Declining Use of Radiotherapy in Stage I and II Hodgkin's Disease and Its Effect on Survival and Secondary Malignancies

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

The 2014 Bowman Lecture—Bowman's and Bruch's: a tale of two membranes during the laser revolution

PubMed Central

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

Shoulder and neck morbidity in quality of life after surgery for head and neck cancer.

PubMed

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.

Nocturnal polyuria and saluresis in renal allograft recipients.

PubMed Central

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

Prophylactic red blood cell exchange may be beneficial in the management of sickle cell disease in pregnancy.

PubMed

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.

[Treatment of posterior noninfectious uveitis : Current situation and future developments].

PubMed

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.

Laparoscopic inguinal hernioplasty after robot-assisted laparoscopic radical prostatectomy.

PubMed

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.

Early versus late distant metastasis and adjuvant chemotherapy alone versus both radiotherapy and chemotherapy in molecular apocrine breast cancer

PubMed Central

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

The influence of symptoms on quality of life among patients who have undergone oesophageal cancer surgery.

PubMed

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.

Effects of gastric pacing on gastric emptying and plasma motilin

PubMed Central

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

Developments in purification methods for obtaining and evaluation of collagen derived endogenous angioinhibitors

PubMed Central

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

When left-hemisphere reading is compromised: Comparing reading ability in participants after left cerebral hemispherectomy and participants with developmental dyslexia.

PubMed

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.

Effect of early correction of nasal septal deformity in unilateral cleft lip and palate on inferior turbinate hypertrophy and nasal patency.

PubMed

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.

Incidence of ovarian cancer after hysterectomy: a nationwide controlled follow up.

PubMed

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.

The evolving potential of companion diagnostics.

PubMed

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.

[Relations between extraction of wisdom teeth and temporomandibular disorders: a case/control study].

PubMed

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.

Preoperative determinant of early postoperative renal function following radical cystectomy and intestinal urinary diversion.

PubMed

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.

Selective impairment of attention networks in breast cancer patients receiving chemotherapy treatment.

PubMed

Chen, Xingui; Li, Jingjing; Ren, Jing; Hu, Xinglong; Zhu, Chunyan; Tian, Yanghua; Hu, Panpan; Ma, Huijuan; Yu, Fengqiong; Wang, Kai

2014-10-01

Complaints about attention disorders are common among breast cancer survivors who have undergone chemotherapy treatment. However, it is not known whether these complaints indicate a global attention deficit or the selective impairment of attention networks. This study sought to investigate the attentional abilities of breast cancer patients after chemotherapy treatment using the attention network test (ANT). The participants included breast cancer patients who had undergone chemotherapy (CT, N = 58), patients who had not undergone chemotherapy (non-CT, N = 53), and matched healthy controls (HC, N = 55). All participants completed the ANT, which provides measures of three independent attention networks (alerting, orienting, and executive control) and neuropsychological background tests. Our results indicated that the chemotherapy-treated breast cancer patients had significant deficits in the alerting and executive control networks but not in the orienting network. The CT group scored significantly lower in several cognitive tasks, including attention, memory, and information processing tasks, relative to the other two groups. Additionally, significant correlations were found between information processing and the efficiency of the executive control network within the CT group. These results suggest that the three attention networks were selectively impaired following chemotherapy treatment, which affected different brain areas in the breast cancer survivors. Copyright © 2014 John Wiley & Sons, Ltd.

Early versus late distant metastasis and adjuvant chemotherapy alone versus both radiotherapy and chemotherapy in molecular apocrine breast cancer.

PubMed

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.

Results of arthroscopic joint debridement in different stages of chondromalacia of the knee joint.

PubMed

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.

Analysis of the Effect of Cyclophosphamide and Methotrexate on Chrysomya megacephala (Diptera: Calliphoridae).

PubMed

Trivia, Ana Letícia; de Carvalho Pinto, Carlos José

2018-01-19

Forensic entomotoxicology investigates the effects of chemical substances in the development of scavenger insects and the reflection on estimating the minimum postmortem interval (PMI). To evaluate the impact of the chemotherapeutic drugs cyclophosphamide (CF) and methotrexate (MTX) on the postembryonic development of Chrysomya megacephala, controlled experiments were performed by rearing the larvae on spiked minced beef with different concentrations of these drugs. The results indicated that CF significantly decreased their developmental rate up to 28 h but had no significant effect on larval and adult sizes, survival rate, and sex ratio, whereas MTX decreased larval and adult sizes, survival rate, and there was a deviation in the expected sex ratio toward females in MTX-exposed larvae but had no significant impact on developmental rate. These negative interference factors should be considered in cases of suspected death of people that have undergone chemotherapy. © 2018 American Academy of Forensic Sciences.

Psychological impact of female genital mutilation among adolescent Egyptian girls: a cross-sectional study.

PubMed

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.

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.

Female genital mutilation and efforts to achieve Millennium Development Goals 3, 4, and 5 in southeast Nigeria.

PubMed

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.

Evaluation of cryopreserved homografts in the right ventricular outflow tract after the Ross procedure: intermediate-term follow up.

PubMed

Ward, K E; Elkins, R C; Overholt, E D; Knott-Craig, C J; Razook, J D; Lane, M M; Gilliland, S S

1997-03-01

The Ross procedure involves replacing a transplanted pulmonary valve with a cryopreserved homograft in order to re-establish right ventricle-pulmonary artery continuity. This study reviews mid-term results of such surgery in children and young adults. Since November 1986, 114 patients have undergone the Ross procedure at the Children's Hospital of Oklahoma using cryopreserved pulmonary homografts (n = 113) and aortic homograft (n = 1) to reconstruct the right ventricular outflow tract. Graft size ranged from 16 to 32 mm. Ninety-three patients (mean age at implant 10.4 years (range: 0.8-22 years) have had complete mean follow up of 3.2 years (range: 5 months to 8.4 years) after surgery. Homograft evaluation included clinical reports and comparison of early post-implant and latest echocardiography. Measurements of homograft valve annulus and peak instantaneous Doppler gradient were compared; quality of valve leaflets, location of obstruction, and the degree of pulmonary regurgitation were assessed. Compared with early postoperative data, mean homograft annulus size decreased by 15% (p < 0.0001); in 88% of patients, the decrease ranged from one to nine millimeter. Peak Doppler gradient increased significantly (from 10 to 17 mmHg, p < 0.0001); 25% of patients developed gradients > 25 mmHg, and four had gradients > 50 mmHg. Significant obstruction developed most often at the supravalvular level or in the homograft conduit itself. This usually occurred within one year of implant, and was associated with calcification and contracture of the homograft wall. Significant pulmonary regurgitation developed in 19 cases (20%), but was more than mild in only three. Leaflet integrity was maintained except in those who developed severe stenosis or regurgitation. Two patients have undergone re-operation for homograft stenosis 2.8 and 5.4 years respectively after the Ross procedure; one has developed recurrent severe stenosis in the homograft four months later. After the Ross procedure: (i) Pulmonary homografts undergo significant annular reduction in most patients, though this is usually not associated with the development of significant obstruction. (ii) Peak Doppler gradients across the homograft increase in most patients, though only 4% develop more than mild obstruction. (iii) Mild pulmonary regurgitation is common (20%); moderate or severe regurgitation is rare and usually develops in concert with severe stenosis. (iv) Severe homograft valve degeneration usually occurs within one year of implant, and may reflect an immune-mediated response.

Chest Reconstruction and Chest Dysphoria in Transmasculine Minors and Young Adults: Comparisons of Nonsurgical and Postsurgical Cohorts.

PubMed

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.

Comparison between open and laparoscopic repair of perforated peptic ulcer disease.

PubMed

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.

Interruption of Transmission of Onchocerca volvulus in the Southern Chiapas Focus, México

PubMed Central

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

The role of a lack of social integration in never having undergone breast cancer screening: results from a population-based, representative survey in the Paris metropolitan area in 2010.

PubMed

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.

The effect of a nurse-led telephone-based care coordination program on the follow-up and control of cardiovascular risk factors in patients with coronary artery disease.

PubMed

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

SPEECH EVALUATION WITH AND WITHOUT PALATAL OBTURATOR IN PATIENTS SUBMITTED TO MAXILLECTOMY

PubMed Central

de Carvalho-Teles, Viviane; Pegoraro-Krook, Maria Inês; Lauris, José Roberto Pereira

2006-01-01

Most patients who have undergone resection of the maxillae due to benign or malignant tumors in the palatomaxillary region present with speech and swallowing disorders. Coupling of the oral and nasal cavities increases nasal resonance, resulting in hypernasality and unintelligible speech. Prosthodontic rehabilitation of maxillary resections with effective separation of the oral and nasal cavities can improve speech and esthetics, and assist the psychosocial adjustment of the patient as well. The objective of this study was to evaluate the efficacy of the palatal obturator prosthesis on speech intelligibility and resonance of 23 patients with age ranging from 18 to 83 years (Mean = 49.5 years), who had undergone inframedial-structural maxillectomy. The patients were requested to count from 1 to 20, to repeat 21 words and to spontaneously speak for 15 seconds, once with and again without the prosthesis, for tape recording purposes. The resonance and speech intelligibility were judged by 5 speech language pathologists from the tape recordings samples. The results have shown that the majority of patients (82.6%) significantly improved their speech intelligibility, and 16 patients (69.9%) exhibited a significant hypernasality reduction with the obturator in place. The results of this study indicated that maxillary obturator prosthesis was efficient to improve the speech intelligibility and resonance in patients who had undergone maxillectomy. PMID:19089242

The Arab Spring and health: two years on.

PubMed

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.

New Phase of Internationalization of Higher Education and Institutional Change

ERIC Educational Resources Information Center

Wadhwa, Rashim

2016-01-01

Internationalization of higher education has undergone significant change in the current scenario. The approach to traditional internationalization which was based on international co-operation and rarely a profit making activity were at the center of traditional internationalization has changed significantly from the last two decades. Emergence…

From Mosquitos to Humans: Genetic Evolution of Zika Virus

PubMed Central

Wang, Lulan; Valderramos, Stephanie G.; Wu, Aiping; Ouyang, Songying; Li, Chunfeng; Brasil, Patricia; Bonaldo, Myrna; Coates, Thomas; Nielsen-Saines, Karin; Jiang, Taijiao; Aliyari, Roghiyh; Cheng, Genhong

2017-01-01

Initially isolated in 1947, Zika virus (ZIKV) has recently emerged as significant public health concern. Sequence analysis of all 41 known ZIKV RNA open reading frames to date indicates that ZIKV has undergone significant changes in both protein and nucleotide sequences during the past half century. PMID:27091703

Risk Factors for Venous Thromboembolism After Spine Surgery

PubMed Central

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

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.

Can foam sclerotherapy be used to safely treat bilateral varicose veins?

PubMed

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.

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…

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.

Brother-sister incest: data from anonymous computer-assisted self interviews.

PubMed

Stroebel, Sandra S; O'Keefe, Stephen L; Beard, Keith W; Kuo, Shih-Ya; Swindell, Samuel; Stroupe, Walter

2013-01-01

Retrospective data were entered anonymously by 1,521 adult women using computer-assisted self interview. Forty were classified as victims of brother-sister incest, 19 were classified as victims of father-daughter incest, and 232 were classified as victims of sexual abuse by an adult other than their father before reaching 18 years of age. The other 1,230 served as controls. The victims of brother-sister incest had significantly more problematic outcomes than controls on many measures (e.g., more likely than the controls to endorse feeling like damaged goods, thinking that they had suffered psychological injury, and having undergone psychological treatment for childhood sexual abuse). However, victims of brother-sister incest also had significantly less problematic outcomes than victims of father-daughter incest on some measures (e.g., significantly less likely than the father-daughter incest victims to endorse feeling like damaged goods, thinking that they had suffered psychological injury, and having undergone psychological treatment for childhood sexual abuse).

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

Influence of nasoalveolar molding on skeletal development in patients with unilateral cleft lip and palate at 5 years of age.

PubMed

Akarsu-Guven, Bengisu; Arisan, Arda; Ozgur, Figen; Aksu, Muge

2018-04-01

The aim of this retrospective study was to assess the influence of presurgical nasoalveolar molding (NAM) on skeletal development in patients with operated unilateral cleft lip and palate at 5 years of age. Lateral cephalometric radiographs of 26 unilateral cleft lip and palate patients who had undergone presurgical NAM (NAM group) and 20 unilateral cleft lip and palate patients who did not have any presurgical NAM (non-NAM group) were analyzed. The radiographs were digitally traced using Quick Ceph Studio software (version 3.5.1.r (1151); Quick Ceph Systems, San Diego, Calif). Independent samples t tests were performed for statistical analysis. No significant differences were observed in sagittal and vertical skeletal measurements between the NAM and non-NAM groups. NAM resulted in no significant difference in skeletal development in unilateral cleft lip and palate patients compared with those without NAM in early childhood. Copyright © 2018. Published by Elsevier Inc.

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

Caudell, Jimmy J.; Schaner, Philip E.; Meredith, Ruby F.

Purpose: The use of altered fractionation radiotherapy (RT) regimens, as well as concomitant chemotherapy and RT, to intensify therapy for locally advanced head-and-neck cancer can lead to increased rates of long-term dysphagia. Methods and Materials: We identified 122 patients who had undergone definitive RT for locally advanced head-and-neck cancer, after excluding those who had been treated for a second or recurrent head-and-neck primary, had Stage I-II disease, developed locoregional recurrence, had <12 months of follow-up, or had undergone postoperative RT. The patient, tumor, and treatment factors were correlated with a composite of 3 objective endpoints as a surrogate for severemore » long-term dysphagia: percutaneous endoscopic gastrostomy tube dependence at the last follow-up visit; aspiration on a modified barium swallow study or a clinical diagnosis of aspiration pneumonia; or the presence of a pharyngoesophageal stricture. Results: A composite dysphagia outcome occurred in 38.5% of patients. On univariate analysis, the primary site (p = 0.01), use of concurrent chemotherapy (p = 0.01), RT schedule (p = 0.02), and increasing age (p = 0.04) were significantly associated with development of composite long-term dysphagia. The use of concurrent chemotherapy (p = 0.01), primary site (p = 0.02), and increasing age (p = 0.02) remained significant on multivariate analysis. Conclusion: The addition of concurrent chemotherapy to RT for locally advanced head-and-neck cancer resulted in increased long-term dysphagia. Early intervention using swallowing exercises, avoidance of nothing-by-mouth periods, and the use of intensity-modulated RT to reduce the dose to the uninvolved swallowing structures should be explored further in populations at greater risk of long-term dysphagia.« less

Theory and operation of the real-time data acquisition system for the NASA-LaRC differential absorption lidar (DIAL)

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.

Remote programming of cochlear implants: a telecommunications model.

