year postoperatively. One of every 6 patients received a knee joint prosthesis within the 1st year. Therefore, the patients' preoperative expectations have to be clearly objectified. The surgical procedure as an operation with a low complication risk can also be justified as a temporary alternative to total knee arthroplasty in patients suffering from a high-grade degeneration of the joint.
Proteus mirabilis and its role in dacryocystitis.
Borgman, Christopher J
2014-09-01
Dacryocystitis is a common inflammation of the lacrimal sac, usually from an underlying bacterial infection. Most cases can be attributed to common ocular flora such as Staphylococcus aureus or Streptococcus pneumoniae; however, uncommon bacterial causes such as Proteus mirabilis can still occur. P. mirabilis is a gram-negative bacillus that is found abundantly in people who have undergone long-term catheterization and is uncommonly found in or around the eyes except in people who have undergone long-term catheterization. Proteus species can cause conjunctivitis, canaliculitis, and dacryocystitis and have the ability to manifest into preseptal cellulitis; therefore, timely recognition and treatment are important to prevent potential further complications. An 84-year-old white man had several recurrences of acute dacryocystitis that had marginal improvement with empiric antibiotic treatment. Resultant culture of the ocular discharge revealed an uncommon bacterium, P. mirabilis. Successful dosing of oral antibiotics resolved the infection but ultimately the patient required an external dacryocystorhinostomy (DCR) procedure to maintain patency of the nasolacrimal lacrimal system and prevent recurrence. At 3 months after external DCR, the patient was symptom free with no recurrences. Dacryocystitis has a distinctive clinical presentation and is usually easily treated when appropriate oral antibiotics are directed at the underlying pathogen. In nonresponsive cases, culturing of the ocular discharge should be performed to identify the underlying pathogen. Cases of dacryocystitis caused by Proteus species are usually responsive to several standard antibiotics used orally in eye care; however, culturing and susceptibility testing can streamline the diagnostic and management sequence considerably in unclear or unresponsive cases. Typically, patients with dacryocystitis return to normal after appropriate treatment, but chronic recurrences and epiphora are potential sequelae. Patients should be educated that a DCR surgical procedure may be needed to prevent future recurrences in some cases.
Early nutrition and health: short- and long-term outcomes.
Gruszfeld, Dariusz; Socha, Piotr
2013-01-01
Maternal diet, nutritional status during pregnancy, and the early diet of the offspring play an important role in later health. The short- and long-term outcomes of early nutrition have been extensively studied in recent decades. One of the most commonly investigated nutritional interventions is breastfeeding, which is associated with a number of positive short- and long-term outcomes. A short-term effect of breastfeeding is reduced morbidity and mortality in children from poor living conditions and in preterm infants. Breastfeeding is associated with better cognitive development and also has a long-term protective effect on obesity risk, prevalence of type 2 diabetes, and a lowering effect on blood pressure. Selected nutrients have undergone extensive investigation to show their role in disease prevention or improved development, e.g. protein intake in infancy seems to be associated with a later risk of obesity or docosahexaenoic acid supplementation has a positive impact on cognitive function. Another consideration is the fast catch-up growth in small for gestational age infants as an important factor associated with adult risk of cardiovascular problems. On the other hand, high protein and energy intake seems to be positively associated with some indicators of cognitive development. Most of the evidence comes from observational studies that cannot exclude potential confounders. Animal studies demonstrate causality but should not be directly extrapolated to humans. The number of randomized controlled studies is increasing but long-term follow-ups are necessary to obtain convincing results. The majority of these trials compare different infant formula compositions and macro- or micronutrient supplementation. One of the major questions is to define a critical (or opportunity) window and a mechanism of nutritional influence on several health outcomes. Copyright © 2013 S. Karger AG, Basel.
NASA Advances Technologies for Additive Manufacturing of GRCop-84 Copper Alloy
NASA Technical Reports Server (NTRS)
Gradl, Paul; Protz, Chris
2017-01-01
The Low Cost Upper Stage Propulsion project has successfully developed and matured Selective Laser Melting (SLM) Fabrication of the NASA developed GRCop-84 copper alloy. Several parts have been printed in house and at a commercial vendor, and these parts have been successfully machined and have undergone further fabrication steps to allow hot-fire testing. Hot-fire testing has demonstrated parts manufactured with this technique can survive and perform well in the relevant environments for liquid rocket propulsion systems.
The concept of identification in the work of Freud, Ferenczi, and Abraham: a review and commentary.
Compton, A
1985-04-01
The development of the concept of identification in the work of Freud, Ferenczi, and Abraham is reviewed and analyzed from the standpoint of the development of the psychoanalytic object concept in general. Problems in the theory are seen to be related to ambiguity of the terms, ego and object, especially as reflected in the idea of introjection. The concept of identification, on the other hand, is shown to have undergone consistent evolution and expansion.
Effects of Drake Passage on the Ocean's Thermal and Mechanical Energy Budget in a Coupled AOGCM
NASA Astrophysics Data System (ADS)
von der Heydt, A. S.; Viebahn, J. P.
2016-12-01
During the Cenozoic Earth's climate has undergone a major long-term transition from `greenhouse' to `icehouse' conditions with extensive ice sheets in the polar regions of both hemispheres. The gradual cooling may be seen as response to the overall slowly decreasing atmospheric CO2-concentration due to weathering processes in the Earth System, however, continental geometry has changed considerably over this period and the long-term gradual trend was interrupted, by several rapid transitions and periods where temperature and greenhouse gas concentrations seem to be decoupled. The Eocene-Oligocene boundary ( 34 Ma, E/O) and mid-Miocene climatic transition ( 13 Ma, MCT) reflect major phases of Antarctic ice sheet build-up and global climate cooling, while Northern Hemisphere ice sheets developed much later ( 2.7Ma). Thresholds in atmospheric CO2-concentration together with feedback mechanisms related to land ice formation are among the favoured mechanisms of these climatic transitions, while the long-proposed ocean circulation changes caused by opening of tectonic gateways seem to play a less direct role. The opening of the Southern Ocean gateways, however, has eventually led to the development of today's strongest ocean current, the Antarctic Circumpolar Current, playing a major role in the transport properties of the global ocean circulation. The overall state of the global ocean circulation, therefore, must precondition the climate system to dramatic events such as major ice sheet formation. Closing Drake Passage in ocean-only and coupled climate models under otherwise present-day boundary conditions has become a classic experiment, indicating that there exists a considerable uncertainty in the climate response of those models to a closed Drake Passage. Here we quantify the climate response to a closed Drake Passage in a state-of-the-art coupled climate model (CESM). We show that the ocean gateway mechanism is robust in the sense that the equatorward expansion of the Southern Ocean sub-polar gyres inevitably leads to widespread warming around Antarctica. Moreover, we provide a framework to characterise the ocean temperature response to a closed Drake Passage in terms of both the mechanical and thermal energy budget of the ocean.
Kanda, Yukihiko; Kumagami, Hidetaka; Hara, Minoru; Sainoo, Yuzuru; Sato, Chisei; Yamamoto-Fukuda, Tomomi; Yoshida, Haruo; Ito, Akiko; Tanaka, Chiharu; Baba, Kyoko; Nakata, Ayaka; Tanaka, Hideo; Fukushima, Kunihiro; Kasai, Norio; Takahashi, Haruo
2012-04-01
We conducted multi-directional language development tests as a part of the Research on Sensory and Communicative Disorders (RSVD) in Japan. This report discusses findings as well as factors that led to better results in children with severe-profound hearing loss. We evaluated multiple language development tests in 33 Japanese children with cochlear implants (32 patients) and hearing aid (1 patient), including 1) Test for question and answer interaction development, 2) Word fluency test, 3) Japanese version of the Peabody picture vocabulary test-revised, 4) The standardized comprehension test of abstract words, 5) The screening test of reading and writing for Japanese primary school children, 6) The syntactic processing test of aphasia, 7) Criterion-referenced testing (CRT) for Japanese language and mathematics, 8) Pervasive development disorders ASJ rating scales, and 9) Raven's colored progressive matrices. Furthermore, we investigated the factors believed to account for the better performances in these tests. The first group, group A, consisted of 14 children with higher scores in all tests than the national average for children with hearing difficulty. The second group, group B, included 19 children that scored below the national average in any of the tests. Overall, the results show that 76.2% of the scores obtained by the children in these tests exceeded the national average scores of children with hearing difficulty. The children who finished above average on all tests had undergone a longer period of regular habilitation in our rehabilitation center, had their implants earlier in life, were exposed to more auditory verbal/oral communication in their education at affiliated institutions, and were more likely to have been integrated in a regular kindergarten before moving on to elementary school. In this study, we suggest that taking the above four factors into consideration will have an affect on the language development of children with severe-profound hearing loss.
The prospects of transition metal dichalcogenides for ultimately scaled CMOS
NASA Astrophysics Data System (ADS)
Thiele, S.; Kinberger, W.; Granzner, R.; Fiori, G.; Schwierz, F.
2018-05-01
MOSFET gate length scaling has been a main source of progress in digital electronics for decades. Today, researchers still spend considerable efforts on reducing the gate length and on developing ultimately scaled MOSFETs, thereby exploring both new device architectures and alternative channel materials beyond Silicon such as two-dimensional TMDs (transition metal dichalcogenide). On the other hand, the envisaged scaling scenario for the next 15 years has undergone a significant change recently. While the 2013 ITRS edition required a continuation of aggressive gate length scaling for at least another 15 years, the 2015 edition of the ITRS suggests a deceleration and eventually a levelling off of gate length scaling and puts more emphasis on alternative options such as pitch scaling to keep Moore's Law alive. In the present paper, future CMOS scaling is discussed in the light of emerging two-dimensional MOSFET channel, in particular two-dimensional TMDs. To this end, the scaling scenarios of the 2013 and 2015 ITRS editions are considered and the scaling potential of TMD MOSFETs is investigated by means of quantum-mechanical device simulations. It is shown that for ultimately scaled MOSFETs as required in the 2013 ITRS, the heavy carrier effective masses of the Mo- and W-based TMDs are beneficial for the suppression of direct source-drain tunneling, while to meet the significantly relaxed scaling targets of the 2016 ITRS heavy-effective-mass channels are not needed.
Semiparametric temporal process regression of survival-out-of-hospital.
Zhan, Tianyu; Schaubel, Douglas E
2018-05-23
The recurrent/terminal event data structure has undergone considerable methodological development in the last 10-15 years. An example of the data structure that has arisen with increasing frequency involves the recurrent event being hospitalization and the terminal event being death. We consider the response Survival-Out-of-Hospital, defined as a temporal process (indicator function) taking the value 1 when the subject is currently alive and not hospitalized, and 0 otherwise. Survival-Out-of-Hospital is a useful alternative strategy for the analysis of hospitalization/survival in the chronic disease setting, with the response variate representing a refinement to survival time through the incorporation of an objective quality-of-life component. The semiparametric model we consider assumes multiplicative covariate effects and leaves unspecified the baseline probability of being alive-and-out-of-hospital. Using zero-mean estimating equations, the proposed regression parameter estimator can be computed without estimating the unspecified baseline probability process, although baseline probabilities can subsequently be estimated for any time point within the support of the censoring distribution. We demonstrate that the regression parameter estimator is asymptotically normal, and that the baseline probability function estimator converges to a Gaussian process. Simulation studies are performed to show that our estimating procedures have satisfactory finite sample performances. The proposed methods are applied to the Dialysis Outcomes and Practice Patterns Study (DOPPS), an international end-stage renal disease study.
Gram-positive anaerobic cocci--commensals and opportunistic pathogens.
Murphy, Elizabeth Carmel; Frick, Inga-Maria
2013-07-01
Among the Gram-positive anaerobic bacteria associated with clinical infections, the Gram-positive anaerobic cocci (GPAC) are the most prominent and account for approximately 25-30% of all isolated anaerobic bacteria from clinical specimens. Still, routine culture and identification of these slowly growing anaerobes to the species level has been limited in the diagnostic laboratory, mainly due to the requirement of prolonged incubation times and time-consuming phenotypic identification. In addition, GPAC are mostly isolated from polymicrobial infections with known pathogens and therefore their relevance has often been overlooked. However, through improvements in diagnostic and in particular molecular techniques, the isolation and identification of individual genera and species of GPAC associated with specific infections have been enhanced. Furthermore, the taxonomy of GPAC has undergone considerable changes over the years, mainly due to the development of molecular identification methods. Existing species have been renamed and novel species have been added, resulting in changes of the nomenclature. As the abundance and significance of GPAC in clinical infections grow, knowledge of virulence factors and antibiotic resistance patterns of different species becomes more important. The present review describes recent advances of GPAC and what is known of the biology and pathogenic effects of Anaerococcus, Finegoldia, Parvimonas, Peptoniphilus and Peptostreptococcus, the most important GPAC genera isolated from human infections. © 2012 Federation of European Microbiological Societies. Published by Blackwell Publishing Ltd. All rights reserved.
NASA Astrophysics Data System (ADS)
Balletti, C.; D'Agnano, F.; Guerra, F.; Vernier, P.
2016-06-01
The paper describes how new digital methodologies can be used within the field of Cultural Heritage, not only with the aim of documenting the actual state of an architecture but to review the past transformations it has undergone, conserving and representing these histories as well. The premise to conservation and enhancement of our Heritage is a deep study in terms of position, shape, colour, and also of the historical and artistic features. Survey methods have acquired data acquisition techniques in line with technological progress: today's electronic and IT technologies, that are the tools of modern Geomatics, allow the effective survey and representation of 3D objects, from architectural structures to sculptures or archaeological finds. Over the last few years, the methodologies of acquisition and integrated representation for 3D patrimony documentation have developed and consolidated considerably: the possibilities of the digital realm can augment the understanding and the valorisation of a monument. The specific case offered in the present paper, Ca' Venier dei Leoni, the palace where is the Guggenheim Museum in Venice, is a significant example. It suggests not only the theme of the "no longer existing", or better never built, but also the opportunity to formulate hypotheses regarding its implementation and the impact that the palace would have had in the Venetian contest.
Estimating the prevalence of female genital mutilation in Portugal.
Teixeira, A L; Lisboa, M
2016-10-01
Due to globalized migratory processes, female genital mutilation/cutting (FGM/C) has spread to other countries, including countries in Europe, where, with a few exceptions, it remains a concealed problem. To the authors' knowledge, this is the first national extensive study to estimate the prevalence of FGM/C in Portugal. Prevalence estimation. Using extrapolation of country-of-origin prevalence data and the 2011 Census data, this study estimated: the prevalence of FGM/C in Portugal among women of reproductive age (15-49 years) and among all women aged ≥15 years; and the number of girls aged <15 years living in Portugal who have undergone or will probably undergo FGM/C. It is estimated that 6576 women aged ≥15 years living in Portugal have undergone FGM/C, with cases distributed unevenly throughout the national territory. In addition, it is estimated that 1830 girls aged <15 years living in Portugal have undergone or are likely to undergo FGM/C. This study estimated that more than 6000 women living in Portugal have undergone FGM/C, and many girls remain at risk. These two groups need different types of interventions. Awareness of the number and geographical dispersion of cases of FGM/C will enable more informed and targeted definition of public health policies for protection of females who have undergone or are at risk of undergoing FGM/C. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Awtrey, Christopher S; Abu-Rustum, Nadeem R; Disa, Joseph J; Ivy, Joseph J; Kauff, Noah D; Hummer, Amanda J; Barakat, Richard R
2005-12-01
The aim of this study was to describe the feasibility and outcome of laparoscopic risk-reducing salpingo-oophorectomy (RRSO) in patients with a history of breast cancer who previously had undergone a transverse rectus abdominus myocutaneous (TRAM) flap reconstruction. We performed a retrospective review of patients with a history of breast cancer who had undergone laparoscopic RRSO between February 1995 and April 2002. Patients who had undergone TRAM flap reconstructive surgery were compared with patients who had undergone laparoscopic RRSO without prior reconstructive surgery. We identified 102 patients with a history of breast cancer who were candidates for a laparoscopic RRSO during the study period. One hundred one of these patients underwent the procedure, including 10 patients with a history of TRAM flap breast reconstructive surgery. One patient did not undergo the procedure because she was noted to be hypotensive prior to the procedure from her bowel preparation. There were no differences between the groups with or without prior history of TRAM flap reconstruction with respect to body mass index, prior abdominal surgery, menopausal status, or preoperative ultrasound characteristics. Operatively, there was no difference between the groups with respect to estimated blood loss, hospital stay, and intraoperative and postoperative complication rates. The only noted difference between the two groups was the estimated operating time (TRAM group, 91 min; non-TRAM group, 70 min [P<0.01]). Laparoscopic RRSO is safe and feasible in patients who have undergone a prior TRAM flap reconstruction.
Assessment of the incidence of GDV following splenectomy in dogs.
Goldhammer, M A; Haining, H; Milne, E M; Shaw, D J; Yool, D A
2010-01-01
To establish if splenectomy increases the incidence of gastric dilatation and volvulus (GDV) in dogs. Two case-series studies of cases and controls were performed. Records of dogs that had undergone splenectomy (37 cases) were compared with records of dogs that had undergone other abdominal surgery (43 cases). Records of dogs that presented for non-elective gastropexy (33 cases) were compared with records of dogs presented to the hospital for unrelated reasons (39 cases). Survival following splenectomy and development of GDV in the first 12 months following surgery were retrieved from the clinical records and by questionnaire-based canvassing of the referring clinician. The incidence of GDV following splenectomy was established and the association between a current episode of GDV and previous splenectomy was assessed. There was no evidence that splenectomy was associated with an increased incidence of subsequent GDV (P=0.469). No association between a current episode of GDV and previous splenectomy was found. Splenectomy is not associated with an increase in the incidence of GDV.
The Pre-exponential Factor in Electrochemistry.
He, Zheng-Da; Chen, Yan-Xia; Santos, Elizabeth; Schmickler, Wolfgang
2018-07-02
Like many branches of science, not to mention culture in general, electrochemistry has a number of recurring topics: Areas of research that are popular for a certain time, then fade away as their possibilities seem to have been exhausted, only to return decades later as progress in experimental or theoretical techniques offer new possibilities for their investigation. A prime example are fuel cells, which have undergone five such cycles, but here we discuss a general concept of kinetics-the pre-exponential factor of a rate constant-which has undergone two such cycles. The first cycle was in the 1950-1980s, when the methods of electrochemical kinetics were developed, and the interpretation was based on transition-state theory. The second was triggered by the re-discovery of Kramers theory for reactions in condensed phases. This Minireview will show that the time has come for a third cycle based on recent progress in electrocatalysis. © 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.
NASA Astrophysics Data System (ADS)
Waltham, Nathan J.; Barry, Michael; McAlister, Tony; Weber, Tony; Groth, Dominic
2014-10-01
The Gold Coast City is the tourist center of Australia and has undergone rapid and massive urban expansion over the past few decades. The Broadwater estuary, in the heart of the City, not only offers an array of ecosystems services for many important aquatic wildlife species, but also supports the livelihood and lifestyles of residents. Not surprisingly, there have been signs of imbalance between these two major services. This study combined a waterway hydraulic and pollutant transport model to simulate diffuse nutrient and sediment loads under past and future proposed land-use changes. A series of catchment restoration initiatives were modeled in an attempt to define optimal catchment scale restoration efforts necessary to protect and enhance the City's waterways. The modeling revealed that for future proposed development, a business as usual approach to catchment management will not reduce nutrient and sediment loading sufficiently to protect the community values. Considerable restoration of upper catchment tributaries is imperative, combined with treatment of stormwater flow from intensively developed sub-catchment areas. Collectively, initiatives undertaken by regulatory authorities to date have successfully reduced nutrient and sediment loading reaching adjoining waterways, although these programs have been ad hoc without strategic systematic planning and vision. Future conservation requires integration of multidisciplinary science and proactive management driven by the high ecological, economical, and community values placed on the City's waterways. Long-term catchment restoration and conservation planning requires an extensive budget (including political and societal support) to handle ongoing maintenance issues associated with scale of restoration determined here.
Social disparities in access to breast and cervical cancer screening by women living in Spain.
Ricardo-Rodrigues, I; Jiménez-García, R; Hernández-Barrera, V; Carrasco-Garrido, P; Jiménez-Trujillo, I; López de Andrés, A
2015-07-01
To describe uptake of breast and cervical cancer screening by women living in Spain, analyse the possible associated social and health factors, and compare uptake rates with those obtained in previous surveys. Cross-sectional study using data from the 2011 Spanish national health survey. Uptake of breast cancer screening was analysed by asking women aged 40-69 years whether they had undergone mammography in the previous two years. Uptake of cervical cancer screening was analysed by asking women aged 25-65 years whether they had undergone cervical cytology in the previous three years. Independent variables included sociodemographic characteristics, and variables related to health status and lifestyle. Seventy-two percent of women had undergone mammography in the previous two years. Having private health insurance increased the probability of breast screening uptake four-fold [odds ratio (OR) 3.96, 95% confidence interval (CI) 2.71-5.79], and being an immigrant was a negative predictor for breast screening uptake. Seventy percent of women had undergone cervical cytology in the previous three years. Higher-educated women were more likely to have undergone cervical cancer screening (OR 2.59, 95% CI 1.97-3.40), and obese women and women living in rural areas were less likely to have undergone cervical cancer screening. There have been no relevant improvements in uptake rates of either breast or cervical cancer screening since 2006. Uptake of breast and cervical cancer screening could be improved in Spain, and uptake rates have stagnated over recent years. Social disparities have been detected with regard to access to these screening tests, indicating that it is necessary to continue researching and optimizing prevention programmes in order to improve uptake and reduce these disparities. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
ERIC Educational Resources Information Center
Panther Bishoff, Jennifer
2010-01-01
In recent years, higher education has undergone many changes. The advent of assessment, accountability, and a newfound focus on teaching have required faculty to examine how they are teaching. Administrators and faculty are beginning to recognize that learning is not a "one size fits all" enterprise. To this end, Chickering and Gamson developed an…
Daniel A. Yaussy; Gregory J. Nowacki; Thomas M. Schuler; Daniel C. Dey
2008-01-01
Many national forests and grasslands in the Central Hardwoods region of the United States recently have undergone Land Management Plan revision, which include management areas that promote restoration through a variety of management activities. Monitoring is a vital component of adaptive management whereby the effects from a variety of treatments (including controls)...
ERIC Educational Resources Information Center
Fritsch, Nina-Sophie
2016-01-01
As a result of various reforms carried out in the last decade, the academic sphere has undergone perceptible change, with redevelopment and reshaping at different institutional levels. These reforms have had an effect on gender relations, especially within the past several years, with an increasing proportion of female academics now in leading…
ERIC Educational Resources Information Center
Yumoto, Hiroyuki
2017-01-01
Japan's educational system has undergone a series of reforms over the past decade or so. Through these reforms, the ruling party has strengthened the involvement of the government and local authorities in education. At the same time, there has been a growing tendency for teachers to avoid taking up political issues in classrooms, in order to…
Insulin resistance for glucose metabolism in disused soleus muscle of mice
NASA Technical Reports Server (NTRS)
Seider, M. J.; Nicholson, W. F.; Booth, F. W.
1981-01-01
Results of this study on mice provide the first direct evidence of insulin resistance for glucose metabolism in skeletal muscle that has undergone a previous period of reduced muscle usage. This lack of responsiveness to insulin developed in one day and in the presence of hypoinsulinemia. Future studies will utilize the model of hindlimb immobilization to determine the causes of these changes.
NASA Technical Reports Server (NTRS)
1976-01-01
The design, fabrication tests, and engineering model components of a 10.6 mum wideband transceiver system are reported. The effort emphasized the transmitter subsystem, including the development of the laser, the modulator driver, and included productization of both the transmitter and local oscillator lasers. The transmitter subsystem is functionally compatible with the receiver engineering model terminal, and has undergone high data rate communication system testing against that terminal.
The place of robotics in gynecologic surgery.
Quemener, J; Boulanger, L; Rubod, C; Cosson, M; Vinatier, D; Collinet, P
2012-10-01
Robot-assisted laparoscopic gynecologic surgery has undergone widespread development in recent years. The surgical literature on this subject continues to grow. The goal of this article is to summarize the principal indications for robotic assistance in gynecologic surgery and to offer a general overview of the principal articles dealing with robotic surgery for both benign and malignant disease. Copyright © 2012 Elsevier Masson SAS. All rights reserved.
ERIC Educational Resources Information Center
Craggs, Holly; Kelly, Catherine
2018-01-01
A sense of school belonging has a powerful effect on students' emotional, motivational, and academic functioning, yet there have been few attempts to listen to students' views on school belonging, or to seek their opinions on how best to promote it. Managed move protocols to facilitate a move to an alternative school were developed in the UK as a…
Biaryl Phosphine Ligands in Palladium-Catalyzed Amination
Surry, David S.
2012-01-01
Palladium-catalyzed amination of aryl halides has undergone rapid development in the last 12 years. This has been largely driven by implementation of new classes of ligands. Biaryl phosphines have proven to provide especially active catalysts in this context. This review discusses the applications that these catalysts have found in C-N cross-coupling in heterocycle synthesis, pharmaceuticals, materials science and natural product synthesis. PMID:18663711
Gustavell, Tina; Langius-Eklöf, Ann; Wengström, Yvonne; Segersvärd, Ralf; Sundberg, Kay
2018-03-27
Patients who have undergone pancreaticoduodenectomy because of pancreatic cancer experience distressing symptoms and unmet supportive care needs after discharge. To meet these needs, we have developed a mobile health app (Interaktor) for daily assessment of symptoms and access to self-care advice that includes a risk assessment model for alerts with real-time interactions with professionals. The study aim was to develop and test a version of the Interaktor app adapted for patients who have undergone pancreaticoduodenectomy. The app was developed and tested for feasibility in 6 patients during 4 weeks. One nurse monitored and responded to alerts. Logged data from the app were collected, and all participants were interviewed about their experiences. Adherence to reporting daily was 84%. Alerts were generated in 41% of the reports. The patients felt reassured and cared for and received support for symptom management. The app was easy to use, had relevant content, and had few technical problems, although suggestions for improvement were given. The daily reporting of symptoms and having access to a nurse in real time in the case of an alarming symptom seem to enhance symptom management and render a feeling of security in patients. Some modifications of the app are needed before use in a larger sample. Daily reporting of symptoms after pancreaticoduodenectomy enhances symptom management, self-care, and participation without being a burden to patients, indicating that mobile health can be used in clinical practice by patients with poor prognosis who experience severe symptoms.
2012-01-01
Background Improvements in treatment have resulted in an increasing number of cancer survivors potentially being able to return to work after medical treatment. In this paper we focus on the considerations regarding return to work (RTW) of breast cancer absentees in the Belgian context and how these considerations are related to reactions from their social environment. Methods A qualitative study was performed to understand the RTW considerations of Belgian breast cancer absentees who had undergone breast cancer surgery in 2006. Twenty-two participants (mean age 46) were included and interviewed between May 2008 and August 2009 in their personal environment. An in-depth analysis (Grounded Theory) took place using the Qualitative Analysis Guide of Leuven (Quagol). Results Before the actual RTW, breast cancer employees try to build an image of the future resumption of work based on medical grounds and their knowledge of the workplace. Four matters are considered prior to RTW: (i) women want to leave the sick role and wish to keep their job; (ii) they consider whether working is worth the effort; (iii) they reflect on their capability; and (iv) they have doubts about being accepted in the workplace after returning. These inner thoughts are both product and input for the interaction with the social environment. The whole process is coloured by uncertainty and vulnerability. Conclusion Our study demonstrated that mental preparation for RTW is not a linear process of improvement. It shows a detailed picture of four types of considerations made by breast cancer survivors before they actually resume work. Vulnerability appears to be an overarching theme during mental preparation. As the social environment plays an important role, people from that environment must become more aware of their influence on decreasing or increasing a woman’s vulnerability while preparing for RTW. PMID:22824548
Pua, Yong-Hao; Mentiplay, Benjamin F; Clark, Ross A; Ho, Jia-Ying
2017-11-01
Study Design Prospective cohort. Background Quadriceps strength is associated with hop distance and jump height in persons who have undergone anterior cruciate ligament (ACL) reconstruction. However, it is unknown whether the ability to rapidly generate quadriceps torque in the early phase of recovery is associated with future hopping and jumping performance in this population. Objective To evaluate the prospective associations among quadriceps strength and rate of torque development (RTD) and single-leg hop for distance, vertical jump height, vertical ground reaction force (vGRF), and vertical force loading rate during a landing task in persons who have undergone ACL reconstruction. Methods Seventy patients with unilateral ACL reconstruction participated. At 6 weeks post ACL reconstruction, isometric quadriceps strength and RTD were measured using a dynamometer. At 6 months following ACL reconstruction, patients performed the single-leg hop for distance test. Patients also performed the single-leg vertical jump test on a force plate that measured maximum jump height, vGRF, and average loading rate during landing. Results Both quadriceps strength and RTD at 6 weeks post ACL reconstruction were associated with all hopping and jumping measures at 6 months post ACL reconstruction (P≤.04). Single-leg hop distance was associated more closely with quadriceps strength than with quadriceps RTD (P = .05), and vertical jump height and vGRF measures were associated more closely with quadriceps RTD than with quadriceps strength (P = .05 and P<.01, respectively). Both quadriceps measures were associated with loading rate. Conclusion Quadriceps strength and RTD are complementary but distinct predictors of future hopping and jumping performance in persons who have undergone ACL reconstruction. These findings may contribute to improved rehabilitation of patients who are at risk for poor jumping/hopping performance and abnormal knee loading. J Orthop Sports Phys Ther 2017;47(11):845-852. Epub 13 Oct 2017. doi:10.2519/jospt.2017.7133.
Opportunities and Challenges of Electric Vehicles Development in Mitigating Climate Change in China
NASA Astrophysics Data System (ADS)
Liu, R.; Li, M. H.; Zhang, H. N.
2017-10-01
As a developing country, China has also undergone a noticeable climate change due to the increasing consumption of fossil fuels. The automotive market in China is estimated to be the world’s second largest new automotive growth market. China is now capable of manufacturing cars totally independently, which makes car prices more attractive to middle- income families. As one of the energy solutions, Electric Vehicles Technologies cannot be considered solely in environmental aspects. One energy system should not only contribute to sustainable development, but also to the environmental, social and economic aspects.
Iwata, Hiroko; Mori, Emi; Maekawa, Tomoko; Maehara, Kunie; Sakajo, Akiko; Ozawa, Harumi; Morita, Akiko
2012-12-01
The purpose of this study was to develop the Maternity Portfolio to promote maternal role attainment in women who underwent artificial reproductive treatment. The following procedures were undertaken to develop the Maternity Portfolio: (i) a literature review was conducted to identify studies and articles related to maternal diary or portfolio usage; (ii) the research members discussed objectives and usages of the Maternity Portfolio; (iii) a trial product was developed in collaboration with two pregnant women (one following artificial reproductive treatment and one infertility patient) and seven nurses, and after feedback was completed, the product was revised; and (iv) the final product of the Maternity Portfolio was patented. The final Maternity Portfolio product consisted of a 40-page booklet; it contained an information section and a patient comments section. Following artificial reproductive treatment, this booklet can be provided to women during the first trimester. Women would then be instructed to bring the Maternity Portfolio to their prenatal checkups, where a nursing intervention program would be conducted by certified nurses. Through this program and the Maternity Portfolio, participating women are expected to obtain necessary information and maternal role attainment. The Maternity Portfolio was developed to promote maternal role attainment for women who have undergone artificial reproductive treatment. The intervention study with the Maternity Portfolio is a work in progress; therefore, a future evaluation of the study will clarify both positive and negative aspects, which should facilitate refinement of the functions and qualities of the Maternity Portfolio. © 2011 The Authors. Japan Journal of Nursing Science © 2011 Japan Academy of Nursing Science.
Austin, Allana; Lin, Jean-Pierre; Selway, Richard; Ashkan, Keyoumars; Owen, Tamsin
2017-01-01
Dystonia is characterised by involuntary movements and postures. Deep Brain Stimulation (DBS) is effective in reducing dystonic symptoms in primary dystonia in childhood and to lesser extent in secondary dystonia. How families and children decide to choose DBS surgery has never been explored. To explore parental decision-making for DBS in paediatric secondary dystonia. Data was gathered using semi-structured interviews with eight parents of children with secondary dystonia who had undergone DBS. Interviews were analysed using Interpretative Phenomenological Analysis. For all parents the decision was viewed as significant, with life altering consequences for the child. These results suggested that parents were motivated by a hope for a better life and parental duty. This was weighed against consideration of risks, what the child had to lose, and uncertainty of DBS outcome. Decisions were also influenced by the perspectives of their child and professionals. The decision to undergo DBS was an ongoing process for parents, who ultimately were struggling in the face of uncertainty whilst trying to do their best as parents for their children. These findings have important clinical implications given the growing referrals for consideration of DBS childhood dystonia, and highlights the importance of further quantitative research to fully establish the efficacy of DBS in secondary dystonia to enhance informed decision-making. Copyright © 2016. Published by Elsevier Ltd.
Asma, Suheyl; Kozanoglu, Ilknur; Tarım, Ebru; Sarıturk, Cagla; Gereklioglu, Cigdem; Akdeniz, Aydan; Kasar, Mutlu; Turgut, Nurhilal H; Yeral, Mahmut; Kandemir, Fatih; Boga, Can; Ozdogu, Hakan
2015-01-01
Sickle cell disease (SCD) is associated with chronic hemolysis and painful episodes. Pregnancy accelerates sickle cell complications, including prepartum and postpartum vasoocclusive crisis, pulmonary complications, and preeclampsia or eclampsia. Fetal complications include preterm birth and its associated risks, intrauterine growth restriction, and a high rate of perinatal mortality. The purpose of this study was to evaluate pregnancy outcomes in patients with SCD who underwent planned preventive red blood cell exchange (RBCX). We retrospectively evaluated the complications of SCD in 37 pregnant patients. Patients with SCD who had undergone prophylactic RBCX were compared with a control group who had not undergone RBCX during pregnancy. Forty-three exchange procedures were performed in 24 patients. The control group comprised 13 patients with a mean age of 27.4 ± 3.3 years who had not undergone RBCX during pregnancy. Four of the five patients who developed a vasoocclusive crisis died. There was a significant difference in maternal mortality between the study and control groups (p = 0.011). There was also a significant difference in the incidence of vasoocclusive crisis between the study and control groups. One fetal death occurred in the 20th gestational week in a patient in the control group, although there were no postpartum complications in either the babies or the mothers in the control group. This study has demonstrated that prophylactic RBCX during pregnancy is a feasible and safe procedure for prevention of complications. Given the decrease in the risks of transfusion, RBCX warrants further study. © 2014 AABB.
Interruption of Transmission of Onchocerca volvulus in the Southern Chiapas Focus, México
Rodríguez-Pérez, Mario A.; Domínguez-Vázquez, Alfredo; Unnasch, Thomas R.; Hassan, Hassan K.; Arredondo-Jiménez, Juan I.; Orozco-Algarra, María Eugenia; Rodríguez-Morales, Kristel B.; Rodríguez-Luna, Isabel C.; Prado-Velasco, Francisco Gibert
2013-01-01
Background The Southern Chiapas focus of onchocerciasis in Southern Mexico represents one of the major onchocerciasis foci in Latin America. All 559 endemic communities of this focus have undergone semi-annual mass treatment with ivermectin since 1998. In 50 communities of this focus, ivermectin frequency shifted from twice to four times a year in 2003; an additional 113 communities were added to the quarterly treatment regimen in 2009 to achieve a rapid suppression of transmission. Methodology/Principal findings In-depth epidemiologic and entomologic assessments were performed in six sentinel communities (which had undergone 2 rounds of ivermectin treatment per year) and three extra-sentinel communities (which had undergone 4 rounds of ivermectin treatment per year). None of the 67,924 Simulium ochraceum s.l. collected from this focus during the dry season of 2011 were found to contain parasite DNA when tested by polymerase chain reaction-enzyme-linked immunosorbent assay (PCR-ELISA), resulting in an upper bound of the 95% confidence interval (95%-ULCI) of the infective rate in the vectors of 0.06/2,000 flies examined. Serological assays testing for Onchocerca volvulus exposure conducted on 4,230 children 5 years of age and under (of a total population of 10,280 in this age group) revealed that 2/4,230 individuals were exposed to O. volvulus (0.05%; one sided 95% confidence interval = 0.08%). Conclusions/Significance The in-depth epidemiological and entomological findings from the Southern Chiapas focus meet the criteria for interruption of transmission developed by the international community. PMID:23556018
Fawcett, Richard John; Kernohan, George
2017-09-12
To discover if healthcare professionals working within an ED are able to make a diagnosis of female genital mutilation (FGM) in those patients who have previously undergone the procedure and report it as per UK law. A retrospective analysis of patients' notes who were assigned an FGM code during the period of May 2015 to August 2016. Single-centre, large UK major trauma centre offering a tertiary FGM clinic. Any woman coded during the study period as having undergone FGM. Number of FGM cases identified by the ED. Mean age, presenting complaint, discharge diagnosis, genitourinary exam and defibulation status. 34 patients were identified as having undergone FGM, 19 had previously attended ED and none had their FGM identified during their ED attendance. The age range of those identified was 23 to 40 years. None had undergone defibulation. This study demonstrates that the identification of FGM victims by an ED is very poor, and more work needs to be done to increase awareness of the subject by front-line staff. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Evolution of speech-specific cognitive adaptations.
de Boer, Bart
2015-01-01
This paper argues that an evolutionary perspective is natural when investigating cognitive adaptations related to language. This is because there appears to be correspondence between traits that linguists consider interesting and traits that have undergone selective pressure related to language. The paper briefly reviews theoretical results that shed light on what kind of adaptations we can expect to have evolved and then reviews concrete work related to the evolution of adaptations for combinatorial speech. It turns out that there is as yet no strong direct evidence for cognitive traits that have undergone selection related to speech, but there is indirect evidence that indicates selection. However, the traits that may have undergone selection are expected to be continuously variable ones, rather than the discrete ones that linguists have focused on traditionally.