PubMed

McElveen, John T; Blackburn, Erin L; Green, J Douglas; McLear, Patrick W; Thimsen, Donald J; Wilson, Blake S

2010-09-01

Evaluate the effectiveness of remote programming for cochlear implants. Retrospective review of the cochlear implant performance for patients who had undergone mapping and programming of their cochlear implant via remote connection through the Internet. Postoperative Hearing in Noise Test and Consonant/Nucleus/Consonant word scores for 7 patients who had undergone remote mapping and programming of their cochlear implant were compared with the mean scores of 7 patients who had been programmed by the same audiologist over a 12-month period. Times required for remote and direct programming were also compared. The quality of the Internet connection was assessed using standardized measures. Remote programming was performed via a virtual private network with a separate software program used for video and audio linkage. All 7 patients were programmed successfully via remote connectivity. No untoward patient experiences were encountered. No statistically significant differences could be found in comparing postoperative Hearing in Noise Test and Consonant/Nucleus/Consonant word scores for patients who had undergone remote programming versus a similar group of patients who had their cochlear implant programmed directly. Remote programming did not require a significantly longer programming time for the audiologist with these 7 patients. Remote programming of a cochlear implant can be performed safely without any deterioration in the quality of the programming. This ability to remotely program cochlear implant patients gives the potential to extend cochlear implantation to underserved areas in the United States and elsewhere.

Long-term serum bile acid concentrations in 51 dogs after complete extrahepatic congenital portosystemic shunt ligation.

PubMed

Bristow, P; Tivers, M; Packer, R; Brockman, D; Ortiz, V; Newson, K; Lipscomb, V

2017-08-01

To report the long-term bile acid stimulation test results for dogs that have undergone complete suture ligation of a single congenital extrahepatic portosystemic shunt. Data were collected from the hospital records of all dogs that had undergone a complete suture ligation of a single congenital extrahepatic portosystemic shunt. Owners were invited to return to the referral centre or their local veterinarian for repeat serum bile acid measurement. Dogs diagnosed with idiopathic epilepsy and undergoing bile acid stimulation tests were used as a comparison population. Fifty-one study dogs were included, with a mean follow-up time of 62 months. 48 dogs had no evidence of multiple acquired shunts and a significant reduction in the pre- and post-prandial serum bile acid concentrations at long-term follow-up compared with pre-operative measurements. Pre- and post-prandial serum bile acids were statistically significantly greater for dogs that had undergone a full ligation (with no evidence of multiple acquired shunts) at all time points compared to the control dogs (P<0·001 for all comparisons). The results suggest that in dogs treated with complete suture ligation mild increases in serum bile acids are not clinically relevant if there are no physical examination abnormalities, a normal body condition score and no relapse in clinical signs. © 2017 British Small Animal Veterinary Association.

Female genital mutilation among mothers and daughters in Harar, eastern Ethiopia.

PubMed

Oljira, Teshome; Assefa, Nega; Dessie, Yadeta

2016-12-01

To assess the practice of female genital mutilation (FGM) among mothers and daughters, and to investigate sociodemographic factors influencing the practice of FGM in Harar, Ethiopia. A community-based cross-sectional study was conducted among women aged 15 years or older who had at least one living daughter younger than 12 years via the Harar Health and Demographic Surveillance System 2013. Data were collected through face-to-face interviews. The practice of FGM was compared between mothers and their daughters. Whether the daughter had undergone FGM was included as an outcome variable in bivariate and multivariate analyses. Among 842 mothers, 669 (79.5%) reported that they had undergone FGM themselves, and 160 (19.0%) that their daughter had undergone FGM. Traditional practitioners were said to be the major performers of FGM by 151 (94.4%) mothers. Mothers whose daughter was mutilated mentioned social acceptance (144 [90.0%] women) and better marriage prospects (96 [60.0%]) as the major benefits. Genital mutilation of daughters was significantly associated with maternal age, education to grade 1-4, and FGM experience. Amhara ethnic origin was significantly associated with a reduced likelihood of FGM among daughters. Over one generation, the incidence of FGM has reduced. Increasing advocacy against FGM and enforcement of law should be emphasized. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

The fretted terrain of the Nilosyrtis Mensae region of Mars: Clues to the timing of dichotomy formation and the emplacement of the northern plains

NASA Technical Reports Server (NTRS)

Detroye, Jeff E.; Williams, Steven H.

1994-01-01

Geologic mapping of the fretted terrain of the Nilosyrtis Mensae region of Mars has revealed geomorphic evidence that the breakup of the plateau units to the south of Nilosyrtis occurred well before the plains units to the north were emplaced in the late Hesperian time. The plains units were deposited against the fretted terrain which has undergone some modification by mass wasting but not significant backwasting. The morphology observed at the contact between plains and the fretted terrain is consistent with that expected where the edge of a pile of sedimentary debris has undergone mass wasting and other erosion.

Surgical Correction of Metopic Craniosynostosis: A 3-D Photogrammetric Analysis of Cranial Vault Outcomes.

PubMed

Linden, Olivia E; Baratta, Vanessa M; Gonzalez, Jose A; Byrne, Margaret E; Klinge, Petra M; Sullivan, Stephen R; Taylor, Helena O

2018-01-01

To evaluate 3-dimensional (3-D) photogrammetry as a tool for assessing the postoperative head shape of patients who had undergone cranial vault remodeling for metopic synostosis. We prospectively analyzed images of patients with metopic craniosynostosis who had undergone anterior cranial vault remodeling and age-matched controls. To ensure standardized facial orientation, each 3-D image was positioned to "best fit" the preoperative face by aligning 6 soft tissue landmarks. Forehead measurements were taken from a standardized position behind the surface of the face to landmarks placed in a ray configuration across the forehead. Academic teaching hospital. Thirteen pediatric patients with metopic craniosynostosis who had undergone anterior cranial vault remodeling and age-matched controls. Images were taken preoperatively, immediately postoperatively, and over 1-year postoperatively. Forehead contours preoperatively and postoperatively, with statistics performed using a multivariate analysis of variance shape analysis. Mean postoperative follow-up was 1.8 (0.6) years. The average distance from the origin to forehead landmarks was 55.1 (3.4) mm preoperatively, 59.3 (0.7) mm immediate postoperatively, 59.1 (1.0) mm 1-year postoperatively, and 59.4 (0.6) mm in controls. Postoperative metopic forehead contours varied significantly from preoperative contours ( P < .01), while there was no statistical difference between the 2 postoperative time points ( P = .70). One-year postoperative patients were not significantly different from their age-matched controls ( P > .99). Preoperative metopic forehead contours varied significantly from postoperative contours. Cranial reconstructions approximated the foreheads of normal controls, and reconstructions were stable at more than 1-year follow-up.

[AT THE CROSSROADS: THE ROLE OF LABORATORY MEDICINE IN THE PATIENT CARE PROCESS].

PubMed

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.

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…

Clinical effect of pancreaticojejunostomy with a long-internal stent during pancreaticoduodenectomy in patients with a main pancreatic duct of small diameter.

PubMed

Yamamoto, Tomohisa; Satoi, Sohei; Yanagimoto, Hiroaki; Hirooka, Satoshi; Yamaki, So; Ryota, Hironori; Kotsuka, Masaya; Matsui, Yoichi; Kon, Masanori

2017-06-01

Post-operative pancreatic fistula (POPF) is one of the most common causes of death following pancreaticoduodenectomy (PD). The aim of this study was to evaluate the clinical effect of a long-internal stent on the development of POPF in patients with a main pancreatic duct diameter of 3 mm or less. Patients (N = 108) with a main pancreatic duct (≤3 mm) who underwent PD were included in this single-institution historical control study. Between January 2012 and December 2013, 54 patients had undergone PJ with a long-internal stent across the duct-to-mucosa anastomosis (long-stent group), and between February 2009 and December 2011, 54 patients had undergone PJ without a stent (control). There was no significant difference between groups (long-stent vs control) in the incidence of POPF (70% vs. 56%, p = 0.110) and grade B/C POPF (26% vs. 26%, p = 1.000). Univariate analysis identified body mass index, extent of blood loss and soft pancreatic parenchyma as risk factors related to POPF. Multivariate analysis identified extent of blood loss and soft pancreatic parenchyma as significant risk factors. Placement of a long-internal stent during PJ did not reduce POPF after PD in patients with a main pancreatic duct of small diameter. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

Post-thyroidectomy hypocalcemia: Impact on length of stay.

PubMed

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.

Mitral stenosis and percutaneous mitral valvuloplasty (part 1).

PubMed

Guérios, Enio E; Bueno, Ronaldo; Nercolini, Deborah; Tarastchuk, José; Andrade, Paulo; Pacheco, Alvaro; Faidiga, Alysson; Negrao, Stefan; Barbosa, Antonio

2005-07-01

Although the incidence and severity of rheumatic mitral stenosis have declined in developed countries, the disease is still highly prevalent in many of the poorer and most densely populated areas of the globe, remaining a major public health issue and reflecting the socioeconomic status of the region. In the last 30 years, mitral stenosis therapy has undergone a reorientation with the introduction of percutaneous mitral valvuloplasty. This manuscript is an updated review of percutaneous dilation of mitral stenosis in its different aspects, encompassing traditional techniques, technical innovations, the most significant case loads worldwide, an analysis of the procedure as well as immediate and late outcomes.

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

Smith, T. E.; Nash, C. A.

It is desired to recover Cm-244 through Cm-248 from dissolved Mark-18A targets following anion exchange processing to remove the Pu. The Cm will be sent to Oak Ridge National Laboratory (ORNL) for additional R&D. Approximately 5-8 L per quarter of a Mark-18A target will have undergone anion exchange treatment and will contain Cm. A significant portion of this volume of anion exchange raffinate solution is dissolved fission products not desired to be recovered which could be sent to waste. To reduce the amount of material being sent to ORNL, a waste and volume minimization strategy was developed and is describedmore » in this report.« less

Structural analyses for the modification and verification of the Viking aeroshell

NASA Technical Reports Server (NTRS)

Stephens, W. B.; Anderson, M. S.

1976-01-01

The Viking aeroshell is an extremely lightweight flexible shell structure that has undergone thorough buckling analyses in the course of its development. The analytical tools and modeling technique required to reveal the structural behavior are presented. Significant results are given which illustrate the complex failure modes not usually observed in simple models and analyses. Both shell-of-revolution analysis for the pressure loads and thermal loads during entry and a general shell analysis for concentrated tank loads during launch were used. In many cases fixes or alterations to the structure were required, and the role of the analytical results in determining these modifications is indicated.

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…

The Information Needs of Women Who Have Undergone Breast Cancer Surgery in the West of Turkey.

PubMed

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.

Development and significance of a fetal electrocardiogram recorded by signal-averaged high-amplification electrocardiography.

PubMed

Hayashi, Risa; Nakai, Kenji; Fukushima, Akimune; Itoh, Manabu; Sugiyama, Toru

2009-03-01

Although ultrasonic diagnostic imaging and fetal heart monitors have undergone great technological improvements, the development and use of fetal electrocardiograms to evaluate fetal arrhythmias and autonomic nervous activity have not been fully established. We verified the clinical significance of the novel signal-averaged vector-projected high amplification ECG (SAVP-ECG) method in fetuses from 48 gravidas at 32-41 weeks of gestation and in 34 neonates. SAVP-ECGs from fetuses and newborns were recorded using a modified XYZ-leads system. Once noise and maternal QRS waves were removed, the P, QRS, and T wave intervals were measured from the signal-averaged fetal ECGs. We also compared fetal and neonatal heart rates (HRs), coefficients of variation of heart rate variability (CV) as a parasympathetic nervous activity, and the ratio of low to high frequency (LF/HF ratio) as a sympathetic nervous activity. The rate of detection of a fetal ECG by SAVP-ECG was 72.9%, and the fetal and neonatal QRS and QTc intervals were not significantly different. The neonatal CVs and LF/HF ratios were significantly increased compared with those in the fetus. In conclusion, we have developed a fetal ECG recording method using the SAVP-ECG system, which we used to evaluate autonomic nervous system development.

Effects of ITS on transit system cost structures

DOT National Transportation Integrated Search

2002-10-01

The operation of public transit system has undergone significant changes over the past five decades. In the 1960s, most U.S. transit systems were privately owned and received little federal assistance. Most transit systems in the United States are cu...

Treatment of Chronic Plantar Fasciitis With Percutaneous Latticed Plantar Fasciotomy.

PubMed

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.

Obtaining Reliable Predictions of Terrestrial Energy Coupling From Real-Time Solar Wind Measurement

NASA Technical Reports Server (NTRS)

Weimer, Daniel R.

2001-01-01

The first draft of a manuscript titled "Variable time delays in the propagation of the interplanetary magnetic field" has been completed, for submission to the Journal of Geophysical Research. In the preparation of this manuscript all data and analysis programs had been updated to the highest temporal resolution possible, at 16 seconds or better. The program which computes the "measured" IMF propagation time delays from these data has also undergone another improvement. In another significant development, a technique has been developed in order to predict IMF phase plane orientations, and the resulting time delays, using only measurements from a single satellite at L1. The "minimum variance" method is used for this computation. Further work will be done on optimizing the choice of several parameters for the minimum variance calculation.

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…

Efficacy of Early Rehabilitation After Surgical Repair of Acute Aneurysmal Subarachnoid Hemorrhage: Outcomes After Verticalization on Days 2-5 Versus Day 12 Post-Bleeding.

PubMed

Milovanovic, Andjela; Grujicic, Danica; Bogosavljevic, Vojislav; Jokovic, Milos; Mujovic, Natasa; Markovic, Ivana Petronic

2017-01-01

To develop a specific rehabilitation protocol for patients who have undergone surgical repair of acute aneurysmal subarachnoid hemorrhage (aSAH), and to determine the time at which verticalization should be initiated after aSAH. Sixty-five patients who underwent acute-term surgery for aSAH and early rehabilitation were evaluated in groups: Group 1 (n=34) started verticalization on days 2-5 post-bleeding whereas Group 2 (n=31) started verticalization approximately day 12 post-bleeding. All patients were monitored for early complications, vasospasm and ischemia. Assessments of motor status, depression and anxiety (using Zung scales), and cognitive status (using the Mini-Mental State Examination (MMSE)) were conducted at discharge and at 1 and 3 months post-surgery. At discharge, Group 1 had a significantly higher proportion of patients with ischemia than Group 2 (p=0.004). Group 1 had a higher proportion of patients with hemiparesis than Group 2 three months post-surgery (p=0.015). Group 1 patients scored significantly higher on the Zung depression scale than Group 2 patients at 1 month (p=0.005) and 3 months post-surgery (p=0.001; the same applies to the Zung anxiety scale (p=0.006 and p=0.000, respectively). Group 2 patients scored significantly higher on the MMSE than those in Group 1 at discharge (p=0.040) and 1 month post-surgery (p=0.025). Early verticalization had no effect with respect to preventing early postoperative complications in this patient group. Once a patient has undergone acute surgical repair of aSAH, it is safe and preferred that rehabilitation be initiated immediately postsurgery. However, verticalization should not start prior to day 12 post-bleeding.

Effects of Space Weathering on Lunar Rocks: Scanning Electron Microscope Petrography

NASA Technical Reports Server (NTRS)

Wentworth, Susan J.; Keller, Lindsay P.; McKay, David S.

1998-01-01

Lunar rocks that have undergone direct exposure to the space weathering environment at the surface of the Moon commonly have patinas on their surfaces. Patinas are characterized by visible darkening and other changes in spectral properties of rocks. They form as a result of bombardment by micrometeorites, solar wind, and solar flares. Processes of space weathering and patina production have clearly been significant in the formation and history of the lunar regolith. It is very likely that other planetary bodies without atmospheres have undergone similar alteration processes; therefore, it is critical to determine the relationship between patinas and their host rocks in view of future robotic and remote-sensing missions to the Moon and other planetary bodies.

Adaptive evolution of the STRA6 genes in mammalian.

PubMed

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.

Duodenogastric regurgitation in hepaticoduodenostomy after excision of congenital biliary dilatation (choledochal cyst).

PubMed

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.

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…

Achilles Tendon Open Surgical Treatment With Platelet-Rich Fibrin Matrix Augmentation: Biomechanical Evaluation.

PubMed

Alviti, Federica; Gurzì, Michele; Santilli, Valter; Paoloni, Marco; Padua, Roberto; Bernetti, Andrea; Bernardi, Marco; Mangone, Massimiliano

The relationship between surgical technique and ankle biomechanical properties after surgery for acute rupture of the Achilles tendon (ATR) has not yet been fully investigated. Platelet-rich fibrin (PRF) matrices seem to play a central role in the complex processes of tendon healing. Our aim was to analyze the biomechanical characteristics, stiffness, and mechanical work of the ankle during walking in patients who had undergone surgery after ATR with and without PRF augmentation. We performed a retrospective review of all consecutive patients who had been treated with surgical repair after ATR. Of the 20 male subjects enrolled, 9 (45%) had undergone conventional open repair of the Achilles tendon using the Krackow technique (no-PRF) and 11 (55%) had undergone surgery with PRF augmentation. An additional 8 healthy subjects were included as a control group. A gait analysis evaluation was performed at 6 months after surgery. The percentage of the stance time of the operated leg, double-support time of the healthy leg, and net work of the ankle during the gait cycle showed statistically significant differences between the no-PRF and the healthy group (p < .005). No differences were found between the PRF and healthy groups. Treatment with suture and PRF augmentation could result in significant functional improvements in term of efficiency of motion. Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Veterinary parasitology teaching in China in the 21st century - Challenges, opportunities and perspectives.

PubMed

Liu, Guo-Hua; Zhang, Long-Xian; Zou, Feng-Cai; Yuan, Zi-Guo; Zhao, Guang-Hui; Hu, Min; Suo, Xun; Zhu, Xing-Quan

2018-03-15

China has made significant achievements in social-economic development in the last three decades, and the numbers of livestock and companion animals are rapidly increasing. Some advances have been made in the control and prevention of animal parasitic diseases, but there are still some significant challenges, particularly in relation to foodborne parasitic zoonoses and vector-borne diseases. In addition, new molecular (e.g., genomic and transcriptomic) technologies have been developed and are gradually being introduced into the veterinary parasitology field. Therefore, teaching of veterinary parasitology in Chinese universities has undergone significant changes over the years, in terms of topics, depth and breadth, and also in the ways in which courses are delivered. In this article, we describe the current status of veterinary parasitology teaching at the undergraduate and postgraduate levels in Chinese universities, summarise changes and improvement in veterinary parasitology teaching, and discuss the challenges and opportunities for veterinary parasitology teaching in the 21st century, including the use of new teaching technologies and the integration of the "One Health" concept into veterinary parasitology courses. Copyright © 2018 Elsevier B.V. All rights reserved.

Percutaneous drainage in conservative therapy for perforated gastroduodenal ulcers.

PubMed

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.

Institutional Breakdown? An Exploratory Taxonomy of Australian University Failure

ERIC Educational Resources Information Center

Murray, David; Dollery, Brian

2006-01-01

Australian higher education has undergone radical change aimed transforming universities into commercial enterprises less dependent on public funding. Despite some significant successes, including dramatic increases in the numbers of domestic and international students, decreased Commonwealth subsidies, and more private sector finance, there are…

The Metamorphosis of an Introduction to Computer Science.

ERIC Educational Resources Information Center

Ben-Jacob, Marion G.

1997-01-01

Introductory courses in computer science at colleges and universities have undergone significant changes in 20 years. This article provides an overview of the history of introductory computer science (FORTRAN, ANSI flowchart symbols, BASIC, data processing concepts, and PASCAL) and its future (robotics and C++). (PEN)

The Toxicity Data Landscape for Environmental Chemicals (journal)

EPA Science Inventory

Thousands of chemicals are in common use but only a portion of them have undergone significant toxicological evaluation, leading to the need to prioritize the remainder for targeted testing. To address this issue, the U.S. Environmental Protection Agency (U.S. EPA) and other orga...

Citrus fruit quality assessment; producer and consumer perspectives

USDA-ARS?s Scientific Manuscript database

Consumption of citrus fruit and juices is popular with consumers worldwide and makes an important contribution to a healthy diet. Nevertheless, consumer preferences for citrus have undergone significant changes over the last twenty years and it is important to understand what consumers are looking ...

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…

Changes in the absorption of bile acids after total colectomy in patients with an ileostomy or pouch-anal anastomosis.

PubMed

Nasmyth, D G; Johnston, D; Williams, N S; King, R F; Burkinshaw, L; Brooks, K

1989-03-01

Bile acid absorption was investigated using 75Se Taurohomocholate (SeHCAT) in controls and patients who had undergone total colectomy with either conventional ileostomy or pouch-anal anastomosis for ulcerative colitis or adenomatous polyposis. Whole-body retention of SeHCAT after 168 hours was greater in the controls than the patients who had undergone colectomy (P less than .05). Retention of SeHCAT did not differ significantly between patients with an ileostomy and patients with pouch-anal anastomosis, but patients with an ileostomy and ileal resection of more than 20 cm retained less SeHCAT than patients with a pouch-anal anastomosis (P less than .01). Analysis of fecal bile acids from ileostomies and pouches showed that bacterial metabolism of primary conjugated bile acids was greater in patients with a pouch. It was concluded that bile acid absorption was not significantly impaired by construction of a pouch compared with conventional ileostomy, but bacterial metabolism of bile acids was greater in the pouches.

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

Nasmyth, D.G.; Johnston, D.; Williams, N.S.

Bile acid absorption was investigated using /sup 75/Se Taurohomocholate (SeHCAT) in controls and patients who had undergone total colectomy with either conventional ileostomy or pouch-anal anastomosis for ulcerative colitis or adenomatous polyposis. Whole-body retention of SeHCAT after 168 hours was greater in the controls than the patients who had undergone colectomy (P less than .05). Retention of SeHCAT did not differ significantly between patients with an ileostomy and patients with pouch-anal anastomosis, but patients with an ileostomy and ileal resection of more than 20 cm retained less SeHCAT than patients with a pouch-anal anastomosis (P less than .01). Analysis ofmore » fecal bile acids from ileostomies and pouches showed that bacterial metabolism of primary conjugated bile acids was greater in patients with a pouch. It was concluded that bile acid absorption was not significantly impaired by construction of a pouch compared with conventional ileostomy, but bacterial metabolism of bile acids was greater in the pouches.« less

[Induced abortion and use of contraceptive methods among prostitutes in Almería (Spain)].

PubMed

Cabrerizo Egea, María Jesús; Barroso García, María Pilar; Rodríguez-Contreras Pelayo, Rafael

2015-01-01

To analyze the performance of induced abortion (IA) in prostitutes in Almería (Spain) and its association with the use of contraceptive methods. A cross-sectional study was conducted in 110 women. A bivariate analyses using either the χ(2) test or Fisher's exact test was carried out (significance level <0.05), with calculation of odds ratios and 95% confidence intervals. A total of 52.7% of women had undergone at least one IA. All of these women used condoms and 35.5% of them also used another contraceptive method. No statistically significant association was found between condom breakage and the performance of IA or in the use of other contraceptive methods. A high percentage of this group of women had undergone IA, despite widespread condom use. However, there was a high percentage of condom breakage and a low percentage of use of emergency contraceptive pills after risky sexual relationships. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

Carcinoma of the cervix and sexual function.

PubMed

Seibel, M M; Freeman, M G; Graves, W L

1980-04-01

Forty-six patients were interviewed more than a year after treatment for carcinoma of the cervix to establish the effects of radiation therapy and of surgical therapy on sexual feelings and performance. Group 1 consisted of 22 patients who had undergone radiation therapy for stage I, II, or III cancer of the cervix. Group 2 consisted of 20 patients who had undergone hysterectomy with or without partial vaginectomy for carcinoma in situ. The irradiated patients experienced statistically significant decreases in sexual enjoyment, ability to attain orgasm, libido, frequency of intercourse, opportunity, and sexual dreams. The surgically treated group had no significant change in sexual function after treatment. Both groups experienced a change in self-image but did not feel that their partners or family viewed them differently. Myths about cancer and the actual effects of pelvic irradiation were found to have disrupted the sexual-marital relationships of many women. Therapeutic programs are discussed through which women can be helped through this difficult time in their lives.

Graft-versus-host disease after radiation therapy in patients who have undergone allogeneic stem cell transplantation: two case reports.

PubMed

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?

PubMed

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.

United States state-level population estimates: Colonization to 1999

Treesearch

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...

Creative Problem Solving as Sequential BVSR: Exploration (Total Ignorance) versus Elimination (Informed Guess)

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…

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…

Recent Developments in Intellectual Property Law: Avoiding Traps in the Pursuit of University Research

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.…

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

Treatment of male urethral strictures - possible reasons for the use of repeated dilatation or internal urethrotomy rather than urethroplasty.

PubMed

Heyns, C F; van der Merwe, J; Basson, J; van der Merwe, A

2012-07-16

To investigate the possible reasons for repeated urethral dilatation or optical internal urethrotomy rather than urethroplasty in the treatment of male urethral strictures. Men referred to the stricture clinic of our institution during the period April 2007 - March 2008 were reviewed and the operative urological procedures performed in the same period were analysed. Statistical analysis was performed using Student's t-test and Fisher's exact test (p<0.05 statistically significant). The mean age of the 125 men was 49.9 years (range 12.8 - 93.4 years). Previous stricture treatment had been given 1 - 2, 3 - 4 and 5 - 6 times in 52%, 32% and 12% of patients, respectively (4% had not undergone treatment). In these groups, previous treatment was dilatation in 70%, 76% and 72%, urethrotomy in 26%, 15% and 28%, and urethroplasty in 4%, 9% and 0, respectively. The group with 5 - 6 compared with 1 - 2 previous treatments was significantly older (mean age 60.2 v. 46.6 years) and had a significantly greater proportion with underlying co-morbidities (80% v. 52%). The group that had undergone urethroplasty compared with 5 - 6 repeated dilatations or urethrotomies was significantly younger (mean age 48.2 v. 60.2 years) with a lower prevalence of co-morbidities (47% v. 80%). During the study period urethroplasty was performed in 16 (2%) of 821 inpatients, whereas 55 men were seen who had undergone ≥3 previous procedures, indicating that urethroplasty was performed in less than one-third of cases in which it would have been the optimal treatment. Owing to limited theatre time, procedures indicated for malignancy, urolithiasis, renal failure and congenital anomalies were performed more often than urethroplasty. Factors that possibly influenced the decision to perform repeated urethrotomy or dilatation instead of urethroplasty were limited theatre time, increased patient age and the presence of underlying co-morbidities.

Tradition, Discipline, Literary History

ERIC Educational Resources Information Center

Kargiotis, Dimitrios

2007-01-01

In its attempt to respond to changing historical realities the university has undergone significant transformations, most of which, however, have focused on teaching material, tools, methods or practices adapted to the new demands. Taking as a case study the literary disciplines, this article focuses on the theoretical, mostly implicit,…

"Doi Moi" (Renovation) and Higher Education Reform in Vietnam

ERIC Educational Resources Information Center

Thanh, Pham Thi Hong

2011-01-01

Vietnam has experienced significant social, economic, political, and educational changes during the last two decades since the "Doi Moi" policy was implemented. To respond to new requirements required by the global economy, Vietnamese education has undergone remarkable reforms. This article critically examines these reforms in three…

Collegial Participation in University Governance: A Case Study of Institutional Change

ERIC Educational Resources Information Center

Meyer, Luanna H.

2007-01-01

New Zealand universities have undergone significant structural change accompanied by declining public funding and increasing demands for accountability in recent years. In 2000, one of the country's largest universities redirected resources and funding in a "repositioning" exercise that resulted in redundancies and other consequences…

A Missing Link? Contemporary Insights into Principal Preparation and Training in Russia

ERIC Educational Resources Information Center

Bysik, Nadezhda; Evstigneeva, Nadezhda; Isaeva, Natalia; Kukso, Katsiaryna; Harris, Alma; Jones, Michelle

2015-01-01

Over the last decade, the Russian education system has undergone significant transformation that has radically changed the expectations placed upon the school principals. This current reform process has placed far greater responsibilities and accountabilities upon principals to secure school effectiveness and improved student learning outcomes.…

A Review of Selected Ecosystem Services Supplied by Coastal Wetlands of the Laurentian Great Lakes

EPA Science Inventory

Significant ecosystem services derive from the coastal wetlands of the Laurentian Great Lakes even though they have undergone substantial declines since European settlement. Basin-wide, two-thirds of the original coastal wetlands have been lost, and the remaining 126,000 ha of US...

Apraxia and the Parietal Lobes

ERIC Educational Resources Information Center

Goldenberg, Georg

2009-01-01

The widely held belief in a central role of left parietal lesions for apraxia can be traced back to Liepmann's model of a posterior to anterior stream converting mental images of intended action into motor execution. Although this model has undergone significant changes, its modern descendants still attribute the parietal contribution to the…

Teaching and Learning Centres: Towards Maturation

ERIC Educational Resources Information Center

Challis, Di; Holt, Dale; Palmer, Stuart

2009-01-01

Approximately 70% of Australian Teaching and Learning Centres have been restructured and/or have undergone leadership changes in the last three years. The volatility of this environment reflects the number of significant challenges faced by Teaching and Learning Centres. In determining what makes Centres successful, the issues that are likely to…

School Business Administration: A Planning Approach. Third Edition.

ERIC Educational Resources Information Center

Candoli, I. Carl; And Others

The school business administration function in the operation of American schools has undergone dramatic changes during the past several years. Changing demographics, high technology, the movement to professionalize school administration, and changes by the legislative and judicial systems have all had significant impact on the character of school…

Evaluating Causes of Ecological Impairments in the Estuaries of Ukraine

EPA Science Inventory

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. ...

Impact of surgery on quality of life in Crohn´s disease patients: final results of Czech cohort.