Aristarhov, V G; Danilov, N V; Aristarkhov, R V; Puzin, D A; Birykov, C V
2016-01-01
Long-term results of treatment of 180 patients operated 5 years ago for benign thyroid nodular pathology have been analyzed in the present paper, the results being analyzed depending on the volume of surgical intervention. The rate of postoperative hypothyrodism is lower in patients who had undergone limited thyroid resection, recurrent cases are more frequent, but they are not clinically significant and seldom require reoperation. It should also be noted that those patients have fewer cardiac complaints as the dose of hormone replacement therapy preparations is small. Elder patients who had undergone functionally significant thyroidectomy and need to take great doses of Thyroxin (107-150 mcg/day) have cardiac complaints more often (43 %) comparing to those who had undergone limited resections (35 %).
Emergency medicine in Dubai, UAE.
Partridge, Robert; Abbo, Michael; Virk, Alamjit
2009-08-18
Dubai has rapidly risen to prominence in the Persian Gulf region as a center of global commerce and tourism and as a cultural crossroad between East and West. The health-care infrastructure has undergone rapid development. Collaborations with academic medical centers now exist to advance clinical care, teaching and research. Emergency medicine has also advanced and is undergoing dynamic change. Dubai may soon emerge as a regional leader in emergency medicine training and practice.
Analytical electron microscope study of the omega phase transformation in a zirconium-niobium alloy
DOE Office of Scientific and Technical Information (OSTI.GOV)
Zaluzec, N. J.
1979-01-01
The study of the as-quenched omega phase morphology shows that the domain size of Zr-15% Nb is on the order of 30 A. No alignment of omega domains along <222>..beta.. directions was observed and samples having undergone thermal cycling in thin foil form, did not develop a long-period structure of alternating ..beta.. and ..omega.. phases below the omega transformation temperature. (FS)
Cell physiology at the Mount Desert Island Biological Laboratory: a brief look back and forward
2011-01-01
The Mount Desert Island Biological Laboratory (MDIBL) has played important roles in the development of modern physiological concepts and tools, particularly in the fields of kidney and epithelial cell physiology. Over the last decade, MDIBL has undergone remarkable growth and evolution. This article will briefly review MDIBL's past and outline its future directions. It is hoped that this overview will renew and stimulate interest in MDIBL and, in particular, will encourage an even wider community of physiologists to participate in its ongoing growth and development. PMID:21068363
Ebola vaccine, therapeutics, and diagnostics.
Furuyama, Wakako; Takada, Ayato
2016-01-01
Ebolaviruses, members of the family Filoviridae, cause severe hemorrhagic fever in humans and nonhuman primates, with human case fatality rates of up to 90%. No effective prophylaxis or treatment for Ebola virus disease (EVD) is yet commercially available. During the latest outbreak of EVD in West Africa, several unapproved drugs were used for the treatment of patients. This outbreak has indeed accelerated efforts to develop antiviral strategies and some of the vaccine and drug candidates have undergone clinical trials. This article reviews previous researches and recent advances on the development of vaccine, therapeutics, and diagnostics for EVD.
[Urban development and the demographic situation in Chaco and its capital between 1960 and 1990].
Foschiatti De Dell'orto, A M
1992-01-01
"The large demographic growth registered in the Chaco province [of Argentina] at the beginning of this Century slowed down since the 1950s as a result of the successive economic crisis undergone by this province. The demographic response was the outmigration toward the more developed areas of the country and to the capital city of Chaco. A large share of Resistencia demographic growth is provided by this internal migration. This rapid increase makes inadequate the functional and the service structure of the city." (SUMMARY IN ENG) excerpt
[Treatment of posterior noninfectious uveitis : Current situation and future developments].
Pleyer, U; Pohlmann, D; Stübiger, N
2016-05-01
Treatment of autoimmune diseases has undergone significant changes and developments in recent years. New classes of active substances, in particular biologics and small molecules have resulted in previously unknown success in the treatment of many diseases. In particular patients suffering from autoimmune rheumatic or dermatological diseases have benefited. For autoimmune uveitis there are numerous reports indicating excellent therapeutic and preventive effects; however, statutory approval for therapy in adults is still pending. This article outlines recent advances and future therapeutic options for the treatment of posterior segment noninfectious uveitis.
Lawani, Lucky O; Onyebuchi, Azubuike K; Iyoke, Chukwuemeka A; Okeke, Nwabunike E
2014-05-01
To determine the prevalence of female genital mutilation (FGM), the common forms of FGM, reasons for the practice, associated obstetric outcomes, and how these have affected efforts to achieve Millennium Development Goals (MDGs) 3, 4, and 5 in southeast Nigeria. A prospective descriptive study of parturients in southeast Nigeria was conducted from January to December 2012. All primigravid women attending delivery services at 2 health institutions during the study period were recruited, examined, and classified using the 2008 WHO classification for FGM. The mean age of the 516 participants was 27.24±4.80 years and most (66.3%) had undergone FGM. Type II FGM was the most common form, accounting for 59.6% of cases. Most FGM procedures were performed in infancy (97.1%) and for cultural reasons (60.8%). Women who had undergone FGM had significantly higher risk for episiotomy, perineal tear, hemorrhage, cesarean delivery, neonatal resuscitation, fresh stillbirth/early neonatal death, and longer hospitalization, with higher risk ratios associated with higher degrees of FGM. FGM is still a common practice in southeast Nigeria, where its association with adverse reproductive outcomes militates against efforts to achieve MDGs 3, 4, and 5. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Kazimoglu, Cemal; Yalcin, Nadir; Onvural, Burak; Akcay, Serkan; Agus, Haluk
2015-08-01
Debridement, antibiotic, and implant retention (DAIR) is an attractive treatment modality after hip hemiarthroplasty (HA) infections. Data about the success of the procedure after acute onset infections is lacking. The aim of this study was to analyze the clinical outcome and associated risk factors. A multicenter, retrospective cohort study was designed, including 39 patients with acute onset prosthetic infection who had undergone debridement and irrigation with prosthesis retention. The primary outcome measure was infection eradication without prosthesis removal. We also analyzed how the success rate was influenced by the length of the interval between implantation of the prosthesis and the beginning of the treatment. The overall success rate was 41%. Sedimentation rate over 60 mm/h and the longer duration (2 weeks) after prosthesis implantation were found as factors negatively influencing the success rate. Our results indicated limited success to DAIR- treated patients with infected HA. The high failure rate of DAIR treatment after 2 weeks from the implantation should be taken into consideration.
Manning, Wendy D.
2015-01-01
The American family has undergone rapid transformation. Careful measurement attention to family formation is important because families are at the heart of numerous decisions, roles, and responsibilities with implications for understanding the well-being of families, adults and children. This paper considers whether there is a need for a new household panel study that addresses family formation. This paper consists of a review of the recent body of population-based, American surveys and finds a considerable gap in the ability to study the implications of families for the health and well-being of Americans. Earlier panel surveys used to assess family life anchored questions around marital events, but changes in family patterns require attention to a more diverse set of family forms. The paper concludes with recommendations for a multi-purpose panel study. The key challenge is to keep to pace with complexity and changes in American family life while at the same time maintaining a parsimonious set of survey questions. PMID:26612969
Decision-Making for Induced Abortion in the Accra Metropolis, Ghana.
Gbagbo, Fred Yao; Amo-Adjei, Joshua; Laar, Amos
2015-06-01
Decision-making for induced abortion can be influenced by various circumstances including those surrounding onset of a pregnancy. There are various dimensions to induced abortion decision-making among women who had an elective induced abortion in a cosmopolitan urban setting in Ghana, which this paper examined. A cross-sectional mixed method study was conducted between January and December 2011 with 401 women who had undergone an abortion procedure in the preceding 12 months. Whereas the quantitative data were analysed with descriptive statistics, thematic analysis was applied to the qualitative data. The study found that women of various profiles have different reasons for undergoing abortion. Women considered the circumstances surrounding onset of pregnancy, person responsible for the pregnancy, gestational age at decision to terminate, and social, economic and medical considerations. Pressures from partners, career progression and reproductive intentions of women reinforced these reasons. First time pregnancies were mostly aborted regardless of gestational ages and partners' consent. Policies and programmes targeted at safe abortion care are needed to guide informed decisions on induced abortions.
Immune monitoring of clinical trials with biotherapies.
Whiteside, Theresa L
2008-01-01
Immune monitoring of biotherapy clinical trials has undergone a considerable change in recent years. Technical advances together with new insights into molecular immunology have ushered a new genre of assays into immune monitoring. Single-cell assays, multiplex profiling, and signaling molecule detection have replaced formerly used bulk assays, such as proliferation or cytotoxicity. The emphasis on immune cell functions and quantitation of antigen-specific T cells has been playing a major role in attempts to establish correlations between therapy-induced alterations in immune responses and clinical endpoints. However, this has been an elusive goal to achieve, and there is a special need for improving the quality of serial monitoring to ensure that it adequately and reliably measures changes induced by administered biotherapy. In this respect, monitoring performed in specialized reference laboratories operating as good laboratory practice (GLP) facilities and strengthening of interactions between the clinical investigator, the clinical immunologist, and the biostatistician are crucial for successful use of immune monitoring in clinical studies.
Kim, Jung-Hee; Shin, Sujin; Park, Jin-Hwa
2015-04-01
The purpose of this study was to evaluate the methodological quality of nursing studies using structural equation modeling in Korea. Databases of KISS, DBPIA, and National Assembly Library up to March 2014 were searched using the MeSH terms 'nursing', 'structure', 'model'. A total of 152 studies were screened. After removal of duplicates and non-relevant titles, 61 papers were read in full. Of the sixty-one articles retrieved, 14 studies were published between 1992 and 2000, 27, between 2001 and 2010, and 20, between 2011 and March 2014. The methodological quality of the review examined varied considerably. The findings of this study suggest that more rigorous research is necessary to address theoretical identification, two indicator rule, distribution of sample, treatment of missing values, mediator effect, discriminant validity, convergent validity, post hoc model modification, equivalent models issues, and alternative models issues should be undergone. Further research with robust consistent methodological study designs from model identification to model respecification is needed to improve the validity of the research.
Ethical challenges with awake craniotomy for tumor.
Kirsch, Brandon; Bernstein, Mark
2012-01-01
Awake brain surgery is useful for the treatment of a number of conditions such as epilepsy and brain tumor, as well as in functional neurosurgery. Several studies have been published regarding clinical results and outcomes of patients who have undergone awake craniotomy but few have dealt with related ethical issues. The authors undertake to explore broadly the ethical issues surrounding awake brain surgery for tumor resection to encourage further consideration and discussion. Based on a review of the literature related to awake craniotomy and in part from the personal experience of the senior author, we conducted an assessment of the ethical issues associated with awake brain tumor surgery. The major ethical issues identified relate to: (1) lack of data; (2) utilization; (3) conflict of interest; (4) informed consent; (5) surgical innovation; and (6) surgical training. The authors respectfully suggest that the selection of patients for awake craniotomy needs to be monitored according to more consistent, objective standards in order to avoid conflicts of interest and potential harm to patients.
Global warming in the context of 2000 years of Australian alpine temperature and snow cover.
McGowan, Hamish; Callow, John Nikolaus; Soderholm, Joshua; McGrath, Gavan; Campbell, Micheline; Zhao, Jian-Xin
2018-03-13
Annual resolution reconstructions of alpine temperatures are rare, particularly for the Southern Hemisphere, while no snow cover reconstructions exist. These records are essential to place in context the impact of anthropogenic global warming against historical major natural climate events such as the Roman Warm Period (RWP), Medieval Climate Anomaly (MCA) and Little Ice Age (LIA). Here we show for a marginal alpine region of Australia using a carbon isotope speleothem reconstruction, warming over the past five decades has experienced equivalent magnitude of temperature change and snow cover decline to the RWP and MCA. The current rate of warming is unmatched for the past 2000 years and seasonal snow cover is at a minimum. On scales of several decades, mean maximum temperatures have undergone considerable change ≈ ± 0.8 °C highlighting local scale susceptibility to rapid temperature change, evidence of which is often masked in regional to hemisphere scale temperature reconstructions.
NASA Technical Reports Server (NTRS)
Spudis, P. D.; Hawke, B. R.
1982-01-01
Chemical mixing model studies of lunar geochemical data for the central and Taurus-Littrow lunar highlands were performed utilizing pristine highland rock types as end member compositions. The central highlands show considerable diversity in composition; anorthosite is the principal rock type in the Apollo 16/Descartes region, while norite predominates in the highlands west of the landing site. This change in crustal composition is coincident with a major color boundary seen in earth-based multispectral data and probably represents the presence of distinct geochemical provinces within the central highlands. The Taurus-Littrow highlands are dominated by norite; anorthosite is far less abundant than in the central highlands. This suggests that the impact target for the Serenitatis basin was different than that of the Nectaris basin and further strengthens the hypothesis that the lunar highlands are petrologically heterogeneous on a regional basis. It is suggested that the lunar highlands should be viewed in terms of geochemical provinces that have undergone distinct and complex igneous and impact histories.
Hollanda Carvalho, Pedro; Maia Queiroz Lima, Sergio; Henrique Zawadzki, Cláudio; Oliveira, Cláudio; de Pinna, Mario
2016-09-01
The upper Paraná River system (UP) is a highly diverse biogeographic province for freshwater fishes, but little is known about processes which shaped that diversity. This study describes the phylogeographic pattern in Hypostomus ancistroides, a suckermouth catfish species that is widespread in the UP and also reported from the adjoining Ribeira do Iguape basin. We used complete mtDNA sequences of ATPase 6/8 of 162 specimens to infer haplotype distribution using phylogenetic and demographic analyses and a Bayesian molecular clock. Results suggest that during the Quaternary H. ancistroides has undergone superimposed phylogeographic histories, alternating between isolation and subsequent merging of different populations. Occurrence of an isolated population on the Ribeira de Iguape is demonstrated to be a Pleistocene headwater capture event. Widely distributed haplotypes indicate deep genetic differences and suggest that populations of H. ancistroides were isolated for considerable time, but did not undergo speciation because of recurrent population mixing.
Demographics of the Canadian dairy industry from 1991 to 2011.
Jelinski, Murray D; LeBlanc, Stephen; Kennedy, Richard
2015-07-01
A retrospective study of the demographics of the Canadian dairy industry was conducted using data derived from Statistics Canada's Census of Agriculture from 1991 to 2011. This longitudinal study shows that Canada's dairy industry has undergone considerable consolidation. From 1991 to 2011, the number of dairy producers and dairy farms decreased by 48.9% and 61.9%, respectively. Furthermore, this trend in consolidation is likely to continue; nearly half (45.8%) of all dairy producers in Canada were ≥ 50 y of age in 2011. Not only will most of these producers be retired by 2021, but younger producers will also exit the industry for other reasons. These findings mirror what is occurring in Canada's cow-calf industry, underscoring that supply-managed sectors experience demographic consolidation similar to non-supply managed sectors. These substantial changes will have ramifications for the veterinary profession. There will be fewer but larger farms, and the services and knowledge demanded of veterinarians will change accordingly, which has implications for food animal veterinary education.
Demographics of the Canadian dairy industry from 1991 to 2011
Jelinski, Murray D.; LeBlanc, Stephen; Kennedy, Richard
2015-01-01
A retrospective study of the demographics of the Canadian dairy industry was conducted using data derived from Statistics Canada’s Census of Agriculture from 1991 to 2011. This longitudinal study shows that Canada’s dairy industry has undergone considerable consolidation. From 1991 to 2011, the number of dairy producers and dairy farms decreased by 48.9% and 61.9%, respectively. Furthermore, this trend in consolidation is likely to continue; nearly half (45.8%) of all dairy producers in Canada were ≥ 50 y of age in 2011. Not only will most of these producers be retired by 2021, but younger producers will also exit the industry for other reasons. These findings mirror what is occurring in Canada’s cow-calf industry, underscoring that supply-managed sectors experience demographic consolidation similar to non-supply managed sectors. These substantial changes will have ramifications for the veterinary profession. There will be fewer but larger farms, and the services and knowledge demanded of veterinarians will change accordingly, which has implications for food animal veterinary education. PMID:26130831
Space Propulsion Research Facility (B-2): An Innovative, Multi-Purpose Test Facility
NASA Technical Reports Server (NTRS)
Hill, Gerald M.; Weaver, Harold F.; Kudlac, Maureen T.; Maloney, Christian T.; Evans, Richard K.
2011-01-01
The Space Propulsion Research Facility, commonly referred to as B-2, is designed to hot fire rocket engines or upper stage launch vehicles with up to 890,000 N force (200,000 lb force), after environmental conditioning of the test article in simulated thermal vacuum space environment. As NASA s third largest thermal vacuum facility, and the largest designed to store and transfer large quantities of propellant, it is uniquely suited to support developmental testing associated with large lightweight structures and Cryogenic Fluid Management (CFM) systems, as well as non-traditional propulsion test programs such as Electric and In-Space propulsion. B-2 has undergone refurbishment of key subsystems to support the NASA s future test needs, including data acquisition and controls, vacuum, and propellant systems. This paper details the modernization efforts at B-2 to support the Nation s thermal vacuum/propellant test capabilities, the unique design considerations implemented for efficient operations and maintenance, and ultimately to reduce test costs.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Harrison, Thomas E.; Marra, Rachel E., E-mail: tharriso@nmsu.edu, E-mail: rmarra@nmsu.edu
We present new moderate-resolution near-infrared spectroscopy of three CVs obtained using GNIRS on Gemini-North. These spectra covered three {sup 13}CO bandheads found in the K -band, allowing us to derive the isotopic abundance ratios for carbon. We find small {sup 12}C/{sup 13}C ratios for all three donor stars. In addition, these three objects show carbon deficits, with AE Aqr being the most extreme ([C/Fe] = −1.4). This result confirms the conjecture that the donor stars in some long-period CVs have undergone considerable nuclear evolution prior to becoming semi-contact binaries. In addition to the results for carbon, we find that themore » abundance of sodium is enhanced in these three objects, and the secondary stars in both RU Peg and SS Cyg suffer magnesium deficits. Explaining such anomalies appears to require higher mass progenitors than commonly assumed for the donor stars of CVs.« less
From compassionate ageism to intergenerational conflict?
Binstock, Robert H
2010-10-01
During the 50 years in which The Gerontologist has been publishing, the politics of aging in the United States has undergone distinct changes. The political behavior of older individuals has remained largely the same even though different birth cohorts have succeeded each other in populating the ranks of older people. But the politics of policies on aging-the organized interest and advocacy groups active in this arena, the tenor of public discourse about older people as beneficiaries of policies on aging, the national political agendas regarding public old-age benefits, and the broader U.S. political economy-have changed substantially over these five decades. Now, in the contexts of the aging of the baby boom and concerns about reducing large federal fiscal deficits (annual and cumulative), the politics of U.S. policies on aging may change considerably from those of yesterday and today. Is there a possibility of future intergenerational political conflict over taxes and expenditures for the major old-age benefit programs? If so, what might prevent or mitigate it?
Murray, P K
1998-08-01
The unique structure, role and operations of government high-security (HS) laboratories which work on animal diseases are described, with particular reference to the laboratories of nine countries. High-security laboratories provide cost-effective insurance against catastrophic losses which could occur following exotic disease outbreaks. The importance of these laboratories is reflected in the fact that several new laboratories have recently been constructed at considerable expense and older facilities have undergone major renovations. Biosecurity is fundamental to the operation of high-security laboratories, so good facility design and microbiological security practices are very important. High-security laboratories conduct exotic disease diagnosis, certification and surveillance, and also perform research into virology, disease pathogenesis and improvements to diagnostic tests and vaccines. The mandate of these laboratories includes the training of veterinarians in the recognition of exotic diseases. One extremely important role is the provision of expert advice on exotic diseases and participation (both nationally and internationally) in policy decisions regarding animal disease issues.
Haderslev, Kent Valentin; Jeppesen, Paller Bekker; Sorensen, Henrik Ancher; Mortensen, Per Brobech; Staun, Michael
2003-07-01
Patients who have undergone resection of the small intestine have lower body weight than do healthy persons. It remains unclear whether it is the body fat mass or the lean tissue mass that is reduced. We compared body-composition values in patients who had undergone small-intestinal resection with reference values obtained in healthy volunteers, and we studied the relation between body-composition estimates and the net intestinal absorption of energy. In a cross-sectional study, we included 20 men and 24 women who had undergone small-intestinal resection and had malabsorption of energy > 2000 kJ/d. Diagnoses were Crohn disease (n = 37) and other conditions (n = 7). Body composition was estimated by dual-energy X-ray absorptiometry, and data were compared with those from a reference group of 173 healthy volunteers. Energy absorption was measured during 48-h balance studies by using bomb calorimetry, and individual values were expressed relative to the basal metabolic rate. Body weight and body mass index in patients were significantly (P < 0.05) lower than the reference values. Fat mass was 6.4 kg (30%) lower (95% CI: -8.8, -3.9 kg), but lean tissue mass was only slightly and insignificantly lower (1.5 kg, or 3.3%; 95% CI: -3.7, 0.60 kg). Weight, body mass index, and body-composition estimates by dual-energy X-ray absorptiometry did not correlate significantly with the net energy absorption relative to the basal metabolic rate, expressed as a percentage. Patients who had undergone small-intestinal resection had significantly lower body weights and body mass indexes than did healthy persons, and they had significant changes in body composition, mainly decreased body fat mass.
[The role of selected risk factors in Barrett's esophagus development].
Kiciński, Przemysław; Mokrowiecka, Anna; Czkwianianc, Elzbieta; Kolasa-Kicińska, Marzena; Wozniakowska-Gesicka, Teresa; Małecka-Panas, Ewa
2009-05-01
Barrett's esophagus is the proved stage of increasing risk for development of esophageal adenocarcinoma. Why among wide spread GERD, a few patients only develop Barrett's esophagus is still not clear. To define the factors, which significantly increase the risk for development Barrett's esophagus. The study involved 36 patients hospitalized in the years 2005-2007 in the Department of Digestive Tract Diseases, Medical University in Lódź, with diagnosed Barrett's esophagus (based on gastroscopy with biopsy and histopathologic findings). For the analysis, two control groups of healthy subjects were chosen: I--35 patients (mean age 54.3 years) with normal gastroscopy, II--40 patients (mean age 54.2 years) who had not undergone gastroscopy Risk factors were evaluated according to the self-elaborated, filled-in questionnaire. The following risk factors were taken into consideration: age, sex, BMI, stimulants (cigarettes, alcohol and coffee), diet, eating habits (preferred food, fruit and vegetables consumption, regularity and quantity of meals), physical activity, heartburn sensation, swallowing disorders, nausea, other diseases and family history. Mean age of patients with diagnosed Barrett's esophagus was 55.9 +/- 11.2 years; in men: 55.7 +/- 12.2 and in women: 56.3 +/- 9.2. In the analyzed group there were 25 men (69.4%) and 11 women (30.6%), the man/woman ratio was 2.3:1. In the group with diagnosed Barrett's esophagus the heartburn sensation was observed in 30 (83.3%) patients, overweight and obesity (BMI >25 kg/m2) in 22 (61.1%) patients, 16 (44.4%) patients smoked cigarettes, 11 (30.6%) had swallowing problems, 12 (33.3%) suffered from nausea. Factors and symptoms, mentioned above have been significantly more often observed, as compared to I and/or II control group (p < or = 0.05). Statistical significance for other analyzed factors was not reached (significance value p < or = 0.05). Barrett's esophagus is associated with: male sex, overweight and obesity (BMI > 25 kg/m2), cigarette smoking, heartburn sensation, swallowing disorders and nausea.
Xu, Zongda; Sun, Lidan; Zhou, Yuzhen; Yang, Weiru; Cheng, Tangren; Wang, Jia; Zhang, Qixiang
2015-10-01
SQUAMOSA promoter-binding protein (SBP)-box family genes encode plant-specific transcription factors that play crucial roles in plant development, especially flower and fruit development. However, little information on this gene family is available for Prunus mume, an ornamental and fruit tree widely cultivated in East Asia. To explore the evolution of SBP-box genes in Prunus and explore their functions in flower and fruit development, we performed a genome-wide analysis of the SBP-box gene family in P. mume. Fifteen SBP-box genes were identified, and 11 of them contained an miR156 target site. Phylogenetic and comprehensive bioinformatics analyses revealed that different groups of SBP-box genes have undergone different evolutionary processes and varied in their length, structure, and motif composition. Purifying selection has been the main selective constraint on both paralogous and orthologous SBP-box genes. In addition, the sequences of orthologous SBP-box genes did not diverge widely after the split of P. mume and Prunus persica. Expression analysis of P. mume SBP-box genes revealed their diverse spatiotemporal expression patterns. Three duplicated SBP-box genes may have undergone subfunctionalization in Prunus. Most of the SBP-box genes showed high transcript levels in flower buds and young fruit. The four miR156-nontargeted genes were upregulated during fruit ripening. Together, these results provide information about the evolution of SBP-box genes in Prunus. The expression analysis lays the foundation for further research on the functions of SBP-box genes in P. mume and other Prunus species, especially during flower and fruit development.
Cagáňová, Veronika; Borský, Jiří; Smahel, Zbyněk; Velemínská, Jana
2014-01-01
To describe the effect of secondary alveolar bone grafting in patients with unilateral cleft lip and palate by comparison with a sample of patients who have undergone primary periosteoplasty. Cephalometric analysis of lateral x-ray films in a retrospective semilongitudinal study. Lateral x-ray films of 18 secondary alveolar bone grafting patients and 48 primary periosteoplasty patients at 10 years of age and again at 15 years of age. The treatment of secondary alveolar bone grafting patients included lip repair according to Tennison, palatoplasty including retropositioning, pharyngeal flap surgery, and secondary alveolar bone grafting. The lips of primary periosteoplasty patient were repaired using the methods of Tennison and Veau, followed by primary periosteoplasty, palatoplasty including retropositioning, and pharyngeal flap surgery. Lateral radiographs were assessed using classical morphometry. There were few significant differences at 10 years of age between the secondary alveolar bone grafting and primary periosteoplasty patients. At 15 years of age, there were several significant differences. Compared with primary periosteoplasty patients, subsequent development in patients who had undergone secondary alveolar bone grafting was characterized by a significantly better position of the upper and lower dentoalveolar components in relation to the facial plane, a higher increase in the global convexity of the soft profile, a significantly better maxillary inclination, and a more favorable development of vertical intermaxillary relationships. Craniofacial development in secondary alveolar bone grafting patients was better than that in primary periosteoplasty patients due to the more marked facial convexity, the increased prominence of the nose, and better vertical intermaxillary relationships.
Zonn, I S
1995-01-01
During the second half of the 20th century Kalmykia has undergone severe desertification. Under Soviet rule, rangelands were increasingly devoted to animal production, and pastures were converted to cropland in a campaign to increase crops. Pastures were grazed two to three times their sustainable production, saiga populations and habitat greatly decreased, more than 17 million ha were subjected to wind erosion, 380,000 ha were transformed into moving sands, and 106,000 ha were ruined by secondary salinization and waterlogging. By the 1990s almost 80% of the Republic had undergone desertification, and 13% had been transformed into a true desert. In 1986 the General Scheme of Desertification Control was formulated. The scheme called for rotating pastures, reclaiming blown sand using silviculture, tilling overgrazed pastures and sowing fodder plants, and developing water supplies for pastures. In its early years the scheme has been successful. But the management of restored pastures usually reverts to the same farms responsible for the poor conditions, and there is great apprehension that degradation could reoccur. This case study concludes that the general cattle and agriculture development in Kalmykia is unviable for ecological and economic reasons, that Kalmykia should implement an adaptive policy oriented toward conservation and accommodating the interrelation and variability of land resources, that the desertification problem can be solved only by changing agrarian policy as a whole, and that a desertification control program must become an integral part of economic and social development of the Republic.
Ellis, Michael P; Broxterman, Emily C; Hromas, Alan R; Whittaker, Thomas J; Sokol, Jason A
2018-01-10
Surgical management of ophthalmic Graves' disease traditionally involves, in order, orbital decompression, followed by strabismus surgery and eyelid surgery. Nunery et al. previously described two distinct sub-types of patients with ophthalmic Graves' disease; Type I patients exhibit no restrictive myopathy (no diplopia) as opposed to Type II patients who do exhibit restrictive myopathy (diplopia) and are far more likely to develop new-onset worsening diplopia following medial wall and floor decompression. Strabismus surgery involving extra-ocular muscle recession has, in turn, been shown to potentially worsen proptosis. Our experience with Type II patients who have already undergone medial wall and floor decompression and strabismus surgery found, when additional decompression is necessary, deep lateral wall decompression (DLWD) appears to have a low rate of post-operative primary-gaze diplopia. A case series of four Type II ophthalmic Graves' disease patients, all of whom had already undergone decompression and strabismus surgery, and went on to develop worsening proptosis or optic nerve compression necessitating further decompression thereafter. In all cases, patients were treated with DLWD. Institutional Review Board approval was granted by the University of Kansas. None of the four patients treated with this approach developed recurrent primary-gaze diplopia or required strabismus surgery following DLWD. While we still prefer to perform medial wall and floor decompression as the initial treatment for ophthalmic Graves' disease, for proptosis following consecutive strabismus surgery, DLWD appears to be effective with a low rate of recurrent primary-gaze diplopia.
Estimated Chemical Warfare Agent Surface Clearance Goals for Remediation Pre-Planning
DOE Office of Scientific and Technical Information (OSTI.GOV)
Dolislager, Frederick; Bansleben, Dr. Donald; Watson, Annetta Paule
2010-01-01
Health-based surface clearance goals, in units of mg/cm2, have been developed for the persistent chemical warfare agents sulfur mustard (HD) and nerve agent VX as well as their principal degradation products. Selection of model parameters and critical receptor (toddler child) allow calculation of surface residue estimates protective for the toddler child, the general population and adult employees of a facilty that has undergone chemical warfare agent attack.
2005-06-01
Perceived Career Success , Commitment and Turnover Intentions. The Journal of American Academy of Business, Cambridge, 164-170. 22 undergone an...organizational commitment and career success and longevity, which was described earlier.40 One key to all of the opportunities for development presented...2004, September) The Effects of Mentoring on Perceived Career Success , Commitment and Turnover Intentions. The Journal of American Academy of
2009-05-01
adoptive therapy using CD19-specific chimeric antigen receptor re-directed T cells for recurrent/refrctory follicular lymphoma...Beauty (SB) transposon/transposase system to express a CD19-specific chimeric antigen receptor (CAR). T cells that have undergone transposition...accomplished using genetic engineering to express a chimeric antigen receptor (CAR) to redirect the specificity of T cells for CD19 on malignant B cells
Gunda, Venugopal; Verma, Raj K.; Pawar, Smita C.; Sudhakar, Yakkanti A.
2013-01-01
Collagen constitutes one of the vital components of the basement membrane scaffolds. Non-collagenous domains (NC1) derived from collagens exhibit potent anti-angiogenic properties, thus attaining significance in regulation of angiogenesis promoted diseases. Individual NC1 domains essential for anti-angiogenic evaluations are generally obtained through purification of individual non-collagenous domains, which have undergone steady developments for enhancing the yields, purpose of biological evaluations and solubility based on the nature of different NC1 domains. This review focuses on the method developments in obtaining biologically active NC1 domains and for specific evaluations in different scenarios. PMID:24215863
Effects and effectiveness of telemedicine.
Grigsby, J; Kaehny, M M; Sandberg, E J; Schlenker, R E; Shaughnessy, P W
1995-01-01
The use of telemedicine has recently undergone rapid growth and proliferation. Although the feasibility of many applications has been tested for nearly 30 years, data concerning the costs, effects, and effectiveness of telemedicine are limited. Consequently, the development of a strategy for coverage, payment, and utilization policy has been hindered. Telemedicine continues to expand, and pressure for policy development increases in the context of Federal budget cuts and major changes in health service financing. This article reviews the literature on the effects and medical effectiveness of telemedicine. It concludes with several recommendations for research, followed by a discussion of several specific questions, the answers to which might have a bearing on policy development.
NASA Technical Reports Server (NTRS)
Johnson, K. L.; Reysa, R. P.; Fricks, D. H.
1981-01-01
Vapor compression distillation (VCD) is considered the most efficient water recovery process for spacecraft application. This paper reports on a preprototype VCD which has undergone the most extensive operational and component development testing of any VCD subsystem to date. The component development effort was primarily aimed at eliminating corrosion and the need for lubrication, upgrading electronics, and substituting nonmetallics in key rotating components. The VCD evolution is documented by test results on specific design and/or materials changes. Innovations worthy of further investigation and additional testing are summarized for future VCD subsystem development reference. Conclusions on experience gained are presented.
A kinematic model for the development of the Afar Depression and its paleogeographic implications
NASA Astrophysics Data System (ADS)
Redfield, T. F.; Wheeler, W. H.; Often, M.
2003-11-01
The Afar Depression is a highly extended region of continental to transitional oceanic crust lying at the junction of the Red Sea, the Gulf of Aden and the Ethiopian rifts. We analyze the evolution of the Afar crust using plate kinematics and published crustal models to constrain the temporal and volumetric evolution of the rift basin. Our reconstruction constrains the regional-scale initial 3D geometry and subsequent extension and is well calibrated at the onset of rifting (˜20 Ma) and from the time of earliest documented sea-floor spreading anomalies (˜6 Ma Red Sea; ˜10 Ma Gulf of Aden). It also suggests the Danakil block is a highly extended body, having undergone between ˜200% and ˜400% stretch. Syn-rift sedimentary and magmatic additions to the crust are taken from the literature. Our analysis reveals a discrepancy: either the base of the crust has not been properly imaged, or a (plume-related?) process has somehow caused bulk removal of crustal material since extension began. Inferring subsidence history from thermal modeling and flexural considerations, we conclude subsidence in Afar was virtually complete by Mid Pliocene time. Our analysis contradicts interpretations of late (post 3 Ma) large (˜2 km) subsidence of the Hadar area near the Ethiopian Plateau, suggesting paleoclimatic data record regional, not local, climate change. Tectonic reconstruction (supported by paleontologic and isotopic data) suggests that a land bridge connected Africa and Arabia, via Danakil, up to the Early to Middle Pliocene. The temporal constraints on land bridge and escarpment morphology constrain Afar paleogeography, climate, and faunal migration routes. These constraints (particularly the development of geographic isolation) are fundamentally important for models evaluating and interpreting biologic evolution in the Afar, including speciation and human origins.
Ideology, psychiatric practice and professionalism.
Bouras, N; Ikkos, G
2013-01-01
Psychiatry, associated as it is with social and cultural factors, has undergone profound changes over the last 50 years. Values, attitudes, beliefs and ideology all influence psychiatry. Deinstitutionalisation, the normalization principle, advocacy, empowerment and the recovery model are ideologies that have been closely associated with policy, service developments and clinical practice in psychiatry. A "new professionalism" is emerging as a consequence of a number of changes in mental health care that needs to be guided by the highest standards of care which are best epitomized in psychiatry as a social contract with society. Looking to the future it is important that the profession recognises the impact ideology can make, if it is not to remain constantly on the defensive. In order to engage proactively and effectively with ideology as well as clinical science and evidence based service development, psychiatry as a profession will do best to approach significant future policy, practice and service changes by adopting an ethical approach, as a form a social contract. Psychiatrists must pay increasing attention to understanding values as expressed by ideologies, working in a collaborative way with other mental health professionals, involve service users and manage systems as well as be competent in clinical assessment and treatment. Whether in time of plenty or in times of deprivation, ideology produces effects on practice and in the context of constantly changing knowledge and the current financial stress this is likely to be more the case (and not less) in the foreseeable future. Psychiatrists must take into consideration the new social problems seen in some high income countries with the increased availability of highly potent "street drugs", perceived threats from various immigrant and minority communities and breakdown of "social capital" such as the decline of the nuclear family.
Rind, Esther; Jones, Andy; Southall, Humphrey
2014-03-01
In recent decades, the prevalence of physical activity has declined considerably in many developed countries, which has been related to rising levels of obesity and several weight-related medical conditions, such as coronary heart disease. There is evidence that areas exhibiting particularly low levels of physical activity have undergone a strong transition away from employment in physically demanding occupations. It is proposed that such processes of deindustrialisation may be causally linked to unexplained geographical disparities in physical activity. This study investigates how geographical variations in deindustrialisation are associated with current levels of physical activity across different activity domains and relevant macro-economic time periods in England. The analysis includes data on 27,414 adults from the Health Survey for England 2006 and 2008 who reported total, occupational, domestic, recreational and walking activity. Based on employment change in industries associated with heavy manual work, a local measurement of industrial decline was developed, covering the period 1841-2001. We applied a multilevel modelling approach to study associations between industrial decline and physical activity. Results indicate that the process of deindustrialisation appears to be associated with patterns of physical activity and that this is independent of household income. The effects observed were generally similar for men and women. However, the nature of the association differed across areas, time periods and employment types; in particular, residents of districts characterised by a history of manufacturing and mining employment had increased odds of reporting low activity levels. We conclude that post-industrial change may be a factor in explaining present-day variations in physical activity, emphasising the plausible impact of inherited cultures and regional identities on health related behaviours. Copyright © 2013 Elsevier Ltd. All rights reserved.