PubMed

Kunovský, Lumír; Mitas, Ladislav; Marek, Filip; Dolina, Jiri; Poredska, Karolina; Kucerova, Lenka; Benesova, Klara; Kala, Zdeněk

2018-01-01

Crohns disease (CD) belongs to chronic diseases that highly affect the patient´s quality of life (QoL). The effect of the disease and impairment of QoL in CD patients is already known. The aim was to assess how surgical treatment influences the patients QoL and determine factors that can affect postoperative QoL. We compared the QoL before and after surgery in patients who had undergone a bowel resection at our department due to CD between 2010-2016. The patients filled in a standardized QLQ-CR29 questionnaire to assess QoL in the preoperative period and the postoperative period after a 2-month interval. The control groups were CD patients who had not undergone surgical treatment (bowel resection) and a healthy cohort. In the QoL evaluation, 132 patients with CD who had undergone surgery (bowel resection), 83 patients with CD without an operation and 104 healthy subjects were enrolled. 104 of the operated patients experienced a postoperative improvement of the overall QoL (78.8 %), 2 patients did not register any changes in QoL (1.5 %) and 26 patients (19.7 %) experienced a worsening of their postoperative QoL. The results were statistically significant (p < 0.001). We detected a significant improvement of the overall QoL after surgical resection in CD patients (measured 2 months after surgery). Gender was identified as the only statistically relevant factor with influence on postoperative QoL.Key words: bowel resection - Crohn´s disease - Czech cohort - inflammatory bowel disease - quality of life - surgical treatment.

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.

PubMed

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.

Risk factors for infection development after transrectal prostate biopsy and the role of resistant bacteria in colonic flora.

PubMed

Eruz, Emine Dilek; Yalci, Aysun; Ozden, Eriz; Aslaner, Halide; Ogucu-Durgun, Suna; Koseoglu-Taymur, Deniz Derya; Memikoglu, Kemal Osman; Erdem, Hakan; Kurt, Halil

2017-02-28

In this study, we aimed to identify risk factors for the development of infectious complications after prostate biopsy and to investigate the role of intestinal colonization of bacteria that are resistant to prophylactic antibiotics. A total of 168 patients who had undergone transrectal prostate biopsy (TRPB) under ciprofloxacin and gentamycin prophylaxis were included in the study. Stool cultures and subsequent antibiotic susceptibility testing were performed in all patients before the start of antibiotic prophylaxis. Of the 168 patients, 17 (10.1%) developed urinary tract infection (UTI), while 6 (3.57%) developed sepsis within seven days after biopsy. Ciprofloxacin-resistant bacterial colonization was detected in 81 (48.2%) of the patients. None of the patients with ciprofloxacin-sensitive bacteria in intestinal flora developed a UTI. The colonization of intestinal ciprofloxacin-resistant bacteria increased UTI risk significantly after TRPB (p < 0.0001). Urolithiasis history, presence of permanent urinary catheterization, hospitalization history for more than 48 hours in the last year, and recent antibiotic usage significantly increased UTI risk after TRPB. Development of an infection was more frequent in patients with resistant bacterial colonization. We hope to guide more comprehensive studies designed to find a standard prophylactic regimen for TRPB that can be used all over the world.

Analysis on the relationship between economic development and water environment pollution in Shandong province

NASA Astrophysics Data System (ADS)

Liu, Yi; Zhang, Zhengxian

2018-02-01

With the continuous development of the economy of the Shandong Province watershed, a large number of pollutant emission, resulting in water quality of the basin has undergone significant changes. To study the Shandong Province watershed economic development and the relationship between the discharge of pollutants, in this paper, the relationship between economic growth and pollutant emissions in the Shandong Province watershed was established by Shandong Province watershed in 2002-2015 per capita GDP and wastewater, COD, ammonia nitrogen(AN) pollutant emissions. The data were analyzed by software such as SPSS, and the cubic equation model between various pollutants and economic indexes was fitted. To further make the relationship between pollutants and economic development map to study the conventional pollutant emissions and economic development trends. It is found that only the relationship between industrial wastewater discharge and per capita GDP is most coordinated, that is, industrial wastewater emissions with the continuous development of the basin economy, showing a tendency to rise first and then fall. Finally, ultimately based on the results of the study of the water environment and economic development proposals were proposed.

The effects of a smoking cessation programme on health-promoting lifestyles and smoking cessation in smokers who had undergone percutaneous coronary intervention.

PubMed

Park, Ai Hee; Lee, Suk Jeong; Oh, Seung Jin

2015-04-01

Smoking is a major risk factor for not only the occurrence of myocardial ischaemia but also recurrences of vascular stenosis. This study aimed to evaluate health-promoting lifestyles and abstinence rate after a smoking cessation programme. Sixty-two smokers who had undergone percutaneous coronary intervention were randomly assigned to either the experimental or control group. The experimental group (n = 30) received 10 phone counselling sessions and 21 short message service messages for abstinence and coronary disease prevention, whereas the control group (n = 32) received only the standard education. After the intervention, 14 members of the experimental group had switched to a non-smoking status, confirmed biochemically; moreover, their physical activity and stress management scores increased significantly. However, self-efficacy of smoking cessation was not reflected in the cotinine levels. Thus, it is necessary not only to increase self-efficacy but also to determine the factors that affect the success of smoking cessation so that they can be included in the intervention. Our results suggest that phone counselling and short message service messaging might be important tools for the realization of smoking cessation and lifestyle changes among patients who have undergone percutaneous coronary intervention. © 2013 Wiley Publishing Asia Pty Ltd.

Incremental Role of Mammography in the Evaluation of Gynecomastia in Men Who Have Undergone Chest CT.

PubMed

Sonnenblick, Emily B; Salvatore, Mary; Szabo, Janet; Lee, Karen A; Margolies, Laurie R

2016-08-01

The purpose of this study was to determine whether additional breast imaging is clinically valuable in the evaluation of patients with gynecomastia incidentally observed on CT of the chest. In a retrospective analysis, 62 men were identified who had a mammographic diagnosis of gynecomastia and had also undergone CT within 8 months (median, 2 months). We compared the imaging findings of both modalities and correlated them with the clinical outcome. Gynecomastia was statistically significantly larger on mammograms than on CT images; however, there was a high level of concordance in morphologic features and distribution of gynecomastia between mammography and CT. In only one case was gynecomastia evident on mammographic but not CT images, owing to cachexia. Two of the 62 men had ductal carcinoma, which was obscured by gynecomastia. Both of these patients had symptoms suggesting malignancy. The appearance of gynecomastia on CT scans and mammograms was highly correlated. Mammography performed within 8 months of CT is unlikely to reveal cancer unless there is a suspicious clinical finding or a breast mass eccentric to the nipple. Men with clinical symptoms of gynecomastia do not need additional imaging with mammography to confirm the diagnosis if they have undergone recent cross-sectional imaging.

Health-related quality of life of hematopoietic stem cell transplant childhood survivors: state of the science.

PubMed

Tanzi, Elizabeth M

2011-01-01

The notion of health-related quality of life (HRQoL) holds unique significance in the treatment of patients who have undergone hematopoietic stem cell transplantation (HSCT). Not only is transplant procedure inevitably associated with immediate and late medical effects along with high mortality and morbidity rates, but it can also significantly affect the HRQoL for the patient and family. This review of literature will assist advanced practice nurses and pediatric oncology nurses in distinguishing and targeting interventions for patients and families who are at high risk of encountering distress during and following HSCT. It provides information on the assessment of pre-HSCT variables to identify patient subgroups in need of more aggressive supportive care to improve HRQoL during transplant. Furthermore, it serves as a guideline for developing interventional strategies and the role of the advanced practice nurse and pediatric oncology nurse caring for the patient throughout and following transplant.

Photorefractive keratectomy (PRK) at 193 nm using an erodible mask: new developments and clinical progress

NASA Astrophysics Data System (ADS)

Gordon, Michael; Seiler, Theo; Carey, Joseph P.; Friedman, Marc D.; Johnsson, N. M. F.; King, Michael C.; Muller, David F.

1993-06-01

This paper reports on our progress using an erodible mask to perform photorefractive keratectomy (PRK) for the correction of myopic astigmatism. We describe modifications to the mask, the mask eye cup and the surgical microscope aimed at simplifying the procedure and improving the ergonomics of the hardware. We report the clinical results of the post-op exam for 20 patients who have undergone PRK for myopic astigmatism under a Phase IIA study. The results compare favorably with an earlier Phase IIA study for performing PRK with a computer-controlled iris. Most important, the clinical data show the absence of any significant corneal haze and no significant decrease in spectacle corrected visual acuity. Although more long term follow-up is needed, the preliminary results support the safety and effectiveness of using an erodible mask to perform PRK for myopic astigmatism.

Analysis of the significance of the measurement of acceleration with respect to lateral laxity of the anterior cruciate ligament insufficient knee.

PubMed

Yoshimura, I; Naito, M; Hara, M; Zhang, J

2000-01-01

The purpose of this study was to assess dynamically the lateral thrust of anterior cruciate ligament (ACL) insufficient knees, and from the findings determine any relationship between ACL insufficiency and the later development of osteoarthritis (OA). We investigated 80 knees in 40 patients awaiting ACL reconstruction and 25 knees of 25 patients, which had undergone ACL reconstruction. An acceleration sensor was fixed to the anterior tibial tubercle and this 'acted' in two directions--medial lateral and perpendicular. The peak value of the lateral acceleration immediately after heel strike was significantly greater in the ACL insufficient knees when compared to their opposite normal knees. When the periods from injury were compared, the lateral thrust of the injured side after 3 years or more was significantly greater than in the first 3 years. There was no significant difference between the normal knees and the ACL reconstructed knees. The results indicated that the lateral acceleration peak value was significantly greater in the ACL insufficient knees than in their opposite normal knees.

Chemical transfers along slowly eroding catenas developed on granitic cratons in southern Africa

USGS Publications Warehouse

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.

Watershed modeling and development of ecological flows in the Apalachicola-Chattahoochee-Flint River Basin, Alabama, Florida, and Georgia

Treesearch

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...

Dissecting cancer evolution at the macro-heterogeneity and micro-heterogeneity scale.

PubMed

Barber, Louise J; Davies, Matthew N; Gerlinger, Marco

2015-02-01

Intratumour heterogeneity complicates biomarker discovery and treatment personalization, and pervasive cancer evolution is a key mechanism leading to therapy failure and patient death. Thus, understanding subclonal heterogeneity architectures and cancer evolution processes is critical for the development of effective therapeutic approaches which can control or thwart cancer evolutionary plasticity. Current insights into heterogeneity are mainly limited to the macroheterogeneity level, established by cancer subclones that have undergone significant clonal expansion. Novel single cell sequencing and blood-based subclonal tracking technologies are enabling detailed insights into microheterogeneity and the dynamics of clonal evolution. We assess how this starts to delineate the rules governing cancer evolution and novel angles for more effective therapeutic intervention. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Comparative evaluation of monocular augmented-reality display for surgical microscopes.

PubMed

Rodriguez Palma, Santiago; Becker, Brian C; Lobes, Louis A; Riviere, Cameron N

2012-01-01

Medical augmented reality has undergone much development recently. However, there is a lack of studies quantitatively comparing the different display options available. This paper compares the effects of different graphical overlay systems in a simple micromanipulation task with "soft" visual servoing. We compared positioning accuracy in a real-time visually-guided task using Micron, an active handheld tremor-canceling microsurgical instrument, using three different displays: 2D screen, 3D screen, and microscope with monocular image injection. Tested with novices and an experienced vitreoretinal surgeon, display of virtual cues in the microscope via an augmented reality injection system significantly decreased 3D error (p < 0.05) compared to the 2D and 3D monitors when confounding factors such as magnification level were normalized.

Can the global carbon budget be balanced?

USGS Publications Warehouse

Markewich, Helaine W.; Bliss, Norman B.; Stallard, Robert F.; Sundquist, Eric T.

1997-01-01

The Mississippi Basin Carbon Project of the U.S. Geological Survey (USGS) is an effort to examine interactions between the global carbon cycle and human-induced changes to the land surface, such as farming and urbanization. Investigations in the Mississippi River basin will provide the data needed for calculating the global significance of land-use changes on land-based carbon cycling. These data are essential for predicting and mitigating the effects of global environmental change.The Mississippi Basin Carbon Project is focused on the third largest river system in the world. The Mississippi River and its tributaries drain more than 40% of the conterminous United States. The basin includes areas that typify vast regions of the Earth's surface that have undergone human development.

The Cold War is Over. What Now?

DOE R&D Accomplishments Database

Hecker, S. S.

1995-04-01

As you might imagine, the end of the Cold War has elicited an intense reexamination of the roles and missions of institutions such as the Los Alamos National Laboratory. During the past few years, the entire defense establishment has undergone substantial consolidation, with a concomitant decrease in support for research and development, including in areas such as materials. The defense industry is down-sizing at a rapid pace. Even universities have experienced significant funding cutbacks from the defense community. I view this as a profound time in history, bringing changes encompassing much more than just the defense world. In fact, support for science and technology is being reexamined across the board more completely than at any other time since the end of World War II.

Prevalence of Late Functional Tricuspid Regurgitation in Degenerative Mitral Regurgitation Surgery.

PubMed

Vaturi, Mordehay; Kotler, Tali; Shapira, Yaron; Weisenberg, Daniel; Monakier, Daniel; Sagie, Alexander

2016-03-01

Although significant late tricuspid regurgitation (TR) may develop after surgery for degenerative mitral regurgitation (MR), the use of routine tricuspid annuloplasty is debatable. The study aim was to determine the prevalence and predictors of significant late TR after surgery for degenerative MR. A total of 112 patients who had undergone surgery for degenerative MR without concomitant tricuspid valve repair (average follow up 7.7 ± 4.0 years) was studied retrospectively. The prevalence of post-surgical TR and predictors of progression were determined. The majority of patients (97%) had non-significant TR (less than moderate) prior to surgery, although an overall trend of progression towards significant TR (grades 2 or 3) was noted in 17 patients (p = 0.0006). Of the 18 patients (16%) with late postoperative significant TR, only nine (8%) had severe TR with only a single referral to surgery. New-onset post-surgical atrial fibrillation was more common in patients who developed late significant TR (p = 0.002). Multivariate analysis of the pre-surgery variables, age >65 years and left ventricular dysfunction were shown to be independent predictors of late functional TR. Significant progression in TR after surgery for degenerative MR was rare in this patient cohort. The impact of older age and left ventricular dysfunction at the time of surgery showed a strong association with post-surgical atrial fibrillation.

The Dynamic Flux of Continuing Higher Education: Redefining the New Roles, Responsibilities, and Expectations

ERIC Educational Resources Information Center

Braverman, Lisa R.

2013-01-01

Continuing higher education has undergone a significant transformation in recent years, illustrated by such innovations as MOOCs, globalization, strategic collaborations with government and industry, and increased entrepreneurship. As a result, continuing education (CE) units have experienced a fundamental shift in the way they conduct business in…

Reaching the Underserved: Complementary Models of Effective Schooling

ERIC Educational Resources Information Center

DeStefano, Joseph; Moore, Audrey-Marie Schuh; Balwanz, David; Hartwell, Ash

2007-01-01

Many countries that have undergone expansion of access to public education still face significant disparities in school enrollment and attendance rates at sub-national levels, and fail to reach a high proportion of children who are outside of the government system. Completion and student learning have also continued to be system-wide challenges…

The Value of School Librarian Support in the Digital World

ERIC Educational Resources Information Center

Ballew, Linda M.

2014-01-01

The mission of school librarians in the digital age of information gathering and messaging has not undergone any real change of focus. Even though the tools and methods available for accessing information have significantly altered the way people now use library services, school libraries remain a constant place to make valuable discoveries. The…

Student Perceptions to Teaching Undergraduate Anatomy in Health Sciences

ERIC Educational Resources Information Center

Anderton, Ryan S.; Chiu, Li Shan; Aulfrey, Susan

2016-01-01

Anatomy and physiology teaching has undergone significant changes to keep up with advances in technology and to cater for a wide array of student specific learning approaches. This paper examines perceptions towards a variety of teaching instruments, techniques, and innovations used in the delivery and teaching of anatomy and physiology for health…

The Impact of the School-Based Psychosocial Structured Activities (PSSA) Program on Conflict-Affected Children in Northern Uganda

ERIC Educational Resources Information Center

Ager, Alastair; Akesson, Bree; Stark, Lindsay; Flouri, Eirini; Okot, Braxton; McCollister, Faith; Boothby, Neil

2011-01-01

Background: Children in northern Uganda have undergone significant psychosocial stress during the region's lengthy conflict. A Psychosocial Structured Activities (PSSA) program was implemented in 21 schools identified as amongst those most severely affected by conflict-induced displacement across Gulu and Amuru Districts. The PSSA intervention…

Parents' Perceptions of the Usefulness of Chromosomal Microarray Analysis for Children with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Reiff, Marian; Giarelli, Ellen; Bernhardt, Barbara A.; Easley, Ebony; Spinner, Nancy B.; Sankar, Pamela L.; Mulchandani, Surabhi

2015-01-01

Clinical guidelines recommend chromosomal microarray analysis (CMA) for all children with autism spectrum disorders (ASDs). We explored the test's perceived usefulness among parents of children with ASD who had undergone CMA, and received a result categorized as pathogenic, variant of uncertain significance, or negative. Fifty-seven parents…

Spatial and temporal dynamics of disturbance interactions along an ecological gradient

Treesearch

Christopher D. O' Connor

2013-01-01

Interactions among site conditions, disturbance events, and climate determine the patterns of forest species recruitment and mortality across landscapes. Forests of the American Southwest have undergone significant changes over a century of altered disturbance regimes, human land uses, and changing environmental conditions. Along steep vertical gradients such as those...

Stress among Greek and Cypriot University Administrators: An Exploratory Study

ERIC Educational Resources Information Center

Lazaridou, Angeliki; Athanasoula-Reppa, Anastasia; Fris, Joe

2008-01-01

Over the past few decades universities and colleges have undergone changes that have increased the complexity of academic managers' roles. There is some evidence now that these managers have come to experience significant role ambiguity, conflict, stress, and other negative effects--and that their wellbeing has been compromised. However, the…

Market Segmentation and the Restructuring of Banking Jobs. IEE Brief Number 24.

ERIC Educational Resources Information Center

Hughes, Katherine; Bernhardt, Annette

The banking industry has undergone marked changes over the past 20 years, driven by deregulation and new technologies. Two strategies have emerged: the low-cost transaction approach and the high-road relationship banking approach. The number of employees in commercial banking has fallen significantly, and average hourly earnings for nonmanagerial…

Pros and Cons: Compulsory 12 Year Education Reform in Turkey

ERIC Educational Resources Information Center

Kasa, Basak; Ersöz, Yasemin

2016-01-01

Turkey has undergone two significant education reforms in the last two decades. In 1997, the compulsory education period was increased from five years to eight years with the unification of primary school (five years) and middle school (three years) and vocational middle schools were dismissed. In 2012, compulsory education was increased from…

Language Transfer in Language Learning. Language Acquisition & Language Disorders 5.

ERIC Educational Resources Information Center

Gass, Susan M., Ed.; Selinker, Larry, Ed.

The study of native language influence in Second Language Acquisition has undergone significant changes over the past few decades. This book, which includes 12 chapters by distinguished researchers in the field of second language acquisition, traces the conceptual history of language transfer from its early role within a Contrastive Analysis…

Tough Questions Facing Women's Colleges

ERIC Educational Resources Information Center

Kratzok, Sara

2010-01-01

Since their creation in the latter part of the nineteenth century, women's colleges in America have undergone many significant changes. In 1960, over 230 women's colleges were in operation; over the next forty years more than 75 percent chose to admit men or shut their doors entirely (Miller-Bernal, 2006a). This chapter will shed light on the…

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…

The Development of Science Education Research in Brazil and Contributions from the History and Philosophy of Science

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…

Vulnerability of Internally Displaced Children in Disaster Relief Camps of Pakistan: Issues, Challenges, and Way Forward

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…

Revitalization of open apex teeth with apical periodontitis using a collagen-hydroxyapatite scaffold.

PubMed

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

EPA Science Inventory

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...

Characterizing Early Psychosocial Functioning of Parents of Children with Moderate to Severe Genital Ambiguity due to Disorders of Sex Development.

PubMed

Suorsa, Kristina I; Mullins, Alexandria J; Tackett, Alayna P; Reyes, Kristy J Scott; Austin, Paul; Baskin, Laurence; Bernabé, Kerlly; Cheng, Earl; Fried, Allyson; Frimberger, Dominic; Galan, Denise; Gonzalez, Lynette; Greenfield, Saul; Kropp, Bradley; Meyer, Sabrina; Meyer, Theresa; Nokoff, Natalie; Palmer, Blake; Poppas, Dix; Paradis, Alethea; Yerkes, Elizabeth; Wisniewski, Amy B; Mullins, Larry L

2015-12-01

We examined the psychosocial characteristics of parents of children with disorders of sex development at early presentation to a disorders of sex development clinic. Parental anxiety, depression, quality of life, illness uncertainty and posttraumatic stress symptoms were assessed. Additionally we evaluated the relationship of assigned child gender to parental outcomes. A total of 51 parents of children with ambiguous or atypical genitalia were recruited from 7 centers specializing in treatment of disorders of sex development. At initial assessment no child had undergone genitoplasty. Parents completed the Cosmetic Appearance Rating Scale, Beck Anxiety Inventory, Beck Depression Inventory, SF-36, Parent Perception of Uncertainty Scale and Impact of Event Scale-Revised. A large percentage of parents (54.5%) were dissatisfied with the genital appearance of their child, and a small but significant percentage reported symptoms of anxiety, depression, diminished quality of life, uncertainty and posttraumatic stress. Few gender differences emerged. Although many parents function well, a subset experience significant psychological distress around the time of diagnosis of a disorder of sex development in their child. Early screening to assess the need for psychosocial interventions is warranted. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

[New perspectives of mourning].

PubMed

Csikós, Ágnes; Menyhért, Mónika; Radványi, Ildikó; Busa, Csilla

2015-09-27

Grief is a natural part of life and it is always individual. Researchers have tried and still try to develop different theories to interpret, explain, and approach this particular phenomenon. The aim of the authors was to review the theoretical literature of mourning and to present new bereavement theories for domestic professionals. From the first half of the 20th century until presently mourning theories have undergone significant changes. Today the determinant models includes the flexible, coping-oriented dual process model, meaning reconstruction model which focuses on the meaning making, and the model which focuses on the development after the loss. The authors conclude that experts, who work in the clinical area should know the prevailing theories of grief, because they encounter often with loss at work. The presented models may contribute to more efficient work, to better understanding of the mourning process and to a better support of families.

Representations in plastic surgery: the impact of self-image and self-confidence in the work environment.

PubMed

Foustanos, A; Pantazi, L; Zavrides, H

2007-01-01

This research was initiated by the authors' conviction that many people currently pay great attention to their personal appearance, which is directly linked to their self-confidence. The external image of individuals appears to have a decisive influence on their behavior and personal choices regarding both their personal and professional lives. Accordingly, it can be assumed that appearance influences professional choices and development. Moreover, individuals associate increased self-confidence with positive social images. Therefore, the main variables used in this study were self-image, self-confidence, and work environment. For the purpose of this study, the authors developed a questionnaire and distributed it to a sample of 100 women who had undergone aesthetic plastic surgery. The aim of the questionnaire was to discover the opinion of these women concerning the aforementioned assumptions. After the data processing and analysis, the authors concluded that the aforementioned variables are statistically significant and correlated.

From Index Catalogue to Gopher space: changes in our profession as reflected in the Handbook and CPHSL.

PubMed Central

Bunting, A

1994-01-01

A fifty-year review of the history of health sciences librarianship, as reflected in four editions of the Handbook of Medical Library Practice and its successor, Current Practice in Health Sciences Librarianship, illustrates the significant changes our profession has undergone. Publication in 1943 of the first edition of the Handbook marked an important milestone in the development of the Medical Library Association, as a group of dedicated volunteers documented standard practice and recorded useful data. Administration of health sciences libraries has moved from art to science. Responsibility for the development of collections is now the sole purview of professional librarians. Automation and bibliographic standards have revolutionized the methods for controlling and providing access to information resources. And, the means by which assistance is provided to library users, through the use of computer and telecommunications technology, has changed dramatically. PMID:8136754

Correlation of Lactate Concentration in Peripheral Plasma and Cerebrospinal Fluid with Glasgow Outcome Scale for Patients with Tuberculous Meningitis Complicated by Acute Hydrocephalus Treated with Fluid Diversions.

PubMed

Faried, Ahmad; Arief, Gusman; Arifin, Muhammad Z; Nataprawira, Heda M

2018-03-01

Tuberculous meningitis (TBM) is an endemic infectious disease in developing countries, and it can become a serious illness in children. Treatment of TBM is more difficult and prone to failure than treatment of pulmonary tuberculosis. TBM causes hydrocephalus, cerebral edema, increased intracranial pressure, global ischemia, and neurologic deficits, which disturb cellular metabolism and increase lactate levels. A reliable, widely available clinical indicator of TBM severity is needed. Successful treatment of TBM is assessed using the Glasgow Outcome Scale (GOS). This prospective cohort study included 34 patients with TBM and acute hydrocephalus who had undergone fluid diversions and were admitted to Dr. Hasan Sadikin Hospital in Bandung from 2014 to 2015. A portable machine for blood glucose measurement was used to measure lactate concentrations. Statistical significance was defined as P ≤ 0.05. Average levels of plasma and cerebrospinal fluid (CSF) lactate were 1.99 ± 0.70 mmol/L and 3.04 ± 1.05 mmol/L, respectively. A significantly higher level of lactate was observed in CSF compared with plasma. Preoperative plasma lactate was negatively correlated to GOS (r = -0.539; P = 0.013), and CSF lactate was negatively correlated to GOS (r = -0.412; P = 0.027). Average lactate levels in CSF (central) were higher than plasma (peripheral) levels. GOS scale of patients decreased with increased plasma and CSF lactate levels. Examination of plasma and CSF lactate levels should be included in routine examinations to determine extent of cellular damage and GOS score in patients with TBM and acute hydrocephalus who have undergone fluid diversions. Copyright © 2017 Elsevier Inc. All rights reserved.

Biomaterials and Nanotherapeutics for Enhancing Skin Wound Healing

PubMed Central

Das, Subhamoy; Baker, Aaron B.

2016-01-01

Wound healing is an intricate process that requires complex coordination between many cell types and an appropriate extracellular microenvironment. Chronic wounds often suffer from high protease activity, persistent infection, excess inflammation, and hypoxia. While there has been intense investigation to find new methods to improve cutaneous wound care, the management of chronic wounds, burns, and skin wound infection remain challenging clinical problems. Ideally, advanced wound dressings can provide enhanced healing and bridge the gaps in the healing processes that prevent chronic wounds from healing. These technologies have great potential for improving outcomes in patients with poorly healing wounds but face significant barriers in addressing the heterogeneity and clinical complexity of chronic or severe wounds. Active wound dressings aim to enhance the natural healing process and work to counter many aspects that plague poorly healing wounds, including excessive inflammation, ischemia, scarring, and wound infection. This review paper discusses recent advances in the development of biomaterials and nanoparticle therapeutics to enhance wound healing. In particular, this review focuses on the novel cutaneous wound treatments that have undergone significant preclinical development or are currently used in clinical practice. PMID:27843895

A survey of the satisfaction of patients who have undergone implant surgery with and without employing a computer-guided implant surgical template

PubMed Central

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

Management of epithelial ingrowth after laser in situ keratomileusis on a tertiary care cornea service.

PubMed

Rapuano, Christopher J

2010-03-01

To review the management of epithelial ingrowth after laser in situ keratomileusis (LASIK) on the Wills Eye Institute Cornea Service from 1996 through 2007. Data of all patients referred to the Wills Eye Cornea Service after having undergone LASIK were reviewed. Charts of all patients with the diagnosis of epithelial ingrowth were analyzed. Data included patient demographics, previous ocular history, visual acuity, size and location of the ingrowth, and management. Additional data on eyes that underwent removal of the ingrowth at Wills were obtained. Three hundred five patients (153 female and 152 male, mean age: 44.7 years) were referred for eye problems after LASIK during the study period. Epithelial ingrowth was confirmed in 46 patients (15%) (19 female and 27 male, mean age: 47.4 years) involving 55 eyes (27 right and 28 left). Patients with epithelial ingrowth were seen at a mean of 26 months after LASIK (range: 0.5-108 months). Twenty-four eyes had undergone previous enhancements, 2 twice. Fourteen eyes had undergone previous removal of epithelial ingrowth, 8 more than once (range: 2-8). In 35 eyes, simple observation was recommended. In 7 eyes, epithelial removal was recommended to the referring physician. Thirteen eyes underwent flap lift and epithelial removal at Wills Eye; 9 included flap suturing. One eye required repeat treatment with flap suturing and fibrin glue, after which no recurrence was found. In the other 12 eyes, there was no recurrence in 9, small recurrences in 2, and a large recurrence in 1 eye (mean follow-up: 16 months). Epithelial ingrowth after LASIK is not rare in our referral practice. Mild ingrowth can be observed, whereas significant ingrowth can respond well to removal with a low chance of significant recurrence.