Dong, Xiaofeng; Armstrong, Stuart D; Xia, Dong; Makepeace, Benjamin L; Darby, Alistair C; Kadowaki, Tatsuhiko
2017-03-01
The number of managed honey bee colonies has considerably decreased in many developed countries in recent years and ectoparasitic mites are considered as major threats to honey bee colonies and health. However, their general biology remains poorly understood. We sequenced the genome of Tropilaelaps mercedesae, the prevalent ectoparasitic mite infesting honey bees in Asia, and predicted 15 190 protein-coding genes that were well supported by the mite transcriptomes and proteomic data. Although amino acid substitutions have been accelerated within the conserved core genes of two mites, T. mercedesae and Metaseiulus occidentalis, T. mercedesae has undergone the least gene family expansion and contraction between the seven arthropods we tested. The number of sensory system genes has been dramatically reduced, but T. mercedesae contains all gene sets required to detoxify xenobiotics. T. mercedesae is closely associated with a symbiotic bacterium (Rickettsiella grylli-like) and Deformed Wing Virus, the most prevalent honey bee virus. T. mercedesae has a very specialized life history and habitat as the ectoparasitic mite strictly depends on the honey bee inside a stable colony. Thus, comparison of the genome and transcriptome sequences with those of a tick and free-living mites has revealed the specific features of the genome shaped by interaction with the honey bee and colony environment. Genome and transcriptome sequences of T. mercedesae, as well as Varroa destructor (another globally prevalent ectoparasitic mite of honey bee), not only provide insights into the mite biology, but may also help to develop measures to control the most serious pests of the honey bee. © The Author 2017. Published by Oxford University Press.
Tilney, N L; Guttmann, R D; Daar, A S; Hoffenberg, R; Kennedy, I; Lock, M; Radcliffe-Richards, J; Sells, R A
2001-03-15
Clinical organ transplantation has evolved through advances in patient care in parallel with investigations in associated biologies. It has developed from a cottage industry to an important medical specialty driven increasingly by the availability of newer and more effective immunosuppressive drugs, and dependent on consistently close collaborations between university-based clinical scientists and the pharmaceutical industry. Particularly during the past decade, however, this industry has undergone striking changes, consolidating into huge multi-national corporations, each competing for patients, their doctors, and for support of the allied hospitals. Because of the growth of "Big Pharma," the relationship between academia and industry has changed. There have been many advantages to such mutually dependent interactions. A combination of university-based expertise and the specialized knowledge and resources of industry have produced important scientific gains in drug development. Commercial sponsorship of applied research has been crucial. The orchestration of multicenter controlled clinical drug trials has provided invaluable information about the effectiveness of newer agents. But there are also disadvantages of increasing concern. Indeed, the power of "Big Pharma" in many medical fields including transplantation is such that presentation of data can be delayed, adverse results withheld, and individual investigations hampered. Clinical trials may be protracted to stifle competition. Monetary considerations may transcend common sense. Several measures to enhance the clinical relationship between the pharmaceutical industry and those involved with organ transplantation are suggested, particularly the use of third party advisors in the production of clinical trials, support for more basic research and in the dissemination of results. In this way, the increasingly problematic phenomenon of commercialization of the field of transplantation can be tempered and controlled.
Cost-effectiveness of statins revisited: lessons learned about the value of innovation.
Lindgren, Peter; Jönsson, Bengt
2012-08-01
The economic evaluation of statins has undergone a development from risk-factor-based models to modeling of hard end points in clinical trials with a shift back to risk-factor models after increased confidence in their predictive power has now been established. At this point, we can look back on the historical economic data on simvastatin to see what lesson regarding reimbursement we can learn. Historical data on the usage and sales of simvastatin in Sweden were combined with published epidemiological and clinical data to calculate the social value of simvastatin to the present day and to make projection until projected until 2018. The distribution of the social surplus was calculated by taking the costs born by society and the producer of the drug into consideration. The cost of simvastatin fell drastically following patent expiration, although the number of treated patients has continued to grow. Presently, the use of simvastatin is close to cost neutrality taking direct and indirect cost savings from reduced morbidity into account. However, the major part of the social surplus generated comes from the value of improved quality-adjusted survival. Of the social surplus generated, the producer appropriated 20-43% of the value during the on-patent period, a figure dropping to 1% following loss of exclusivity. The total producer surplus between 1987 and 2018 is 2-5% of the total social surplus. Only a small part of the surplus value generated was appropriated by the producer. A regulatory and reimbursement approach that favors early market access and coverage with evidence development as opposed to long-term trials as a pre-requisite for launch is more attractive from both a company and social perspective.
Defining the Bobath concept using the Delphi technique.
Raine, Sue
2006-03-01
The Bobath concept, based on the work of Berta and Karel Bobath, offers therapists working in the field of neurological rehabilitation a framework for their clinical interventions. It is the most commonly used approach in the UK. Although they recognize that over the last half-century the concept has undergone considerable developments, proponents of the Bobath concept have been criticized for not publishing these changes. The aim of the present study was to use the Delphi technique to enable experts in the field to define the current Bobath concept. A four-round Delphi study design was used. The sample included all members of the British Bobath Tutor's Association, who are considered experts in the field. Initial statements were identified from the literature, with respondents generating additional statements during the study. The level of agreement was determined using a five-point Likert scale. The respondents were then provided with feedback on group opinions and given an opportunity to re-rate each statement. The level of group consensus was set at 80%. Fifteen experts took part. The response rate was 85% in the first round, and 93% in each subsequent round. Ten statements from the literature were rated with a further 12 generated by the experts. Thirteen statements achieved consensus for agreement and seven for disagreement. The Delphi study was an effective research tool, maintaining anonymity of responses and exploring expert opinions on the Bobath concept. The experts stated that Bobath's work has been misunderstood if it is considered as the inhibition of spasticity and the facilitation of normal movement, as described in some literature. They agreed that the Bobath concept was developed by the Bobaths as a living concept, understanding that as therapists' knowledge base grows their view of treatment broadens.
Emren, Sadık Volkan; Kocabaş, Uğur; Duygu, Hamza; Levent, Fatih; Şimşek, Ersin Çağrı; Yapan Emren, Zeynep; Tülüce, Selcen
2016-01-01
The HATCH score predicts the development of persistent and permanent atrial fibrillation (AF) one year after spontaneous or pharmacological conversion to sinus rhythm in patients with AF. However, it remains unknown whether HATCH score predicts short-term success of the procedure at early stages for patients who have undergone electrical cardioversion (EC) for AF. The present study evaluated whether HATCH score predicts short-term success of EC in patients with AF. The study included patients aged 18 years and over, who had undergone EC due to AF lasting less than 12 months, between December 2011 and October 2013. HATCH score was calculated for all patients. The acronym HATCH stands for Hypertension, Age (above 75 years), Transient ischaemic attack or stroke, Chronic obstructive pulmonary disease, and Heart failure. This scoring system awards two points for heart failure and transient ischaemic attack or stroke and one point for the remaining items. The study included 227 patients and short-term EC was successful in 163 of the cases. The mean HATCH scores of the patients who had undergone successful or unsuccessful EC were 1.3 ± 1.4 and 2.9 ± 1.4, respectively (p < 0.001). The area of the HATCH score under the curve in receiver operating characteristics analysis was (AUC) 0.792 (95% CI 0.727-0.857, p < 0.001). A HATCH score of two and above yielded 77% sensitivity, 62% specificity, 56% positive predictive value, and 87% negative predictive value in predicting unsuccessful cardioversion. HATCH score is useful in predicting short-term success of EC at early stages for patients with AF, for whom the use of a rhythm-control strategy is planned.
TOTAL KNEE REPLACEMENT IN PATIENTS WITH BELOW-KNEE AMPUTATION
Karam, Matthew D; Willey, Michael; Shurr, Donald G
2010-01-01
Total knee replacement (TKR) is reserved for patients with severe and disabling arthritis that is non-responsive to conservative measures. Based on existing data, total knee replacement is a safe and cost-effective treatment for alleviating pain and improving physical function in patients who do not respond to conservative therapy. Despite the large variation in health status of patients and types of prosthesis implanted, total knee replacement has proven to be a relatively low risk and successful operation. Each year in the United States surgeons perform approximately 300,000 TKR.1 Likewise, lower extremity amputation is commonly performed in the United States with an annual incidence of 110,000 per year.2 Nearly 70% of all lower extremity amputations are performed as the result of chronic vascular disease, followed by trauma (22%), congenital etiology and tumor (4% each).3 Approximately 50% of all lower extremity amputations are performed secondary to complications from Diabetes Mellitus. Norvell et al. demonstrated that patients who have previously undergone transtibial amputation and ambulate with a prosthesis are more likely to develop degenerative joint disease in the con-tralateral extremity than the ipsilateral extremity.4 Further, radiographic changes consistent with osteoporosis have been demonstrated in up to 88% of limbs that have undergone transtibial amputation.8 To our knowledge, there have been only three reported cases of total knee replacement in patients with ipsilateral transtibial amputation.5,7 The purpose of the present study is to review the existing data on total knee replacement in patients who have undergone transtibial amputation. Further we present a patient with a transtibial amputation who underwent contralateral total knee replacement. PMID:21045987
Katzir, Tami; Christodoulou, Joanna A; de Bode, Stella
2016-10-01
We investigated reading skills in individuals who have undergone left cerebral hemispherectomy and in readers with developmental dyslexia to understand diverse characteristics contributing to reading difficulty. Although dyslexia is a developmental disorder, left hemispherectomy requires that patients (re)establish the language process needed to perform the language-based tasks in the nondominant (right) hemisphere to become readers. Participants with developmental dyslexia (DD; n = 11) and participants who had undergone left hemispherectomy (HEMI; n = 11) were matched on age and gender, and were compared on timed and untimed measures of single word and pseudo-word reading. The hemispherectomy group was subdivided into prenatal (in utero) and postnatal (>3 years) insult groups, indicating the timing of the primary lesion that ultimately required surgical intervention. On an untimed reading measure, the readers with DD were comparable to individuals who had undergone left hemispherectomy due to prenatal insult, but both scored higher than the postnatal hemispherectomy group. Timed word reading differed across groups. The hemispherectomy prenatal subgroup had low average scores on both timed and untimed tests. The group with dyslexia had average scores on untimed measures and below average scores on timed reading. The hemispherectomy postnatal group had the lowest scores among the groups by a significant margin, and the most pronounced reading difficulty. Patients with prenatal lesions leading to an isolated right hemisphere (RH) have the potential to develop reading to a degree comparable to that in persons with dyslexia for single word reading. This potential sharply diminishes in individuals who undergo hemispherectomy due to postnatal insult. The higher scores of the prenatal hemispherectomy group on timed reading suggest that under these conditions, individuals with an isolated RH can compensate to a significant degree. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.
A saltwater flotation technique to identify unincubated eggs
Devney, C.A.; Kondrad, S.L.; Stebbins, K.R.; Brittingham, K.D.; Hoffman, D.J.; Heinz, G.H.
2009-01-01
Field studies on nesting birds sometimes involve questions related to nest initiation dates, length of the incubation period, or changes in parental incubation behavior during various stages of incubation. Some of this information can be best assessed when a nest is discovered before the eggs have undergone any incubation, and this has traditionally been assessed by floating eggs in freshwater. However, because the freshwater method is not particularly accurate in identifying unincubated eggs, we developed a more reliable saltwater flotation method. The saltwater method involves diluting a saturated saltwater solution with freshwater until a salt concentration is reached where unincubated eggs sink to the bottom and incubated eggs float to the surface. For Laughing Gulls (Leucophaeus atricilla), floating eggs in freshwater failed to identify 39.0% (N = 251) of eggs that were subsequently found by candling to have undergone incubation prior to collection. By contrast, in a separate collection of gull eggs, no eggs that passed the saltwater test (N = 225) were found by a later candling to have been incubated prior to collection. For Double-crested Cormorants (Phalacrocorax auritus), floating eggs in freshwater failed to identify 15.6% (N = 250) of eggs that had undergone incubation prior to collection, whereas in a separate collection, none of the eggs that passed the saltwater test (N = 85) were found by a later candling to have been incubated prior to collection. Immersion of eggs in saltwater did not affect embryo survival. Although use of the saltwater method is likely limited to colonial species and requires calibrating a saltwater solution, it is a faster and more accurate method of identifying unincubated eggs than the traditional method of floating eggs in freshwater.
Wilson, G. S.
1966-01-01
Accident and safety are related terms; the higher the accident rate in any industry, the greater is the need for safety measures designed to prevent accidents. This article discusses the accident and safety problems in agriculture, which includes horticulture and forestry. There is still a tendency among townspeople to think of the countryside as peaceful and tranquil, a place where nothing happens very quickly and far removed from violent death or crippling injury. This pleasant rustic picture has undergone a striking change in the last 30 years owing to considerable agricultural mechanization and the development of chemical pesticides, which have brought new dangers to those who live and work on the land. Although men have readily adapted themselves to new machines and methods, they have not proved as able to recognize new dangers and learn how to guard against them. In consequence, accidents have increased to such an extent that the whole industry has realized the need for positive preventive measures. In this country, it is generally accepted that an employer of labour has a responsibility to provide safe working conditions for those he employs. Farm safety legislation goes a little further and usually requires an employer to provide necessary safeguards, with the added requirement on a worker to make use of them. It is a feature of accident prevention work that it never reaches a stage when it can be regarded as complete. Even when a reduction in accidents has been achieved, the effort must be sustained or the trend will be quickly reversed. Images PMID:5904095
Lateral prefrontal cortex: architectonic and functional organization
Petrides, Michael
2005-01-01
A comparison of the architecture of the human prefrontal cortex with that of the macaque monkey showed a very similar architectonic organization in these two primate species. There is no doubt that the prefrontal cortical areas of the human brain have undergone considerable development, but it is equally clear that the basic architectonic organization is the same in the two species. Thus, a comparative approach to the study of the functional organization of the primate prefrontal cortex is more likely to reveal the essential aspects of the various complex control processes that are the domain of frontal function. The lateral frontal cortex appears to be functionally organized along both a rostral–caudal axis and a dorsal–ventral axis. The most caudal frontal region, the motor region on the precentral gyrus, is involved in fine motor control and direct sensorimotor mappings, whereas the caudal lateral prefrontal region is involved in higher order control processes that regulate the selection among multiple competing responses and stimuli based on conditional operations. Further rostrally, the mid-lateral prefrontal region plays an even more abstract role in cognitive control. The mid-lateral prefrontal region is itself organized along a dorsal–ventral axis of organization, with the mid-dorsolateral prefrontal cortex being involved in the monitoring of information in working memory and the mid-ventrolateral prefrontal region being involved in active judgments on information held in posterior cortical association regions that are necessary for active retrieval and encoding of information. PMID:15937012
Influence of physical exercise on traumatic brain injury deficits: scaffolding effect.
Archer, Trevor
2012-05-01
Traumatic brain injury (TBI) may be due to a bump, blow, or jolt to the head or a penetrating head injury that disrupts normal brain function; it presents an ever-growing, serious public health problem that causes a considerable number of fatalities and cases of permanent disability annually. Physical exercise restores the healthy homeostatic regulation of stress, affect and the regulation of hypothalamic-pituitary-adrenal axis. Physical activity attenuates or reverses the performance deficits observed in neurocognitive tasks. It induces anti-apoptotic effects and buttresses blood-brain barrier intactness. Exercise offers a unique non-pharmacologic, non-invasive intervention that incorporates different regimes, whether dynamic or static, endurance, or resistance. Exercise intervention protects against vascular risk factors that include hypertension, diabetes, cellular inflammation, and aortic rigidity. It induces direct changes in cerebrovasculature that produce beneficial changes in cerebral blood flow, angiogenesis and vascular disease improvement. The improvements induced by physical exercise regimes in brain plasticity and neurocognitive performance are evident both in healthy individuals and in those afflicted by TBI. The overlap and inter-relations between TBI effects on brain and cognition as related to physical exercise and cognition may provide lasting therapeutic benefits for recovery from TBI. It seems likely that some modification of the notion of scaffolding would postulate that physical exercise reinforces the adaptive processes of the brain that has undergone TBI thereby facilitating the development of existing networks, albeit possibly less efficient, that compensate for those lost through damage. © Springer Science+Business Media, LLC 2011
Hirano, Tsukasa; Mikami, Takeshi; Suzuki, Hime; Hirano, Toru; Kimura, Yusuke; Komatsu, Katusya; Akiyama, Yukinori; Wanibuchi, Masahiko; Mikuni, Nobuhiro
2018-04-01
In neurosurgery, extracranial-to-intracranial (EC-IC) bypass surgery is necessary for patients who have undergone surgery in which the superficial temporal artery (STA) was already used for a different bypass procedure or was damaged. Here we report our experience with EC-IC bypass using the occipital artery (OA) in patients in whom the STA was unavailable, and discuss the technical considerations and pitfalls. Five patients with ischemic-onset moyamoya disease and atherosclerotic disease were included. Two patterns of skin incisions were planned according to the OA pathway and recipient artery location. In one of these methods, a skin incision is made above the OA, and a craniotomy is performed under this incision after OA dissection. In the other method, a skin incision is made above the OA to enable its dissection, and a craniotomy is performed via a separate skin incision. No major perioperative complications developed in any of the 5 cases, and bypass patency was confirmed in all patients. There was a significant difference between the preoperative and postoperative asymmetry ratios of the mean transit time values. Our findings suggest that OA-to-middle cerebral artery (MCA) bypass is a simple and effective technique in patients in whom the STA was already used or was damaged by previous intracranial revascularization or craniotomy. This procedure could be an alternative to STA-MCA bypass in patients without an available STA. Copyright © 2018 Elsevier Inc. All rights reserved.
Robotic resection of the liver caudate lobe: technical description and initial consideration.
Marino, Marco Vito; Glagolieva, Anastasiia; Guarrasi, Domenico
2018-03-01
Firstly described in 2002, the robotic liver surgery has not spread widely due to its high cost and the lack of a standardized training program. Still being considered as a 'development in progress' technique, it has however a potential to overcome the traditional limitations of the laparoscopic approach in liver interventions. We analyzed the postoperative outcomes of 10 patients who had undergone robotic partial resection of the caudate lobe (Spiegel lobe) from March 2014 to May 2016 in order to evaluate the advantages of robotic technique in hands of a young surgeon. The mean operative time was 258min (150-522) and the estimated blood loss 137ml (50-359), in none of the cases a blood transfusion was required. No patient underwent a conversion to open surgery; the overall morbidity was 2/10 (20%) and all the complications occurred (biliary fistula and pleural effusion) did not require a surgical revision. At histological examination, the mean tumour size was 2.63cm and we achieved R0-resection rate of 100%. The 90-day mortality rate was null. The 1-year overall and disease free-survival rates were 100% and 80%, respectively. Despite several concerns regarding the cost-effectiveness, a fully robotic partial resection of caudate lobe is an advantageous, implementable technique providing promising short-term postoperative outcomes with acceptable benefit-risk profile. Copyright © 2018 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.
Mercury measurements in the ocean - GEOTRACES intercalibration exercises
NASA Astrophysics Data System (ADS)
Heimbürger, L. E.
2015-12-01
Mercury is amongst the least concentrated trace metals in the ocean. We need to be able to measure, understand and interpret variability in mercury concentrations in seawater, which is often as low as some 10 percent. We organized international intcalibration exercises for total mercury and total methylmercury determination in seawater collected during the 2013 Dutch GEOTRACES MedBlack cruise (GA04- Black Sea), the 2014 French GEOTRACES GEOVIDE (GA01- North Atlantic Ocean) and the 2015 German GEOTRACES TranArc II cruise ( GN04 - Arctic Ocean). The exercises were intended to primarily evaluate the analytical performance of each participating laboratory. Therefore each laboratory received a single sample bottle of similar size, that has undergone the same cleaning procedure prior to sampling, and each sample was preserved in the same manner. The 2013 exercise was intended as a broader screening with a maximum number (25) of participating laboratories. Results indicated substantial disagreement between the participating laboratories, for both total mercury and methylmercury determinations. For the 2014 exercise we could only invite 10 laboratories of the 2013 exercise. Intercomparability of the second exercise was considerably better, but needs to be further improved in the years to come. The 2015 will be organized this summer. We will present the results of both intercalibration exercises in detail, attempt to explain causes for disagreements, and share our ideas about future developments to achieve traceable mercury measurements in the oceans. We will also make use of this occasion to plan the 2016 GEOTRACES intercalibration cruise.
2003-11-25
alkyd resin enamel was 14 Figure 1 -- Test Panels Before Application of WD CARC at MCB Figure 2 -- Test Panels with WD CARC Applied at MCB...WD) Chemical Agent Resistant Coating (CARC) patented (#5,691,410) by the Army Research Laboratory (ARL) has undergone technology Demonstration...Resistant Coating (CARC) patented (#5,691,410) by the Army Research Laboratory (ARL) has undergone technology Demonstration/Validation (Dem/Val) testing
NASA Technical Reports Server (NTRS)
Fournelle, John; Carpenter, Paul
2006-01-01
Modem electron microprobe systems have become increasingly sophisticated. These systems utilize either UNIX or PC computer systems for measurement, automation, and data reduction. These systems have undergone major improvements in processing, storage, display, and communications, due to increased capabilities of hardware and software. Instrument specifications are typically utilized at the time of purchase and concentrate on hardware performance. The microanalysis community includes analysts, researchers, software developers, and manufacturers, who could benefit from exchange of ideas and the ultimate development of core community specifications (CCS) for hardware and software components of microprobe instrumentation and operating systems.
Understanding and managing change in health care organizations.
Nagaike, K
1997-01-01
Change impacts affected people and often causes difficulties. Health care organizations, locally and nationally, have undergone tremendous change to deliver quality services in a more effective and efficient manner in a competitive environment, with varying degrees of success. This article presents Robbins's categories of change and relates them to current changes in health care organizations. It discusses areas to consider to develop adaptable plans and to assist affected employees to better deal with these changes throughout the transition.
Neurotoxicity of cancer chemotherapy☆
Yang, Miyoung; Moon, Changjong
2013-01-01
There is accumulating clinical evidence that chemotherapeutic agents induce neurological side effects, including memory deficits and mood disorders, in cancer patients who have undergone chemotherapeutic treatments. This review focuses on chemotherapy-induced neurodegeneration and hippocampal dysfunctions and related mechanisms as measured by in vivo and in vitro approaches. These investigations are helpful in determining how best to further explore the causal mechanisms of chemotherapy-induced neurological side effects and in providing direction for the future development of novel optimized chemotherapeutic agents. PMID:25206457
Edward T. Sherwood; Holly Greening; Lizanne Garcia; Kris Kaufman; Tony Janicki; Ray Pribble; Brett Cunningham; Steve Peene; Jim Fitzpatrick; Kellie Dixon; Mike Wessel
2016-01-01
The Tampa Bay estuary has undergone a remarkable ecosystem recovery since the 1980s despite continued population growth within the region. However during this time, the Old Tampa Bay (OTB) segment has lagged behind the rest of the Bayâs recovery relative to improvements in overall water quality and seagrass coverage. In 2011, the Tampa Bay Estuary Program, in...
Rasmussen, Keith G; Ritter, Matthew J
2014-12-01
Most anesthetic agents used for electroconvulsive therapy (ECT) have few intrinsic adverse effects. Ketamine, however, is well known to be associated with a variety of adverse effects including nausea, dizziness, and psychotomimetic phenomena. Over the past several decades, there have been numerous reports on the use of ketamine for ECT anesthesia, with varied assessments on how prominent these adverse effects are in the ECT situation. Ketamine has received a resurgence of interest as an ECT anesthetic of late owing to its established independent antidepressant effects and to theoretical reasons why it might lessen the cognitive adverse effects of ECT. In this case series, the author reviews the experience with 14 patients who had undergone ECT who were switched to ketamine as anesthetic from methohexital at the preference of the treating anesthesiologist. All 14 patients spontaneously reported a strong preference not to be given ketamine again due to bothersome adverse effects. The latter consisted of either vestibular-type symptoms (nausea/vomiting, dizziness, and vertigo) or psychotomimetic effects (dissociative phenomena). It is concluded that ketamine is not free of adverse effects when used as an ECT anesthetic. Electroconvulsive therapy clinicians should be vigilant about assessing for these effects when ketamine is used, and consideration should be given to using a benzodiazepine such as diazepam or midazolam at seizure termination when ketamine anesthesia is used to prevent bothersome adverse effects seen upon awakening.
ERIC Educational Resources Information Center
Ward, James; And Others
The paper reports on a followup study of the work adjustment of 43 mildly retarded adolescents who had undergone training in social and work skills at the Granville Work Preparation Centre in Australia. Among the findings were that 40% of the Ss had a history of full open employment, with no unemployment at all, since leaving the Center; that 21%…
NASA Astrophysics Data System (ADS)
Kleine, Karynne L. M.
The conception of intellectual development has undergone considerable change since Perry's influential study of undergraduates in 1968. Most notably, theorists have tried to account for the fact that women do not appear to be as intellectually developed as men when examined through traditional models that emphasize the use of impersonal and distanced objectivity and logic by acknowledging that rationality may include aspects of emotionalism and subjectivity. One model that shows potential to accurately describe the development of women is presented by Belenky, Clinchy, Goldberger and Tarule (1986). An important application of this development, which holds promise for successful education reform efforts, is the ability to improve the intellectual development of preservice middle level teachers through their teacher preparation programs. Thus, this study sought to (a) examine through case studies the intellectual development of five selected female and male members of a cohort of preservice middle level teachers at Rotunda College (not its real name) exposed to a ten week course emphasizing the use of rationality in various impersonal and relational ways as they developed their teaching practices, and (b) determine whether these preservice teachers came to value rationality as a means to becoming an excellent teacher. This was accomplished by conducting a mixedgender test of the model of intellectual development proposed by Belenky et al. (1986), and by using interviews, questionnaires, and artifacts to note their conceptual changes and changes in their valuing of rationality that occurred over the period of the course. The present study also evaluated Rotunda College's achievement of several aspects of its liberal arts mission. Analysis of qualitative and quantitative data for five case study participants indicates that fostering rationality in preservice middle level teachers through various impersonal and relational ways advances the desire to develop intellectually and supports intellectual growth as shown on measures of intellectual development. Two young, female participants did not demonstrate the high levels or accelerated rates of intellectual development of the other participants, suggesting that there is more work needed in this area to understand the phenomenon of utilizing relational learning environments. Also, the case study students' enhancement of their rational behaviors suggests that Rotunda College, by promoting rationality in a number of ways in its teacher preparation program, successfully imbues those undergraduates with critical aspects of a liberal arts education.
Transcriptome and proteome analysis of ovaries of arrhenotokous and thelytokous Venturia canescens.
Mateo Leach, I; Hesseling, A; Huibers, W H C; Witsenboer, H; Beukeboom, L W; van de Zande, L
2009-08-01
Under arrhenotoky, unfertilized haploid eggs develop as males but under thelytoky they develop into diploid females after they have undergone diploidy restoration. In the parasitoid wasp Venturia canescens both reproductive modes occur. Thelytoky is genetically determined but the underlying genetics of diploidy restoration remain unknown. In this study we aim to identify the genes and/or proteins that control thelytoky. cDNA-amplified fragment length polymorphism (cDNA-AFLP) analysis of total ovarian RNA and two-dimensional protein electrophoresis in combination with mass spectrometry revealed putative transcripts and proteins involved in arrhenotokous and thelytokous development. The detected tubulin and actin protein differences are most likely functionally related to the two types of reproduction.
Design and development of a severe storm research UAS
NASA Astrophysics Data System (ADS)
Avery, Alyssa Shearon
A small unmanned aircraft system (SUAS) was designed and developed to be utilized for meteorological data collection, specifically information useful for severe storm and tornado prediction. The system will operate prior to and during severe weather in order to minimize current knowledge gaps with respect to severe storms. This aircraft was developed to maximize the useful data collection while retaining the operational simplicity required of a tool used in an unpredictable environment. The aircraft design is capable of collecting in-situ atmospheric and IR thermodynamic data continuously in flight and deploying sensor packages, dropsondes, at vital locations. The airframe was built, has undergone initial testing, and will be integrated into an operational system in future work.
Effects and Effectiveness of Telemedicine
Grigsby, Jim; Kaehny, Margaret M.; Sandberg, Elliot J.; Schlenker, Robert E.; Shaughnessy, Peter W.
1995-01-01
The use of telemedicine has recently undergone rapid growth and proliferation. Although the feasibility of many applications has been tested for nearly 30 years, data concerning the costs, effects, and effectiveness of telemedicine are limited. Consequently, the development of a strategy for coverage, payment, and utilization policy has been hindered. Telemedicine continues to expand, and pressure for policy development increases in the context of Federal budget cuts and major changes in health service financing. This article reviews the literature on the effects and medical effectiveness of telemedicine. It concludes with several recommendations for research, followed by a discussion of several specific questions, the answers to which might have a bearing on policy development. PMID:10153466
Post-thyroidectomy hypocalcemia: Impact on length of stay.
Grainger, Joe; Ahmed, Mohammed; Gama, Rousseau; Liew, Leonard; Buch, Harit; Cullen, Ronald J
2015-07-01
Hypocalcemia is a recognized complication following thyroid surgery. Variability in the definition of hypocalcemia and different opinions on its management can lead to unnecessary patient morbidity and longer hospital stays as a result of inappropriate or untimely treatment. Therefore, we developed a management guideline for the recognition and treatment of post-thyroidectomy hypocalcemia, and we conducted a retrospective study to assess its impact on length of stay (LOS). Between April 1, 2007, and March 31, 2009, 29 adults had undergone a total or completion thyroidectomy at our large district general hospital. Of this group, postoperative hypocalcemia (defined as a serum calcium level of <2.00 mmol/L) developed in 13 patients (44.8%) during the first 3 postoperative days. Our guideline went into effect on July 1, 2009, and from that date through June 30, 2010, 18 more adults had undergone a total or completion thyroidectomy. Of that group, hypocalcemia developed in 7 patients (38.9%); the guideline was actually followed in 5 of these 7 cases (71.4%). In the preguideline group, the development of hypocalcemia increased the mean LOS from 2.0 days to 7.0 days (p < 0.001). The management of postoperative hypocalcemia in these cases was highly variable and was dictated by variations in practice rather than patient needs. In the postguideline group, postoperative hypocalcemia increased the mean LOS from 2.7 days to only 3.7 days (p = 0.07). While the difference between LOS in the two hypocalcemic groups did not reach statistical significance, we believe it merely reflects the relatively small number of patients rather than any lack of guideline efficacy. The implementation of a simple flowchart guideline for the management of postoperative hypocalcemia in our hospital has resulted in more uniform management and a reduced LOS.
Yockteng, Roxana; Almeida, Ana M R; Morioka, Kelsie; Alvarez-Buylla, Elena R; Specht, Chelsea D
2013-11-01
The diversity of floral forms in the plant order Zingiberales has evolved through alterations in floral organ morphology. One striking alteration is the shift from fertile, filamentous stamens to sterile, laminar (petaloid) organs in the stamen whorls, attributed to specific pollination syndromes. Here, we examine the role of the SEPALLATA (SEP) genes, known to be important in regulatory networks underlying floral development and organ identity, in the evolution of development of the diverse floral organs phenotypes in the Zingiberales. Phylogenetic analyses show that the SEP-like genes have undergone several duplication events giving rise to multiple copies. Selection tests on the SEP-like genes indicate that the two copies of SEP3 have mostly evolved under balancing selection, probably due to strong functional restrictions as a result of their critical role in floral organ specification. In contrast, the two LOFSEP copies have undergone differential positive selection, indicating neofunctionalization. Reverse transcriptase-polymerase chain reaction, gene expression from RNA-seq data, and in situ hybridization analyses show that the recovered genes have differential expression patterns across the various whorls and organ types found in the Zingiberales. Our data also suggest that AGL6, sister to the SEP-like genes, may play an important role in stamen morphology in the Zingiberales. Thus, the SEP-like genes are likely to be involved in some of the unique morphogenetic patterns of floral organ development found among this diverse order of tropical monocots. This work contributes to a growing body of knowledge focused on understanding the role of gene duplications and the evolution of entire gene networks in the evolution of flower development.
Azumi, Motoi; Suda, Takeshi; Terai, Shuji; Akazawa, Kouhei
2017-01-01
Objective Radiofrequency ablation has been used widely for the local ablation of hepatocellular carcinoma, particularly in its early stages. The study aim was to identify significant prognostic factors and develop a predictive nomogram for patients with hepatocellular carcinoma who have undergone radiofrequency ablation. We also developed the formula to predict the probability of 3- and 5-year overall survival based on clinical variables. Methods We retrospectively studied 96 consecutive patients with hepatocellular carcinoma who had undergone radiofrequency ablation as a first-line treatment. Independent and significant factors affecting the overall survival were selected using a Cox proportional hazards model, and a prognostic nomogram was developed based on these factors. The predictive accuracy of the nomogram was determined by Harrell's concordance index and compared with the Cancer of the Liver Italian Program score and Japan Integrated Staging score. Results A multivariate analysis revealed that age, indocyanine green plasma disappearance rate, and log(des-gamma-carboxy prothrombin) level were independent and significant factors influencing the overall survival. The nomogram was based on these three factors. The mean concordance index of the nomogram was 0.74±0.08, which was significantly better than that of conventional staging systems using the Cancer of the Liver Italian Program score (0.54±0.03) and Japan Integrated Staging score (0.59±0.07). Conclusion This study suggested that the indocyanine green plasma disappearance rate and age at radiofrequency ablation (RFA) and des-gamma-carboxy-prothrombin (DCP) are good predictors of the prognosis in hepatocellular carcinoma patients after radiofrequency ablation. We successfully developed a nomogram using obtainable variables before treatment. PMID:28458303
Azumi, Motoi; Suda, Takeshi; Terai, Shuji; Akazawa, Kouhei
2017-01-01
Objective Radiofrequency ablation has been used widely for the local ablation of hepatocellular carcinoma, particularly in its early stages. The study aim was to identify significant prognostic factors and develop a predictive nomogram for patients with hepatocellular carcinoma who have undergone radiofrequency ablation. We also developed the formula to predict the probability of 3- and 5-year overall survival based on clinical variables. Methods We retrospectively studied 96 consecutive patients with hepatocellular carcinoma who had undergone radiofrequency ablation as a first-line treatment. Independent and significant factors affecting the overall survival were selected using a Cox proportional hazards model, and a prognostic nomogram was developed based on these factors. The predictive accuracy of the nomogram was determined by Harrell's concordance index and compared with the Cancer of the Liver Italian Program score and Japan Integrated Staging score. Results A multivariate analysis revealed that age, indocyanine green plasma disappearance rate, and log (des-gamma-carboxy prothrombin) level were independent and significant factors influencing the overall survival. The nomogram was based on these three factors. The mean concordance index of the nomogram was 0.74±0.08, which was significantly better than that of conventional staging systems using the Cancer of the Liver Italian Program score (0.54±0.03) and Japan Integrated Staging score (0.59±0.07). Conclusion This study suggested that the indocyanine green plasma disappearance rate and age at radiofrequency ablation (RFA) and des-gamma-carboxy-prothrombin (DCP) are good predictors of the prognosis in hepatocellular carcinoma patients after radiofrequency ablation. We successfully developed a nomogram using obtainable variables before treatment.
Candela, G; Di Libero, L; Varriale, S; Manetta, F; Giordano, M; Lanza, M; Argenziano, G; Pizza, A; Sciascia, V; Napolitano, S; Riccio, M; Esposito, D; Santini, L
2007-08-01
The entero-cutaneous fistulas (ECF) are abnormal communications between intestine and abdominal skin. They can occur spontaneously, or after an injury or a surgical procedure. They are associated with a high rate of morbidity and mortality. Spontaneous fistulas can mainly occur in patients affected by cancer, inflammatory bowel disease, diverticulitis, appendicitis, as a result of radiotherapy or injuries. Surgical procedures, carried out in case of neoplastic diseases, inflammatory bowel disease, adhesions removal, represent the primary cause in the development of a postoperative fistulas. Malnourishment, poor general conditions of the patient, high output fistula along with anatomical site of development, and the presence of abscesses, represent the negative factors influencing the spontaneous healing of fistulas. The experience reported here is about three ECF cases occurred after surgery and treated only with medical therapy. The first case is a woman in good general conditions who underwent surgery to remove a recurrent retroperitoneal myxoid liposarcoma situated in the right lower quadrant. The patient had never undergone surgery for an intestinal resection. The other two patients analyzed were affected by sepsis and metabolic unbalance and had developed a fistula after colonic resection. Fluids and electrolytes adjustments and sepsis management have preceded any other kind of therapy. Continuous infusion with somatostatin, fast, proton pump inhibitors and loperamide have been taken up to decrease secretions and intestinal motility. Total parenteral nutrition has been essential to recover nutritional status and improve patients' general conditions. In order to heal and protect peri-fistula skin we have used sterile washing solutions, absorbable ionic exchange resin, silver and polyurethanes based medications and colostomy bags adhesive systems. Since surgical treatment of ECF is associated with high rates of morbidity and mortality, conservative treatment should always be taken into consideration. When conservative treatment fails, delayed surgical intervention has been related to a higher rate of success. The purpose of this study is to describe diagnostic and therapeutic guidelines to general surgeons, like ourselves, whenever they have to deal with ECF cases.
[AT THE CROSSROADS: THE ROLE OF LABORATORY MEDICINE IN THE PATIENT CARE PROCESS].