Comparison of Ovulation Induction Protocols After Endometrioma Resection

PubMed Central

Yasa, Cenk; Dural, Ozlem; Mutlu, Mehmet Firat; Celik, Cem; Ugurlucan, Funda Gungor; Buyru, Faruk

2014-01-01

Background and Objectives: The aim of this study was to compare the in vitro fertilization (IVF) outcomes of long gonadotropin-releasing hormone agonist (GnRH-a) and GnRH-antagonist (GnRH-ant) protocols in endometriosis patients who have undergone laparoscopic endometrioma resection surgery. To our knowledge, there is no study in the current literature that compares the effectiveness of long GnRH-a and GnRH-ant protocols in management of IVF cycles in endometriosis patients who underwent laparoscopic endometrioma resection surgery. Methods: Eighty-six patients with stage III to IV endometriosis who had undergone laparoscopic resection surgery for endometrioma were divided into 2 groups: those who had ovarian stimulation with a long GnRH-a protocol (n = 44), and those who had ovarian stimulation with a GnRH-ant protocol (n = 42). Results: The number of follicles on human chorionic gonadotropin injection day, duration of hyperstimulation, number of retrieved metaphase II oocytes, and total number of grade 1 embryos were statically significantly higher in the long GnRH-a protocol. There were no significant differences in positive β-human chorionic gonadotropin pregnancy rates (25% vs 21.4%; P = .269) and ongoing pregnancy rates per patient (20.5% vs 19.1%; P = .302) between the 2 protocols. Conclusions: Long GnRH-a and GnRH-ant protocols both present similar IVF outcomes in patients with endometriosis who have undergone laparoscopic endometrioma resection surgery. A long GnRH-a protocol may lead to a higher number of embryos that can be cryopreserved, providing the possibility of additional embryo transfers without having to go through the process of ovarian stimulation again. PMID:25392665

HEAVY DUTY DIESEL FINE PARTICULATE MATTER EMISSIONS: DEVELOPMENT AND APPLICATION OF ON-ROAD MEASUREMENT CAPABILITIES

EPA Science Inventory

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...

Tidal inlet development and migration in Isles Dernieres Barrier Island Arc, Louisiana

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

Jaffe, B.E.; Sallenger, A.H.; List, J.H.

The Isles Dernieres barrier arc formed about 420 years ago in response to the abandonment of the Bayou Petit Caillou delta of the Mississippi River. Over the past 100 years, the arc has undergone rapid erosion, with much of the Gulf shorelines retreating more than 1 km (10 m/year). Today, the island area is less than 25% of what it was 100 years ago. Most of this areal loss is from a narrowing of the islands as both the bay and Gulf shorelines retreated. A significant portion, however, is due to development of two large tidal inlets that segmented themore » 32 km long arc into three groups of islands from what was a nearly continuous island in 1890. The presence of these inlets and two recently formed smaller ones alters longshore transport and island erosion patterns. To predict the future of the Isles Dernieres, the authors must understand the history and processes of tidal inlet development.« less

Satisfaction with Facial Appearance and Quality of Life after Treatment of Face Scars with a Transparent Facial Pressure Mask.

PubMed

Kant, S B; Colla, C; Van den Kerckhove, E; Van der Hulst, R R W J; Piatkowski de Grzymala, A

2018-06-01

Treatment of facial hypertrophic scars and deformities has developed from the use of elastic fabric hoods to transparent facemasks. The clinical effects of these masks have been described. However, the psychological impact of wearing such a mask is not well documented. The aim of this study was to assess patients' satisfaction with their current facial appearance, to assess the end result of facemask therapy, and to assess the decision to have undergone facemask therapy by means of four different FACE-Q questionnaires. Out of the eligible 87 patients who completed the facemask therapy between January 2012 and November 2017, 42 filled out the questionnaires. These patients wore a custom-fabricated facemask because of facial hypertrophic scars and severe postsurgical facial irregularities. Patients who wore the mask 12 to 16 hours per day were significantly more satisfied with the end result compared with those who wore it 4 to 8 hours daily. Also, patients who wore the mask 8 to 12 and 12 to 16 hours each day were more satisfied to have undergone therapy compared with those who wore it 4 to 8 hours daily. Furthermore, patients who finished therapy 3 to 4 years and 4 to 5 years ago reported a significant higher satisfaction with facial appearance compared with those who completed therapy in a time period shorter than 1 year ago. Patients who finished therapy 3 to 4 years ago reported higher satisfaction with their facial appearance compared with those who finished therapy 2 to 3 years ago. Additionally, the Patient and Observer Scar Assessments Score (POSAS) showed a significant reduction between start and end of therapy. This study shows facemask therapy to result in long-lasting stable results. It also shows a longer daily wearing of the facemask to result in the highest satisfaction according to patients. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Ventilator-associated pneumonia in patients undergoing major heart surgery: an incidence study in Europe.

PubMed

Hortal, Javier; Muñoz, Patricia; Cuerpo, Gregorio; Litvan, Hector; Rosseel, Peter M; Bouza, Emilio

2009-01-01

Patients undergoing major heart surgery (MHS) represent a special subpopulation at risk for nosocomial infections. Postoperative infection is the main non-cardiac complication after MHS and has been clearly related to increased morbidity, use of hospital resources and mortality. Our aim was to determine the incidence, aetiology, risk factors and outcome of ventilator-associated pneumonia (VAP) in patients who have undergone MHS in Europe. Our study was a prospective study of patients undergoing MHS in Europe who developed suspicion of VAP. During a one-month period, participating units submitted a protocol of all patients admitted to their units who had undergone MHS. Overall, 25 hospitals in eight different European countries participated in the study. The number of patients intervened for MHS was 986. Fifteen patients were excluded because of protocol violations. One or more nosocomial infections were detected in 43 (4.4%) patients. VAP was the most frequent nosocomial infection (2.1%; 13.9 episodes per 1000 days of mechanical ventilation). The microorganisms responsible for VAP in this study were: Enterobacteriaceae (45%), Pseudomonas aeruginosa (20%), methicillin-resistant Staphylococcus aureus (10%) and a range of other microorganisms. We identified the following significant independent risk factors for VAP: ascending aorta surgery (odds ratio (OR) = 6.22; 95% confidence interval (CI) = 1.69 to 22.89), number of blood units transfused (OR = 1.08 per unit transfused; 95% CI = 1.04 to 1.13) and need for re-intervention (OR = 6.65; 95% CI = 2.10 to 21.01). The median length of stay in the intensive care unit was significantly longer (P < 0.001) in patients with VAP than in patients without VAP (23 days versus 2 days). Death was significantly more frequent (P < 0.001) in patients with VAP (35% versus 2.3%). Patients undergoing aortic surgery and those with complicated post-intervention courses, requiring multiple transfusions or re-intervention, constitute a high-risk group probably requiring more active preventive measures.

Toward the development of a children's science curiosity measure

NASA Astrophysics Data System (ADS)

Harty, Harold; Beall, Dwight

Based on the need for, suggestions about the construction, and existing measures serving as models found in the literature both inside and outside of science education, the Children's Science Curiosity Scale has undergone six versions using four different samples of fifth graders. Respectable internal consistency (alpha) and test-retest reliabilities have been calculated. Concurrent validity has been demonstrated by significant positive correlations with another recognized curiosity measure, and by way of significant differences between students who were interested in science and students uncertain about interest in science. Somewhat weak predictive validity has been decided by way of significant positive correlations with students' semester science grades. Construct validity has been described and established by eight judges using six criteria, and supported through the use of factor analysis where four underlying factors were hypothesized as characteristics of science curiosity. Sex differences were also explored where significant differences were not found between the genders. Suggestions have been made concerning future attempts at instrument refinement, establishing conceptual validity, future research involving other variables, and classroom use in a variety of contexts.

Total N-nitrosamine Precursor Adsorption with Carbon Nanotubes: Elucidating Controlling Physiochemical Properties and Developing a Size-Resolved Precursor Surrogate

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.

Risk factors for manipulation after total knee arthroplasty: a pooled electronic health record database study.

PubMed

Pfefferle, Kiel J; Shemory, Scott T; Dilisio, Matthew F; Fening, Stephen D; Gradisar, Ian M

2014-10-01

A commercially available software platform, Explorys (Explorys, Inc., Cleveland, OH), was used to mine a pooled electronic healthcare database consisting of the medical records of more than 27 million patients. A total of 229,420 patients had undergone a total knee arthroplasty; 3470 (1.51%) patients were identified to have undergone manipulation under anesthesia. Individual risk factors of being female, African American race, age less than 60, BMI >30 and nicotine dependence were determined to have relative risk of 1.25, 2.20, 3.46, 1.33 and 1.32 respectively. Depressive disorder, diabetes mellitus, opioid abuse/dependence and rheumatoid arthritis were not significant risk factors. African Americans under the age of 60 at time of TKA had the greatest incidence of MUA (5.17%) and relative risk of 3.73 (CI: 3.36, 4.13). Copyright © 2014 Elsevier Inc. All rights reserved.

Twenty-Five Years of Continuing Professional Development of Teachers in the Post-Communist Era in Slovakia: The Story of Paths Not Taken

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…

Emetogenicity-risk procedures in same day surgery center of an academic university hospital in United States: a retrospective cost-audit of postoperative nausea vomiting management.

PubMed

Gupta, Deepak; Haber, Halim

2014-06-01

Despite the variable results of published studies, it is imperative for ambulatory surgery centers to self-audit local cost-implications for post-operative nausea and vomiting (PONV) management. Our retrospective cost-audit assessed if there were comparative peri-anesthesia care cost-trends among patients who had undergone Low-Emetogenicity-Risk Procedures (LERP), Moderate-Emetogenicity-Risk Procedures (MERP) and Severe-Emetogenicity-Risk Procedures (SERP). This study was a review of Same Day Surgery Center practices in an academic university hospital setting during a three-year period (2010-2012). The patient lists were accessed from CIS and CITRIX App Bar for time audit and OR (operating room) schedule reports. Subsequently, OR pharmacy department ran a search for peri-operative anti-emetics and opioids that were billed for the patients at Same Day Surgery Center for the review period. The primary outcomes were the comparative costs/charges of these medications and comparative durations/ charges for these patients' stay in the post-anesthesia care unit (PACU). Secondary outcomes analyzed in the study included peri-anesthesia durations. A total of 8,657 patient records were analyzed. Almost all analyzed variables revealed statistically significant inter-variable positive correlations. The patients' age was significantly (P < 0.001) different among LERP/MERP/SERP patients (LERP: 48.8 +/- 14.7 years; MERP: 61.8 +/- 14.6 years; SERP: 51.3 +/- 14.5 years). In regards to primary and secondary outcomes, the statistical significant differences among LERP/MERP/SERP patients (after correcting for both patients' age as well as patients' sex) were only achieved for preoperative times (P = 0.002; Power = 0.9), operating room recovery times (P = 0.003; Power = 0.9), PACU stay times (P < 0.001; Power = 1.0), and PACU charges (P < 0.001; Power = 1.0). PACU stay times and PACU charges were significantly higher in patients who had undergone SERP as compared to patients who had undergone LERP or MERP at our Same Day Surgery Center.

Centres of Excellence in the Context of Further Education and Training in South Africa

ERIC Educational Resources Information Center

van der Bijl, Andre; Ebrahim, Adele

2012-01-01

Since 1994 South African further education and training (FET) has undergone significant and fundamental changes. These changes include the transfer of colleges between state departments, curriculum revision, forced mergers and a shift in the student population. As a result of the growing interest in, and funding of, vocationally aligned education,…

Relationships between Eco-Leadership and Problem-Solving Styles of Gifted and Talented Youth

ERIC Educational Resources Information Center

Friedel, Curtis R.; Cletzer, D. Adam; Bush, Sarah A.; Barber, J. Danielle

2017-01-01

Our understanding of leadership has undergone a significant shift in the early part of the 21st century. An emerging perspective, dubbed Eco-Leadership, suggests leadership is a collective process involving both leaders and followers co-creating leadership. Because our beliefs and attitudes toward leadership affect how we lead, it becomes crucial…

Suburban School Districts and Demographic Change: The Technical, Normative, and Political Dimensions of Response

ERIC Educational Resources Information Center

Holme, Jennifer Jellison; Diem, Sarah; Welton, Anjalé

2014-01-01

Purpose: Suburban school districts have undergone significant demographic shifts over the past several decades. The research literature to date, however, has yet to explore how suburban district leaders are responding to such changes, or examine the factors that shape response. In this article, we apply a "zone of mediation" framework to…

Energy-Dispersive X-Ray Fluorescence Spectrometry: A Long Overdue Addition to the Chemistry Curriculum

ERIC Educational Resources Information Center

Palmer, Peter T.

2011-01-01

Portable Energy-Dispersive X-Ray Fluorescence (XRF) analyzers have undergone significant improvements over the past decade. Salient advantages of XRF for elemental analysis include minimal sample preparation, multielement analysis capabilities, detection limits in the low parts per million (ppm) range, and analysis times on the order of 1 min.…

Restoration strategies for a native perennial: Germination and seedling physiology of Sphaeralcea munroana

Treesearch

Olga A. Kildesheva

2011-01-01

The Great Basin region of the western United States has undergone significant disturbance and fragmentation because of overgrazing for livestock production, disruption of the natural fire regimes, and the introduction of non-native species. At present, habitat loss greatly surpasses the rate of system recovery, making restoration integral to ecosystem function and...

The Intersection of Inquiry-Based Science and Language: Preparing Teachers for ELL Classrooms

ERIC Educational Resources Information Center

Weinburgh, Molly; Silva, Cecilia; Smith, Kathy Horak; Groulx, Judy; Nettles, Jenesta

2014-01-01

As teacher educators, we are tasked with preparing prospective teachers to enter a field that has undergone significant changes in student population and policy since we were K-12 teachers. With the emphasis placed on connections, mathematics integration, and communication by the New Generation Science Standards (NGSS) (Achieve in Next generation…

Cultural Identity and Language Attitudes--Into the Second Decade of Postcolonial Hong Kong

ERIC Educational Resources Information Center

Lai, Mee Ling

2011-01-01

As it entered the second decade of the postcolonial era, Hong Kong had undergone significant socio-economic changes which had impacted students' perceptions of cultural identity and their language attitudes. This study, conducted in 2009, reports on an investigation into the related perceptions of the postcolonial generation who grew up in Hong…

Combining field observations and genetic data to reconstruct the invasion of Phytophthora ramorum in California

Treesearch

Peter J.P. Croucher; Silvia Mascheretti; Matteo Garbelotto

2013-01-01

Although it has been convincingly shown that forest populations of the pathogen Phytophthora ramorum have undergone a significant bottleneck and reproduce exclusively asexually (Ivors et al. 2004, 2006; Mascheretti et al. 2008), objective results showing that nurseries were the original source of the introduction remain elusive (Mascheretti et al....

Impacts on South Carolina timber production over the last five decades.

Treesearch

Jinglong Mo; Thomas Straka; Richard Harper

2013-01-01

Timberland ownership patterns and national forest timber harvesting policy have undergone significant changes in South Carolina over the past five decades. Timber output studies for the state commonly focused on short time frames and seldom addressed timberland ownership patterns in detail. We describe fifty-year timber output for South Carolina, allowing us to address...

Classification and spatial analysis of eastern hemlock health using remote sensing and GIS

Treesearch

Laurent R. Bonneau; Kathleen S. Shields; Daniel L. Civco; David R. Mikus

2000-01-01

Over the past decade hemlock stands in southern Connecticut have undergone significant decline coincident with the arrival in 1985 of an exotic insect pest, the hemlock woolly adelgid (Adelges tsugae Annand). The objective of this study was to evaluate image enhancement techniques for rating the health of hemlocks at the landscape level using...