Geffen, Yuval; Zaidise, Itzhak
2017-06-01
In recent decades, the laboratory medicine profession has undergone significant changes due to both technological developments and economic constraints. Technological innovations support automation, provide faster and more accurate equipment, and allow increased efficiency through the use of commercial test kits. These changes, combined with budgetary constraints, have led to mergers and centralization of medical laboratories to optimize work and cut costs. While this centralization may be a business necessity, it leads to a disconnection between the laboratory and the clinical context. In addition, laboratory tests are treated as a commodity, which places emphasis on price only, rather than quality. In this article, we review the developments and changes that medical laboratories and the laboratory medicine profession have undergone in recent decades. We focus on technological and structural challenges affecting the functioning of medical laboratories and the relations between laboratory workers and medical teams. We then introduce vocational education changes required for the laboratory medicine profession. We propose defining the role of medical laboratory directors in terms of their basic training as medical doctors or doctors of science. We suggest that laboratory employees should become a reliable source of information regarding selection of appropriate test methods, processing data and presenting the results to the medical staff. Laboratory workers must deepen their clinical knowledge and become an integral part of the patient care process, along with medical and nursing staff. Special training programs for medical laboratory workers and directors must be developed in order to match the complex activities currently being conducted in laboratories.
2003-12-09
KENNEDY SPACE CENTER, FLA. - In the Orbiter Processing Facility, KSC employee Gene Peavler works in the wheel area on the orbiter Discovery. The vehicle has undergone Orbiter Major Modifications in the past year. Discovery is scheduled to fly on mission STS-121 to the International Space Station.
Ikeda, Mami; Hasegawa, Kiyoshi; Akamatsu, Nobuhisa; Minagawa, Masami; Imamura, Hiroshi; Sugawara, Yasuhiko; Kokudo, Norihiro; Makuuchi, Masatoshi
2006-02-01
Secondary pancreaticoduodenectomy was performed in 2 patients, 1 who had undergone proximal gastrectomy for a gastric carcinoma and 1 who had undergone subtotal esophagectomy with stomach tube reconstruction for an inferior thoracic esophageal carcinoma. To prevent ischemia and congestion of the remnant stomach, the inflow and outflow pathways to the stomach, such as the right gastroepiploic artery and vein, were preserved. In this article, we describe the preservation procedures and discuss the problems of the secondary abdominal surgical procedure.
Thoracic paravertebral ganglioneuroma with high immunohistochemical expression of TrkA.
Nishio, S; Hamada, Y; Nakagawara, A; Haga, S; Suzuki, S; Fukui, M
1999-01-01
A 21-year-old man, who had previously undergone a total resection for a retroperitoneal ganglioneuroblastoma at 7 months of age, was revealed to have a thoracic paravertebral ganglioneuroma, in which immunohistochemical expression of neuron-specific enolase and neurofilament was noted. Furthermore, immunohistochemical expression of TrkA, which is a high-affinity receptor for nerve growth factor, was evident. Although the exact histogenesis remains uncertain, TrkA was considered to be involved in the development of this thoracic paravertebral tumor.
The VSS RASNZ Variable Star Charts: a Story of Co-Evolution
NASA Astrophysics Data System (ADS)
Plummer, A.; Morel, M.
2010-06-01
The background and history of the Charts for Southern Variables of the Variable Star Section of the Royal Astronomical Society of New Zealand (VSS RASNZ) is presented. It is seen that while there are some common origins with the charts of the AAVSO, they have undergone their own unique and important development. After much effort the two organizations' chart resources are now compatible and complementary. Some more general but nonetheless important history of the VSS is also mentioned.
1979-01-01
of his skeleton (16). This man had undergone a prefrontal lobotomy in 1949. His medical and dental records revealed a long history of bruxism coupled...stated that they were often kept awake at night by the sounds of his nocturnal bruxism . In addition to the dental wear, this cranium displayed several...osteolo- gical peculiarities attributable to bruxism . Particularly evident were the robustly developed attachments for the insertion of the masseters and
NASA Langley Airborne High Spectral Resolution Lidar Instrument Description
NASA Technical Reports Server (NTRS)
Harper, David B.; Cook, Anthony; Hostetler, Chris; Hair, John W.; Mack, Terry L.
2006-01-01
NASA Langley Research Center (LaRC) recently developed the LaRC Airborne High Spectral Resolution Lidar (HSRL) to make measurements of aerosol and cloud distribution and optical properties. The Airborne HSRL has undergone as series of test flights and was successfully deployed on the Megacity Initiative: Local and Global Research Observations (MILAGRO) field mission in March 2006 (see Hair et al. in these proceedings). This paper provides an overview of the design of the Airborne HSRL and descriptions of some key subsystems unique to this instrument.
Utilizing virtual and augmented reality for educational and clinical enhancements in neurosurgery.
Pelargos, Panayiotis E; Nagasawa, Daniel T; Lagman, Carlito; Tenn, Stephen; Demos, Joanna V; Lee, Seung J; Bui, Timothy T; Barnette, Natalie E; Bhatt, Nikhilesh S; Ung, Nolan; Bari, Ausaf; Martin, Neil A; Yang, Isaac
2017-01-01
Neurosurgery has undergone a technological revolution over the past several decades, from trephination to image-guided navigation. Advancements in virtual reality (VR) and augmented reality (AR) represent some of the newest modalities being integrated into neurosurgical practice and resident education. In this review, we present a historical perspective of the development of VR and AR technologies, analyze its current uses, and discuss its emerging applications in the field of neurosurgery. Copyright © 2016 Elsevier Ltd. All rights reserved.
The evolving potential of companion diagnostics.
Khoury, Joseph D
2016-01-01
The scope of companion diagnostics in cancer has undergone significant shifts in the past few years, with increased development of targeted therapies and novel testing platforms. This has provided new opportunities to effect unprecedented paradigm shifts in the application of personalized medicine principles for patients with cancer. These shifts involve assay platforms, analytes, regulations, and therapeutic approaches. As opportunities involving each of these facets of companion diagnostics expand, close collaborations between key stakeholders should be enhanced to ensure optimal performance characteristics and patient outcomes.
Cooling techniques for turbojet pre-heater channels
NASA Astrophysics Data System (ADS)
Desaulty, M.; Troullot, P.; Coutor, S.
1985-09-01
Increases in the performance of turbojets with pre-heating are dependent upon technological research in the area of protection of the wall in pre-heater channels. The procedures used to cool the thermal protection jackets have undergone important improvements which have optimized performance, reduced weight and improved cooling efficiency. This report presents a comparison of the thermal protection jackets for several SNECMA engines, as well as the principal stages of development for the jacket from the design stages through static engines tests.
Izquierdo, Giannina; Zubieta, Marcela; Martínez G, María J; Alvarez, Ana M; Aviles, Carmen L; Becker, Ana; Peña, Mónica; Salgado, Carmen; Silva, Pamela; Topelberg, Santiago; Tordecilla, Juan; Varas, Mónica; Villarroel, Milena; Viviani, Tamara; Santolaya, María E
2012-12-01
Infections with varicella-zoster virus (VVZ) in immunocompromised children imply a high mortality. There is no data about VVZ seroprevalence in children with cancer in our country. To determine the prevalence of VVZ antibodies in children with cancer who have undergone chemotherapy or have undergone a hematopoietic stem cell transplant. collaborative, multicenter study. Serum samples were collected from 281 children with cancer and episodes of febrile neutropenia from 6 hospitals belonging to the public health network in the Metropolitan Region between June 2004 and August 2006. These samples were stored at -70 ° C, and 200 of them were randomly chosen and analyzed to determine VVZ IgG (ELISA). 179 samples from 179 children, 65% male. Ninety eighth/179 (55%) were positive, 72/179 (40%) negative and 9/179 (5%) indeterminate. Stratified by age, seropositive percentage was: 1 to 4 years 32%, 5-9 years 42%, 10-14 years 78%, over 15 years 88%. Forty percent of children treated for cancer are seronegative to VVZ infection, a frequency that decreases with age. These results support the adoption of preventive measures to avoid infection in this population of children at risk of developing a serious and possibly fatal illness.
Can foam sclerotherapy be used to safely treat bilateral varicose veins?
Bhogal, R H; Moffat, C E; Coney, P; Nyamekye, I K
2012-02-01
We assessed the use of ultrasound guided foam sclerotherapy (UGFS) to treat bilateral varicose veins either as synchronous or interval procedures. We specifically assessed total foam volume usage and its influence on early outcome and complications. We reviewed our prospectively compiled computerised database of patients with bilateral varicose veins who have undergone UGFS. Duplex findings, foam volumes used and clinical outcome were assessed. One hundred and twelve patients had undergone UGFS for bilateral varicose veins. Sixty-one had bilateral UGFS (122 legs) and 51 had interval UGFS (102 legs). Seventy-eight percent bilateral and 60% interval procedures were for single trunk disease. Median foam volumes per treatment episode were: 17.5 mls bilateral, and 10 mls interval FS. At two weeks 81% of legs had complete occlusion after bilateral UGFS compared to 70% after interval UGFS. One patient in the bilateral UGFS developed transient visual disturbance. There was no systemic complications in the interval UGFS. Bilateral foam sclerotherapy treatment did not adversly affect vein occlusion rates and there was no significant difference in complication rates between the two groups. Bilateral UGFS can be safely performed in selected patient presenting with bilateral varicose veins.
Influence of skin peeling procedure in allergic contact dermatitis.
Kim, Jung Eun; Park, Hyun Jeong; Cho, Baik Kee; Lee, Jun Young
2008-03-01
The prevalence of allergic contact dermatitis in patients who have previously undergone skin peeling has been rarely studied. We compared the frequency of positive patch test (PT) reactions in a patient group with a history of peeling, to that of a control group with no history of peeling. The Korean standard series and cosmetic series were performed on a total of 262 patients. 62 patients had previously undergone peeling and 200 patients did not. The frequency of positive PT reactions on Korean standard series was significantly higher in the peeling group compared with that of the control group (P < 0.05, chi-square test). However, the most commonly identified allergens were mostly cosmetic-unrelated allergens. The frequency of positive PT reactions on cosmetic series in the peeling group was higher than that of the control group, but lacked statistical significance. The frequency (%) of positive PT reactions on cosmetic series in the high-frequency peel group was higher than that of the low-frequency group, but lacked statistical significance. It appears peeling may not generally affect the development of contact sensitization. Further work is required focusing on the large-scale prospective studies by performing a PT before and after peeling.
Immediate breast reconstruction after mastectomy--why do women choose this option?
Shameem, Haque; Yip, Cheng Har; Fong, E
2008-01-01
Mastectomy is an essential but disfiguring operation in cancer treatment. The negative impact on body image can however be prevented by immediate reconstruction. The aim of this study was to determine the reasons why patients choose to have or not to have immediate breast reconstruction. This is a cross sectional descriptive study of breast cancer patients post-mastectomy who had and had not undergone immediate breast reconstruction. The patients were asked a series of questions to ascertain the reasons why they chose or did not choose immediate breast reconstruction. 136 patients in total were interviewed of which 23 had undergone immediate breast reconstruction. 36.8% of the patients had been offered reconstruction. In the non-reconstructed group, the main reason for not having reconstruction were fear of additional surgery. In the group that had reconstruction done, the main reason was to feel whole again. Low on the list were reasons such as trying to improve marital or sexual relations. Only a third of patients undergoing mastectomy were offered immediate reconstruction. In public hospitals in developing countries, limited operating time and availability of plastic surgery services are major barriers to more women being offered the option.
Cost-effectiveness of antiplatelet drugs after percutaneous coronary intervention
Wisløff, Torbjørn; Atar, Dan
2016-01-01
Abstract Aims Clopidogrel has, for long time, been accepted as the standard treatment for patients who have undergone a percutaneous coronary intervention (PCI). The introduction of prasugrel—and more recently, ticagrelor—has introduced a decision-making problem for clinicians and governments worldwide: to use the cheaper clopidogrel or the more effective, and also more expensive prasugrel or ticagrelor. We aim to give helpful contributions to this debate by analysing the cost-effectiveness of clopidogrel, prasugrel, and ticagrelor compared with each other. Methods and results We modified a previously developed Markov model of cardiac disease progression. In the model, we followed up cohorts of patients who have recently had a PCI until 100 years or death. Possible events are revascularization, bleeding, acute myocardial infarction, and death. Our analysis shows that ticagrelor is cost-effective in 77% of simulations at an incremental cost-effectiveness ratio of €7700 compared with clopidogrel. Ticagrelor was also cost-effective against prasugrel at a cost-effectiveness ratio of €7800. Given a Norwegian cost-effectiveness threshold of €70 000, both comparisons appear to be clearly cost-effective in favour of ticagrelor. Conclusion Ticagrelor is cost-effective compared with both clopidogrel and prasugrel for patients who have undergone a PCI. PMID:29474586
Cost-effectiveness of antiplatelet drugs after percutaneous coronary intervention.
Wisløff, Torbjørn; Atar, Dan
2016-01-01
Clopidogrel has, for long time, been accepted as the standard treatment for patients who have undergone a percutaneous coronary intervention (PCI). The introduction of prasugrel-and more recently, ticagrelor-has introduced a decision-making problem for clinicians and governments worldwide: to use the cheaper clopidogrel or the more effective, and also more expensive prasugrel or ticagrelor. We aim to give helpful contributions to this debate by analysing the cost-effectiveness of clopidogrel, prasugrel, and ticagrelor compared with each other. We modified a previously developed Markov model of cardiac disease progression. In the model, we followed up cohorts of patients who have recently had a PCI until 100 years or death. Possible events are revascularization, bleeding, acute myocardial infarction, and death. Our analysis shows that ticagrelor is cost-effective in 77% of simulations at an incremental cost-effectiveness ratio of €7700 compared with clopidogrel. Ticagrelor was also cost-effective against prasugrel at a cost-effectiveness ratio of €7800. Given a Norwegian cost-effectiveness threshold of €70 000, both comparisons appear to be clearly cost-effective in favour of ticagrelor. Ticagrelor is cost-effective compared with both clopidogrel and prasugrel for patients who have undergone a PCI.
Release of peptide YY (PYY) after resection of small bowel, colon, or pancreas in man.
Adrian, T E; Savage, A P; Fuessl, H S; Wolfe, K; Besterman, H S; Bloom, S R
1987-06-01
To investigate the possible role of peptide YY (PYY) in the adaptive changes that accompany enterectomy, plasma levels of this peptide were measured during breakfast in patients with resected small or large intestines and in controls. In 18 patients who had undergone partial ileal resection, basal PYY concentrations were greatly elevated when compared with controls (51.4 +/- 8.7 pmol/L versus 10.3 +/- 1.0; p less than 0.001) and the postprandial response was similarly increased. In contrast, PYY concentrations were low in 16 patients who had undergone colonic resection and ileostomy (fasting 7.1 +/- 0.7 pmol/L, p less than 0.01). In eight patients who had undergone pancreatectomies, basal and postprandial PYY levels were moderately increased (23.4 +/- 3.5 pmol/L; fasting p less than 0.001). PYY does not appear to have a role in the adaptive trophic response after small intestinal resection, but it may contribute to reduction of gastric secretion and gastrointestinal transit in these patients.
Said, Mohamed M; Otomaru, Takafumi; Yeerken, Yesiboli; Taniguchi, Hisashi
2017-07-01
The healing pattern after surgical resection of tumors of the oral cavity involving the maxilla may vary from one patient to another. The result may be open communication between the oral and nasal cavities (open defect) or complete oronasal separation after healing of the defect area (closed defect). The purpose of this clinical study was to compare masticatory function and oral health-related quality of life (OHRQoL) between patients with closed and open defects who had undergone a partial maxillectomy and were wearing dentomaxillary prostheses. Thirty-eight participants who had undergone a partial maxillectomy and who were wearing dentomaxillary prostheses were enrolled between September 2014 and April 2016. Participants were assigned to 2 groups according to the type of defect after healing: 19 participants had a closed defect, and 19 participants had an open defect. Masticatory function was evaluated objectively and subjectively. The objective measurement was food-mixing ability, which was assessed using color-changeable chewing gum. The subjective measurement was perceived mastication ability, rated as a masticatory score based on the patient's responses to a 35-item food intake questionnaire. OHRQoL was assessed using the Geriatric Oral Health Assessment Index (GOHAI). The GOHAI questionnaire consists of 12 items reflecting 3 hypothesized domains of the impact of oral disease: physical function, psychosocial function, and pain or discomfort. Differences in the scores obtained by the 3 measurements were compared between the 2 groups, using the Wilcoxon rank-sum test (α=.05). No significant differences were seen between the 2 groups in objective mixing ability, subjective masticatory score, or GOHAI (P>.05). Regarding the GOHAI physical function domain, only the swallowing item was significantly lower (P=.025) in participants with an open defect than in participants with a closed defect. Regarding the GOHAI psychological function domain, the item related to patients' psychological worries or concerns about their teeth, gingival tissue, or dentures was significantly lower (P=.045) in patients with an open defect than in those with a closed defect. Other items related to physical function, psychological function, and pain or discomfort were not significantly different (P>.05) between the 2 groups. The closed or open defect in patients who had undergone a partial maxillectomy may not influence patients' masticatory function and overall OHRQoL if they have adequate prosthetic rehabilitation. However, special consideration should be given to patients with an open defect with regard to swallowing function and psychological concerns in order to improve their OHRQoL. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.
Earthquakes in Mississippi and vicinity 1811-2010
Dart, Richard L.; Bograd, Michael B.E.
2011-01-01
This map summarizes two centuries of earthquake activity in Mississippi. Work on the Mississippi map was done in collaboration with the Mississippi Department of Environmental Quality, Office of Geology. The earthquake data plotted on the map are from several sources: the Mississippi Department of Environmental Quality, the Center for Earthquake Research and Information, the National Center for Earthquake Engineering Research, and the Arkansas Geological Survey. In addition to earthquake locations, other materials include seismic hazard and isoseismal maps and related text. Earthquakes are a legitimate concern in Mississippi and parts of adjacent States. Mississippi has undergone a number of felt earthquakes since 1811. At least two of these events caused property damage: a magnitude 4.7 earthquake in 1931, and a magnitude 4.3 earthquake in 1967. The map shows all historical and instrumentally located earthquakes in Mississippi and vicinity between 1811 and 2010. The largest historic earthquake in the vicinity of the State was an intensity XI event, on December 16, 1811; the first earthquake in the New Madrid sequence. This violent event and the earthquakes that followed caused considerable damage to the then sparsely settled region.
An imaging colorimeter for noncontact tissue color mapping.
Balas, C
1997-06-01
There has been a considerable effort in several medical fields, for objective color analysis and characterization of biological tissues. Conventional colorimeters have proved inadequate for this purpose, since they do not provide spatial color information and because the measuring procedure randomly affects the color of the tissue. In this paper an imaging colorimeter is presented, where the nonimaging optical photodetector of colorimeters is replaced with the charge-coupled device (CCD) sensor of a color video camera, enabling the independent capturing of the color information for any spatial point within its field-of-view. Combining imaging and colorimetry methods, the acquired image is calibrated and corrected, under several ambient light conditions, providing noncontact reproducible color measurements and mapping, free of the errors and the limitations present in conventional colorimeters. This system was used for monitoring of blood supply changes of psoriatic plaques, that have undergone Psoralens and ultraviolet-A radiation (PUVA) therapy, where reproducible and reliable measurements were demonstrated. These features highlight the potential of the imaging colorimeters as clinical and research tools for the standardization of clinical diagnosis and for the objective evaluation of treatment effectiveness.
Rock, Jack P; Ryu, Samuel; Yin, Fang-Fang; Schreiber, Faye; Abdulhak, Muwaffak
2004-01-01
Traditional management strategies for patients with spinal tumors have undergone considerable changes during the last 15 years. Significant improvements in digital imaging, computer processing, and treatment planning have provided the basis for the application of stereotactic techniques, now the standard of care for intracranial pathology, to spinal pathology. In addition, certain of these improvements have also allowed us to progress from frame-based to frameless systems which now act to accurately assure the delivery of high doses of radiation to a precisely defined target volume while sparing injury to adjacent normal tissues. In this article we will describe the evolution from yesterday's standards for radiation therapy to the current state of the art for the treatment of patients with spinal tumors. This presentation will include a discussion of radiation dosing and toxicity, the overall process of extracranial radiation delivery, and the current state of the art regarding Cyberknife, Novalis, and tomotherapy. Additional discussion relating current research protocols and future directions for the management of benign tumors of the spine will also be presented.
Masselli, Gabriele; Mastroiacovo, Ilaria; De Marco, Emidio; Francione, Giulia; Casciani, Emanuele; Polettini, Elisabetta; Gualdi, Gianfranco
2016-01-01
Crohn’s disease affects more than 500000 individuals in the United States, and about 25% of cases are diagnosed during the pediatric period. Imaging of the bowel has undergone dramatic changes in the past two decades. The endoscopy with biopsy is generally considered the diagnostic reference standard, this combination can evaluates only the mucosa, not inflammation or fibrosis in the mucosa. Actually, the only modalities that can visualize submucosal tissues throughout the small bowel are the computed tomography (CT) enterography (CTE) with the magnetic resonance enterography (MRE). CT generally is highly utilized, but there is growing concern over ionizing radiation and cancer risk; it is a very important aspect to keep in consideration in pediatric patients. In contrast to CTE, MRE does not subject patients to ionizing radiation and can be used to detect detailed morphologic information and functional data of bowel disease, to monitor the effects of medical therapy more accurately, to detect residual active disease even in patients showing apparent clinical resolution and to guide treatment more accurately. PMID:27551337
The Evolution of Private Plans in Medicare.
Patel, Yash M; Guterman, Stuart
2017-12-01
Since the 1980s, private plans have played an increasingly important role in the Medicare program. While initially created with the goals of reducing costs, improving choice, and enhancing quality, risk-based plans--now known as Medicare Advantage plans--have undergone significant policy changes since their inception; these changes have not always aligned with the original policy objectives. To examine major policy changes to Medicare risk plans and the effects of these policies on plan participation, enrollment, average premiums and cost-sharing, total costs to Medicare, and quality of care. Review of key policy documents, reports, position statements, and academic studies. Private plans have changed considerably since their introduction into Medicare. Enrollment has risen to 33 percent of all Medicare beneficiaries; 99 percent of beneficiaries have access to private plans in 2017. Recent policies have improved risk-adjustment methods, rewarded plans’ performance on quality of care, and reduced average payments to private plans to 100 percent of traditional Medicare spending. As enrollment in private plans continues to grow and as health care costs rise, policymakers should enhance incentives for private plans to meet intended goals for higher-quality care at lower cost.
Mirbeik-Sabzevari, Amir; Ashinoff, Robin; Tavassolian, Negar
2018-06-01
Millimeter waves have recently gained attention for the evaluation of skin lesions and the detection of skin tumors. Such evaluations heavily rely on the dielectric contrasts existing between normal and malignant skin tissues at millimeter-wave frequencies. However, current studies on the dielectric properties of normal and diseased skin tissues at these frequencies are limited and inconsistent. In this study, a comprehensive dielectric spectroscopy study is conducted for the first time to characterize the ultra-wideband dielectric properties of freshly excised normal and malignant skin tissues obtained from skin cancer patients having undergone Mohs micrographic surgeries at Hackensack University Medical Center. Measurements are conducted using a precision slim-form open-ended coaxial probe in conjunction with a millimeter-wave vector network analyzer over the frequency range of 0.5-50 GHz. A one-pole Cole-Cole model is fitted to the complex permittivity dataset of each sample. Statistically considerable contrasts are observed between the dielectric properties of malignant and normal skin tissues over the ultra-wideband millimeter-wave frequency range considered.
Si-rich Fe-Ni grains in highly unequilibrated chondrites
NASA Technical Reports Server (NTRS)
Rambaldi, E. R.; Sears, D. W.; Wasson, J. T.
1980-01-01
Consideration is given to the Si contents of Fe-Ni grains in highly unequilibrated chondrites, which have undergone little metamorphosis and thus best preserve the record of processes in the solar nebula. Electron microprobe determinations of silicon content in grains of the Bishunpur chondrite are presented for the six Si-bearing Fe-Ni grains for which data could be obtained, five of which were found to be embedded in olivine chondrules. In addition, all grains are found to be Cr-rich, with Cr increased in concentration towards the grain edge, and to be encased in FeS shells which evidently preserved the Si that entered the FeNi at higher temperatures. A mechanism for the production of Si-bearing metal during the condensation of the cooling solar nebula is proposed which considers the metal to have condensed heterogeneously while the mafic silicates condensed homogeneously with amounts of required undercooling in the low-pressure regions where ordinary and carbonaceous chondrites formed, resulting in Si mole fractions of 0.003 at nebular pressures less than 0.000001 atm.
Cyranka, Katarzyna; Rutkowski, Krzysztof; Mielimąka, Michał; Sobański, Jerzy A; Smiatek-Mazgaj, Bogna; Klasa, Katarzyna; Dembińska, Edyta; Müldner-Nieckowski, Łukasz; Rodziński, Paweł
2016-01-01
The study of group psychotherapy influence on the personality functioning of patients on treatment for neurotic disorders and selected personality disorders (F4-F6 under ICD-10). The study concerned 82 patients (61 women and 21 men) who underwent intensive short-term group psychotherapy in a day ward. A comprehensive assessment of the patients' personality functioning was carried out at the outset and the end of the psychotherapy utilising the MMPI-2 questionnaire. At the treatment outset the majority of the study patients demonstrated a considerable level of disorders in five MMPI-2 clinical scales (Depression, Hysteria, Psychopathic Deviate, Psychastenia, Schizophrenia) and moderate pathology in Hypochondria. In the Mania scale most patients obtained results comparable to the healthy population when the treatment commenced. Having undergone the psychotherapy treatment, the majority of the examined were observed to demonstrate positive changes in those areas of personality functioning which were classified as severe or moderate pathology. Short-term intensive comprehensive group psychotherapy with elements of individual psychotherapy leads to desirable changes in personality functioning.
Ultrasonic Evaluation and Imaging
DOE Office of Scientific and Technical Information (OSTI.GOV)
Crawford, Susan L.; Anderson, Michael T.; Diaz, Aaron A.
2015-10-01
Ultrasonic evaluation of materials for material characterization and flaw detection is as simple as manually moving a single-element probe across a speci-men and looking at an oscilloscope display in real time or as complex as automatically (under computer control) scanning a phased-array probe across a specimen and collecting encoded data for immediate or off-line data analyses. The reliability of the results in the second technique is greatly increased because of a higher density of measurements per scanned area and measurements that can be more precisely related to the specimen geometry. This chapter will briefly discuss applications of the collection ofmore » spatially encoded data and focus primarily on the off-line analyses in the form of data imaging. Pacific Northwest National Laboratory (PNNL) has been involved with as-sessing and advancing the reliability of inservice inspections of nuclear power plant components for over 35 years. Modern ultrasonic imaging techniques such as the synthetic aperture focusing technique (SAFT), phased-array (PA) technolo-gy and sound field mapping have undergone considerable improvements to effec-tively assess and better understand material constraints.« less
Maschio, Marta; Dinapoli, Loredana; Vidiri, Antonello; Pace, Andrea; Fabi, Alessandra; Pompili, Alfredo; Carapella, Maria Carmine; Jandolo, Bruno
2009-01-01
Background Seizure control doesn't represent the only challenging goal in patients with brain tumor-related epilepsy. Side effects have often taken precedence for patients' quality of life. Methods We performed an observational retrospective study on patients with brain tumor-related epilepsy: 35 who had assumed oxcarbazepine monotherapy and 35 patients who had undergone treatment with traditional antiepileptic drugs. Primary variable of efficacy was the mean seizure frequency per month and safety variables were the drop-out for side effects and total incidence of side effects. We applied the Propensity Score technique to minimize selection bias. Results Our results showed a similar efficacy of oxcarbazepine and traditional antiepileptic drugs over time, but the difference in safety and tolerability between the two groups was significant: traditional AEDs caused more side effects, both serious and non serious. Conclusion This study highlights the importance of taking into consideration not only seizure control but also the appearance of side effects when choosing antiepileptic drugs in this patients population. PMID:19419544
Yun, Minwoo; Kim, Eunyoung; Park, Woong-Sub
2017-08-01
To more fully comprehend juvenile delinquency, it is necessary to take an integrative approach, with consideration of both personality traits of social risk factors. Many scholars argue the necessity and strength of integrative approach on the ground that juvenile delinquency is an outcome of interplay of individual and social factors. The present study examines the general applicability of an integrative model of personal traits and social risk factors to youth delinquency in the South Korean context. The empirical results show that the delinquency predictors in the current South Korean sample are closely aligned to Loeber and Farrington's theoretical propositions and that found in Western nations. Perhaps this is because South Korea has undergone rapid Westernization for the last decades. Because the correlates in this sample and Western theoretical propositions and studies overlap, an integrative model of personality trait and social risk factors is indeed generally applicable to South Korea. This finding also depicts the extent of Westernization in the South Korean society at least among adolescents. Limitations of the present study and directions for the future study are discussed.
Assessing community interventions to reduce smoking.
Mackay, J; Davis, R M
1991-01-01
Few major, community-based antismoking programs have undergone specific evaluation in developed countries; the number is even lower in developing countries. Yet not all evaluation need be elaborate, expensive, or overly time-consuming. Data on tobacco trade, import and export, taxation, mortality, and morbidity may already exist within government departments and can be used for evaluation. Published information from the tobacco industry may be obtained easily in trade journals and annual reports. Universities and international and overseas national health agencies may offer information, assistance, and expertise. Indirect evaluation of the importance of any particular antismoking intervention can be measured by how strongly the tobacco industry opposes that measure.
Next-Generation Regimens: The Future of Hepatitis C Virus Therapy.
Vizuete, John; Hubbard, Hope; Lawitz, Eric
2015-11-01
The treatment of chronic hepatitis C virus (HCV) has undergone a period of rapid evolution. The era of combination direct antivirals has led to high rates of sustained viral response (SVR), limited toxicities, and more broad applicability across patient demographics. Even current therapies have their limitations, however, including genotype specificity and variable durations of treatment depending on the presence or absence of cirrhosis. Developing a fixed-duration pangenotypic regimen that can broadly treat all stages of fibrosis with equal rates of SVR in all patients, irrespective of treatment experience, is the goal of future therapies. This article reviews antivirals in development. Copyright © 2015 Elsevier Inc. All rights reserved.
Shuttle waste management system design improvements and flight evaluation
NASA Technical Reports Server (NTRS)
Winkler, H. Eugene; Goodman, Jerry R.; Murray, Robert W.; Mcintosh, Mathew E.
1986-01-01
The Space Shuttle waste management system has undergone a variety of design changes to improve performance and man-machine interface. These design improvements have resulted in more reliable operation and hygienic usage. Design enhancements include individual urinals, increased urine collection airflows, increased solids storage capacity, easier access to personal hygiene items, and additional wet trash stowage. The development and flight evaluation of these improvements are described herein. The Space Shuttle Orbiter has proved to be an invaluable test bed for development and in-flight evaluation of life support and habitability concepts which involve transport or separation of solids, liquids, and gases in a zero-g environment.
Trattner, A; Hodak, E; David, M; Neeman, A; Sandbank, M
1993-11-01
Kaposi's sarcoma has been reported in patients receiving immunosuppressive therapy, most of whom are organ transplant recipients. The development of Kaposi's sarcoma after treatment with corticosteroids has been reported in only 38 patients who have not had acquired immunodeficiency syndrome or undergone organ transplantation. Cutaneous Kaposi's sarcoma developed 2 months after intraarticular steroid injections in a man with ulnar nerve entrapment. The lesions regressed spontaneously after 3 months but reappeared with visceral involvement 18 months later, shortly after initiation of a course of epidural steroid injections for treatment of low back pain. The cutaneous lesions and some visceral lesions rapidly regressed after cessation of treatment.
The Information Needs of Women Who Have Undergone Breast Cancer Surgery in the West of Turkey.
Findik, Ummu Yildiz
2017-09-01
This descriptive study aimed to evaluate the information needs of breast cancer patients who have undergone surgery, and the level to which those information needs are met in the west of Turkey. It was conducted in 55 women who had undergone surgical intervention between March 2013 and March 2014 in a university hospital in the west of Turkey. A personal information form and the Patient Information Needs Scale were used to gather data. Descriptive statistics, the Chi-square test, and the Wilcoxon signed-rank test were used to analyze the data. It was found that the information need of the patients (3.9 +/- 0.6) was near the "very important" level, and that this need was "somewhat met" (2.4 +/- 0.9). When the information needs of the patients and the level to which those needs were fulfilled were compared, the level of fulfillment was statistically significantly lower (p < 0.001). Among the different subscales evaluated, information relating to medication was the most needed, and the information needs pertaining to this subscale were met to a greater degree (p < 0.05) than the remaining subscales. The results showed that the information needs, primarily the medication-related information needs, of the patients were high, but that the level of meeting these needs was low. It should be considered important for patients who have undergone breast cancer surgery to be kept informed and provided with information regarding their medication.
Invited review: Changes in the dairy industry affecting dairy cattle health and welfare.
Barkema, H W; von Keyserlingk, M A G; Kastelic, J P; Lam, T J G M; Luby, C; Roy, J-P; LeBlanc, S J; Keefe, G P; Kelton, D F
2015-11-01
The dairy industry in the developed world has undergone profound changes over recent decades. In this paper, we present an overview of some of the most important recent changes in the dairy industry that affect health and welfare of dairy cows, as well as the science associated with these changes. Additionally, knowledge gaps are identified where research is needed to guide the dairy industry through changes that are occurring now or that we expect will occur in the future. The number of farms has decreased considerably, whereas herd size has increased. As a result, an increasing number of dairy farms depend on hired (nonfamily) labor. Regular professional communication and establishment of farm-specific protocols are essential to minimize human errors and ensure consistency of practices. Average milk production per cow has increased, partly because of improvements in nutrition and management but also because of genetic selection for milk production. Adoption of new technologies (e.g., automated calf feeders, cow activity monitors, and automated milking systems) is accelerating. However, utilization of the data and action lists that these systems generate for health and welfare of livestock is still largely unrealized, and more training of dairy farmers, their employees, and their advisors is necessary. Concurrently, to remain competitive and to preserve their social license to operate, farmers are increasingly required to adopt increased standards for food safety and biosecurity, become less reliant on the use of antimicrobials and hormones, and provide assurances regarding animal welfare. Partly because of increasing herd size but also in response to animal welfare regulations in some countries, the proportion of dairy herds housed in tiestalls has decreased considerably. Although in some countries access to pasture is regulated, in countries that traditionally practiced seasonal grazing, fewer farmers let their dairy cows graze in the summer. The proportion of organic dairy farms has increased globally and, given the pressure to decrease the use of antimicrobials and hormones, conventional farms may be able to learn from well-managed organic farms. The possibilities of using milk for disease diagnostics and monitoring are considerable, and dairy herd improvement associations will continue to expand the number of tests offered to diagnose diseases and pregnancy. Genetic and genomic selection for increased resistance to disease offers substantial potential but requires collection of additional phenotypic data. There is every expectation that changes in the dairy industry will be further accentuated and additional novel technologies and different management practices will be adopted in the future. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.
Treatment of Chronic Plantar Fasciitis With Percutaneous Latticed Plantar Fasciotomy.
Yanbin, Xu; Haikun, Chu; Xiaofeng, Ji; Wanshan, Yang; Shuangping, Liu
2015-01-01
Plantar fasciitis, the most common cause of pain in the inferior heel, accounts for 11% to 15% of all foot symptoms requiring professional care among adults. The present study reports the results of a minimally invasive surgical treatment of chronic plantar fasciitis. All patients with plantar fasciitis who had undergone percutaneous latticed plantar fasciotomy at 3 clinical sites from March 2008 to March 2009 were included in the present study. The follow-up evaluations for this treatment were conducted using the Mayo clinical scoring system. We investigated 17 patients with recalcitrant chronic plantar fasciitis who had undergone this treatment within a follow-up period of ≥13 months. All procedures were performed in the clinic with the patient under local anesthesia. No wound infections or blood vessel or nerve damage occurred. At a mean follow-up period of 16.0 ± 2.29 (range 13 to 21) months, significant improvement was seen in the preoperative mean Mayo score (from 12.06 ± 2.54 to 89.76 ± 4.28, p < .001) and no patient had developed symptom recurrence. Also, none of the patients had developed complex regional pain syndrome. All patients were able to return to regular shoe wear by 3 weeks postoperatively. The technique of plantar fasciitis with percutaneous latticed plantar fasciotomy could be a promising treatment option for patients with recalcitrant chronic plantar fasciitis. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
Liu, Xiaozhen; Yang, Yang; Feng, Xiaolong; Shen, Honghong; Liu, Jian; Liu, Xia; Niu, Yun
2016-01-01
As a new subtype of breast cancer, molecular apocrine breast cancer (MABC) is estrogen receptor (ER) and progesterone receptor (PR) negative expression, but androgen receptor (AR) positive expression. The prognostic significance and clinical biological behavior of MABC have remained unclear up to now. This study aimed to analysis the distant metastasis behavior and response to adjuvant radiotherapy and chemotherapy of MABC subgroup. The report showed that there were significant differences between early and late distant metastasizing tumors with respect to Ki67, epidermal growth factor receptor 2 (HER2) and vascular endothelial growth factor (VEGF) expressions by a retrospective analysis consisting of 410 invasive breast cancer patients, which included 205 MABC and 205 nonMABC cases. MABC subgroup metastasized earlier than nonMABC subgroup, and MABC showed a tendency for a higher metastasis rate in lung, liver and brain, but lower in bone. HER2-positive or VEGF-positive tumors were more inclined to develop bone metastasis within MABC subgroup. The survival rate was superior for patients undergone both adjuvant radiotherapy and chemotherapy than those undergone chemotherapy alone in nonMABC subgroup, but there was no significant difference in MABC subgroup. Our data suggested that MABC subgroup seemed to develop distant metastasis earlier than nonMABC subgroup, and patients with MABC indicated poor prognosis. This study might also provide a foundation for helping patients receive reasonable treatments according to molecular subtype. PMID:27340922
Liu, Xiaozhen; Yang, Yang; Feng, Xiaolong; Shen, Honghong; Liu, Jian; Liu, Xia; Niu, Yun
2016-08-02
As a new subtype of breast cancer, molecular apocrine breast cancer (MABC) is estrogen receptor (ER) and progesterone receptor (PR) negative expression, but androgen receptor (AR) positive expression. The prognostic significance and clinical biological behavior of MABC have remained unclear up to now. This study aimed to analysis the distant metastasis behavior and response to adjuvant radiotherapy and chemotherapy of MABC subgroup. The report showed that there were significant differences between early and late distant metastasizing tumors with respect to Ki67, epidermal growth factor receptor 2 (HER2) and vascular endothelial growth factor (VEGF) expressions by a retrospective analysis consisting of 410 invasive breast cancer patients, which included 205 MABC and 205 nonMABC cases. MABC subgroup metastasized earlier than nonMABC subgroup, and MABC showed a tendency for a higher metastasis rate in lung, liver and brain, but lower in bone. HER2-positive or VEGF-positive tumors were more inclined to develop bone metastasis within MABC subgroup. The survival rate was superior for patients undergone both adjuvant radiotherapy and chemotherapy than those undergone chemotherapy alone in nonMABC subgroup, but there was no significant difference in MABC subgroup. Our data suggested that MABC subgroup seemed to develop distant metastasis earlier than nonMABC subgroup, and patients with MABC indicated poor prognosis. This study might also provide a foundation for helping patients receive reasonable treatments according to molecular subtype.