Altitudinal gradients of bryophyte diversity and community assemblage in southern Appalachian spruce-fir forests

Treesearch

Sarah E. Stehn; Christopher R. Webster; Janice M. Glime; Michael A. Jenkins

2010-01-01

Ground-layer plant communities in spruce-fir forests of the southern Appalachians have likely undergone significant change since the widespread death of canopy Fraser fir (Abies fraseri) caused by the exotic balsam woolly adelgid (Adelges piceae). Bryophytes comprise an important part of the ground-layer flora in the spruce-fir...

Comparison between deep breathing exercises and incentive spirometry after CABG surgery.

PubMed

Renault, Julia Alencar; Costa-Val, Ricardo; Rosseti, Márcia Braz; Houri Neto, Miguel

2009-01-01

To compare the effects of deep breathing exercises (DBE) and the flow-oriented incentive spirometry (IS) in patients undergone coronary artery bypass grafting (CABG) through the following variables: forced vital capacity - FVC, forced expiratory volume in 1 second - FEV(1), maximal respiratory pressures and oxygen saturation. Thirty six patients in CABG postoperative period underwent thirty minutes of non-invasive ventilation during the first 24 hours after extubation and were randomly shared into two groups as following: DBE (n=18) and IS (n=18). The spirometric variables were assessed on the preoperative period and seventh postoperative day (POD). The respiratory muscle strength and oxygen saturation were assessed on the preoperative period, first, second and seventh POD. The groups were considered homogeneous in relation to the demographic and surgical variables. It has been noted fall in the values of FVC and FEV(1) between the preoperative period and the seventh POD, but without significant differences between groups. The maximal respiratory pressures showed drop in the first POD but with and partial recovery until the seventh POD, also without significant differences between groups. The oxygen saturation was the only variable that was completely recovered on the seventh POD, also without significant differences between groups. There were not observed significant differences in maximal respiratory pressures, spirometric variables and oxygen saturation in patients undergone deep breathing exercises and flow-oriented incentive spirometry after coronary artery bypass grafting.

Vitamin B-6 Supplementation Could Mediate Antioxidant Capacity by Reducing Plasma Homocysteine Concentration in Patients with Hepatocellular Carcinoma after Tumor Resection

PubMed Central

Cheng, Shao-Bin; Lin, Ping-Ting; Liu, Hsiao-Tien; Peng, Yi-Shan; Huang, Shih-Chien

2016-01-01

Vitamin B-6 has a strong antioxidative effect. It would be useful to determine whether vitamin B-6 supplementation had effects on antioxidant capacities in patients with hepatocellular carcinoma (HCC) who had recently undergone tumor resection. Thirty-three HCC patients were randomly assigned to either the placebo (n = 16) group or the vitamin B-6 50 mg/d (n = 17) group for 12 weeks. Plasma pyridoxal 5′-phosphate, homocysteine, indicators of oxidative stress, and antioxidant capacities were measured. Plasma homocysteine in the vitamin B-6 group was significantly decreased at week 12, while the level of trolox equivalent antioxidant capacity (TEAC) was significantly increased at the end of the intervention period. Vitamin B-6 supplementation had a significant reducing effect on the change of plasma homocysteine (β = −2.4, p = 0.02) but not on the change of TEAC level after adjusting for potential confounders. The change of plasma homocysteine was significantly associated with the change of TEAC after adjusting for potential confounders (β = −162.0, p = 0.03). Vitamin B-6 supplementation seemed to mediate antioxidant capacity via reducing plasma homocysteine rather than having a direct antioxidative effect in HCC patients who had recently undergone tumor resection. The clinical trial number is NCT01964001, ClinicalTrials.gov. PMID:27051670

Is preoperative hypocholesterolemia a risk factor for severe postoperative pain? Analysis of 1,944 patients after laparoscopic colorectal cancer surgery.

PubMed

Oh, Tak Kyu; Kang, Sung-Bum; Song, In-Ae; Hwang, Jung-Won; Do, Sang-Hwan; Kim, Jin Hee; Oh, Ah-Young

2018-01-01

This study aimed to identify the effect of preoperative serum total cholesterol on postoperative pain outcome in patients who had undergone laparoscopic colorectal cancer surgery. We retrospectively reviewed the medical records of patients diagnosed with colorectal cancer who had undergone laparoscopic colorectal surgery from January 1, 2011, to June 30, 2017, to identify the relationship of total cholesterol levels within a month prior to surgery with the numeric rating scale (NRS) scores and total opioid consumption on postoperative days (PODs) 0-2. We included 1,944 patients. No significant correlations were observed between total cholesterol and the NRS (POD 0), NRS (POD 1), and oral morphine equivalents (PODs 0-2) ( P >0.05). There was no significant difference between the low (<160 mg/dL), medium (160-199 mg/dL), and high (≥200 mg/dL) groups in NRS scores on PODs 0, 1, or 2 ( P >0.05). Furthermore, there was no significant association in multivariate linear regression analysis for postoperative opioid consumption according to preoperative serum total cholesterol level (coefficient 0.08, 95% CI -0.01 to 0.18, P =0.81). This study showed that there was no meaningful association between preoperative total cholesterol level and postoperative pain outcome after laparoscopic colorectal cancer surgery.

The effects of radiation therapy on height and spine MRI characteristics in children with neuroblastoma.

PubMed

Yu, Jeong Il; Lim, Do Hoon; Jung, Sang Hoon; Sung, Ki Woong; Yoo, So-Young; Nam, Heerim

2015-03-01

To investigate the effect of radiotherapy (RT) on height and spine using magnetic resonance imaging (MRI) analysis in children with neuroblastoma and to identify parameters related to patient height. We performed a retrospective cohort study of neuroblastoma patients treated between January 1997 and December 2007. Twenty-seven children were enrolled. Whole spine MRI was completed and height percentiles were compared with national growth charts. The median ages were 28, 43, and 126 months at diagnosis, RT, and analysis, respectively. All of the enrolled children received local RT, and 15 patients received total body irradiation (TBI). Median growth percentiles were 67.0, 54.0, and 4.9 at diagnosis, RT, and analysis, respectively. The number of irradiated vertebrae (P=0.009) and having undergone TBI (P=0.03) were significantly associated with shorter stature. Among the MRI parameters for irradiated vertebrae, signal intensity was higher (P=0.05) and more heterogeneous (P=0.02) in T1-weighted images and roundness was lower (P=0.03) in T2-weighted images. Height of children with neuroblastoma was significantly affected by RT. The number of irradiated vertebrae and having undergone TBI were significantly associated with lower height. Irradiated spine showed changes in both signal and shape on MRI. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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…

Sharpening Our Focus on "Family Life Education": Evidence-Based Curricula for Strengthening Close Relationships

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.…

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…

A novel approach using long‐read sequencing and ddPCR to investigate gonadal mosaicism and estimate recurrence risk in two families with developmental disorders

PubMed Central

Gudmundsson, Sanna; Johansson, Josefin; Ameur, Adam; Stattin, Eva‐Lena; Annerén, Göran; Malmgren, Helena; Frykholm, Carina

2017-01-01

Abstract Objective De novo mutations contribute significantly to severe early‐onset genetic disorders. Even if the mutation is apparently de novo, there is a recurrence risk due to parental germ line mosaicism, depending on in which gonadal generation the mutation occurred. Methods We demonstrate the power of using SMRT sequencing and ddPCR to determine parental origin and allele frequencies of de novo mutations in germ cells in two families whom had undergone assisted reproduction. Results In the first family, a TCOF1 variant c.3156C>T was identified in the proband with Treacher Collins syndrome. The variant affects splicing and was determined to be of paternal origin. It was present in <1% of the paternal germ cells, suggesting a very low recurrence risk. In the second family, the couple had undergone several unsuccessful pregnancies where a de novo mutation PTPN11 c.923A>C causing Noonan syndrome was identified. The variant was present in 40% of the paternal germ cells suggesting a high recurrence risk. Conclusions Our findings highlight a successful strategy to identify the parental origin of mutations and to investigate the recurrence risk in couples that have undergone assisted reproduction with an unknown donor or in couples with gonadal mosaicism that will undergo preimplantation genetic diagnosis. PMID:28921562

A novel approach using long-read sequencing and ddPCR to investigate gonadal mosaicism and estimate recurrence risk in two families with developmental disorders.

PubMed

Wilbe, Maria; Gudmundsson, Sanna; Johansson, Josefin; Ameur, Adam; Stattin, Eva-Lena; Annerén, Göran; Malmgren, Helena; Frykholm, Carina; Bondeson, Marie-Louise

2017-11-01

De novo mutations contribute significantly to severe early-onset genetic disorders. Even if the mutation is apparently de novo, there is a recurrence risk due to parental germ line mosaicism, depending on in which gonadal generation the mutation occurred. We demonstrate the power of using SMRT sequencing and ddPCR to determine parental origin and allele frequencies of de novo mutations in germ cells in two families whom had undergone assisted reproduction. In the first family, a TCOF1 variant c.3156C>T was identified in the proband with Treacher Collins syndrome. The variant affects splicing and was determined to be of paternal origin. It was present in <1% of the paternal germ cells, suggesting a very low recurrence risk. In the second family, the couple had undergone several unsuccessful pregnancies where a de novo mutation PTPN11 c.923A>C causing Noonan syndrome was identified. The variant was present in 40% of the paternal germ cells suggesting a high recurrence risk. Our findings highlight a successful strategy to identify the parental origin of mutations and to investigate the recurrence risk in couples that have undergone assisted reproduction with an unknown donor or in couples with gonadal mosaicism that will undergo preimplantation genetic diagnosis. © 2017 The Authors Prenatal Diagnosis published by John Wiley & Sons Ltd.

The hedonic drive to consume palatable foods appears to be lower in gastric band carriers than in severely obese patients who have not undergone a bariatric surgery.

PubMed

Ullrich, J; Ernst, B; Wilms, B; Thurnheer, M; Hallschmid, M; Schultes, B

2013-04-01

We have recently shown that severely obese patients display a markedly enhanced drive to consume palatable food, and that this hedonic hunger is reduced after gastric bypass surgery. Adjustable gastric banding is another frequently performed bariatric operation with unknown effects on hedonic hunger motivation. Here, we compared the level of hedonic hunger in patients who have undergone a gastric banding with that in severely obese patients who have not undergone a bariatric operation and nonobese controls. In a cross-sectional case-control study, 116 gastric banding patients, 138 severely obese patients, and 133 nonobese controls were examined with the Power of Food Scale (PFS), a questionnaire that reliably measures an individual's motivation to consume highly palatable food. While the severely obese patients displayed markedly higher aggregated PFS scores and scores on the subdomain "generally available" and "physically present" food than the nonobese controls (all P < 0.001), the gastric banding patients showed significantly lower scores on all of these variables than the obese patients (all P < 0.001). However, the generally available food score was still higher in gastric banding patients than in the nonobese controls (P = 0.001). Data suggest that adjustable gastric banding may reduce the excessive appetite for palatable foods in severely obese patients. This suggestion needs to be confirmed in longitudinal studies.

The Use of Unilateral Pericranial Flaps for the Closure of Difficult Medial Orbital and Upper Lateral Nasal Defects.

PubMed

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.

[Selective biopsy of the sentinel lymph node in breast cancer: without axillary recurrences after a mean follow-up of 4.5 years].

PubMed

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.

The risk of stroke after bilateral salpingo-oophorectomy at hysterectomy for benign diseases: A nationwide cohort study.

PubMed

Lai, Jerry Cheng-Yen; Chou, Yiing-Jenq; Huang, Nicole; Chen, Hung-Hui; Wang, Kung-Liahng; Wang, Chien-Wei; Shen, I-Hsuan; Chang, Hung-Chang

2018-08-01

To assess the risk of stroke (and subtypes of stroke) in women after elective bilateral salpingo-oophorectomy at hysterectomy for benign diseases. We conducted a nationwide population-based, retrospective cohort study using claims data from Taiwan's National Health Insurance program between 1997 and 2013. Women aged 20 years or more who underwent bilateral salpingo-oophorectomy at hysterectomy for benign diseases (n = 1083) were compared with women who did not undergo bilateral salpingo-oophorectomy at hysterectomy for benign diseases (n = 3903). The follow-up period ranged from 10 to 16 years. Age-adjusted (or unadjusted) and multivariate Cox proportional hazards regression models were used to estimate the risk of stroke between the two groups. A diagnosis of stroke (and subtypes of stroke). We did not find a significant association between bilateral salpingo-oophorectomy and the risk of incident stroke (or subtypes of stroke) over an average follow-up of 13 years. Among women aged 50 years or more who used estrogen therapy, the risk of developing stroke was 64% lower in those who had undergone bilateral salpingo-oophorectomy (hazard ratio, 0.36; 95% confidence interval, 0.16-0.79) than in those who had undergone hysterectomy only. This study suggests that the use of estrogen after bilateral salpingo-oophorectomy at hysterectomy for benign diseases reduces the risk of stroke in women aged 50 years or more. Copyright © 2018 Elsevier B.V. All rights reserved.

Neuromarkers of Post-Traumatic Stress Disorder (PTSD) in a patient after bilateral hand amputation - ERP case study.

PubMed

Chrapusta, Anna; Kropotov, Juri D; Pąchalska, Maria

2017-06-08

Introduction. There is a lack in the worldwide literature of reports on the Neuromarkers of Post-Traumatic Stress Disorder (PTSD) in patients after bilateral hand amputation The aim of this study was to test a hypothesis regarding developing Post-Traumatic Stress Disorder (PTSD) in a patient after bilateral hand amputation with the use of Event Related Potentials (ERPs). On the basis of previous research, the amplitudes of P3 ERP components elicited in the cued GO/NOGO tasks have been chosen as candidates for neuromarkers of PTSD. Case study. A 24-year-old patient had undergone bilateral hand amputation 12 months previously. The patient was repeatedly operated on (he had undergone successful bilateral hand replantation) and despite the severity of the injuries, he recovered. However, the patient complained of flashbacks, anxiety and sleep difficulties. Specialist tests showed the presence of PTSD. The patient participated in the cued GO/NOGO task (Kropotov, 2009) with recording 19-channel EEG. P3 GO and NOGO waves in this task were found to be significantly smaller, in comparison to a group of healthy control subjects of the same age (N=23) taken from the HBI normative database (https://www.hbimed.com/). This observed pattern of ERP waves in the patient corresponds to the pattern found in PTSD patients. Conclusions. ERPs in a GO/NOGO task can be used in the assessment of the functional brain changes induced by chronic PTSD.