[METABOLIC PREVENTION OF FAT EMBOLISM.
Yakovlev, A Yu; Pevnev, A A; Nikol'skiy, V O; Galanina, T A; Prokin, E G; Kalachev, S A; Ryabikov, D V
2016-07-01
to study the effect of solution with methionine "Remaxol" on metabolic disorders andfat embolism developing in severe combined trauma. 544 patient with severe skeletal trauma were undergone to a prospective study of dynamics of fat embolism syndrome development depending on the inclusion in the program of infusion therapy drug "Remaxol". The dynamics of lactate, glucose, free fatty acids, globularia and the incidence offat embolism syndrome were analyzed. Corrective action drug with methionine "Remaxol" on hyperglycemia, hyperlactatemia, hyperlipemia and de- crease circulation offat globules, which is reflected in the decrease in the frequency of development offat embolism syndrome was identified. One of the proposed mechanisms reduce the risk offat embolism development is assumed restoration of endogenous carnitine synthesis with methionine and transport offree fatty acids in the cell and their subsequent inclusion in metabolic processes.
Hydrology of Lake Carroll, Hillsborough County, Florida
Henderson, S.E.; Hayes, R.D.; Stoker, Y.E.
1985-01-01
Lakeshore property around Lake Carroll has undergone extensive residential development since 1960. This development increased the lake shoreline, altered surface water flow to and from the lake, and may have affected lake-stage characteristics. Some areas of the lake were dredged to provide fill material for lakefront property. Water-balance analyses for 1952-60, a predevelopment period, and 1961-80, a period of residential development, indicate that both net surface water flow to the lake and downward leakage from the lake to the Floridan aquifer were greater after 1960. These changes were due more to changes in the regional climate and related changes in ground-water levels than to changes associated with residential development. Results of water quality analyses in 1980-81 are within State limits for surface waters used for recreation and wildlife propagation. (USGS)
Pepper, M Reese; Black, Maureen M
2011-08-01
Vitamin B12 (cobalamin) is necessary for development of the fetus and child. Pregnant women who are vegetarian or vegan, have Crohn's or celiac disease, or have undergone gastric bypass surgery are at increased risk of B12 deficiency. Low serum levels of B12 have been linked to negative impacts in cognitive, motor, and growth outcomes. Low cobalamin levels also may be related to depression in adults. Some studies indicate that B12 supplementation may improve outcomes in children, although more research is needed in this area. Overall, the mechanisms of B12 action in development remain unclear. Further studies in this area to elucidate the pathways of cobalamin influence on development, as well as to prevent B12 deficiency in pregnant women and children are indicated. Copyright © 2011 Elsevier Ltd. All rights reserved.
Caterson, E J; Shetye, Pradip R; Grayson, Barry H; McCarthy, Joseph G
2013-10-01
The classic Le Fort III procedure was recommended in syndromic craniosynostotic children to reduce exorbitism, improve airway function, and decrease dysmorphism. This study reports on a cohort of syndromic craniosynostosis patients who have undergone early primary subcranial (classic Tessier) Le Fort III advancement and who have been followed longitudinally through skeletal maturity and beyond. In this study, the Le Fort III advancements all occurred between the ages of 3 to 5 years, with a mean age of 4.6 years. Subsequently, these early Le Fort III patients were followed throughout development with longitudinal dental, medical, radiographic, and photographic evaluations conducted through skeletal maturity and beyond. For study inclusion, the patients had to have preoperative medical photographs and cephalometric studies at 6 months and 1, 5, and 10 years postoperatively after the primary Le Fort III advancement as well as cephalometric documentation 6 months and 1 year after the secondary midface advancement after skeletal maturity. After early or primary Le Fort III advancement, there was no evidence of relapse and only minimal anterior or horizontal postoperative growth of the midface. However, there was also a return of occlusal disharmony from "anticipated" mandibular growth, approaching a maximum at skeletal maturity. The dysmorphic concave facial profile and malocclusion, and airway and ocular considerations, provided the impetus for secondary midface surgery after skeletal maturity was attained. The data demonstrate that early Le Fort III advancement performed before the age of mixed dentition does not obviate the need for a secondary advancement after skeletal maturity is reached. Therapeutic, IV.
Barker, Brittany S.; Ríos-Franceschi, Alejandro
2014-01-01
The Mountain Coqui (Eleutherodactylus portoricensis) is a frog endemic to montane rainforests in the Cordillera Central and Luquillo Mountains of Puerto Rico. Classified as endangered by the IUCN Red List and as vulnerable by the Department of Natural and Environmental Resources of Puerto Rico, this species has undergone considerable decline in the Luquillo Mountains. To evaluate the population status of E. portoricensis across its entire range, we conducted ~87 hours of surveys at 18 historical localities and 25 additional localities that we considered suitable for this species. We generated occupancy models to estimate the probability of occurrence at surveyed sites and to identify geographic and climatic factors affecting site occupancy. We also constructed a suitability map to visualize population status in relation to the presence of land cover at elevations where the species has been documented, and determined the dates when populations were last detected at historical localities. Eleutherodactylus portoricensis was detected at 14 of 43 localities, including 10 of 18 historical localities, but it was not detected at any localities west of Aibonito (western Cordillera Central). Occupancy models estimated the probability of occurrence for localities in the western Cordillera Central as zero. Site occupancy was positively associated with montane cloud forest, and negatively associated with the western Cordillera Central, maximum temperature, and precipitation seasonality. The suitability map suggests that declines have occurred despite the presence of suitable habitat. We suggest upgrading the extinction risk of E. portoricensis and potentially developing a captive breeding program for this species. PMID:25685250
Current and anticipated uses of the thermal hydraulics codes at the NRC
DOE Office of Scientific and Technical Information (OSTI.GOV)
Caruso, R.
1997-07-01
The focus of Thermal-Hydraulic computer code usage in nuclear regulatory organizations has undergone a considerable shift since the codes were originally conceived. Less work is being done in the area of {open_quotes}Design Basis Accidents,{close_quotes}, and much more emphasis is being placed on analysis of operational events, probabalistic risk/safety assessment, and maintenance practices. All of these areas need support from Thermal-Hydraulic computer codes to model the behavior of plant fluid systems, and they all need the ability to perform large numbers of analyses quickly. It is therefore important for the T/H codes of the future to be able to support thesemore » needs, by providing robust, easy-to-use, tools that produce easy-to understand results for a wider community of nuclear professionals. These tools need to take advantage of the great advances that have occurred recently in computer software, by providing users with graphical user interfaces for both input and output. In addition, reduced costs of computer memory and other hardware have removed the need for excessively complex data structures and numerical schemes, which make the codes more difficult and expensive to modify, maintain, and debug, and which increase problem run-times. Future versions of the T/H codes should also be structured in a modular fashion, to allow for the easy incorporation of new correlations, models, or features, and to simplify maintenance and testing. Finally, it is important that future T/H code developers work closely with the code user community, to ensure that the code meet the needs of those users.« less
Symptoms of distress and posttraumatic stress among South African former political detainees.
Kagee, Ashraf
2005-05-01
Considerable debate has centred on the question of traumatisation among individuals who have survived human rights violations in societies that have undergone political conflict. In order to gain an estimate of the extent of long-term traumatisation among political activists who experienced torture and abuse in detention during the apartheid era in South Africa, a sample of 148 survivors of such experiences were recruited in a cross-sectional study and asked to complete the Hopkins Symptom Checklist (HSCL), the Impact of Event Scale (IES), and the Trauma Symptoms section of the Harvard Trauma Questionnaire (HTQ). The proportions of the sample that scored above the clinical cut-points on these measures were calculated. On the HSCL, 14.19% of the sample scored above the cut-point for clinical significance of 44; on the IES, 17.57% scored above the clinical cut-point of 44; and on the HTQ, 37.83% scored above the cut-point of 75. Moreover, the sample's mean scores were significantly higher than the cut-point for clinically significant distress on the HSCL (p < 0.001); significantly lower than the cut-point for severe traumatisation on the IES (p < 0.001); and non-significantly lower than the cut-point for clinically significant traumatisation on the HTQ (p = 0.074). These results are considered in terms of current theoretical debates on the relevance and applicability of posttraumatic stress disorder as a circumscribed nosological entity in developing countries that are in the process of coming to terms with a history of political conflict.
Biosimilars in psoriasis: Clinical practice and regulatory perspectives in Latin America.
de la Cruz, Claudia; de Carvalho, André V E; Dorantes, Gladys L; Londoño Garcia, Angela M; Gonzalez, Cesar; Maskin, Matías; Podoswa, Nancy; Redfern, Jan S; Valenzuela, Fernando; van der Walt, Joelle; Romiti, Ricardo
2017-01-01
Latin American countries view biosimilar agents as an effective approach to curtail health-care expenditures while maintaining the safety and efficacy profile of their branded innovator comparators. To understand the complexities of the regulatory landscape and key therapeutic issues for use of biosimilars to treat moderate to severe psoriasis in Latin America, the International Psoriasis Council convened dermatology experts from Argentina, Brazil, Chile, Colombia and Mexico in October 2015 to review the definition, approval, marketing and future of biosimilars in each country and develop a consensus statement. The regulatory framework for marketing approval of biosimilars in Latin America is currently a mosaic of disparate, country-specific, regulatory review processes, rules and standards, with considerable heterogeneity in clarity and specificity. Regulations in Argentina, Brazil, Chile and Mexico have undergone multiple refinements whereas Colombia is finalizing draft guidelines. Verification of the similarity in quality, safety and efficacy of biosimilars to the innovator biologic remains a key challenge for policy makers and regulatory authorities. Other key regulatory challenges include: naming of agents and traceability, pharmacovigilance, extrapolation of indications, and interchangeability and substitution. An urgent need exists for more Latin American countries to establish national psoriasis registries and to integrate their common components into a multinational psoriasis network, thereby enhancing their interpretative power and impact. A Latin American psoriasis network similar to PSONET in Europe would assist health-care providers, pharmaceutical companies, regulators and patients to fully comprehend specific products being prescribed and dispensed and to identify potential regional trends or differences in safety or outcomes. © 2016 Japanese Dermatological Association.
Genetic interpretations of elemental and chemical differences in a soil chronosequence, California
Harden, J.W.
1988-01-01
Soils developed on fluvial terraces in central California have similar parent materials, climatic settings, vegetation cover and slopes but range in age from 40,000 to 3,000,000 years. The soils have chemical compositions that change systematically with increasing age. Such chemical differentiation is most likely the result of long-term weathering and mineralogical transformations that occurred since deposition of terrace fills and stabilization of the geomorphic surfaces. The changes in composition with time closely mimic other studies on mineral weathering, in which alkali and alkali-earth elements are lost more rapidly than transitional elements. The relative rates of element loss were determined by changes in element ratios over time. Net losses and gains of elements in different size fractions were monitored by their concentrations relative to Zr, the most stable constituent. Both sand and finer size fractions have lost considerable amounts of Ca, Mg, Na and K. Aluminum appears to have been lost from the sand fraction and gained in the fine fraction over a 3-million-year-time-span. Although there is no evidence for losses of Fe and Ti from sands, there is a net influx of Fe and Ti into finer fractions, probably gained from undetectable yet significant weathering of sand grains. Etching of sand grains, clay mineralogy, and microprobe analyses also indicate that the soils have undergone these chemical transformations during their formation. Mineralogical analyses also mimic other studies on mineral weathering, in which the pyroxenes weather more rapidly than hornblende, which weathers more rapidly than sphene or zircon. ?? 1988.
[The opportunities, challenges and trends in the rejuvenation of microbiology].
Shen, Ping; Chen, Xiangdong
2010-01-01
In history, the development of microbiology had undergone two golden ages and some depression time as well. In the last two decades, the application of many physiochemical technologies including genomics, structural biology, bioinformatics, PCR, and high-resolution microscopy has led to a series of breakthroughs in microbiology. Microbiology has now awakened and entered its third golden age for development. This review discusses our view of the opportunities, challenges, and trends in the current advancement of microbiology. The topics include: (1) The two golden ages for microbiology in history. (2) The opportunities and challenges in the rejuvenation of microbiology. (3) The characteristics and trends of the current development of microbiology. (4) Integral microbiology--the hallmark of the third golden age.
Studies Toward Birth and Early Mammalian Development in Space
NASA Technical Reports Server (NTRS)
Ronca, April E.; Dalton, Bonnie (Technical Monitor)
2002-01-01
Successful reproduction is the hallmark of a species' ability to adapt to its environment and must be realized to sustain life beyond Earth. Before taking this immense step, we need to understand the effects of altered gravity on critical phases of mammalian reproduction, viz., those events surrounding pregnancy, birth and the early development of offspring. No mammal has yet undergone birth in space. however studies spanning the gravity continuum from 0 to 2-g are revealing insights into how birth and early postnatal development will proceed in space. In this presentation, I will report the results of behavioral studies of rat mothers and offspring exposed from mid- to late pregnancy to either hypogravity (0-g) or hypergravity (1.5 or 2-g).
DOE Office of Scientific and Technical Information (OSTI.GOV)
Zhou, Shengru; Hurlbut, David J; Li, Ma
In recent years, the US electricity market has undergone several stages of reform, and gradually formed the market where the wholesale electricity price is determined by the supply and demand. The US electricity market also changes along with the rapid development of clean energy, forming a number of the market mechanisms that is specifically developed for clean energy power generation characteristics. On the basis of discussing the pricing mechanism of US electricity market, this paper analyzes the experience and practice of encouraging renewable energy development policy and clean energy dispatch from the angle of market mechanism and dispatching decision, andmore » puts forward the reference for clean energy dispatching in China.« less
O'Brodovich, Hugh; Pleinys, Ramune; Laxer, Ronald; Tallett, Susan; Rosenblum, Norman; Sass-Kortsak, Christina
2003-01-01
The Department of Pediatrics at the Hospital for Sick Children, which is funded by an alternative payment plan, has implemented a novel career development and compensation program (CDCP). Job activity profiles were used to more clearly define job expectations, benchmarks guided career development, and peer review was used to assess performance. The objective of this study was to evaluate the departmental pediatricians' satisfaction with the CDCP. Pediatricians, all of whom had undergone CDCP annual reviews, could participate if they had undergone the in-depth triennial CDCP review. Each received a 5-point Likert scale-based questionnaire that asked how well the CDCP had conformed to the principles identified by the department during the development of the CDCP. Anonymous, confidential responses were collated and used to guide focus groups that discussed areas of greatest concern and attempted to identify solutions. Focus groups were led by external facilitators who were experienced in qualitative research. They audiotaped the sessions, transcribed the comments, and analyzed the data with the assistance of a qualitative analysis application. Sixty of the eligible 88 pediatricians participated, and 74% of their responses were that the CDCP had addressed the original principles "somewhat," "to a great extent," or "extremely well." The remainder indicated that some of the principles were either "not addressed" or "only to a small extent" by the CDCP. Results from the 11 focus groups (46 participants) indicated that the CDCP was an improvement over the previous method of career development and determination of the rate of remuneration. Most were also still in agreement with the purpose and design principles. Although they did not want the CDCP to undergo a major redesign, they identified areas that need improvement. Short-, medium-, and long-term action plans to address these areas are under way. Pediatricians at the health science center of the Hospital for Sick Children remain supportive of the CDCP.
Delahunt, Eamonn; Chawke, Mark; Kelleher, Judy; Murphy, Katie; Prendiville, Anna; Sweeny, Lauren; Patterson, Matt
2013-01-01
Context: Deficits in lower limb kinematics and postural stability are predisposing factors to the development of knee ligamentous injury. The extent to which these deficits are present after anterior cruciate ligament (ACL) reconstruction is still largely unknown. The primary hypothesis of the present study was that female athletes who have undergone ACL reconstruction and who have returned to sport participation would exhibit deficits in dynamic postural stability as well as deficiencies in hip- and knee-joint kinematics when compared with an age-, activity-, and sex-matched uninjured control group. Objective: To investigate dynamic postural stability as quantified by the Star Excursion Balance Test (SEBT) and simultaneous hip- and knee-joint kinematic profiles in female athletes who have undergone ACL reconstruction. Design: Descriptive laboratory study. Setting: University motion-analysis laboratory. Patients or Other Participants: Fourteen female athletes who had previously undergone ACL reconstruction (ACL-R) and 17 age- and sex-matched uninjured controls. Intervention(s): Each participant performed 3 trials of the anterior, posterior-medial, and posterior-lateral directional components of the SEBT. Main Outcome Measure(s): Reach distances for each directional component were quantified and expressed as a percentage of leg length. Simultaneous hip- and knee-joint kinematic profiles were recorded using a motion-analysis system. Results: The ACL-R group had decreased reach distances on the posterior-medial (P < .01) and posterior-lateral (P < .01) directional components of the SEBT. During performance of the directional components of the SEBT, ACL-R participants demonstrated altered hip-joint frontal-, sagittal-, and transverse-plane kinematic profiles (P < .05), as well as altered knee-joint sagittal-plane kinematic profiles (P < .05). Conclusions: Deficits in dynamic postural stability and concomitant altered hip- and knee-joint kinematics are present after ACL reconstruction and return to competitive activity. The extent to which these deficits influence potential future injury is worthy of investigation. PMID:23672381
Parity and the risk of cataract: a cross-sectional analysis in the Dongfeng-Tongji cohort study.
Tian, Yaohua; Wu, Jing; Xu, Guiqiang; Shen, Lijun; Yang, Siyi; Mandiwa, Chrispin; Yang, Handong; Liang, Yuan; Wang, Youjie
2015-12-01
Epidemiological evidence showed that prevalence rates of cataract were higher in women than in men. Female reproductive factors were hypothesised to be linked with this sex difference. In this study, we explored possible effects of parity and reproductive factors on the risk of cataract. Women (14 337 total; aged 45-86 years) were recruited from the Dongfeng-Tongji cohort study. All subjects completed baseline questionnaires and medical examinations and provided baseline blood samples. Cataract was diagnosed by the ophthalmologist in the ocular examination. Logistic regression models were used to evaluate the association between parity and the risk of cataract. The prevalence rate of cataract in the study population was 6.8% (972/14 337). After adjustment for potential confounders, women who had undergone two, three, and four or more live births had 1.52 times (95% CI 1.13 to 2.04), 1.67 times (95% CI 1.27 to 2.29) and 1.72 times (95% CI 1.22 to 2.42), respectively, higher risk of cataract compared with women who had undergone one live birth. The risk increased by an estimated 11.3% for each additional live birth. Women who had undergone hormone replacement therapy (OR 1.61; 95% CI 1.05 to 2.47), had diabetes mellitus (OR 1.33; 95% CI 1.11 to 1.58) and/or had the habit of drinking alcohol (OR 1.51; 95% CI 1.08 to 2.10) had a higher risk of cataract. Neither menopause status nor history of contraceptive use was associated with cataract. The findings suggested that parity was an independent risk factor for the development of cataract in Chinese women. 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/
Lenticular fibroxanthomatous nodule.
Lee, Seok J; Ling, Jun X; Aaberg, Thomas M; Grossniklaus, Hans E
2003-02-01
To describe two patients with unique lenticular nodular proliferations. Observational case reports. The clinical histories and pathologic findings of two patients with lenticular nodular proliferations were reviewed. One patient with persistent hyperplastic primary vitreous and another patient with trauma developed lenticular nodular proliferations. The nodules were vascularized collections of foamy histiocytes, multinucleated cells, lens capsule, and lens epithelium that had undergone fibrous metaplasia. The lesions were classified as lenticular fibroxanthomatous nodules. A lenticular fibroxanthomatous nodule is a unique clinicopathologic entity that should be differentiated from Soemmerring ring, Elschnig pearl, and other simulating entities such as juvenile xanthogranuloma.
Multi-time scale dynamics in power electronics-dominated power systems
NASA Astrophysics Data System (ADS)
Yuan, Xiaoming; Hu, Jiabing; Cheng, Shijie
2017-09-01
Electric power infrastructure has recently undergone a comprehensive transformation from electromagnetics to semiconductors. Such a development is attributed to the rapid growth of power electronic converter applications in the load side to realize energy conservation and on the supply side for renewable generations and power transmissions using high voltage direct current transmission. This transformation has altered the fundamental mechanism of power system dynamics, which demands the establishment of a new theory for power system control and protection. This paper presents thoughts on a theoretical framework for the coming semiconducting power systems.
A new data collaboration service based on cloud computing security
NASA Astrophysics Data System (ADS)
Ying, Ren; Li, Hua-Wei; Wang, Li na
2017-09-01
With the rapid development of cloud computing, the storage and usage of data have undergone revolutionary changes. Data owners can store data in the cloud. While bringing convenience, it also brings many new challenges to cloud data security. A key issue is how to support a secure data collaboration service that supports access and updates to cloud data. This paper proposes a secure, efficient and extensible data collaboration service, which prevents data leaks in cloud storage, supports one to many encryption mechanisms, and also enables cloud data writing and fine-grained access control.
Pediatric epilepsy: The Indian experience.
Gadgil, Pradnya; Udani, Vrajesh
2011-10-01
Epilepsy is a common clinical entity in neurology clinics. The understanding of the genetics of epilepsy has undergone a sea change prompting re-classification by the International league against epilepsy recently. The prevalence rates of epilepsy in India are similar to those of developed nations. However, the large treatment gap is a major challenge to our public health system. Perinatal injuries are a major causative factor in pediatric group. We have discussed a few common etiologies such as neurocysticercosis and newer genetic epilepsy syndromes. We have also briefly touched upon the Indian experience in pediatric epilepsy surgery.
Achromatic elemental mapping beyond the nanoscale in the transmission electron microscope.
Urban, K W; Mayer, J; Jinschek, J R; Neish, M J; Lugg, N R; Allen, L J
2013-05-03
Newly developed achromatic electron optics allows the use of wide energy windows and makes feasible energy-filtered transmission electron microscopy (EFTEM) at atomic resolution. In this Letter we present EFTEM images formed using electrons that have undergone a silicon L(2,3) core-shell energy loss, exhibiting a resolution in EFTEM of 1.35 Å. This permits elemental mapping beyond the nanoscale provided that quantum mechanical calculations from first principles are done in tandem with the experiment to understand the physical information encoded in the images.
NOAA Education: Adventures in Strategic Planning, External Review, and Evaluation
NASA Astrophysics Data System (ADS)
Michalopoulos, C.
2010-12-01
Since late 2007, the National Oceanic and Atmospheric Administration has undertaken the development of a 20-year Education Strategic Plan, has undergone an external review by the National Research Council of the National Academies, and has drafted a guiding document on an agency-wide approach for monitoring and evaluation of its education activities and programs. This presentation will review all these processes with special emphasis on lessons learned and on the implications of each one on NOAA’s ability to improve and better coordinate its educational portfolio.
[Post-traumatic complication of trans-appendiceal cystostomy: urinary peritonitis].
Landry, J L; Dubois, R; Chaffange, P; Pelizzo, G; Dodat, H
2001-04-01
Two children who had undergone a transappendicular urinary diversion (type Mitrofanoff) developed bladder rupture, one following abdominal trauma, 4 months after the operation and the other following traumatic self-catheterization at 4 years. The clinical history and standard radiological examinations (ultrasonography, cystography) confirmed the diagnosis of urinary peritonitis. Emergency surgical repair was possible in both cases with an uneventful postoperative course. This serious and rare complication requires emergency surgery and justifies rigorous selection of children suitable for this type of diversion giving preference to increased bladder neck resistance over bladder neck closure.
A current perspective on antimicrobial resistance in Southeast Asia
Zellweger, Raphaël M; Carrique-Mas, Juan; Limmathurotsakul, Direk; Day, Nicholas P. J; Thwaites, Guy E; Baker, Stephen; Ashley, Elizabeth; de Balogh, Katinka; Baird, Kevin; Basnyat, Buddha; Benigno, Carolyne; Bodhidatta, Ladaporn; Chantratita, Narisara; Cooper, Ben; Dance, David; Dhorda, Mehul; van Doorn, Rogier; Dougan, Gordon; Hoa, Ngo Thi; Ip, Margaret; Lawley, Trevor; Lim, Cherry; Lin, Thong Kwai; Ling, Claire; Lubell, Yoel; Mather, Alison; Marks, Florian; Mohan, Venkata Raghava; Newton, Paul; Paris, Daniel; Thomson, Nicholas; Turner, Paul; Serichantalergs, Oralak; Smithuis, Frank; Wuthiekanun, Vanaporn; White, Nicholas; Li Yang, Hsu
2017-01-01
Abstract Southeast Asia, a vibrant region that has recently undergone unprecedented economic development, is regarded as a global hotspot for the emergence and spread of antimicrobial resistance (AMR). Understanding AMR in Southeast Asia is crucial for assessing how to control AMR on an international scale. Here we (i) describe the current AMR situation in Southeast Asia, (ii) explore the mechanisms that make Southeast Asia a focal region for the emergence of AMR, and (iii) propose ways in which Southeast Asia could contribute to a global solution. PMID:28961709
NASA Astrophysics Data System (ADS)
Goryachuk, A. A.; Khodzitsky, M. K.; Borovkova, M. A.; Khamid, A. K.; Dutkinskii, P. S.; Shishlo, D. A.
2016-08-01
Samples of fresh excised tissues obtained from patients who had undergone gastric cancer have been investigated. Samples were consisted of cancer zone, normal zone and zone mixed of normal and cancer tissues. Their optical properties and spectral features were investigated by terahertz time-domain spectroscopy (TDS) in reflection mode. It was found that waveforms of reflected signals from normal and cancer tissues were well distinguished so it can be concluded that it is easy to discriminate gastric cancer tissue from normal by using THz TDS.
Status of commercial fuel cell powerplant system development
NASA Technical Reports Server (NTRS)
Warshay, Marvin
1987-01-01
The primary focus is on the development of commercial Phosphoric Acid Fuel Cell (PAFC) powerplant systems because the PAFC, which has undergone extensive development, is currently the closest fuel cell system to commercialization. Shorter discussions are included on the high temperature fuel cell systems which are not as mature in their development, such as the Molten Carbonate Fuel Cell (MCFC) and the Solid Oxide Fuel Cell (SOFC). The alkaline and the Solid Polymer Electrolyte (SPE) fuel cell systems, are also included, but their discussions are limited to their prospects for commercial development. Currently, although the alkaline fuel cell continues to be used for important space applications there are no commercial development programs of significant size in the USA and only small efforts outside. The market place for fuel cells and the status of fuel cell programs in the USA receive extensive treatment. The fuel cell efforts outside the USA, especially the large Japanese programs, are also discussed.
Shoulder and neck morbidity in quality of life after surgery for head and neck cancer.
van Wilgen, C P; Dijkstra, P U; van der Laan, B F A M; Plukker, J Th; Roodenburg, J L N
2004-10-01
Quality of life has become a major issue in determining the outcome of treatment in head and neck surgery with curative intent. The aim of our study was to determine which factors in the postoperative care, especially shoulder and neck morbidity, are related to quality of life and how these outcomes compared between patients who had undergone surgery and a control group. We analyzed physical symptoms, psychological symptoms, and social and functional well-being at least 1 year after surgery and evaluated the differences in quality of life between patients who had undergone head and neck surgery and a control group. Depression scores contributed significantly to all domains of quality of life. Reduced shoulder abduction, shoulder pain, and neck pain are related to several domains of quality of life. The patient group scored significantly worse for social functioning and limitations from physical problems but scored significantly better for bodily pain and health changes. Depression and shoulder and neck morbidity are important factors in quality of life for patients who have undergone surgery for head and neck cancer. (c) 2004 Wiley Periodicals, Inc.
Duval, Florian; Leroux, Agathe; Bertaud, Valérie; Meary, Fleur; Le Padellec, Clément; Refuveille, Laura; Lemaire, Arnaud; Sorel, Olivier; Chauvel-Lebret, Dominique
2015-09-01
The aim of this study was to assess the impact of extraction of third molars on the occurrence of temporo-mandibular disorders (TMD). A review of the literature and a case-control study have been conducted. The case-control study compares the frequency of extraction of third molars between the sample with TMD (case) and the sample without TMD (control). The proportion of patients who had undergone extractions of wisdom teeth was higher in the case group than in the control group. The difference was statistically significant when patients had undergone extraction of all four wisdom teeth or when the extraction of four wisdom teeth underwent in one sitting or under general anesthesia. The study of patients in case sample shows that all signs of TMD were more common in patients who had undergone extractions in several sessions and under local anesthesia. The temporomandibular joint sounds are significantly more frequent with local anesthesia. In the case group, 85 to 92% of patients have parafunctions and 5 to 11% have malocclusion. This demonstrates the multifactorial etiology of temporomandibular disorders. © EDP Sciences, SFODF, 2015.
Duggleby, Wendy; Williams, Allison
2016-01-01
The purpose of this article is to discuss methodological and epistemological considerations involved in using qualitative inquiry to develop interventions. These considerations included (a) using diverse methodological approaches and (b) epistemological considerations such as generalization, de-contextualization, and subjective reality. Diverse methodological approaches have the potential to inform different stages of intervention development. Using the development of a psychosocial hope intervention for advanced cancer patients as an example, the authors utilized a thematic study to assess current theories/frameworks and interventions. However, to understand the processes that the intervention needed to target to affect change, grounded theory was used. Epistemological considerations provided a framework to understand and, further, critique the intervention. Using diverse qualitative methodological approaches and examining epistemological considerations were useful in developing an intervention that appears to foster hope in patients with advanced cancer. © The Author(s) 2015.
Rethinking the Postgraduate Teaching Program and Examinations in Today's India.
Abraham, Georgi; George, Tarun K
2015-07-01
Postgraduate medical education has undergone drastic changes in the developed and developing countries on par with advancements in technology. The Indian examination system which we imbibed from the British requires a rethinking and restructuring to keep pace with the changing trends shown by the Federation of the Royal Colleges of UK. In this manuscript we look at the strengths and weaknesses of different examination systems. We suggest changes in the theory examination which should be objectively based rather than the outdated essay and short notes. We discuss positive and proactive changes to reform our clinical examination system to enable a just and fair assessment of the candidate in a strictly time bound fashion.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Lynn E. Melander
Over the last several decades, libraries across the nation have undergone dramatic budget cuts, despite being an important resource for regional and national economic growth and innovation. Numerous studies have attempted to show that libraries increase the intellectual level of users and contribute to the economic growth of communities through surveys and customer service data. Within this study, we have attempted to develop a more analytical method for assessing library performance, using the Idaho National Laboratory Research Library as a sample subject. We have developed a mathematical model to measure the financial value of a library’s material resources as wellmore » as its intellectual value to determine if the library is a positive contributor to the wider organization and community it serves.« less
30 CFR 256.20 - Consideration of coastal zone management program.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Consideration of coastal zone management....20 Consideration of coastal zone management program. In the development of the leasing program, consideration shall be given to the coastal zone management program being developed or administered by an...
Adaptive evolution of the STRA6 genes in mammalian.
Wu, Jianghong; Xiang, Hui; Qi, Yunxia; Yang, Ding; Wang, Xiaojuan; Sun, Hailian; Wang, Feng; Liu, Bin
2014-01-01
Stimulated by retinoic acid 6 (STRA6) is the receptor for retinol binding protein and is relevant for the transport of retinol to specific sites such as the eye. The adaptive evolution mechanism that vertebrates have occupied nearly every habitat available on earth and adopted various lifestyles associated with different light conditions and visual challenges, as well as their role in development and adaptation is thus far unknown. In this work, we have investigated different aspects of vertebrate STRA6 evolution and used molecular evolutionary analyses to detect evidence of vertebrate adaptation to the lightless habitat. Free-ratio model revealed significant rate shifts immediately after the species divergence. The amino acid sites detected to be under positive selection are within the extracellular loops of STRA6 protein. Branch-site model A test revealed that STRA6 has undergone positive selection in the different phyla of mammalian except for the branch of rodent. The results suggest that interactions between different light environments and host may be driving adaptive change in STRA6 by competition between species. In support of this, we found that altered functional constraints may take place at some amino acid residues after speciation. We suggest that STRA6 has undergone adaptive evolution in different branch of vertebrate relation to habitat environment.
Metabolic Profiling of IDH Mutation and Malignant Progression in Infiltrating Glioma
NASA Astrophysics Data System (ADS)
Jalbert, Llewellyn E.; Elkhaled, Adam; Phillips, Joanna J.; Neill, Evan; Williams, Aurelia; Crane, Jason C.; Olson, Marram P.; Molinaro, Annette M.; Berger, Mitchel S.; Kurhanewicz, John; Ronen, Sabrina M.; Chang, Susan M.; Nelson, Sarah J.
2017-03-01
Infiltrating low grade gliomas (LGGs) are heterogeneous in their behavior and the strategies used for clinical management are highly variable. A key factor in clinical decision-making is that patients with mutations in the isocitrate dehydrogenase 1 and 2 (IDH1/2) oncogenes are more likely to have a favorable outcome and be sensitive to treatment. Because of their relatively long overall median survival, more aggressive treatments are typically reserved for patients that have undergone malignant progression (MP) to an anaplastic glioma or secondary glioblastoma (GBM). In the current study, ex vivo metabolic profiles of image-guided tissue samples obtained from patients with newly diagnosed and recurrent LGG were investigated using proton high-resolution magic angle spinning spectroscopy (1H HR-MAS). Distinct spectral profiles were observed for lesions with IDH-mutated genotypes, between astrocytoma and oligodendroglioma histologies, as well as for tumors that had undergone MP. Levels of 2-hydroxyglutarate (2HG) were correlated with increased mitotic activity, axonal disruption, vascular neoplasia, and with several brain metabolites including the choline species, glutamate, glutathione, and GABA. The information obtained in this study may be used to develop strategies for in vivo characterization of infiltrative glioma, in order to improve disease stratification and to assist in monitoring response to therapy.
Marquis-Nicholson, Renate; Lai, Daniel; Love, Jennifer M.; Love, Donald R.
2013-01-01
Purpose. The aim of this study was to develop a streamlined mutation screening protocol for the DMD gene in order to confirm a clinical diagnosis of Duchenne or Becker muscular dystrophy in affected males and to clarify the carrier status of female family members. Methods. Sequence analysis and array comparative genomic hybridization (aCGH) were used to identify mutations in the dystrophin DMD gene. We analysed genomic DNA from six individuals with a range of previously characterised mutations and from eight individuals who had not previously undergone any form of molecular analysis. Results. We successfully identified the known mutations in all six patients. A molecular diagnosis was also made in three of the four patients with a clinical diagnosis who had not undergone prior genetic screening, and testing for familial mutations was successfully completed for the remaining four patients. Conclusion. The mutation screening protocol described here meets best practice guidelines for molecular testing of the DMD gene in a diagnostic laboratory. The aCGH method is a superior alternative to more conventional assays such as multiplex ligation-dependent probe amplification (MLPA). The combination of aCGH and sequence analysis will detect mutations in 98% of patients with the Duchenne or Becker muscular dystrophy. PMID:23476807
Videolaparoscopic radical hysterectomy approach: a ten-year experience.
Campos, Luciana Silveira; Limberger, Leo Francisco; Kalil, Antonio Nocchi; de Vargas, Gabriel Sebastião; Damiani, Paulo Agostinho; Haas, Fernanda Feltrin
2009-01-01
Because of the advancements in surgical techniques and laparoscopic instruments, total laparoscopic radical hysterectomy can now be performed for the treatment of uterine cervical carcinoma. We assessed the feasibility, complications, and survival rates of patients who underwent total laparoscopic radical hysterectomy with pelvic lymphadenectomy. We retrospectively collected data from the medical charts of 29 patients who had undergone surgery between 1998 and 2008. The following data were assessed: age, staging, histological type, number of lymph nodes retrieved, parametrial measures, operative time, length of hospital stay, surgical complications, and disease-free time. The mean patient age was 37.07+/-10.45 years. Forty percent of the patients had previously undergone abdominal or pelvic surgeries. Mean operative time was 228.96+/-60.41 minutes, and mean retrieved lymph nodes was 16.9+/-8.12. All patients had free margins. No conversions to laparotomy were necessary. Median time until hospital dismissal was 6.5 days (range 3-38 days). Four patients had intraoperative complications: 2 lacerations of the rectum, 1 laceration of the bladder, and 1 lesion of the ureter. Three patients developed bladder or ureteral fistulas postoperatively that were successfully corrected surgically. Laparoscopic radical hysterectomy is feasible and has acceptable complications. The radicalism of the surgery must be considered, bearing in mind the parametrial measures and the number of lymph nodes retrieved.
Hasker, E; Mpanya, A; Makabuza, J; Mbo, F; Lumbala, C; Kumpel, J; Claeys, Y; Kande, V; Ravinetto, R; Menten, J; Lutumba, P; Boelaert, M
2012-09-01
To enable the human African trypanosomiasis (HAT) control program of the Democratic Republic of the Congo to generate data on treatment outcomes, an electronic database was developed. The database was piloted in two provinces, Bandundu and Kasai Oriental. In this study, we analysed routine data from the two provinces for the period 2006-2008. Data were extracted from case declaration cards and monthly reports available at national and provincial HAT coordination units and entered into the database. Data were retrieved for 15 086 of 15 741 cases reported in the two provinces for the period (96%). Compliance with post-treatment follow-up was very poor in both provinces; only 25% had undergone at least one post-treatment follow-up examination, <1% had undergone the required four follow-up examinations. Relapse rates among those presenting for follow-up were high in Kasai (18%) but low in Bandundu (0.3%). High relapse rates in Kasai and poor compliance with post-treatment follow-up in both provinces are important problems that the HAT control program urgently needs to address. Moreover, in analogy to tuberculosis control programs, HAT control programs need to adopt a recording and reporting routine that includes reporting on treatment outcomes. © 2012 Blackwell Publishing Ltd.
Wolf, Lisa
2004-12-01
Women diagnosed with breast cancer treated by mastectomy can choose breast reconstruction. The information needs of women undergoing this procedure have only been addressed in the research literature to a limited extent. A qualitative approach was used to explore the experiences of women who had undergone breast reconstruction with a specific focus on their views on how they considered their information needs could best be met. A purposeful sample of eight women was recruited to participate in two focus groups, each lasting 2 hours. Framework analysis was used to develop an index of key themes and sub themes which transformed the data into a structured record which facilitated systematic analysis. This paper will present the emergent key themes regarding information giving and the content of information that women perceive as important when preparing for breast reconstruction. Process, delivery and patient factors are presented in the category of information giving. Several sub themes are discussed concerning the content of information considered to be relevant. Those involved in imparting information to women about such surgery should be aware of the type of information that is considered relevant, the manner in which it should be delivered and timing factors that implicate on the process.
Lewicka, Magdalena; Makara-Studzińska, Marta; Sulima, Magdalena; Wiktor, Henryk
2014-01-01
Surgical treatment of women due to gynaecological disorders is the cause of stress and may lead to psychological changes. Studies concerning human response to stress emphasize the importance of the effect of the level of the sense of coherence, anxiety, depression, dispositional optimism and skills of expressing emotions on the quality of feelings and experiences in difficult situations. The study covered 232 women who had undergone gynaecological surgery due to various causes. Permission to conduct the research was obtained from the Bioethical Commission at the Medical University in Lublin. The study was carried out with the use of the State-Trait Anxiety Inventory (STAI), the Beck Depression Inventory, Courtauld Emotional Control Scale (CECS), and Life Orientation Test - Revised (LOT-R). The study showed that investigations of the sense of coherence, level of anxiety and depression, and personal resources allow determination of the characteristics of patients who should be covered with special psycho-prophylactic care during the peri-operative period. In addition, the results of own studies obtained may be used for the development of adequate principles of psycho-prophylactic management in the course of the diagnostic-treatment process with respect to women who had undergone surgical treatment due to gynaecological disorders.
Hamada, Yoshinori; Hamada, Hiroshi; Shirai, Takeshi; Nakamura, Yusuke; Sakaguchi, Tatsuma; Yanagimoto, Hiroaki; Inoue, Kentaro; Kon, Masanori
2017-10-01
We examined the clinical significance of duodenogastric regurgitation (DGR) as a late complication in the long-term follow-up after hepaticoduodenostomy (HD) as a reconstruction surgery for congenital biliary dilatation (CBD). Seventeen patients with CBD were retrospectively analyzed for late complications (mean follow-up, 16.8 years). All patients had undergone total resection of the extrahepatic bile duct followed by HD. DGR was identified using endoscopic examination, intraluminal bile monitoring, and liver scanning. DGR was found in all 17 patients by endoscopic examination and intraluminal bile monitoring. Fourteen of the 17 (82.4%) patients with DGR had experienced abdominal symptoms since a mean of 6.9 years postoperatively. Liver scanning also revealed apparent DGR in all 14 symptomatic patients. We converted 7 of the 14 patients to hepaticojejunostomy reconstruction at a mean of 13.0 years after the initial excisional surgery. Their symptoms were completely relieved postoperatively. DGR is an important complication after HD. Examination of patients for the development of DGR is an essential part of long-term follow-up in patients with CBD who have undergone HD as a reconstruction surgery. Conversion surgery is recommended in patients with DGR accompanied by long-term abdominal symptoms. Level IV. Copyright © 2017 Elsevier Inc. All rights reserved.
Management of Helicobacter pylori infection after gastric surgery
Lin, Yang-Sheng; Chen, Ming-Jen; Shih, Shou-Chuan; Bair, Ming-Joug; Fang, Ching-Ju; Wang, Horng-Yuan
2014-01-01
The Maastricht IV/Florence Consensus Report and the Second Asia-Pacific Consensus Guidelines strongly recommend eradication of Helicobacter pylori (H. pylori) in patients with previous gastric neoplasia who have undergone gastric surgery. However, the guidelines do not mention optimal timing, eradication regimens, diagnostic tools, and follow-up strategies for patients undergoing gastrectomy and do not indicate if eradication of H. pylori reduces the risk of marginal ulcer or stump cancer in the residual stomach after gastrectomy. The purpose of this review is to provide an update which may help physicians to properly manage H. pylori infection in patients who have undergone gastric surgery. This review focuses on (1) the microenvironment change in the stomach after gastrectomy; (2) the phenomenon of spontaneous clearance of H. pylori after gastrectomy; (3) the effects of H. pylori on gastric atrophy and intestinal metaplasia after gastrectomy; (4) incidence and clinical features of ulcers developing after gastrectomy; (5) does eradication of H. pylori reduce the risk of gastric stump cancer in the residual stomach? (6) does eradication of H. pylori reduce the risk of secondary metachronous gastric cancer in the residual stomach? and (7) optimal timing and regimens for H. pylori eradication, diagnostic tools and follow-up strategies for patients undergoing gastrectomy. PMID:24833857
Guide to AERO2S and WINGDES Computer Codes for Prediction and Minimization of Drag Due to Lift
NASA Technical Reports Server (NTRS)
Carlson, Harry W.; Chu, Julio; Ozoroski, Lori P.; McCullers, L. Arnold
1997-01-01
The computer codes, AER02S and WINGDES, are now widely used for the analysis and design of airplane lifting surfaces under conditions that tend to induce flow separation. These codes have undergone continued development to provide additional capabilities since the introduction of the original versions over a decade ago. This code development has been reported in a variety of publications (NASA technical papers, NASA contractor reports, and society journals). Some modifications have not been publicized at all. Users of these codes have suggested the desirability of combining in a single document the descriptions of the code development, an outline of the features of each code, and suggestions for effective code usage. This report is intended to supply that need.
32 CFR 174.10 - Consideration for economic development conveyances.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 32 National Defense 1 2010-07-01 2010-07-01 false Consideration for economic development... Property § 174.10 Consideration for economic development conveyances. (a) For conveyances made pursuant to... the date of the initial transfer of property shall be used to support economic redevelopment of, or...
32 CFR 174.10 - Consideration for economic development conveyances.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 32 National Defense 1 2011-07-01 2011-07-01 false Consideration for economic development... Property § 174.10 Consideration for economic development conveyances. (a) For conveyances made pursuant to... the date of the initial transfer of property shall be used to support economic redevelopment of, or...
Khosla, Rajat; Banerjee, Joya; Chou, Doris; Say, Lale; Fried, Susana T
2017-05-12
Two hundred million girls and women in the world are estimated to have undergone female genital mutilation (FGM), and another 15 million girls are at risk of experiencing it by 2020 in high prevalence countries (UNICEF, 2016. Female genital mutilation/cutting: a global concern. 2016). Despite decades of concerted efforts to eradicate or abandon the practice, and the increased need for clear guidance on the treatment and care of women who have undergone FGM, present efforts have not yet been able to effectively curb the number of women and girls subjected to this practice (UNICEF. Female genital mutilation/cutting: a statistical overview and exploration of the dynamics of change. 2013), nor are they sufficient to respond to health needs of millions of women and girls living with FGM. International efforts to address FGM have thus far focused primarily on preventing the practice, with less attention to treating associated health complications, caring for survivors, and engaging health care providers as key stakeholders. Recognizing this imperative, WHO developed guidelines on management of health complications of FGM. In this paper, based on foundational research for the development of WHO's guidelines, we situate the practice of FGM as a rights violation in the context of international and national policy and efforts, and explore the role of health providers in upholding health-related human rights of women at girls who are survivors, or who are at risk. Findings are based on a literature review of relevant international human rights treaties and UN Treaty Monitoring Bodies.
Dillon, William P.; Schlee, J.S.; Klitgord, Kim D.
1988-01-01
The continental margin of eastern North America was initiated when West Africa and North America were rifted apart in Triassic-Early Jurassic time. Cooling of the crust and its thinning by rifting and extension caused subsidence. Variation in amounts of subsidence led to formation of five basins. These are listed from south to north. (1) The Blake Plateau Basin, the southernmost, is the widest basin and the one in which the rift-stage basement took longest to form. Carbonate platform deposition was active and persisted until the end of Early Cretaceous. In Late Cretaceous, deposition slowed while subsidence persisted, so a deep water platform was formed. Since the Paleocene the region has undergone erosion. (2) The Carolina Trough is narrow and has relatively thin basement, on the basis of gravity modeling. The two basins with thin basement, the Carolina Trough and Scotian Basin, also show many salt diapirs indicating considerable deposition of salt during their early evolution. In the Carolina Trough, subsidence of a large block of strata above the flowing salt has resulted in a major, active normal fault on the landward side of the basin. (3) The Baltimore Canyon Trough has an extremely thick sedimentary section; synrift and postrift sediments exceed 18 km in thickness. A Jurassic reef is well developed on the basin's seaward side, but post-Jurassic deposition was mainly non-carbonate. In general the conversion from carbonate to terrigenous deposition, characteristics of North American Basins, occurred progressively earlier toward the north. (4) The Georges Bank Basin has a complicated deep structure of sub-basins filled with thick synrift deposits. This may have resulted from some shearing that occurred at this offset of the continental margin. Postrift sediments apparently are thin compared to other basins-only about 8 km. (5) The Scotian Basin, off Canada, contains Jurassic carbonate rocks, sandstone, shale and coal covered by deltaic deposits and Upper Cretaceous deeper water chalk and shale. ?? 1988.
Tropical fishes dominate temperate reef fish communities within western Japan.
Nakamura, Yohei; Feary, David A; Kanda, Masaru; Yamaoka, Kosaku
2013-01-01
Climate change is resulting in rapid poleward shifts in the geographical distribution of tropical and subtropical fish species. We can expect that such range shifts are likely to be limited by species-specific resource requirements, with temperate rocky reefs potentially lacking a range of settlement substrates or specific dietary components important in structuring the settlement and success of tropical and subtropical fish species. We examined the importance of resource use in structuring the distribution patterns of range shifting tropical and subtropical fishes, comparing this with resident temperate fish species within western Japan (Tosa Bay); the abundance, diversity, size class, functional structure and latitudinal range of reef fishes utilizing both coral reef and adjacent rocky reef habitat were quantified over a 2 year period (2008-2010). This region has undergone rapid poleward expansion of reef-building corals in response to increasing coastal water temperatures, and forms one of the global hotspots for rapid coastal changes. Despite the temperate latitude surveyed (33°N, 133°E) the fish assemblage was both numerically, and in terms of richness, dominated by tropical fishes. Such tropical faunal dominance was apparent within both coral, and rocky reef habitats. The size structure of the assemblage suggested that a relatively large number of tropical species are overwintering within both coral and rocky habitats, with a subset of these species being potentially reproductively active. The relatively high abundance and richness of tropical species with obligate associations with live coral resources (i.e., obligate corallivores) shows that this region holds the most well developed temperate-located tropical fish fauna globally. We argue that future tropicalisation of the fish fauna in western Japan, associated with increasing coral habitat development and reported increasing shifts in coastal water temperatures, may have considerable positive economic impacts to the local tourism industry and bring qualitative changes to both local and regional fisheries resources.
Tropical Fishes Dominate Temperate Reef Fish Communities within Western Japan
Nakamura, Yohei; Feary, David A.; Kanda, Masaru; Yamaoka, Kosaku
2013-01-01
Climate change is resulting in rapid poleward shifts in the geographical distribution of tropical and subtropical fish species. We can expect that such range shifts are likely to be limited by species-specific resource requirements, with temperate rocky reefs potentially lacking a range of settlement substrates or specific dietary components important in structuring the settlement and success of tropical and subtropical fish species. We examined the importance of resource use in structuring the distribution patterns of range shifting tropical and subtropical fishes, comparing this with resident temperate fish species within western Japan (Tosa Bay); the abundance, diversity, size class, functional structure and latitudinal range of reef fishes utilizing both coral reef and adjacent rocky reef habitat were quantified over a 2 year period (2008–2010). This region has undergone rapid poleward expansion of reef-building corals in response to increasing coastal water temperatures, and forms one of the global hotspots for rapid coastal changes. Despite the temperate latitude surveyed (33°N, 133°E) the fish assemblage was both numerically, and in terms of richness, dominated by tropical fishes. Such tropical faunal dominance was apparent within both coral, and rocky reef habitats. The size structure of the assemblage suggested that a relatively large number of tropical species are overwintering within both coral and rocky habitats, with a subset of these species being potentially reproductively active. The relatively high abundance and richness of tropical species with obligate associations with live coral resources (i.e., obligate corallivores) shows that this region holds the most well developed temperate-located tropical fish fauna globally. We argue that future tropicalisation of the fish fauna in western Japan, associated with increasing coral habitat development and reported increasing shifts in coastal water temperatures, may have considerable positive economic impacts to the local tourism industry and bring qualitative changes to both local and regional fisheries resources. PMID:24312528
Risk Factors for Venous Thromboembolism After Spine Surgery
Tominaga, Hiroyuki; Setoguchi, Takao; Tanabe, Fumito; Kawamura, Ichiro; Tsuneyoshi, Yasuhiro; Kawabata, Naoya; Nagano, Satoshi; Abematsu, Masahiko; Yamamoto, Takuya; Yone, Kazunori; Komiya, Setsuro
2015-01-01
Abstract The efficacy and safety of chemical prophylaxis to prevent the development of deep venous thrombosis (DVT) or pulmonary embolism (PE) following spine surgery are controversial because of the possibility of epidural hematoma formation. Postoperative venous thromboembolism (VTE) after spine surgery occurs at a frequency similar to that seen after joint operations, so it is important to identify the risk factors for VTE formation following spine surgery. We therefore retrospectively studied data from patients who had undergone spinal surgery and developed postoperative VTE to identify those risk factors. We conducted a retrospective clinical study with logistic regression analysis of a group of 80 patients who had undergone spine surgery at our institution from June 2012 to August 2013. All patients had been screened by ultrasonography for DVT in the lower extremities. Parameters of the patients with VTE were compared with those without VTE using the Mann–Whitney U-test and Fisher exact probability test. Logistic regression analysis was used to analyze the risk factors associated with VTE. A value of P < 0.05 was used to denote statistical significance. The prevalence of VTE was 25.0% (20/80 patients). One patient had sensed some incongruity in the chest area, but the vital signs of all patients were stable. VTEs had developed in the pulmonary artery in one patient, in the superficial femoral vein in one patient, in the popliteal vein in two patients, and in the soleal vein in 18 patients. The Mann–Whitney U-test and Fisher exact probability test showed that, except for preoperative walking disability, none of the parameters showed a significant difference between patients with and without VTE. Risk factors identified in the multivariate logistic regression analysis were preoperative walking disability and age. The prevalence of VTE after spine surgery was relatively high. The most important risk factor for developing postoperative VTE was preoperative walking disability. Gait training during the early postoperative period is required to prevent VTE. PMID:25654385
Wong, Ningyan; Chua, Siang Jin Terrance; Gao, Fei; Sim, Sok Tiang Rosalind; Matchar, David; Wong, Sung Lung Aaron; Yeo, Khung Keong; Tan, Wei Chieh Jack; Chin, Chee Tang
2016-12-01
We sought to analyse the impact of a care coordination protocol on transiting patients with coronary artery disease who had undergone percutaneous coronary intervention (PCI) to primary care and its effect on cardiovascular risk factor control. A prospective observational study involving 492 patients who had undergone PCI either electively or after an acute coronary syndrome. A tertiary institution in Singapore. Patients who had undergone a PCI either electively or after an acute coronary syndrome. The SCORE (Standardized Care for Optimal Outcomes, Right-Siting and Rapid Re-evaluation) program was a nurse-led, telephone-based, care coordination protocol. Transition to primary care within 1 year of enrolment, the achievement of low-density lipoprotein (LDL) level of <2.6 mmol/l within 1 year and hospital admissions related to cardiovascular causes within 1 year were studied. Under the SCORE protocol, a significantly higher number of patients transited to primary care and achieved the LDL target within 1 year, as compared with non-SCORE patients. Discharge to primary care and achievement of target LDL continued to be higher among those under the SCORE protocol even after multivariate analysis. Rates of hospital admission due to cardiovascular causes were not significantly different. Care coordination improved the rate of transition of post-PCI patients to primary care and improved LDL control, with no difference in the rate of hospital admissions due to cardiovascular causes. These findings support the implementation of a standardized follow-up protocol in patients who have undergone PCI. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com
Gondo, Tatsuo; Ohno, Yoshio; Nakashima, Jun; Hashimoto, Takeshi; Nakagami, Yoshihiro; Tachibana, Masaaki
2017-02-01
To identify preoperative factors correlated with postoperative early renal function in patients who had undergone radical cystectomy (RC) and intestinal urinary diversion. We retrospectively identified 201 consecutive bladder cancer patients without distant metastasis who had undergone RC at our institution between 2003 and 2012. The estimated glomerular filtration rate (eGFR) was calculated using the modified Chronic Kidney Disease Epidemiology equation before RC and 3 months following RC. Univariate and stepwise multiple linear regression analyses were applied to estimate postoperative renal function and to identify significant preoperative predictors of postoperative renal function. Patients who had undergone intestinal urinary diversion and were available for the collection of follow-up data (n = 164) were eligible for the present study. Median preoperative and postoperative eGFRs were 69.7 (interquartile range [IQR] 56.3-78.0) and 70.7 (IQR 57.3-78.1), respectively. In univariate analyses, age, preoperative proteinuria, thickness of abdominal subcutaneous fat tissue (TSF), preoperative serum creatinine level, preoperative eGFR, and urinary diversion type were significantly associated with postoperative eGFR. In a stepwise multiple linear regression analysis, preoperative eGFR, age, and TSF were significant factors for predicting postoperative eGFR (p < 0.001, p = 0.02, and p = 0.046, respectively). The estimated postoperative eGFRs correlated well with the actual postoperative eGFRs (r = 0.65, p < 0.001). Preoperative eGFR, age, and TSF were independent preoperative factors for determining postoperative renal function in patients who had undergone RC and intestinal urinary diversion. These results may be used for patient counseling before surgery, including the planning of perioperative chemotherapy administration.
Curriculum reform at Chinese medical schools: what have we learned?
Huang, Lei; Cheng, Liming; Cai, Qiaoling; Kosik, Russell Olive; Huang, Yun; Zhao, Xudong; Xu, Guo-Tong; Su, Tung-Ping; Chiu, Allen Wen-Hsiang; Fan, Angela Pei-Chen
2014-12-01
Curriculum reform at Chinese medical schools has attracted a lot of attention recently. Several leading medical schools in China have undergone exploratory reforms and in so doing, have accumulated significant experience and have made considerable progress. An analysis of the reforms conducted by 38 Chinese medical colleges that were targeted by the government for upgrade was performed. Drawing from both domestic and international literature, we designed a questionnaire to determine what types of curricular reforms have occurred at these institutions and how they were implemented. Major questions touched upon the purpose of the reforms, curricular patterns, improvements in teaching methods post-reform, changes made to evaluation systems post-reform, intra-university reform assessment, and what difficulties the schools faced when instituting the reforms. Besides the questionnaire, relevant administrators from each medical school were also interviewed to obtain more qualitative data. Out of the 38 included universities, twenty-five have undergone major curricular reforms. Among them, 60.0% adopted an organ system-based curriculum model, 32.0% adopted a problem-based curriculum model, and 8.0% adopted a hybrid curriculum model. About 60.0% of the schools' reforms involved both the "pre-clinical" and the "clinical" curricula, 32.0% of the schools' reforms were limited to the "pre-clinical" curricula, and 8.0% of the schools' reforms only involved the "clinical" curricula. Following curricular reform, 60.0% of medical schools experienced an overall reduction in teaching hours, 76.0% reported an increase in their students' clinical skills, and 60.0% reported an increase in their students' research skills. Medical curricular reform is still in its infancy in China. The republic's leading medical schools have engaged in various approaches to bring innovative teaching methods to their respective institutions. However, due to limited resources and the shackle of traditional pedagogical beliefs among many faculty and administrators, progress has been significantly hindered. Despite these and other challenges, many medical schools report positive initial results from the reforms that they have enacted. Although the long term effects of such reforms remain unclear, curricular reform appears to be the inevitable solution to China's growing need for high-quality medical doctors.
Detection, causes and projection of climate change over China: An overview of recent progress
NASA Astrophysics Data System (ADS)
Ding, Yihui; Ren, Guoyu; Zhao, Zongci; Xu, Ying; Luo, Yong; Li, Qiaoping; Zhang, Jin
2007-11-01
This article summarizes the main results and findings of studies conducted by Chinese scientists in the past five years. It is shown that observed climate change in China bears a strong similarity with the global average. The country-averaged annual mean surface air temperature has increased by 1.1°C over the past 50 years and 0.5-0.8°C over the past 100 years, slightly higher than the global temperature increase for the same periods. Northern China and winter have experienced the greatest increases in surface air temperature. Although no significant trend has been found in country-averaged annual precipitation, interdecadal variability and obvious trends on regional scales are detectable, with northwestern China and the mid and lower Yangtze River basin having undergone an obvious increase, and North China a severe drought. Some analyses show that frequency and magnitude of extreme weather and climate events have also undergone significant changes in the past 50 years or so. Studies of the causes of regional climate change through the use of climate models and consideration of various forcings, show that the warming of the last 50 years could possibly be attributed to an increased atmospheric concentration of greenhouse gases, while the temperature change of the first half of the 20th century may be due to solar activity, volcanic eruptions and sea surface temperature change. A significant decline in sunshine duration and solar radiation at the surface in eastern China has been attributed to the increased emission of pollutants. Projections of future climate by models of the NCC (National Climate Center, China Meteorological Administration) and the IAP (Institute of Atmospheric Physics, Chinese Academy of Sciences), as well as 40 models developed overseas, indicate a potential significant warming in China in the 21st century, with the largest warming set to occur in winter months and in northern China. Under varied emission scenarios, the country-averaged annual mean temperature is projected to increase by 1.5-2.1°C by 2020, 2.3-3.3°C by 2050, and by 3.9-6.0°C by 2100, in comparison to the 30-year average of 1961-1990. Most models project a 10%-12% increase in annual precipitation in China by 2100, with the trend being particularly evident in Northeast and Northwest China, but with parts of central China probably undergoing a drying trend. Large uncertainty exists in the projection of precipitation, and further studies are needed. Furthermore, anthropogenic climate change will probably lead to a weaker winter monsoon and a stronger summer monsoon in eastern Asia.
NASA Astrophysics Data System (ADS)
Needham, Erin Michelle
As drinking water sources become increasingly impaired with nutrients and wastewater treatment plant (WWTP) effluent, formation of disinfection byproducts (DBPs)--such as trihalomethanes (THMs), dihaloacetonitriles (DHANs), and N-nitrosamines--during water treatment may also increase. N-nitrosamines may comprise the bulk of the chronic toxicity in treated drinking waters despite forming at low ng/L levels. This research seeks to elucidate physicochemical properties of carbon nanotubes (CNTs) for removal of DBP precursors, with an emphasis on total N-nitrosamines (TONO). Batch experiments with CNTs were completed to assess adsorption of THM, DHAN, and TONO precursors; physiochemical properties of CNTs were quantified through gas adsorption isotherms and x-ray photoelectron spectroscopy. Numerical modeling was used to elucidate characteristics of CNTs controlling DBP precursor adsorption. Multivariate models developed with unmodified CNTs revealed that surface carboxyl groups and, for TONO precursors, cumulative pore volume (CPV), controlled DBP precursor adsorption. Models developed with modified CNTs revealed that specific surface area controlled adsorption of THM and DHAN precursors while CPV and surface oxygen content were significant for adsorption of TONO precursors. While surrogates of THM and DHAN precursors leverage metrics from UV absorbance and fluorescence spectroscopy, a TONO precursor surrogate has proved elusive. This is important as measurements of TONO formation potential (TONOFP) require large sample volumes and long processing times, which impairs development of treatment processes. TONO precursor surrogates were developed using samples that had undergone oxidative or sorption treatments. Precursors were analyzed with asymmetric flow field-flow fractionation (AF4) with inline fluorescence detection (FLD) and whole water fluorescence excitation-emission matrices (EEMs). TONO precursor surrogates were discovered, capable of predicting changes in TONOFP in WWTP samples that have undergone oxidation (R2 = 0.996) and sorption (R2 = 0.576). Importantly, both surrogates only require just 2 mL of sample volume to measure and take only 1 hour. Application of the sorption precursor surrogate revealed that DBP precursor adsorption was feasible with freeform CNT microstructures with various dimensions and surface chemistries, establishing a framework for development of this novel CNT application for drinking water treatment.
Clinical, pathological and sonographic characteristics of unexpected gallbladder carcinoma
Wang, Jin-Huan; Liu, Bo-Ji; Xu, Hui-Xiong; Sun, Li-Ping; Li, Dan-Dan; Guo, Le-Hang; Liu, Lin-Na; Xu, Xiao-Hong
2015-01-01
Objectives: To investigate the clinical, pathological, and sonographic characteristics of unexpected gallbladder carcinoma (UGC). Methods: Of 5424 patients who had undergone cholecystectomy from December 2006 to October 2013, 54 patients with primary gallbladder carcinomas confirmed by pathological diagnosis were identified. The patients were divided into two groups: diagnosed before operation (n=34) and UGC groups (n=20), of whom the clinical, pathological, and sonographic characteristics were compared. Results: No significant differences in age, gender, location of lesion, histological type, length of the gallbladder, existence of biliary sludge, and intestinal gas interference between the two groups were found (all P>0.05). The clinical symptoms, laboratory abnormalities, tumor markers, coexisting gallbladder stones, lesion size, lesion type, degree of differentiation, and tumor staging showed statistically significant differences between the two groups (all P<0.05). On ultrasound, the width of the gallbladder, gallbladder wall thickness, vascularity on color Doppler ultrasound, and bile volume in the gallbladder showed significant differences (all P<0.05). Conclusions: UGCs are commonly found at an early stage, often well-differentiated, wall thickened, and are generally accompanied with cholelithiasis. UGCs should be taken into consideration in cases with cholelithiasis or small gallbladder on ultrasound. PMID:26379911
The cooperative economy of food: Implications for human life history and physiology.
Kramer, Karen L
2018-04-06
The human diet has undergone substantial modifications since the emergence of modern humans and varies considerably in today's traditional societies. Despite these changes and cross-cultural differences, the human diet can be characterized by several common elements. These include diverse, high quality foods, technological complexity to acquire and process food, and the establishment of home bases for storage, processing and consumption. Together these aspects of the human diet challenge any one individual to independently meet all of his or her daily caloric needs. Humans solve this challenge through food sharing, labor exchange and the division of labor. The cooperative nature of the human diet is associated with many downstream effects on our life history and physiology. This paper overviews the constellation of traits that likely led to a cooperative economy of food, and draws on ethnographic examples to illustrate its effects on human life history and physiology. Two detailed examples using body composition, time allocation and food acquisition data show how cooperation among Savanna Pumé hunter-gatherers affects activity levels, sexual dimorphism in body fat, maturational pace and age at first birth. Copyright © 2018. Published by Elsevier Inc.
Fast DNA sieving through submicrometer cylindrical glass capillary matrix.
Cao, Zhen; Yobas, Levent
2014-01-07
Here, we report on DNA electrophoresis through a novel artificial sieving matrix based on the highly regular submicrometer cylindrical glass capillary segments alternatingly arranged with wells. Such round capillaries pose a higher-order confinement resulting in a lower partition coefficient and greater entropic energy barrier while limiting the driving field strength to a small fraction of the applied electric field. In return, the separation can be performed at high average field strengths (up to 1.6 kV/cm) without encountering the field-dependent loss of resolving power. This leads to fast DNA sieving as demonstrated here on the capillaries of 750 nm in diameter. The 600 bp to 21 kbp long chains are shown to resolve within 4 min after having undergone a fairly limited number of entropic barriers (128 in total). The capillary matrix also exhibits a critical field threshold below which DNA bands fail to launch, and this occurs at a considerably greater magnitude than in other matrixes. The submicrometer capillaries are batch-fabricated on silicon through a fabrication process that does not require high-resolution advanced lithography or well-controlled wafer bonding techniques to define their critical dimension.
Dental tourism from Switzerland to Germany.
Gheorghe, Raluca; Zürcher, Andrea; Filippi, Andreas
In recent years the topic of dental tourism has increasingly come into focus of dentists and patients. In the present study an attempt was made to find out, why patients from a restricted region travel to Germany for dental care. In five German dental clinics located in the border area between Switzerland and Germany, 272 women and 236 men ranging in age from 5 to 94 years, who had undergone at least one dental treatment in Germany, were questioned concerning the reasons for their visits. The interviews took place within a period of 6 months and relied on a questionnaire to collect data regarding sociodemographic features and patient behavior. In comparison to residents of Germany, patients residing in Switzerland took on considerably longer travel distances for the dental visit, in some cases more than 50km (9.7%). For patients residing in Switzerland the technical equipment of the practice was more important (p<0.001), whereas for residents of Germany the cost-effective treatment was decisive (p<0.05). Almost all patients residing in Switzerland (95.6%) confirmed that dental treatments in Germany were cheaper and that additional family members also came to Germany for dental care (65.0%).
Yucel, Hulya
2015-01-01
[Purpose] The aim of this retrospective study was to determine the associations between clinical, physical, and neurophysiological outcomes and self-reported symptoms and functions of patients after surgical carpal tunnel release. [Subjects and Methods] Among 261 patients who had undergone open surgical carpal tunnel release within the last three years, 83 (mean age 50.27 ± 11.13 years) participated in this study. Their socio-demographics and comorbidities were recorded. The intensity of pain, paresthesia, and fatigue symptoms in the hand were assessed by means of a Visual Analogue Scale, the Semmes-Weinstein Monofilaments test of light touch pressure sensation, and Jamar dynamometry for measurement of grip and pinch strengths. The Boston Carpal Tunnel Questionnaire evaluated the severity of symptoms and hand functional status, and the variables were analyzed by multivariate linear regression. [Results] The severity of the symptoms and functional status of release surgery patients was associated with diabetes mellitus, migraine, night pain, paresthesia and fatigue symptoms, impaired light touch pressure, and lack of medical treatment. [Conclusion] Appropriate post-surgery treatment programs for these factors should be taken into consideration to help patients obtain optimal functionality and health in their daily lives. PMID:25995565
Organ procurement from executed prisoners in China.
Sharif, A; Singh, M Fiatarone; Trey, T; Lavee, J
2014-10-01
Organ procurement from executed prisoners in China is internationally condemned, yet this practice continues unabated in 2014. This is despite repeated announcements from Chinese authorities that constructive measures have been undertaken to conform to accepted ethical standards. While there is unanimous agreement on the unethical nature of using organs from executed prisoners, due to its limitations on voluntary and informed consent, there is insufficient coverage of forced organ procurement from prisoners of conscience without consent. Strategies to influence positive change in China over the last few decades have failed to bring this practice to an end. While organ donation and transplantation services in China have undergone considerable structural changes in the last few years, fundamental attempts to shift practice to ethically sourced organs have floundered. In this article, we discuss the organ trade in China, reflect upon organ procurement from executed prisoners (including both capital prisoners and prisoners of conscience) and provide an overview of contradictory Chinese efforts to halt forced organ procurement from executed prisoners. Finally, we highlight current actions being taken to address this issue and offer comprehensive recommendations to bring this ethically indefensible practice to an immediate end. © Copyright 2014 The American Society of Transplantation and the American Society of Transplant Surgeons.
Earthquakes in Arkansas and vicinity 1699-2010
Dart, Richard L.; Ausbrooks, Scott M.
2011-01-01
This map summarizes approximately 300 years of earthquake activity in Arkansas. It is one in a series of similar State earthquake history maps. Work on the Arkansas map was done in collaboration with the Arkansas Geological Survey. The earthquake data plotted on the map are from several sources: the Arkansas Geological Survey, the Center for Earthquake Research and Information, the National Center for Earthquake Engineering Research, and the Mississippi Department of Environmental Quality. In addition to earthquake locations, other materials presented include seismic hazard and isoseismal maps and related text. Earthquakes are a legitimate concern in Arkansas and parts of adjacent states. Arkansas has undergone a number of significant felt earthquakes since 1811. At least two of these events caused property damage: a magnitude 4.7 earthquake in 1931, and a magnitude 4.3 earthquake in 1967. The map shows all historical and instrumentally located earthquakes in Arkansas and vicinity between 1811 and 2010. The largest historic earthquake in the vicinity of the State was an intensity XI event, on December 16, 1811; the first earthquake in the New Madrid sequence. This violent event and the earthquakes that followed caused considerable damage to the then sparsely settled region.
Vestibular function in families with inherited autosomal dominant hearing loss
Street, Valerie A.; Kallman, Jeremy C.; Strombom, Paul D.; Bramhall, Naomi F.; Phillips, James O.
2008-01-01
The inner ear contains the developmentally related cochlea and peripheral vestibular labyrinth. Given the similar physiology between these two organs, hearing loss and vestibular dysfunction may be expected to occur simultaneously in individuals segregating mutations in inner ear genes. Twenty-two different genes have been discovered that when mutated lead to non-syndromic autosomal dominant hearing loss. A review of the literature indicates that families segregating mutations in 13 of these 22 genes have undergone formal clinical vestibular testing. Formal assessment revealed vestibular dysfunction in families with mutations in ten of these 13 genes. Remarkably, only families with mutations in the COCH and MYO7A genes self-report considerable vestibular challenges. Families segregating mutations in the other eight genes do not self-report significant balance problems and appear to compensate well in everyday life for vestibular deficits discovered during formal clinical vestibular assessment. An example of a family (referred to as the HL1 family) with progressive hearing loss and clinically-detected vestibular hypofunction that does not report vestibular symptoms is described in this review. Notably, one member of the HL1 family with clinically-detected vestibular hypofunction reached the summit of Mount Kilimanjaro. PMID:18776598
Morgentaler, Abraham; Conners III, William P
2015-01-01
For several decades any diagnosis of prostate cancer (PCa) has been considered an absolute contraindication to the use of testosterone (T) therapy in men. Yet this prohibition against T therapy has undergone recent re-examination with refinement of our understanding of the biology of androgens and PCa, and increased appreciation of the benefits of T therapy. A reassuringly low rate of negative outcomes has been reported with T therapy after radical prostatectomy (RP), radiation treatments, and in men on active surveillance. Although the number of these published reports are few and the total number of treated men is low, these experiences do provide a basis for consideration of T therapy in selected men with PCa. For clinicians considering offering this treatment, we recommend first selecting patients with low grade cancers and undetectable prostate-specific antigen following RP. Further research is required to define the safety of T therapy in men with PCa. However, many patients symptomatic from T deficiency are willing to accept the potential risk of PCa progression or recurrence in return for the opportunity to live a fuller and happier life with T therapy. PMID:25652633
Detraditionalisation and attitudes to sex outside marriage in China.
Zheng, Weijun; Zhou, Xudong; Zhou, Chi; Liu, Wei; Li, Lu; Hesketh, Therese
2011-05-01
China has undergone massive socio-economic change over the past 30 years. In parallel, there have been huge changes in social and sexual mores. Until the end of the Mao era strict norms prevailed, with sex outside marriage widely regarded as immoral and unacceptable. Detraditionalisation theory describes the abandonment or reconfiguration of the socio-cultural traditions and has been explored widely in Western settings. This study aimed to explore its relevance for China through exploring attitudes towards premarital sex, extramarital sex, same-sex relations and sex work. We conducted semi-structured interviews with 212 men and women aged 18 to 39 in urban and rural areas of three provinces: Zhejiang, Guizhou and Yunnan. Analysis identified emerging themes. Results show varying degrees of acceptance of the four sexual behaviours, with premarital sex seen as common, homosexuality still regarded as unacceptable by the majority but considerable acceptance of commercial sex work as part of male business transactions and social life. China appears to be on a pathway of detraditionalisation with specific Chinese features. This study suggests that the concept of detraditionalisation applies well to non-Western contexts, but the path it takes is culture-specific and relatively unpredictable. © 2011 Taylor & Francis
NASA Astrophysics Data System (ADS)
Bergen, H. Robert, III; Benson, Linda M.; Naylor, Stephen
2000-10-01
Mass spectrometry has undergone considerable changes in the past decade. The advent of "soft ionization" techniques such as electrospray ionization (ESI) affords the direct analysis of very polar molecules without need for the complex inefficient derivatization procedures often required in GC-MS. These ionization techniques make possible the direct mass spectral analysis of polar nonvolatile molecules such as DNA and proteins, which previously were difficult or impossible to analyze by MS. Compounds that readily take on a charge (acids and bases) lend themselves to ESI-MS analysis, whereas compounds that do not readily accept a charge (e.g. sugars) are often not seen or are seen only as inefficient adducts (e.g., M+Na+). To gain exposure to this state-of-the-art analytical procedure, high school students utilize ESI-MS in an analysis of aspartame and caffeine. They dilute a beverage sample and inject the diluted sample into the ESI-MS. The lab is procedurally simple and the results clearly demonstrate the potential and limitations of ESI-coupled mass spectrometry. Depending upon the instructional goals, the outlined procedures can be used to quantify the content of caffeine and aspartame in beverages or to understand the capabilities of electrospray ionization.
Taphonomic bias in pollen and spore record: a review
DOE Office of Scientific and Technical Information (OSTI.GOV)
Fisk, L.H.
The high dispersibility and ease of pollen and spore transport have led researchers to conclude erroneously that fossil pollen and spore floras are relatively complete and record unbiased representations of the regional vegetation extant at the time of sediment deposition. That such conclusions are unjustified is obvious when the authors remember that polynomorphs are merely organic sedimentary particles and undergo hydraulic sorting not unlike clastic sedimentary particles. Prior to deposition in the fossil record, pollen and spores can be hydraulically sorted by size, shape, and weight, subtly biasing relative frequencies in fossil assemblages. Sorting during transport results in palynofloras whosemore » composition is environmentally dependent. Therefore, depositional environment is an important consideration to make correct inferences on the source vegetation. Sediment particle size of original rock samples may contain important information on the probability of a taphonomically biased pollen and spore assemblage. In addition, a reasonable test of hydraulic sorting is the distribution of pollen grain sizes and shapes in each assemblage. Any assemblage containing a wide spectrum of grain sizes and shapes has obviously not undergone significant sorting. If unrecognized, taphonomic bias can lead to paleoecologic, paleoclimatic, and even biostratigraphic misinterpretations.« less
Law and older people--the rise and fall of Israel's Senior Citizens' Act.
Doron, Israel
2008-01-01
Within the broad and complex framework of those Israeli laws that relate to the social welfare of the older population, this article uses a case study approach to focus on Israel's Senior Citizens' Act of 1989. During its hitherto brief life, this law has undergone numerous transformations, additions, and deletions as well as successes and failures. At the time of its enactment, many hoped that this law would considerably bolster the rights of older people. Echoing legal and political theories of the 1980s, it seemed to reflect the fact that politicians were sensitive to the potential power of the pensioner vote, while echoing the approach to social engineering that advocated the use of the law both as a means for social change and a symbol of power. As of today, however, this article argues that the law has failed to realize what were declared to be its objectives. Instead of promoting social change and providing older people with political power, the Senior Citizens' Act has become an empty symbol that hides the fact that the older generation in Israel still lacks the real political power it needs in order to use the law to improve society's treatment of older people.
All things rhabdoid and SMARC: An enigmatic exploration with Dr. Louis P. Dehner.
Fuller, Christine E
2016-11-01
Over the past several decades, our understanding of malignant rhabdoid tumors (MRT) and the central nervous system equivalent atypical teratoid/rhabdoid tumor (ATRT) has undergone considerable refinement, particularly in terms of genetic characterization. MRT (both renal and extra-renal) and ATRT share phenotypic similarities and a common genetic signature, that being inactivating alterations of the SWI/SNF complex component SMARCB1 (or rarely SMARCA4). Unfortunately, a wide array of tumors bears significantly overlapping phenotypic characteristics to MRT/ATRT, posing a formidable diagnostic challenge. Likewise, the list of tumors bearing SMARC-related alterations has grown at a dizzying pace, and the original assumption that SMARCB1 alterations were unique to MRT/ATRT has been essentially negated. It should come as no surprise that Dr. Louis P. Dehner, no stranger to enigmatic lesions, participated significantly in this pathologic controversy, and the circuitous journey of entity discovery and clarification. This review aims to (1) summarize our current knowledge of MRT and ATRT with an emphasis on genetic characterization, (2) present insight into so-called "composite rhabdoid tumors" (CRTs), and (3) and provide an updated account of others tumors bearing SMARC alterations. Copyright © 2016 Elsevier Inc. All rights reserved.
Muranushi, Ryo; Miyazaki, Tatsuya; Saito, Hideyuki; Kuriyama, Kengo; Yoshida, Tomonori; Kumakura, Yuji; Honjyo, Hiroaki; Yokobori, Takehiko; Sakai, Makoto; Sohda, Makoto; Kuwano, Hiroyuki
2017-12-01
The right gastroepiploic artery is commonly used in coronary artery bypass grafting. Appropriate strategies are required when performing upper abdominal surgeries after the right gastroepiploic artery has been used in coronary artery bypass grafting because compressing or injuring the graft may cause myocardial ischemia and fatal arrhythmias. To our knowledge, this is the first reported case of surgery for achalasia performed after coronary artery bypass grafting using the right gastroepiploic artery. We have discussed the surgical procedure and particular intraoperative considerations. A 62-year-old man who had undergone coronary artery bypass grafting using the right gastroepiploic artery presented with achalasia. Because medication and balloon dilation had been ineffective and he was having difficulty ingesting food, we performed a Heller-Dor procedure via laparotomy. The right gastroepiploic artery was not damaged during this surgery, and there were no perioperative cardiovascular complications. Adequate control of symptoms was achieved. When performing upper abdominal surgeries after coronary artery bypass grafting with the right gastroepiploic artery, it is necessary to investigate the patient carefully preoperatively and adapt the intraoperative procedure to minimize risk of injury to the graft and consequent cardiovascular complications.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Abdullah, Mohd Zamri, E-mail: zamriab@petronas.com.my; Ismail, Siti Salwa
2015-07-22
The utilization of non-living biomass as an alternative biosorbent for heavy metal removal has gain a tremendous consideration through the years. Pandanus amaryllifolius Roxb or pandan leaves, which is widely used as food additives in the South East Asia region, has been selected for its viability in the said effort due to the presence of chemical functional groups on its cellular network that enables the sorption to occur. In order to elucidate the possible mechanisms participated during the heavy metal removal process, the biosorbent undergone a series of modification techniques to alter the chemical functional groups present on its constituent.more » From the outcome of the chemically-modified biosorbent being subjected to the contact with metal cations, nitrogen- and oxygen-containing groups present on the biosorbent are believed to be responsible for the metal uptake to occur through complexation mechanism. Modifying amine groups causes 14% reduction of Cu(II) uptake, whereas removing protein element increases the uptake to 26% as compared to the unmodified biosorbent. Also, scanning electron micrographs further suggested that the adsorption mechanism could perform in parallel, as attributed to the evidence of porous structure throughout the biosorbent fibrous nature.« less
NASA Astrophysics Data System (ADS)
Abdullah, Mohd. Zamri; Ismail, Siti Salwa
2015-07-01
The utilization of non-living biomass as an alternative biosorbent for heavy metal removal has gain a tremendous consideration through the years. Pandanus amaryllifolius Roxb or pandan leaves, which is widely used as food additives in the South East Asia region, has been selected for its viability in the said effort due to the presence of chemical functional groups on its cellular network that enables the sorption to occur. In order to elucidate the possible mechanisms participated during the heavy metal removal process, the biosorbent undergone a series of modification techniques to alter the chemical functional groups present on its constituent. From the outcome of the chemically-modified biosorbent being subjected to the contact with metal cations, nitrogen- and oxygen-containing groups present on the biosorbent are believed to be responsible for the metal uptake to occur through complexation mechanism. Modifying amine groups causes 14% reduction of Cu(II) uptake, whereas removing protein element increases the uptake to 26% as compared to the unmodified biosorbent. Also, scanning electron micrographs further suggested that the adsorption mechanism could perform in parallel, as attributed to the evidence of porous structure throughout the biosorbent fibrous nature.
Prescription drug coupons: evolution and need for regulation in direct-to-consumer advertising.
Mackey, Tim K; Yagi, Nozomi; Liang, Bryan A
2014-01-01
Pharmaceutical marketing in the United States had undergone a shift from largely exclusively targeting physicians to considerable efforts in targeting patients through various forms of direct-to-consumer advertising ("DTCA"). This includes the use of DTCA in prescription drug coupons ("PDCs"), a new form of DTCA that offers discounts and rebates directly to consumers to lower costs of drug purchasing. Our examination of PDCs reveals that the use and types of PDC programs is expanding and includes promotion of the vast majority of top grossing pharmaceuticals. However, controversy regarding this emerging form of DTCA has given rise to health policy concerns about their overall impact on prescription drug expenditures for consumers, payers, and the health care system, and whether they lead to optimal long-term utilization of pharmaceuticals. In response to these concerns and the growing popularity of PDCs, what we propose here are clearer regulation and regulatory guidance for PDC DTCA use. This would include review for appropriate disclosure of marketing claims, increased transparency in PDC use for pharmaceutical pricing, and leveraging potential positive benefits of PDC use for vulnerable or underserved patient populations. Copyright © 2014 Elsevier Inc. All rights reserved.
NASA Astrophysics Data System (ADS)
Gurney, K. R.; Liang, J.; Patarasuk, R.; O'Keeffe, D.; Newman, S.; Rao, P.; Hutchins, M.; Huang, J.
2016-12-01
The Los Angeles Basin represents one of the largest metropolitan areas in the United States and is home to the Megacity Carbon Project, a multi-institutional effort led by NASA JPL to understand the total carbon budget of the Los Angeles Basin. A key component of that effort is the Hestia bottom-up fossil fuel CO2 emissions data product, which quantifies FFCO2 every hour to the spatial scale of individual buildings and road segments. This data product has undergone considerable revision in the last year and the version 2.0 data product is now complete covering the 2011-2014 time period. In this presentation, we highlight the advances in the Hestia version 2.0 including the improvements to onroad, building and industrial emissions. We make comparisons to the independently reported GHG reporting program of the EPA and to in-situ atmospheric measurement of CO2 at two monotiring locations in Pasadena and Palos Verdes. We provide an analysis of the socioeconomic drivers of emissions in the building and onroad transportation sectors across the domain highlighting hotspots of emissions and spatially-specific opportunities for reductions.
ReEDS-Mexico: A Capacity Expansion Model of the Mexican Power System
DOE Office of Scientific and Technical Information (OSTI.GOV)
Ho, Jonathan L; Cole, Wesley J; Spyrou, Evangelia
This report documents the ReEDS-Mexico capacity expansion model, which is an extension of the ReEDS model to the Mexican power system. In recent years Mexico’s power sector has undergone considerable reform that has significant potential to impact the future electricity mix (Alpizar–Castro and Rodríguez–Monroy 2016). Day-ahead and real-time trading in Mexico’s power markets opened in early 2016. In addition to this reform, Mexico is striving to ensure that 35% of its electricity is generated from clean energy sources by 2024, 40% by 2035, and 50% by 2050 (Presidencia de la República 2016). These rapid changes in both the market andmore » the generation mix create a need for robust tools that can help electricity sector stakeholders make informed decisions. The purpose of this report is to document the extension of the National Renewable Energy Laboratory’s (NREL’s) Regional Energy Deployment System (ReEDS) model (Eurek et al. 2016) to cover the Mexico power system. This extension, which we will refer to throughout this paper as ReEDS-Mexico, provides a model of the Mexico power sector using a system-wide, least-cost optimization framework.« less
Extensive gene conversion at the PMS2 DNA mismatch repair locus.
Hayward, Bruce E; De Vos, Michel; Valleley, Elizabeth M A; Charlton, Ruth S; Taylor, Graham R; Sheridan, Eamonn; Bonthron, David T
2007-05-01
Mutations of the PMS2 DNA repair gene predispose to a characteristic range of malignancies, with either childhood onset (when both alleles are mutated) or a partially penetrant adult onset (if heterozygous). These mutations have been difficult to detect, due to interference from a family of pseudogenes located on chromosome 7. One of these, the PMS2CL pseudogene, lies within a 100-kb inverted duplication (inv dup), 700 kb centromeric to PMS2 itself on 7p22. Here, we show that the reference genomic sequences cannot be relied upon to distinguish PMS2 from PMS2CL, because of sequence transfer between the two loci. The 7p22 inv dup occurred prior to the divergence of modern ape species (15 million years ago [Mya]), but has undergone extensive sequence homogenization. This process appears to be ongoing, since there is considerable allelic diversity within the duplicated region, much of it derived from sequence exchange between PMS2 and PMS2CL. This sequence diversity can result in both false-positive and false-negative mutation analysis at this locus. Great caution is still needed in the design and interpretation of PMS2 mutation screens. 2007 Wiley-Liss, Inc.
Stereotactic Radiosurgery versus Natural History in Patients with Growing Vestibular Schwannomas.
Tu, Albert; Gooderham, Peter; Mick, Paul; Westerberg, Brian; Toyota, Brian; Akagami, Ryojo
2015-08-01
Objective To describe our experience with stereotactic radiosurgery and its efficacy on growing tumors, and then to compare this result with the natural history of a similar cohort of non-radiation-treated lesions. Study Design A retrospective chart review and cohort comparison. Methods The long-term control rates of patients having undergone radiosurgery were collected and calculated, and this population was then compared with a group of untreated patients from the same period of time with growing lesions. Results A total of 61 patients with growing vestibular schwannomas treated with radiosurgery were included. After a mean of 160 months, we observed a control rate of 85.2%. When compared with a group of 36 patients with growing tumors who were yet to receive treatment (previously published), we found a corrected control rate or relative risk reduction of only 76.8%. Conclusion Radiosurgery for growing vestibular schwannomas is less effective than previously reported in unselected series. Although radiosurgery still has a role in managing this disease, consideration should be given to the actual efficacy that may be calculated when the natural history is known. We hope other centers will similarly report their experience on this cohort of patients.
Stereotactic Radiosurgery versus Natural History in Patients with Growing Vestibular Schwannomas
Tu, Albert; Gooderham, Peter; Mick, Paul; Westerberg, Brian; Toyota, Brian; Akagami, Ryojo
2015-01-01
Objective To describe our experience with stereotactic radiosurgery and its efficacy on growing tumors, and then to compare this result with the natural history of a similar cohort of non-radiation–treated lesions. Study Design A retrospective chart review and cohort comparison. Methods The long-term control rates of patients having undergone radiosurgery were collected and calculated, and this population was then compared with a group of untreated patients from the same period of time with growing lesions. Results A total of 61 patients with growing vestibular schwannomas treated with radiosurgery were included. After a mean of 160 months, we observed a control rate of 85.2%. When compared with a group of 36 patients with growing tumors who were yet to receive treatment (previously published), we found a corrected control rate or relative risk reduction of only 76.8%. Conclusion Radiosurgery for growing vestibular schwannomas is less effective than previously reported in unselected series. Although radiosurgery still has a role in managing this disease, consideration should be given to the actual efficacy that may be calculated when the natural history is known. We hope other centers will similarly report their experience on this cohort of patients. PMID:26225318
Beneficial effects of naloxone in a patient with intestinal pseudoobstruction
DOE Office of Scientific and Technical Information (OSTI.GOV)
Schang, J.C.; Devroede, G.
1985-06-01
A 15-day course of Naloxone treatment was given to a patient with intestinal pseudoobstruction who had previously undergone subtotal colectomy with terminal ileostomy for invalidating constipation. The effects of the drug were assessed according to symptoms, by recording the myoelectric activity of the stomach, and by measuring gastric emptying of a radiolabeled solid-liquid meal and the intestinal transit time of radiopaque markers. All tests were performed 1) at baseline; 2) after 2 wk with Naloxone 1.6 mg subcutaneous per day; and 3) after 8 days of placebo. Results showed that before treatment gastric emptying of solids was delayed, emptying ofmore » liquids was normal, myoelectric activity of the stomach was normal, small intestinal transit time of radiopaque markers was considerably increased while ileal output was markedly decreased. After Naloxone, gastric emptying of solids was markedly accelerated, emptying of liquids remained normal, gastric electrical spiking activity increased, small intestinal transit time strikingly decreased, and ileal output increased. After placebo, a tendency to return to pretreatment values was observed. This observation suggests that Naloxone may be helpful in the treatment of some patients with intestinal pseudoobstruction.« less
Viviers, Petrus J
2014-08-01
Seeding of splenic tissue to extra-abdominal sites is a relatively infrequent consequence of open abdominal trauma. Immunological function of these small foci of ectopic splenic tissue is unknown and their use in determining the splenic function may be limited. In this case report, a patient is described who had previously undergone an emergency splenectomy. The absence of Howell-Jolly bodies on the blood smear in a patient who had previously undergone surgical splenectomy raised the suspicion of splenosis. The immunological features as well as non-invasive evaluation of these ill-defined splenic tissue sites are discussed.
NASA Astrophysics Data System (ADS)
Popov, Alexey P.; Priezzhev, Alexander V.; Lademann, Jürgen; Myllylä, Risto
2007-05-01
This paper focuses on the simulation of propagation of radiation in UV and visible wavelength regions within a superficial skin layer (stratum corneum, SC) partially filled with titanium dioxide (TiO II) nanoparticles. Volume concentrations of the particles (0.67% - 2.25%) correspond to the maximal concentrations of the considered particles in the frames of independent scattering. Transmittance of 307-, 400-, and 500-nm light through a 20-μm thick SC is calculated. The effect of the TiO II nanoparticles on the contribution of photons undergone different numbers of scattering acts into transmittance is considered. It is shown that administration of the nanoparticles results in the broadening of the distribution of transmitted photons over undergone scattering acts. It also results in the shift of the maximum location of this distribution to larger number of scattering acts for the wavelengths of 400 and 500 nm being the latter the most pronounced. The increase of undergone scattering acts leads to the elongation of photon trajectories within the medium and results in the increase of the diffuse reflected light and the transmittance decrease.
Patenaude, Andrea F; Orozco, Sara; Li, Xiaochun; Kaelin, Carolyn M; Gadd, Michelle; Matory, Yvedt; Mayzel, Kathleen; Roche, Constance A; Smith, Barbara L; Farkas, Walden; Garber, Judy E
2014-01-01
Summary Prophylactic mastectomy (PM) offers 90% or greater reduction in risk of breast cancer to women at increased hereditary risk. Nonetheless, acceptance in North America has been low (0–36%). Most women report reduced cancer worry post-operatively, but up to 25–50% of women electing surgery also report psychological distress and/or difficulty adapting following PM. Psychological consultation to aid decision-making and improve post-surgical coping isn’t routinely offered. This retrospective, cross-sectional study explored, quantitatively and qualitatively, interest in and acceptability of psychological consultation for issues related to PM among 108 women who had undergone or were considering surgery. Of the 71 women who had undergone PM, more than half felt pre-surgical psychological consultation was advisable and nearly 2/3 felt post-surgical psychological consultation would be helpful. All 37 women (100%) currently considering PM believed psychological consultation would aid decision-making and preparation for surgery. Narratives from the interviews illustrate the nature and intensity of the need for psychological support and describe preferences for the role of the psychologist. Suggestions are offered for the integration of psychological services for women deciding about or adapting to PM. PMID:18636423
Nocturnal polyuria and saluresis in renal allograft recipients.
Chan, M K; Varghese, Z; Fernando, O N; Moorhead, J F
1980-01-01
The evolution of nocturnal polyuria and saluresis in renal allograft recipients was studied by comparing the day to night (D:N) ratios of urine volume and sodium excretion in 15 patients who had undergone transplantation less than one year previously (recent-transplant group) with those in 11 patients who had undergone transplantation at least one year previously. Eleven patients with chronic renal failure and 12 normal subjects served as controls. Patients in the recent-transplant group had significantly lower D:N ratios of urine volume and sodium excretion than the patients who had undergone transplantation at least a year before, while the ratios in this last group did not differ significantly from those in the normal subjects. Nocturnal polyuria and saluresis gradually subsided in five patients studied for three months. Chronic renal failure and uraemic autonomic neuropathy were unlikely causes of the nocturia. The patients in the recent-transplant group had significantly lower D:N ratios of urine volume than the controls with chronic renal failure, and the mean Valsalva ratio in eight of them was not significantly different from that in the normal subjects. An undue sensitivity of renal allografts to postural influences was proposed. PMID:6986946
Ahmed, Magdy R; Shaaban, Mohamed M; Meky, Heba K; Amin Arafa, Mohamed E; Mohamed, Tamer Y; Gharib, Waleed F; Ahmed, Abeer B
2017-08-01
Worldwide, at least 200 million women and girls have undergone female genital mutilation (FGM). The medical and sexual consequences have been documented, but the psychological impact has not been studied to the same extent. The aim of this study was to explore the relationship between FGM and psychiatric problems among adolescent girls. A total of 204 girls, aged 14-19 years, were included in a cross-sectional study conducted at Suez Canal University Hospitals. All participants completed an Arabic-validated, structured questionnaire covering nine symptom scales. Sociodemographic data were also collected. Main outcome measures were the prevalence of psychiatric problems among adolescent girls who had undergone FGM. Overall, 66.2% of girls had undergone FGM. The percentage in rural areas was 91.8%, compared with 43.0% in urban areas. There were no significant differences between the FGM and non-FGM groups as regards religion, educational and socioeconomic levels. FGM girls had a significantly higher level of psychological problems with regard to somatisation, depression, anxiety, phobic anxiety and hostility compared with non-FGM girls (p < .0001). FGM is a traumatic experience that may leave a lasting psychological mark and a negative impact on the psychological status of affected girls.
Percutaneous drainage in conservative therapy for perforated gastroduodenal ulcers.
Oida, Takatsugu; Kano, Hisao; Mimatsu, Kenji; Kawasaki, Atsushi; Kuboi, Youichi; Fukino, Nobutada; Kida, Kazutoshi; Amano, Sadao
2012-01-01
The management of peptic ulcers has dramatically changed and the incidence of elective surgery for gastroduodenal peptic ulcers has markedly decreased; hence, the incidence of emergency surgery for perforated peptic ulcers has slightly increased. In select cases, conservative therapy can be used as an alternative for treating perforated gastroduodenal ulcers. In this study, we evaluated the efficacy of percutaneous abdominal drainage for the conservative treatment of perforated gastroduodenal ulcers. We retrospectively studied 51 patients who had undergone conservative therapy for perforated gastroduodenal ulcers. These patients were divided into 2 groups on the basis of the initial treatment with conservative therapy with or without percutaneous drainage: group PD included patients who had undergone percutaneous drainage and group NPD, patients who had undergone non-percutaneous drainage. In the PD group, 14.3% (n=3) of the patients did not respond to conservative therapy, while this value was 43.3% (n=13) in the NPD group. The 2 groups differed significantly with respect to conversion from conservative therapy to surgery (p<0.0352). Conservative therapy for perforated gastroduodenal ulcers should be performed only in the case of patients meeting the required criteria; its combination with percutaneous intraperitoneal drainage is effective as initial conservative therapy.
[Four-port pars plana vitrectomy for severe proliferative diabetic retinopathy].
Wei, Wen-bin; Yang, Qiong; Mo, Jing; Zhou, Dan
2008-01-01
To investigate the 4-port pars plana vitrectomy in eyes with severe proliferative diabetic retinopathy (PDR). It was a case-control study. Twenty-eight eyes in 27 patients with extensive fibrovascular proliferation associated with PDR were retrospectively collected, who were undergone 4-port pars plana vitreous surgery with bimanual manipulation techniques, such as membrane dissections and enbloc membranectomy. The control group consisted of 30 eyes in 30 patients with PDR which were undergone 3-port pars plana vitrectomy by the same surgeon. Twenty-eight eyes were undergone membrane dissection and enbloc membranectomy smoothly during 4-port pars plana vitrectomy, 2 iatrogenic holes occurred in 1 eye. During the follow up 7 months to 4.5 years, the retina was fully attached in all eyes, visual acuity had improved except 1 eye which complicated with neovascular glaucoma. In the control group, membranes partially remained in 2 eyes, 4 iatrogenic holes appeared in 3 eyes, neovascular glaucoma occurred in 3 eyes, the retina was reattached during the follow-up time from 12 to 34 months. For severe proliferative diabetic retinopathy, the 4-port pars plana vitrectomy with bimanual manipulations of membrane peeling is safe and efficiency.
Effects of gastric pacing on gastric emptying and plasma motilin
Yang, Min; Fang, Dian-Chun; Li, Qian-Wei; Sun, Nian-Xu; Long, Qing-Lin; Sui, Jian-Feng; Gan, Lu
2004-01-01
AIM: To investigate the effects of gastric pacing on gastric emptying and plasma motilin level in a canine model of gastric motility disorders and the correlation between gastric emptying and plasma motilin level. METHODS: Ten healthy Mongrel dogs were divided into: experimental group of six dogs and control group of four dogs. A model of gastric motility disorders was established in the experimental group undergone truncal vagotomy combined with injection of glucagon. Gastric half-emptying time (GEt1/2) was monitored with single photon emission computerized tomography (SPECT), and the half-solid test meal was labeled with an isotope 99mTc sulfur colloid. Plasma motilin concentration was measured with radioimmunoassay (RIA) kit. Surface gastric pacing at 1.1-1.2 times the intrinsic slow-wave frequency and a superimposed series of high frequency pulses (10-30 Hz) was performed for 45 min daily for a month in conscious dogs. RESULTS: After surgery, GEt1/2 in dogs undergone truncal vagotomy was increased significantly from 56.35 ± 2.99 min to 79.42 ± 1.91 min (P < 0.001), but surface gastric pacing markedly accelerated gastric emptying and significantly decreased GEt1/2 to 64.94 ± 1.75 min (P < 0.001) in animals undergone vagotomy. There was a significant increase of plasma level of motilin at the phase of IMCIII (interdigestive myoelectrical complex, IMCIII) in the dogs undergone bilateral truncal vagotomy (baseline vs vagotomy, 184.29 ± 9.81 pg/ml vs 242.09 ± 17.22 pg/ml; P < 0.01). But plasma motilin concentration (212.55 ± 11.20 pg/ml; P < 0.02) was decreased significantly after a long-term treatment with gastric pacing. Before gastric pacing, GEt1/2 and plasma motilin concentration of the dogs undergone vagotomy showed a positive correlation (r = 0.867, P < 0.01), but after a long-term gastric pacing, GEt1/2 and motilin level showed a negative correlation (r = -0.733, P < 0.04). CONCLUSION: Surface gastric pacing with optimal pacing parameters can improve gastric emptying parameters and significantly accelerate gastric emptying and can resume or alter motor function in a canine model of motility disorders. Gastric emptying is correlated well with plasma motilin level before and after pacing, which suggests that motilin can modulate the mechanism of gastric pacing by altering gastric motility. PMID:14760770
Comparison between open and laparoscopic repair of perforated peptic ulcer disease.
Bhogal, Ricky H; Athwal, Ruvinder; Durkin, Damien; Deakin, Mark; Cheruvu, Chandra N V
2008-11-01
The place of laparoscopic repair of perforated peptic ulcer followed by peritoneal toilet has been established, although it is not routinely practiced. This prospective study compared laparoscopic and open repair of perforated peptic ulcer disease. We evaluated whether the early results from laparoscopic repair resulted in improved patient outcome compared with conventional open repair. All patients who underwent repair of perforated peptic ulcer disease during a 12-month period in our unit were included in the study. The primary end points that were evaluated were total operative time, nasogastric tube utilisation, intravenous fluid requirement, total time of urinary catheter and abdominal drainage usage, time taken to return to normal diet, intravenous/intramuscular opiate use, time to full mobilization, and total in-patient hospital stay. Thirty-three patients underwent surgical repair of perforated peptic ulcer disease (19 laparoscopic repairs and 14 open repairs; mean age, 54.2 (range, 32-82) years). There was no increase in total operative time in patients who had undergone laparoscopic repair (mean: 61 minutes laparoscopic versus 57 minutes open). There was significantly less requirement for intravenous/intramuscular opiate analgesia in patients who had undergone laparoscopic repair (mean time to oral analgesia: 1.2 days laparoscopic versus 3.8 days open). In addition there was a significant decrease in the time that the nasogastric tube (mean: 2.1 days laparoscopic versus 3.1 days open), urinary catheter (mean: 2.3 days laparoscopic versus 3.7 days open) and abdominal drain (mean: 2.2 days laparoscopic versus 3.8 days open) were required during the postoperative period. Patients who had undergone laparoscopic repair required less intravenous fluids (mean: 1.4 days laparoscopic versus 3.1 days open) and returned to normal diet (mean: 2.3 days laparoscopic versus 4.8 days open) and full mobilization significantly earlier than those who had undergone open repair (mean: 2.3 days laparoscopic versus 3.3 days open). In addition, patients who had undergone laparoscopic repair required a shorter in-patient hospital stay (mean: 3.1 days laparoscopic versus 4.3 days open). Laparoscopic repair is a viable and safe surgical option for patients with perforated peptic ulcer disease and should be considered for all patients, providing that the necessary expertise is available.
NASA Technical Reports Server (NTRS)
OKeefe, J. A.
1960-01-01
Tektites are probably extraterrestrial, rather than the result of heating some terrestrial materials, because they are a chemically homogeneous group with definite peculiarities (high silica, excess of alkaline earths over alkalis, excess of potash over soda, absence of water), and because some of them (the australites) appear to have undergone ablation in flight through the atmosphere. Since comparatively slow heating is required to explain the liquefaction of the tektite material, it is suggested that the tektites arrived along orbits which were nearly parallel to the surface of the earth, and which resulted from the decay of the orbit of a natural satellite. The great meteor procession of February 9, 1913, is an example of such an object. Comparison with the reentry phenomena of the artificial satellite 1957 Beta suggests that the 1913 shower consisted of a single large stone weighing about 400 kilograms, and a few dozen smaller bodies weighing about 40 grams each, formed by ablation from the larger body. It is shown that under the observed conditions considerable liquid flow would be expected in the stone, which would be heated to about 2100 K. Objects falling from such a shower near the perigee point of the orbit would have a considerable distribution along the orbit as a result of slight variations in height or drag coefficient. The distribution in longitude would be made wider by the turning of the earth under the orbit during the time of fall. The ultimate source of the body which produces a tektite shower is probably the moon, which appears, by virtue of its polarization and the phase distribution of the returned light, to contain high-silica materials. It is suggested that the Igast object alleged to have fallen in 1855 is in fact genuine and represents an unmelted portion of the lunar crust.
Orion Absolute Navigation System Progress and Challenge
NASA Technical Reports Server (NTRS)
Holt, Greg N.; D'Souza, Christopher
2012-01-01
The absolute navigation design of NASA's Orion vehicle is described. It has undergone several iterations and modifications since its inception, and continues as a work-in-progress. This paper seeks to benchmark the current state of the design and some of the rationale and analysis behind it. There are specific challenges to address when preparing a timely and effective design for the Exploration Flight Test (EFT-1), while still looking ahead and providing software extensibility for future exploration missions. The primary onboard measurements in a Near-Earth or Mid-Earth environment consist of GPS pseudo-range and delta-range, but for future explorations missions the use of star-tracker and optical navigation sources need to be considered. Discussions are presented for state size and composition, processing techniques, and consider states. A presentation is given for the processing technique using the computationally stable and robust UDU formulation with an Agee-Turner Rank-One update. This allows for computational savings when dealing with many parameters which are modeled as slowly varying Gauss-Markov processes. Preliminary analysis shows up to a 50% reduction in computation versus a more traditional formulation. Several state elements are discussed and evaluated, including position, velocity, attitude, clock bias/drift, and GPS measurement biases in addition to bias, scale factor, misalignment, and non-orthogonalities of the accelerometers and gyroscopes. Another consideration is the initialization of the EKF in various scenarios. Scenarios such as single-event upset, ground command, and cold start are discussed as are strategies for whole and partial state updates as well as covariance considerations. Strategies are given for dealing with latent measurements and high-rate propagation using multi-rate architecture. The details of the rate groups and the data ow between the elements is discussed and evaluated.
Neurodevelopmental Disorders (ASD and ADHD): DSM-5, ICD-10, and ICD-11.
Doernberg, Ellen; Hollander, Eric
2016-08-01
Neurodevelopmental disorders, specifically autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) have undergone considerable diagnostic evolution in the past decade. In the United States, the current system in place is the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), whereas worldwide, the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) serves as a general medical system. This review will examine the differences in neurodevelopmental disorders between these two systems. First, we will review the important revisions made from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) to the DSM-5, with respect to ASD and ADHD. Next, we will cover the similarities and differences between ASD and ADHD classification in the DSM-5 and the ICD-10, and how these differences may have an effect on neurodevelopmental disorder diagnostics and classification. By examining the changes made for the DSM-5 in 2013, and critiquing the current ICD-10 system, we can help to anticipate and advise on the upcoming ICD-11, due to come online in 2017. Overall, this review serves to highlight the importance of progress towards complementary diagnostic classification systems, keeping in mind the difference in tradition and purpose of the DSM and the ICD, and that these systems are dynamic and changing as more is learned about neurodevelopmental disorders and their underlying etiology. Finally this review will discuss alternative diagnostic approaches, such as the Research Domain Criteria (RDoC) initiative, which links symptom domains to underlying biological and neurological mechanisms. The incorporation of new diagnostic directions could have a great effect on treatment development and insurance coverage for neurodevelopmental disorders worldwide.
Rodó, J; Farré, X; Martín, E
2001-02-01
Cyclophosphamide and its derivatives induce hemorrhagic cystitis. A substantial number of patients receive bladder augmentation or replacements using bowel. If patients who have undergone colocystoplasty need treatment with cyclophosphamide before or after the operation, does hemorrhagic cystitis develop? We evaluated the histological changes produced in the colon wall and bladder related to cyclophosphamide and its derivatives in rats that underwent colocystoplasty. Sprague-Dawley rats of each sex were grouped according to whether they received a single 200 mg./kg. dose of cyclophosphamide, underwent colocystoplasty, underwent each technique or served as controls. The technique of colocystoplasty was the same in all groups. Results were analyzed according to previously reported criteria, by the gross appearance of the bladder and colon segment used for colocystoplasty, and by histological changes. Two weeks after surgery colocystoplasty had not resulted in secondary changes in the implanted colon segment or original bladder, while there were only nonspecific changes of an inflammatory type in the anastomotic area. After cyclophosphamide administration the animals lost considerable weight and in the bladder area we observed hemorrhagic cystitis that was greater in males than in females, and greater in isolated bladder than when the bladder was sutured to the colon segment. In the colon there was no inflammation or hemorrhage damage of the hemorrhagic cystitis type in the bladder. A total of 12 days after colocystoplasty there were no secondary histological changes except in the anastomotic area. A single 200 mg./kg. dose of cyclophosphamide caused substantial weight loss and hemorrhagic cystitis. Cystitis was quantitatively greater in males than in females and greater in isolated bladder than in bladder anastomosed to the colon. Administering a single dose of cyclophosphamide did not result in lesions in the colon segment used for colocystoplasty analogous to those of the bladder, such as hemorrhagic cystitis.
Rossi, Simone; Hallett, Mark; Rossini, Paolo M.; Pascual-Leone, Alvaro
2011-01-01
This article is based on a consensus conference, which took place in Certosa di Pontignano, Siena (Italy) on March 7–9, 2008, intended to update the previous safety guidelines for the application of transcranial magnetic stimulation (TMS) in research and clinical settings. Over the past decade the scientific and medical community has had the opportunity to evaluate the safety record of research studies and clinical applications of TMS and repetitive TMS (rTMS). In these years the number of applications of conventional TMS has grown impressively, new paradigms of stimulation have been developed (e.g., patterned repetitive TMS) and technical advances have led to new device designs and to the real-time integration of TMS with electroencephalography (EEG), positron emission tomography (PET) and functional magnetic resonance imaging (fMRI). Thousands of healthy subjects and patients with various neurological and psychiatric diseases have undergone TMS allowing a better assessment of relative risks. The occurrence of seizures (i.e., the most serious TMS-related acute adverse effect) has been extremely rare, with most of the few new cases receiving rTMS exceeding previous guidelines, often in patients under treatment with drugs which potentially lower the seizure threshold. The present updated guidelines review issues of risk and safety of conventional TMS protocols, address the undesired effects and risks of emerging TMS interventions, the applications of TMS in patients with implanted electrodes in the central nervous system, and safety aspects of TMS in neuroimaging environments. We cover recommended limits of stimulation parameters and other important precautions, monitoring of subjects, expertise of the rTMS team, and ethical issues. While all the recommendations here are expert based, they utilize published data to the extent possible. PMID:19833552
Influence of Material Distribution on Impact Resistance of Hybrid Composites
NASA Technical Reports Server (NTRS)
Abatan, Ayu; Hu, Hurang
1998-01-01
Impact events occur in a wide variety of circumstances. A typical example is a bullet impacting a target made of composite material. These impact events produce time-varying loads on a structure that can result in damage. As a first step to understanding the damage resistance issue in composite laminates, an accurate prediction of the transient response during an impact event is necessary. The analysis of dynamic loadings on laminated composite plates has undergone considerable development recently. Rayleigh-Ritz energy method was used to determine the impact response of laminated plates. The impact response of composite plates using shear deformation plate theory was analyzed. In recent work a closed-form solution was obtained for a rectangular plate with four edges simply supported subjected to a center impact load using classical plate theory. The problem was further investigated and the analysis results compared of both classical plate theory and shear deformation theory, and found that classical plate theory predicts very accurate results for the range of small deformations considered. In this study, the influence of cross sectional material distribution on the comparative impact responses of hybrid metal laminates subjected to low and medium velocity impacts is investigated. A simple linear model to evaluate the magnitude of the impact load is proposed first, and it establishes a relation between the impact velocity and the impact force. Then a closed-form solution for impact problem is presented. The results were compared with the finite element analysis results. For an 11 layer-hybrid laminate, the impact response as a function of material distribution in cross-section is presented. With equal areal weight, the effect of the number of laminate layers on the impact resistance is also investigated. Finally, the significance of the presented results is discussed.
Llewellyn, Martin S.; Miles, Michael A.; Carrasco, Hernan J.; Lewis, Michael D.; Yeo, Matthew; Vargas, Jorge; Torrico, Faustino; Diosque, Patricio; Valente, Vera; Valente, Sebastiao A.; Gaunt, Michael W.
2009-01-01
Trypanosoma cruzi is the most important parasitic infection in Latin America and is also genetically highly diverse, with at least six discrete typing units (DTUs) reported: Tc I, IIa, IIb, IIc, IId, and IIe. However, the current six-genotype classification is likely to be a poor reflection of the total genetic diversity present in this undeniably ancient parasite. To determine whether epidemiologically important information is “hidden” at the sub-DTU level, we developed a 48-marker panel of polymorphic microsatellite loci to investigate population structure among 135 samples from across the geographic distribution of TcI. This DTU is the major cause of resurgent human disease in northern South America but also occurs in silvatic triatomine vectors and mammalian reservoir hosts throughout the continent. Based on a total dataset of 12,329 alleles, we demonstrate that silvatic TcI populations are extraordinarily genetically diverse, show spatial structuring on a continental scale, and have undergone recent biogeographic expansion into the southern United States of America. Conversely, the majority of human strains sampled are restricted to two distinct groups characterised by a considerable reduction in genetic diversity with respect to isolates from silvatic sources. In Venezuela, most human isolates showed little identity with known local silvatic strains, despite frequent invasion of the domestic setting by infected adult vectors. Multilocus linkage indices indicate predominantly clonal parasite propagation among all populations. However, excess homozygosity among silvatic strains and raised heterozygosity among domestic populations suggest that some level of genetic recombination cannot be ruled out. The epidemiological significance of these findings is discussed. PMID:19412340
Gui, Li; Gu, Shen; Barriball, K Louise; While, Alison E; Chen, Guoliang
2014-05-01
Nurse education has undergone considerable changes creating new opportunities and challenges for nurse teachers. Limited comparative research of the working lives of nurse teachers has been reported, thus similarities and differences that may exist are unidentified. This paper reports a study of the working lives of nurse teachers in mainland China and the United Kingdom. A cross-sectional questionnaire survey. Census sample of nurse teachers working in four nursing schools in mainland China (n=3) and the United Kingdom (n=1). The overall response rate was 56.8% (China=61, 61.0%, UK=60, 53.1%). Completion of questionnaire specifically developed for the study but comprising six validated tools to collecting data on: job satisfaction, sense of coherence, role conflict and role ambiguity, work empowerment and professional identification. Data on self-reported roles and personal details were also collected. Data were collected between September 2008 and January 2009. Both samples were satisfied with their jobs overall but reported low levels of satisfaction with promotion. Chinese nurse teachers working full-time reported the lowest level for sense of coherence and professional identification. Nurse teachers working full-time in the United Kingdom reported the highest role conflict score. Sense of coherence and work empowerment were significantly and positively correlated to job satisfaction. Role conflict and role ambiguity were negatively correlated (but not always significantly) to job satisfaction and its facets. For respondents in mainland China, professional identification was significantly and positively correlated with overall job satisfaction and its facets. Strategies to improve job satisfaction with promotion opportunities for both samples are indicated. Respondents working full-time in both mainland China and the United Kingdom experienced greater challenges at work than their part-time colleagues. © 2013.
Richards, Imogen; Tesson, Stephanie; Porter, David; Phillips, Kelly-Anne; Rankin, Nicole; Musiello, Toni; Marven, Michelle; Butow, Phyllis
2016-04-01
Most women with unilateral breast cancer (BC) without BRCA1/2 gene mutations are at low risk of contralateral breast cancer (CBC). One CBC risk-management option is contralateral prophylactic mastectomy (CPM). While there is no evidence that CPM increases life-expectancy, its uptake is increasing. This study aimed to assess the validity of an extended social-cognition model, the Theory of Planned Behaviour (TPB), in predicting women's intentions to undergo CPM. Four hundred women previously treated for BC completed an online survey exploring demographic and disease factors, attitude, subjective norm, perceived behavioural control, anticipated regret, uncertainty avoidance, self-efficacy to not have CPM and intentions to undergo CPM in a common hypothetical decision-making scenario. The TPB uniquely explained 25.7% of intention variance. Greater anticipated regret, uncertainty avoidance and lower self-efficacy to cope with not having CPM were associated with stronger CPM intentions, explaining an additional 7.7%, 10.6% and 2.9% respectively, of variance over and above the TPB. Women who had undergone CPM, had not attended university, and had children reported stronger CPM intentions. A holistic understanding of CPM decision-making appears to require consideration beyond CBC risk, demographics and disease characteristics, exploring women's expectations about CPM outcomes, others' opinions, and avoidance of emotionality and difficulties associated with not undergoing surgery. This study provides a theoretical basis from which the complexity of CPM decision-making may be understood, and from which resources for patients and treating staff may be developed to support women's informed decision-making aligning with their personal values. Copyright © 2015 Elsevier Ltd. All rights reserved.
Oji, Tomito; Hayashi, Akiteru; Ogino, Akihiro; Onishi, Kiyoshi
2018-05-01
Lengthening temporalis myoplasty is a faster and less invasive alternative to free muscle transfer for smile reconstruction. However, it requires a nasolabial fold incision, which leaves a midfacial scar. Based on esthetic considerations, a modified approach, involving an extended lazy-S (parotidectomy) incision instead of a nasolabial fold incision, was developed. A cadaveric study involving 10 hemifaces was conducted. From February 2013 to March 2016, the modified lengthening temporalis myoplasty procedure was employed in 10 patients. The results were graded from 1 (poor) to 5 (excellent) according to the Terzis grading system. The excursion of the oral commissure was also measured. The extended lazy-S incision provides easy and safe access to the coronoid process and good visibility. The patients' mean age was 56.5 years, and the mean duration of the postoperative follow-up period was 22.2 months. The patients' underlying conditions included acoustic neuroma (n = 2), Bell palsy (n = 3), congenital conditions (n = 2), brain infarction (n = 1), Ramsay Hunt syndrome (n = 1), and malignant parotid lymphoma (n = 1). One patient suffered a surgical site infection, which was successfully treated with irrigation. All the patients achieved improvements in smile symmetry: 2, 5, and 3 patients obtained excellent, good, and moderate results, respectively. The excursion of the oral commissure ranged from 5 to 10 mm. The modified lengthening temporalis myoplasty procedure provides satisfactory functional outcomes without causing significant complications. It does not leave a facial scar and is a preferable option, especially for young and female patients, and patients who have undergone ablative surgery involving the parotid region.
SAS doctors career progression survey 2013.
Oroz, Carlos; Sands, Lorna R; Lee, John
2016-03-01
We conducted a national survey of Staff, Associate Specialists and Specialty (SAS) doctors working in sexual health clinics in the UK in 2013 in order to explore their career progression. The aim of the survey was to assess SAS doctors' experience in passing through the thresholds and to gather information about the adherence by SAS doctors and employers to the terms and conditions of service laid out by the new 2008 contract. Out of 185 responders, whom the authors estimate comprise 34% of the total workforce, 159 were on the new contract. Of those, most SAS doctors were women (84%), the majority (67%) worked less than nine programmed activities per week; only a few had intentions to join the consultant grade (15%), and a considerable minority (26%) were older than 54 years of age and likely to retire in the next ten years. The survey showed that most participating SAS doctors had undergone appraisal in the previous 15 months (90%), most had a job planning discussion (83%) with their employer and most had some allocated time for supporting professional activities (86%). However, a significant minority had no appraisal (10%), no job planning discussion (17%) and had no allocated supporting professional activities (14%), which allows time for career development in the specialty. Most SAS doctors, who had the opportunity, had progressed through the thresholds automatically (88%); some experienced difficulties in passing (8%) and only a few did not pass (4%). SAS doctors must ensure that they work together with their employer in order to improve adherence to the terms and conditions of service of the contract, which allow for career progression and benefit both the individual doctors and ultimately service provision. © The Author(s) 2015.
Bannuru, Raveendhara R.; Lessard, Darleen; Gore, Joel M.; Lindenauer, Peter K.; Goldberg, Robert J.
2012-01-01
Background: There are limited data describing contemporary trends in the management and outcomes of patients with COPD who develop acute myocardial infarction (AMI). Methods: The study population consisted of patients hospitalized with AMI at all greater Worcester, Massachusetts, medical centers between 1997 and 2007. Results: Of the 6,290 patients hospitalized with AMI, 17% had a history of COPD. Patients with COPD were less likely to be treated with β-blockers or lipid-lowering therapy or to have undergone interventional procedures during their index hospitalization than patients without COPD. Patients with COPD were at higher risk for dying during hospitalization (13.5% vs 10.1%) and at 30 days after discharge (18.7% vs 13.2%), and their outcomes did not improve during the decade-long period under study. After multivariable adjustment, the adverse effects of COPD remained on both in-hospital (OR, 1.25; 95% CI, 0.99-1.50) and 30-day all-cause mortality (OR, 1.31; 95% CI, 1.10-1.58). The use of evidence-based therapies for all patients with AMI increased between 1997 and 2007, with a particularly marked increase for patients with COPD. Conclusions: Our results suggest that the gap in medical care between patients with and without COPD hospitalized with AMI narrowed substantially between 1997 and 2007. Patients with COPD, however, remain less aggressively treated and are at increased risk for hospital adverse outcomes than patients without COPD in the setting of AMI. Careful consideration is necessary to ensure that these high-risk complex patients are not denied the benefits of effective cardiac therapies. PMID:22207679
Beyond cysteine: recent developments in the area of targeted covalent inhibition.
Mukherjee, Herschel; Grimster, Neil P
2018-05-29
Over the past decade targeted covalent inhibitors have undergone a renaissance due to the clinical validation and regulatory approval of several small molecule therapeutics that are designed to irreversibly modify their target protein. Invariably, these compounds rely on the serendipitous placement of a cysteine residue proximal to the small molecule binding site; while this strategy has afforded numerous successes, it necessarily limits the number of proteins that can be targeted by this approach. This drawback has led several research groups to develop novel methodologies that target non-cysteine residues for covalent modification. Herein, we survey the current literature of warheads that covalently modify non-cysteine amino acids in proteins. Copyright © 2018 Elsevier Ltd. All rights reserved.
[The clinical and X-ray classification of osteonecrosis of the low jaw].
Medvedev, Iu A; Basin, E M; Sokolina, I A
2013-01-01
To elaborate a clinical and X-ray classification of osteonecrosis of the low jaw in people with desomorphine or pervitin addiction. Ninety-two patients with drug addiction who had undergone orthopantomography, direct frontal X-ray of the skull, and multislice computed tomography, followed by multiplanar and three-dimensional imaging reconstruction were examined. One hundred thirty four X-ray films and 74 computed tomographic images were analyzed. The authors proposed a clinical and X-ray classification of osteonecrosis of the low jaw in people with desomorphine or pervitin addiction and elaborated recommendations for surgical interventions on the basis of the developed classification. The developed clinical and X-ray classification and recommendations for surgical interventions may be used to treat osteonecroses of various etiology.
Dolapoglu, Ahmet; de la Cruz, Kim I; Preventza, Ourania; Coselli, Joseph S
2016-10-01
Dilation of the ascending aorta and aortic dissections are often seen in Marfan syndrome; however, true aneurysms of the subclavian and axillary arteries rarely seem to develop in patients who have this disease. We present the case of a 58-year-old man with Marfan syndrome who had undergone a Bentall procedure and thoracoabdominal aortic repair for an aortic dissection and who later developed multiple aneurysmal dilations of his right subclavian and axillary arteries. The aneurysms were successfully repaired by means of a surgical bypass technique in which a Dacron graft was placed between the carotid and brachial arteries. We also discuss our strategy for determining the optimal surgical approach in these patients.
Petty, Julia; Treves, Richard
2017-03-06
A digital storytelling resource focusing on the experience of nursing in neonatal care was developed using the narratives of six undergraduate children's nursing students who had undergone a practice placement on a neonatal unit. An evaluation of the resource in relation to its contribution to learning for students in a new, specialised area of practice revealed that storytelling based on peers' experiences is a valuable and insightful approach to learning. This is particularly important in a specialty such as neonatal care where the unfamiliarity of the environment and patient group can cause anxiety and uncertainty among students. Overall, the resource was seen to be useful to children's nursing students who are preparing for a practice placement in an unfamiliar clinical area.
Risk factors for the development of postoperative pneumonia after cardiac surgery.
Vera Urquiza, Rafael; Bucio Reta, Eduardo Rafael; Berríos Bárcenas, Enrique Alexander; Choreño Machain, Tania
2016-01-01
Identify risk factors that determine pneumonia development in patients who have undergone cardiac surgery. Prospective study of a single cohort in a postoperative intensive care unit at a tertiary care center, encompassing all patients undergoing cardiac surgery from January to July 2014. 31 postoperative pneumonia cases were enrolled out of 211 patients (14.6%). The following independent risk factors were identified: hypertension (OR: 3.94, p=0.01), chronic renal failure (OR: 13.67, p=0.02), reintubation (OR: 22.29, p=0.001) and extubation after 6h (OR: 15.81, p=0.005). Main determinants for pneumonia after surgery were hypertension, chronic renal failure, extubation after 6h and reintubation. Copyright © 2016. Publicado por Masson Doyma México S.A.
Castiglia, Luisa Luciani; Drummond, Nancy; Purden, Margaret A
2011-08-01
Women undergoing minimally invasive robotic-assisted surgery for a gynecologic malignancy have many questions and concerns related to the cancer diagnosis and surgery. The provision of information enhances coping with such illness-related challenges. A lack of print materials for these patients prompted the creation of a written teaching tool to improve informational support. A booklet was developed using guidelines for the design of effective patient education materials, including an iterative process of collaboration with healthcare providers and women who had undergone robotic-assisted surgery, as well as attention to readability. The 52-page booklet covers the trajectory of the woman's experience and includes the physical, psychosocial, and sexual aspects of recovery.
Homomorphic encryption experiments on IBM's cloud quantum computing platform
NASA Astrophysics Data System (ADS)
Huang, He-Liang; Zhao, You-Wei; Li, Tan; Li, Feng-Guang; Du, Yu-Tao; Fu, Xiang-Qun; Zhang, Shuo; Wang, Xiang; Bao, Wan-Su
2017-02-01
Quantum computing has undergone rapid development in recent years. Owing to limitations on scalability, personal quantum computers still seem slightly unrealistic in the near future. The first practical quantum computer for ordinary users is likely to be on the cloud. However, the adoption of cloud computing is possible only if security is ensured. Homomorphic encryption is a cryptographic protocol that allows computation to be performed on encrypted data without decrypting them, so it is well suited to cloud computing. Here, we first applied homomorphic encryption on IBM's cloud quantum computer platform. In our experiments, we successfully implemented a quantum algorithm for linear equations while protecting our privacy. This demonstration opens a feasible path to the next stage of development of cloud quantum information technology.
Future space experiments on cosmic rays and radiation on Russian segments of ISS
DOE Office of Scientific and Technical Information (OSTI.GOV)
Panasyuk, Mikhail; Galper, Arkady; Stozhov, Yurii
1999-01-22
The report presents a survey of the Russian space program in the field of radiation and cosmic ray studies. The experimental projects were developed by scientists of different Russian Institutes and are intended for implementation on the future ISS. All the projects mentioned in this report have undergone various expertise stages in the Space Council of the Russian Science Academy ('Cosmic Ray Physics' section); the International Science-Technology Center of the Rocket-Space Corporation 'Energia' ('Astrophysics and radiation Measurements' section); Committee on Science-Technical Co-operation of the Russian Space Agency.
21. AERIAL VIEW OF THE ROCKY FLATS PLANT LOOKING NORTHWEST. ...
21. AERIAL VIEW OF THE ROCKY FLATS PLANT LOOKING NORTHWEST. BY THE LATE 1960S, THE SITE HAD UNDERGONE TWO MAJOR EXPANSIONS. THE FIRST EXPANSION IN 1956-57, WHEN THE TRIGGER DESIGN CHANGED AND NECESSITATED THE ADDITION OF SEVEN NEW BUILDINGS. THE SECOND LARGE EXPANSION TOOK PLACE FROM 1964-65, WHEN ROCKY FLATS BECAME THE SOLE PRODUCER OF TRIGGERS. DURING THIS EXPANSION, ELEVEN BUILDINGS WERE ADDED, PRIMARILY IN RESEARCH AND DEVELOPMENT LABORATORIES, GUARD HOUSES, AND WASTE WATER TREATMENT (7/1/69). - Rocky Flats Plant, Bounded by Indiana Street & Routes 93, 128 & 72, Golden, Jefferson County, CO
Pediatric epilepsy: The Indian experience
Gadgil, Pradnya; Udani, Vrajesh
2011-01-01
Epilepsy is a common clinical entity in neurology clinics. The understanding of the genetics of epilepsy has undergone a sea change prompting re-classification by the International league against epilepsy recently. The prevalence rates of epilepsy in India are similar to those of developed nations. However, the large treatment gap is a major challenge to our public health system. Perinatal injuries are a major causative factor in pediatric group. We have discussed a few common etiologies such as neurocysticercosis and newer genetic epilepsy syndromes. We have also briefly touched upon the Indian experience in pediatric epilepsy surgery. PMID:22069423
Emerald oil field on production in North Sea
DOE Office of Scientific and Technical Information (OSTI.GOV)
Not Available
1992-08-31
This paper reports that Midland and Scottish Energy Ltd. (MSE) has placed Emerald oil field on stream in the U.K. North Sea with a floating production unit. Initial production, from two satellite wells, will be used to commission facilities. Three water injection wells have been unplugged and are ready for start-up. MSE will place a central cluster of wells-five producers and one water injector-on stream during the next few weeks. Production will build to an expected 25,000 b/d from 35 million bbl of reserves. Field development has undergone an unusually large number of setbacks and changes.
Transition-metal-catalyzed direct arylation of (hetero)arenes by C-H bond cleavage.
Ackermann, Lutz; Vicente, Rubén; Kapdi, Anant R
2009-01-01
The area of transition-metal-catalyzed direct arylation through cleavage of C-H bonds has undergone rapid development in recent years, and is becoming an increasingly viable alternative to traditional cross-coupling reactions with organometallic reagents. In particular, palladium and ruthenium catalysts have been described that enable the direct arylation of (hetero)arenes with challenging coupling partners--including electrophilic aryl chlorides and tosylates as well as simple arenes in cross-dehydrogenative arylations. Furthermore, less expensive copper, iron, and nickel complexes were recently shown to be effective for economically attractive direct arylations.
Transcatheter aortic valve insertion (TAVI): a review
Morgan-Hughes, G; Roobottom, C
2014-01-01
The introduction of transcatheter aortic valve insertion (TAVI) has transformed the care provided for patients with severe aortic stenosis. The uptake of this procedure is increasing rapidly, and clinicians from all disciplines are likely to increasingly encounter patients being assessed for or having undergone this intervention. Successful TAVI heavily relies on careful and comprehensive imaging assessment, before, during and after the procedure, using a range of modalities. This review outlines the background and development of TAVI, describes the nature of the procedure and considers the contribution of imaging techniques, both to successful intervention and to potential complications. PMID:24258463
Lung abscess presenting as tension pyopneumothorax in a gastrointestinal cancer patient.
Okita, Riki; Miyata, Yoshihiro; Hamai, Yoichi; Hihara, Jun; Okada, Morihito
2014-01-01
We report a surgical case of tension pyopneumothorax in a patient who was receiving chemotherapy for esophageal cancer. A 68-year-old man who had undergone total gastrectomy with splenectomy for gastric cancer and was receiving chemotherapy for esophageal cancer was presented to our hospital with dyspnea. Left tension pyopneumothorax was diagnosed, and he received left lower lobectomy after pleural drainage. His postoperative course was uneventful, and he is alive without any cancer recurrences 5 years after the lobectomy. Once tension pyopneumothorax has developed from lung abscess, emergent lobectomy may be a useful option to prevent lethal aspiration pneumonia.
The Arab Spring and health: two years on.
Coutts, Adam; Stuckler, David; Batniji, Rajaie; Ismail, Sharif; Maziak, Wasim; McKee, Martin
2013-01-01
The "Arab Spring" has touched almost all countries in the Middle East and North Africa. While most attention has focused on security and political developments, there are significant consequences for population health. These include immediate problems, such as violent deaths and injuries, population displacement, and damage to essential infrastructure, but also longer term vulnerabilities not yet addressed by the political changes, including high unemployment, the low status of women, erosion of already weak welfare systems, and rising food prices. It will be important to tackle these underlying issues while not repeating the mistakes made in other countries that have undergone rapid political transition.
NASA Technical Reports Server (NTRS)
Dowden, Donald J.; Bessette, Denis E.
1987-01-01
The AFTI F-16 Automated Maneuvering Attack System has undergone developmental and demonstration flight testing over a total of 347.3 flying hours in 237 sorties. The emphasis of this phase of the flight test program was on the development of automated guidance and control systems for air-to-air and air-to-ground weapons delivery, using a digital flight control system, dual avionics multiplex buses, an advanced FLIR sensor with laser ranger, integrated flight/fire-control software, advanced cockpit display and controls, and modified core Multinational Stage Improvement Program avionics.
MAS NMR of HIV-1 protein assemblies
NASA Astrophysics Data System (ADS)
Suiter, Christopher L.; Quinn, Caitlin M.; Lu, Manman; Hou, Guangjin; Zhang, Huilan; Polenova, Tatyana
2015-04-01
The negative global impact of the AIDS pandemic is well known. In this perspective article, the utility of magic angle spinning (MAS) NMR spectroscopy to answer pressing questions related to the structure and dynamics of HIV-1 protein assemblies is examined. In recent years, MAS NMR has undergone major technological developments enabling studies of large viral assemblies. We discuss some of these evolving methods and technologies and provide a perspective on the current state of MAS NMR as applied to the investigations into structure and dynamics of HIV-1 assemblies of CA capsid protein and of Gag maturation intermediates.
Oncolytic viruses: From bench to bedside with a focus on safety
Buijs, Pascal RA; Verhagen, Judith HE; van Eijck, Casper HJ; van den Hoogen, Bernadette G
2015-01-01
Oncolytic viruses are a relatively new class of anti-cancer immunotherapy agents. Several viruses have undergone evaluation in clinical trials in the last decades, and the first agent is about to be approved to be used as a novel cancer therapy modality. In the current review, an overview is presented on recent (pre)clinical developments in the field of oncolytic viruses that have previously been or currently are being evaluated in clinical trials. Special attention is given to possible safety issues like toxicity, environmental shedding, mutation and reversion to wildtype virus. PMID:25996182
New theory insights and experimental opportunities in Majorana wires
NASA Astrophysics Data System (ADS)
Alicea, Jason
Over the past decade, the quest for Majorana zero modes in exotic superconductors has undergone transformational advances on the design, fabrication, detection, and characterization fronts. The field now seems primed for a new era aimed at Majorana control and readout. This talk will survey intertwined theory and experimental developments that illuminate a practical path toward these higher-level goals. In particular, I will highlight near-term opportunities for testing fundamentals of topological quantum computing and longer-term strategies for building scalable hardware. Supported by the National Science Foundation (DMR-1341822), Institute for Quantum Information and Matter, and Walter Burke Institute at Caltech.
Calhoun, Darlene A; Christensen, Robert D
2004-03-01
The practice of complete bowel rest in prematurely delivered neonates and those who have undergone surgery for congenital anomalies of the gastrointestinal (GI) tract is common in neonatal intensive care units (NICU). However, increased recognition of the critical role of growth factors in GI development suggests that this practice might be modified to include the administration of synthetic amniotic fluid-like solutions designed to bridge the neonate between their intra-uterine environment and that of the NICU. This article reviews advances in administering synthetic amniotic fluid-like solutions in the NICU.
The relationship between addictions and bariatric surgery for nurses in recovery.
Fogger, Susanne A; McGuinness, Teena M
2012-01-01
Determinants of morbid obesity are complex and numerous, yet understanding the neurobiological underpinnings improves our knowledge of this serious issue. Emerging science supports a comparison of disordered eating with other addictive substances. The study used a sub-analysis of a cross-sectional study of nurses in a state-monitoring program. A study of 173 participants in a state-monitoring program for impaired nurses revealed that 14% (n= 25) had undergone bariatric surgery. Of these, 17 developed an addiction after surgery. Evidence suggests that some individuals may require additional treatment, similar to those with pharmacological addictions. © 2011 Wiley Periodicals, Inc.
2006-09-29
originating in Los Angeles. The long ridge of ozone in the north east part of Figure 14a is due to polluted air from San Diego area that has undergone...Further north of this small ridge (2 ppbv), we find a decrease in O3 of up to 6ppb (i.e., without DoD emissions, O3 is reduced by 6ppb). This period is...ships on urban air quality. 35 6.0 References Alexis, A., P. Gaffney , C. Garcia, M. Nystrom, and R. Rood (2000), The 1999 California Almanac of
History of the Development of Liquid-Applied Coatings for Protection of Reinforced Concrete
NASA Technical Reports Server (NTRS)
Curran, Joseph J.; Hansen, marlin H.
2005-01-01
Corrosion of reinforcing steel in concrete is an insidious problem for structures at Kennedy Space Center (KSC). KSC is located on the coast of Florida in a highly corrosive atmosphere. Launch pads, highway bridge infrastructure, and buildings are strongly affected. To mitigate these problems, NASA initiated a development program for a Galvanic Liquid-Applied Coating System (GLACS). A breakthrough in this area would have great commercial value in transportation, marine and construction industry infrastructures. The patented NASA GLACS system has undergone considerable testing to meet the needs of commercialization. A moisture-cure coating gives excellent adhesion with ease of application compared to existing galvanic products on the market. The latest development, GalvaCori; can be sprayed or hand applied to almost any structure shape. A self-adhesive conductive tape system has been devised to simplify current collection within the coating areas. In testing programs, millivolt potential and milliamp output per square foot of anode have been closely studied at actual test sites. These two parameters are probably the most challenging items of a resin-based, room-temperature-applied, galvanic coating. Extensive re-formulation has resulted in a system that provides the needed polarization for catholic protection of reinforcing steel in concrete in a variety of structure environments. The rate of corrosion of rebar in concrete is greatly affected by the environment of the structure. In addition to this, for any given concrete structure; moisture level, carbonization, and chloride contamination influences the rate of rebar corrosion. Similarly, the cathodic protection level of galvanic systems is also dependent on the moisture level of the concrete. GalvaCorr is formulated to maintain galvanic activity as the moisture level of the structure declines. GalvaCorr is available as a three-part kit. The mixing step requires about ten minutes. The viscosity can be easily adjusted to meet the application needs. The pot or working life is four to six hours, depending on the temperature. GalvaCorr can be thought of as a spray-on coating, battery ready to provide up to -1.4 volts (relative to CSE) of cathodic protection (CP) potential.
Electromagnetic field and brain development.
Kaplan, Suleyman; Deniz, Omur Gulsum; Önger, Mehmet Emin; Türkmen, Aysın Pınar; Yurt, Kıymet Kübra; Aydın, Işınsu; Altunkaynak, Berrin Zuhal; Davis, Devra
2016-09-01
Rapid advances in technology involve increased exposures to radio-frequency/microwave radiation from mobile phones and other wireless transmitting devices. As cell phones are held close to the head during talking and often stored next to the reproductive organs, studies are mostly focused on the brain. In fact, more research is especially needed to investigate electromagnetic field (EMF)'s effects on the central nervous system (CNS). Several studies clearly demonstrate that EMF emitted by cell phones could affect a range of body systems and functions. Recent work has demonstrated that EMF inhibit the formation and differentiation of neural stem cells during embryonic development and also affect reproductive and neurological health of adults that have undergone prenatal exposure. The aim of this review is to discuss the developing CNS and explain potential impacts of EMF on this system. Copyright © 2015 Elsevier B.V. All rights reserved.
Confucian virtues and Chinese adolescent development: a conceptual review.
Shek, Daniel T L; Yu, Lu; Fu, Xiao
2013-01-01
Despite the fact that different Chinese communities have already undergone industrialization and urbanization, Confucian virtues are still regarded as developmental ideals in Chinese culture. Unfortunately, while Confucian virtues are commonly discussed under Chinese philosophies, they are rarely examined in the context of developmental research. In this paper, several key Confucian virtues are discussed, including loyalty ("zhong"), filial piety ("xiao"), benevolence ("ren"), affection ("ai"), trustworthiness ("xin"), righteousness ("yi"), harmony ("he"), peace ("ping"), propriety ("li"), wisdom ("zhi"), integrity ("lian") and shame ("chi"). These Chinese traditional virtues are also linked to the concepts of character strengths and positive youth development constructs highlighted in Western culture. It is argued that Confucian virtues provide an indigenous conceptual framework to understand character strengths and positive youth development in Chinese culture. Furthermore, when service leadership is considered in Chinese contexts, these virtues should be regarded as important cornerstones.
Pinto, Valentina; Piccin, Ottavio; Burgio, Luca; Summo, Valeria; Antoniazzi, Elisa; Morselli, Paolo G
2018-05-01
A relatively neglected aspect of cleft lip nasal deformity is the effect of septal deviation and inferior turbinate hypertrophy (ITH) on the functional airway. In particular, ITH in the noncleft side can be especially problematic, because it reduces the healthy nasal area, creating bilateral nasal obstruction that might affect the growth of the maxillofacial skeleton. Although these anatomic and functional changes are documented, few recommendations have been developed regarding the proper approach to ITH. The aim of the present study was to asses the ITH severity and determine the degree of nasal airway patency in patients who have undergone primary correction of the nasal septum during lip repair compared to patients operated on without primary septal correction. The study population included two groups. One group consisted of twenty unilateral cleft lip palate UCLP patients who have previously undergone primary rhinoseptoplasty as part of their treatment plan. The control group consisted of twenty UCLP patients operated on without rhinoseptal correction. The Nasal Obstructive Symptom Evaluation (NOSE) scale and nasal endoscopy were used to assess nasal obstruction. The overall untreated group reported severe symptoms across all NOSE scale dimensions more frequently than children who have undergone primary rhinoseptoplasty. The difference was statistically significant for each dimensions (p < 0.05). The mean NOSE score for group A and group B was 21.4 ± 9.4 and 70.8 ± 17.2 respectively (p < 0.0001). In group A turbinate size decreased significantly (p < 0.05) compared to pre-operative data. Comparing the two groups a statistically significant difference in turbinate size was observed (p < 0.0001). The results of the present study confirm that there is a significant degree of ITH and nasal airway dysfunction in patients with UCLP. Early septal repositioning during primary cleft lip repair results in a statistically significant reduction in IT size and improvement of nasal patency. Copyright © 2018 Elsevier B.V. All rights reserved.
Videolaparoscopic Radical Hysterectomy Approach: a Ten-Year Experience
Limberger, Leo Francisco; Kalil, Antonio Nocchi; de Vargas, Gabriel Sebastião; Damiani, Paulo Agostinho; Haas, Fernanda Feltrin
2009-01-01
Background: Because of the advancements in surgical techniques and laparoscopic instruments, total laparoscopic radical hysterectomy can now be performed for the treatment of uterine cervical carcinoma. We assessed the feasibility, complications, and survival rates of patients who underwent total laparoscopic radical hysterectomy with pelvic lymphadenectomy. Methods: We retrospectively collected data from the medical charts of 29 patients who had undergone surgery between 1998 and 2008. The following data were assessed: age, staging, histological type, number of lymph nodes retrieved, parametrial measures, operative time, length of hospital stay, surgical complications, and disease-free time. Results: The mean patient age was 37.07±10.45 years. Forty percent of the patients had previously undergone abdominal or pelvic surgeries. Mean operative time was 228.96±60.41 minutes, and mean retrieved lymph nodes was 16.9±8.12. All patients had free margins. No conversions to laparotomy were necessary. Median time until hospital dismissal was 6.5 days (range 3–38 days). Four patients had intraoperative complications: 2 lacerations of the rectum, 1 laceration of the bladder, and 1 lesion of the ureter. Three patients developed bladder or ureteral fistulas postoperatively that were successfully corrected surgically. Conclusion: Laparoscopic radical hysterectomy is feasible and has acceptable complications. The radicalism of the surgery must be considered, bearing in mind the parametrial measures and the number of lymph nodes retrieved. PMID:20202391
Cruz, Sabrina; Matos, Andréa; da Cruz, Suelem Pereira; Pereira, Silvia; Saboya, Carlos; Ramalho, Andréa
2017-09-08
The aim of this study was to compare the nutritional status of vitamin A per trimester of pregnancy, as well as to assess its influence on pre-pregnancy BMI, total gestational weight gain (TGWG) and presence of anemia in women who had previously undergone Roux-en-Y gastric bypass (RYGB). An analytical, longitudinal and retrospective study comprising 30 pregnant women who had previously undergone RYGB was undertaken. In all trimesters of pregnancy, the serum concentrations of retinol, β-carotene, stages of vitamin A deficiency (VAD), night blindness (NB), anemia and anthropometric variables were assessed. VAD in pregnancy affected 90% of women, 86.7% developed NB and 82.8% had mild VAD. TGWG above/below the recommended range was related to the low serum concentrations of β-carotene ( p = 0.045) in the second trimester and women with TGWG above the recommended range showed 100% of inadequacy of this nutrient in the third trimester. Among the pregnant women with anemia, 90.9% had VAD and 86.4% had NB. This study highlights the importance of monitoring the nutritional status of vitamin A in prenatal care, due to its relationship with TGWG and the high percentage of VAD and NB found since the beginning of pregnancy. It also reaffirms the use of the cut-off <1.05 μmol/L for determining VAD.
Ibrahim, Nafisa B; Anandan, Srividya; Hartman, Audrey L; McSweeney, Michelle; Chun, Jeanette; McKee, Andrea; Yang, Rebecca; Kim, Cathleen
2015-01-01
The use of accelerated partial breast irradiation (APBI) following breast-conserving surgery is rapidly gaining popularity as an alternative to whole-breast irradiation (WBI) in selected patients with early-stage breast cancer. Although data on the long-term effectiveness and safety of APBI accelerated partial breast irradiation are still being gathered, the shorter treatment course and narrowed radiation target of APBI accelerated partial breast irradiation provide an attractive alternative for carefully selected patients. These patients include those with relatively small tumors (≤3 cm), negative or close margins, and negative sentinel lymph nodes. Possible long-term complications include telangiectasia and the development of a palpable mass at the lumpectomy site. Mammographic findings in patients who have undergone APBI accelerated partial breast irradiation are distinct from those in patients who have undergone conventional WBI whole-breast irradiation . The most common post-APBI accelerated partial breast irradiation radiographic findings include formation of seromas at the lumpectomy site, focal parenchymal changes such as increased trabeculation and parenchymal distortion, fat necrosis, and skin changes such as thickening or retraction. Given the continued evolution of breast cancer treatment, it is important that radiologists have a comprehensive understanding of APBI accelerated partial breast irradiation in terms of rationale, patient selection criteria, common postprocedural radiographic findings (and how they differ from post-WBI whole-breast irradiation findings), and advantages and potential complications. RSNA, 2015
Cohort profile: the Nordic Antireflux Surgery Cohort (NordASCo)
Wahlin, Karl; Artama, Miia; Brusselaers, Nele; Färkkilä, Martti; Lynge, Elsebeth; Mattsson, Fredrik; Pukkala, Eero; Romundstad, Pål; Tryggvadóttir, Laufey; von Euler-Chelpin, My; Lagergren, Jesper
2017-01-01
Purpose To describe a newly created all-Nordic cohort of patients with gastro-oesophageal reflux disease (GORD), entitled the Nordic Antireflux Surgery Cohort (NordASCo), which will be used to compare participants having undergone antireflux surgery with those who have not regarding risk of cancers, other diseases and mortality. Participants Included were individuals with a GORD diagnosis recorded in any of the nationwide patient registries in the Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) in 1964–2014 (with various start and end years in different countries). Data regarding cancer, other diseases and mortality were retrieved from the nationwide registries for cancer, patients and causes of death, respectively. Findings to date The NordASCo includes 945 153 individuals with a diagnosis of GORD. Of these, 48 433 (5.1%) have undergone primary antireflux surgery. Median age at primary antireflux surgery ranged from 47 to 52 years in the different countries. The coding practices of GORD seem to have differed between the Nordic countries. Future plans The NordASCo will initially be used to analyse the risk of developing known or potential GORD-related cancers, that is, tumours of the oesophagus, stomach, larynx, pharynx and lung, and to evaluate the mortality in the short-term and long-term perspectives. Additionally, the cohort will be used to evaluate the risk of non-malignant respiratory conditions that might be caused by aspiration of gastric contents. PMID:28600380