Oncogene-induced senescence results in marked metabolic and bioenergetic alterations

PubMed Central

Quijano, Celia; Cao, Liu; Fergusson, Maria M; Romero, Hector; Liu, Jie; Gutkind, Sarah; Rovira, Ilsa I; Mohney, Robert P; Karoly, Edward D

2012-01-01

Oncogene-induced senescence (OIS) is characterized by permanent growth arrest and the acquisition of a secretory, pro-inflammatory state. Increasingly, OIS is viewed as an important barrier to tumorgenesis. Surprisingly, relatively little is known about the metabolic changes that accompany and therefore may contribute to OIS. Here, we have performed a metabolomic and bioenergetic analysis of Ras-induced senescence. Profiling approximately 300 different intracellular metabolites reveals that cells that have undergone OIS develop a unique metabolic signature that differs markedly from cells undergoing replicative senescence. A number of lipid metabolites appear uniquely increased in OIS cells, including a marked increase in the level of certain intracellular long chain fatty acids. Functional studies reveal that this alteration in the metabolome reflects substantial changes in overall lipid metabolism. In particular, Ras-induced senescent cells manifest a decline in lipid synthesis and a significant increase in fatty acid oxidation. Increased fatty acid oxidation results in an unexpectedly high rate of basal oxygen consumption in cells that have undergone OIS. Pharmacological or genetic inhibition of carnitine palmitoyltransferase 1, the rate-limiting step in mitochondrial fatty acid oxidation, restores a presenescent metabolic rate and, surprisingly, selectively inhibits the secretory, pro-inflammatory state that accompanies OIS. Thus, Ras-induced senescent cells demonstrate profound alterations in their metabolic and bioenergetic profiles, particularly with regards to the levels, synthesis and oxidation of free fatty acids. Furthermore, the inflammatory phenotype that accompanies OIS appears to be related to these underlying changes in cellular metabolism. PMID:22421146

Laser direct writing of micro- and nano-scale medical devices

PubMed Central

Gittard, Shaun D; Narayan, Roger J

2010-01-01

Laser-based direct writing of materials has undergone significant development in recent years. The ability to modify a variety of materials at small length scales and using short production times provides laser direct writing with unique capabilities for fabrication of medical devices. In many laser-based rapid prototyping methods, microscale and submicroscale structuring of materials is controlled by computer-generated models. Various laser-based direct write methods, including selective laser sintering/melting, laser machining, matrix-assisted pulsed-laser evaporation direct write, stereolithography and two-photon polymerization, are described. Their use in fabrication of microstructured and nanostructured medical devices is discussed. Laser direct writing may be used for processing a wide variety of advanced medical devices, including patient-specific prostheses, drug delivery devices, biosensors, stents and tissue-engineering scaffolds. PMID:20420557

Genome-wide detection and characterization of positive selection in human populations.

PubMed

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.

Post-fire response of coast redwood one year after the Mendocino lightning complex fires

Treesearch

Robert B. Douglas; Tom. Bendurel

2012-01-01

Coast redwood (Sequoia sempervirens) forests have undergone significant changes over the past century and are now in state more conducive for wildfires. Because fires have been uncommon in redwood forests over the past 80 years, managers have limited data to make decisions about the post-fire environment. In June 2008, a series of lightning storms...

Building Content Knowledge in Elementary English Language Arts: How a Shift in Curriculum Affects Teacher Perception of Reading

ERIC Educational Resources Information Center

Ellis, Raquel

2017-01-01

Desert Elementary is a suburban Phoenix K-5 school. The school has undergone a significant change in its approach to reading instruction due to the Common Core State Standards (CCSS) instructional shift of building knowledge through content rich nonfiction. Teachers implemented this shift in their classrooms through a 16-month professional…

Exploring the Impact of No Child Left Behind on the Maine Superintendent

ERIC Educational Resources Information Center

Pease, Sylvia

2009-01-01

The role of the superintendent has undergone numerous changes in the last century. Many report the job has become almost undoable and superintendents are becoming overwhelmed as new expectations are being placed upon them. No Child Left Behind has had a significant impact on the role of the school superintendent as they attempt to balance three…

The Promise of Technology for College Instruction: From Drill and Practice to Avatars

ERIC Educational Resources Information Center

Kuhlenschmidt, Sally; Kacer, Barbara

2010-01-01

Technology and its uses have undergone significant change in the past several decades. Although the technology of 2010 has changed in ways unimaginable in 1960, the promise of technology today is similar to the promise of technology then. The achievement of student learning seems more likely to lie in the minds of the people who use the technology…

The Effects of Single-Sex Classrooms on Student Outcomes on Mathematics and Reading in an Elementary School

ERIC Educational Resources Information Center

Pilson, Sylvia Yvonne Reddick

2013-01-01

The curriculum for elementary students has undergone a significant change in the past decade. This led to an increased expectation for higher academic performance for fifth grade students in the areas of reading and mathematics. Teachers seek innovative ways to provide instructional practices within their classrooms that will aid success for all…

Trends in University Finances in the New Millennium, 2000/01-2012/13. CAUT Education Review

ERIC Educational Resources Information Center

Canadian Association of University Teachers, 2015

2015-01-01

Since the turn of the 21st century, universities in Canada have undergone significant changes. Student enrollment has exploded. This issue of the Canadian Association of University Teachers (CAUT) Education Review provides an analysis of the current state of university finances in Canada, as well as longer-term trends in university revenues and…

Leadership for Instructional Improvement: An Examination of How Principals Share Leadership

ERIC Educational Resources Information Center

Garceau, Mark

2012-01-01

Beginning in the latter part of the 20th century, and especially since the advent of No Child Left Behind, the roles and responsibilities of the elementary school principal have undergone significant expansion. While the primary function of the principal at one time may have been to serve as the manager of the physical plant of the school and as…

The Future of the U.S. Workforce: Middle Skills Jobs and the Growing Importance of Postsecondary Education

ERIC Educational Resources Information Center

Achieve, Inc., 2012

2012-01-01

The U.S. workforce has undergone significant changes in the past few decades. Increasingly sophisticated technology, changes in the structure of the economy and the growing global marketplace have resulted in employers putting a higher premium than ever on educated workers. Much has been said about the importance of increasing the labor supply for…

Ecosystem stressors in southern Nevada [Chapter 2] (Executive Summary)

Treesearch

Burton K. Pendleton; Jeanne C. Chambers; Matthew L. Brooks; Steven M. Ostoja

2013-01-01

Southern Nevada ecosystems are subject to a number of stressors that range in scope from local to regional to global. At the regional scale, human population growth and related activities constitute a major stressor. Nevada has undergone significant change due to unprecedented population growth and ongoing global change processes. Nevada’s growth rate has been the...

Teacher Perceptions about the Influence of Formative Assessment on the Reading Gains of Fourth Grade Students with Disabilities

ERIC Educational Resources Information Center

Mulcahy, Juli

2010-01-01

The education of students with disabilities (SWD) has undergone some significant changes within the public education system since the enactment of the Individuals with Disabilities Act (IDEA) and the No Child Left Behind Act (NCLB). Special education legislation has historically focused on equal access for all students. Too much time has been…

The Role of Search in University Productivity: Inside, outside, and Interdisciplinary Dimensions. NEBR Working Paper No. 15489

ERIC Educational Resources Information Center

Adams, James D.; Clemmons, J. Roger

2009-01-01

Due to improving information technology, the growing complexity of research problems, and policies designed to foster interdisciplinary research, the practice of science in the United States has undergone significant structural change. Using a sample of 110 top U.S. universities observed during the late 20th century we find that knowledge flows,…

Evaluating the Effectiveness of the New Jersey Leaders to Leaders Induction Program: A Case Study

ERIC Educational Resources Information Center

Parent, Michael

2012-01-01

Since the publication of the groundbreaking 1983 report A Nation At Risk: The Imperative For Educational Reform and the enactment of No Child Left Behind (NCLB) in 2001, America's public schools have undergone dramatic changes. These significant changes have required school administrators to be more of an educational leader to students and staff,…

Liposuction for Submental Lymphedema Improves Appearance and Self-Perception in the Head and Neck Cancer Patient.

PubMed

Brake, Maria K; Jain, Lauren; Hart, Robert D; Trites, Jonathan R B; Rigby, Matthew; Taylor, S Mark

2014-08-01

Patients who have undergone treatment for head and neck cancer are at risk for neck lymphedema, which can severely affect quality of life. Liposuction has been used successfully for cancer patients who suffer from posttreatment limb lymphedema. The purpose of our study was to review the outcomes of head and neck cancer patients at our center who have undergone submental liposuction for posttreatment lymphedema. Prospective cohort study. Oncology center in tertiary hospital setting. Head and neck cancer patients who underwent submental liposuction for posttreatment lymphedema were included. Nine patients met the study criteria. Patients completed 2 surveys (Modified Blepharoplasty Outcome Evaluation and the validated Derriford Appearance Scale) pre- and postoperatively to assess satisfaction. Patients' pre- and postoperative photos were graded by independent observers to assess outcomes objectively. Our study demonstrated a statistically significant improvement in patients' self-perception of appearance and statistically significant objective scoring of appearance following submental liposuction. Submental liposuction improves the appearance and quality of life for head and neck cancer patients suffering from posttreatment lymphedema by way of improving their self-perception and self-confidence. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

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.…

Children's Behaviors and Emotions in Small-Group Argumentative Discussion: Explore the Influence of Big Five Personality Factors

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…

Linking Strategic Planning, Institutional Assessment, and Resource Allocation: Paradise Valley Community College's Model.

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…

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…

Risk factors for development of postoperative cerebellar mutism syndrome in children after medulloblastoma surgery.

PubMed

Pols, San Y C V; van Veelen, Marie Lise C; Aarsen, Femke K; Gonzalez Candel, Antonia; Catsman-Berrevoets, Coriene E

2017-07-01

OBJECTIVE Postoperative cerebellar mutism syndrome (pCMS) occurs in 7%-50% of children after cerebellar tumor surgery. Typical features include a latent onset of 1-2 days after surgery, transient mutism, emotional lability, and a wide variety of motor and neurobehavioral abnormalities. Sequelae of this syndrome usually persist long term. The principal causal factor is bilateral surgical damage (regardless of tumor location) to any component of the proximal efferent cerebellar pathway, which leads to temporary dysfunction of cerebral cortical regions as a result of diaschisis. Tumor type, cerebellar midline location, and brainstem involvement are risk factors for pCMS that have been identified repeatedly, but they do not explain its latent onset. Ambiguous or negative results for other factors, such as hydrocephalus, postoperative meningitis, length of vermian incision, and tumor size, have been reached. The aim of this study was to identify perioperative clinical, radiological, and laboratory factors that also increase risk for the development of pCMS. The focus was on factors that might explain the delayed onset of pCMS and thus might provide a time window for taking precautionary measures to prevent pCMS or reduce its severity. The study was focused specifically on children who had undergone surgery for medulloblastoma. METHODS In this single-center retrospective cohort study, the authors included 71 children with medulloblastoma, 28 of whom developed pCMS after primary resection. Clinical and laboratory data were collected prospectively and analyzed systematically. Variables were included for univariate and multivariate analysis. RESULTS Univariate regression analysis revealed 7 variables that had a significant influence on pCMS onset, namely, tumor size, maximum tumor diameter > 5 cm, tumor infiltration or compression of the brainstem, significantly larger decreases in hemoglobin (p = 0.010) and hematocrit (p = 0.003) in the pCMS group after surgery than in the no-pCMS group, significantly more reported incidents of severe bleeding in the tumor bed during surgery in the pCMS group, preoperative hydrocephalus, and a mean body temperature rise of 0.5°C in the first 4 days after surgery in the pCMS group. Multiple regression analysis revealed that tumor size, tumor infiltration into or compression of the brainstem, and higher mean body temperature in the first 4 postoperative days were independent and highly significant predictors for pCMS. CONCLUSIONS The authors confirmed earlier findings that tumor-associated preoperative conditions, such as a maximum tumor diameter ≥ 5 cm and infiltration into or compression of the brainstem, are associated with a higher risk for the development of pCMS. Most importantly, the authors found that a 0.5°C higher mean body temperature in the first 4 postoperative days increased the odds ratio for the development of pCMS almost 5-fold. These data suggest that an important focus for the prevention of pCMS in children who have undergone medulloblastoma surgery might be rigorous maintenance of normothermia as standard care after surgery.

Developments in hydrogenation technology for fine-chemical and pharmaceutical applications.

PubMed

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.

Patient and operative factors associated with complications following adolescent idiopathic scoliosis surgery: an analysis of 36,335 patients from the Nationwide Inpatient Sample.

PubMed

De la Garza Ramos, Rafael; Goodwin, C Rory; Abu-Bonsrah, Nancy; Jain, Amit; Miller, Emily K; Huang, Nicole; Kebaish, Khaled M; Sponseller, Paul D; Sciubba, Daniel M

2016-12-01

OBJECTIVE The aim of this study was to investigate the incidence of and factors associated with complications following idiopathic scoliosis surgery in adolescents. METHODS The Nationwide Inpatient Sample database was used to identify patients 10-18 years of age who had undergone spinal fusion for adolescent idiopathic scoliosis (AIS) from 2002 to 2011. Twenty-three unique in-hospital postoperative complications, including death, were examined. A series of logistic regressions was used to determine if any demographic, comorbid, or surgical parameter was associated with complication development. Results of multiple logistic regression analyses were reported as odds ratios with 95% confidence intervals. All analyses were performed after the application of discharge weights to produce national estimates. RESULTS A total of 36,335 patients met the study inclusion criteria, 7.6% of whom (95% CI 6.3%-8.9%) developed at least one in-hospital complication. The 3 most common complications were respiratory failure (3.47%), reintubation (1.27%), and implant related (1.14%). Major complications such as death, pancreatitis, disseminated intravascular coagulation, visual loss, spinal cord injury, cardiac arrest, sepsis, nerve root injury, deep vein thrombosis, pulmonary embolism, shock, malignant hyperthermia, myocardial infarction, and iatrogenic stroke each had an incidence ≤ 0.2%. On multiple logistic regression analysis, an increasing age (OR 0.80) was associated with significantly lower odds of complication development; patients who were male (OR 1.80) or who had anemia (OR 2.10), hypertension (OR 2.51), or hypothyroidism (OR 2.27) or underwent revision procedures (OR 5.55) were at a significantly increased risk for complication development. The rates of postoperative complications for posterior, anterior, and combined approaches were 6.7%, 10.0%, and 19.8%, respectively (p < 0.001). Length of fusion (< 8 vs ≥ 8 levels) was not associated with complication development (p = 0.311). CONCLUSIONS Analysis of 36,335 patients who had undergone surgery for AIS revealed that younger patients, male patients, patients with a history of anemia, hypertension, or hypothyroidism, as well as those undergoing revision or anterior or combined approaches may have higher rates of postoperative complications. However, the overall complication rate was low (7.6%), and major complications had a rate ≤ 0.2% for each event. These findings suggest that surgery for AIS remains relatively safe, and future prospective investigations may further help to decrease the postoperative morbidity rate.

Psychometric appraisal of the Scale for Interpersonal Behavior (SIB) in France.

PubMed

Bouvard, M; Arrindell, W A; Guérin, J; Bouchard, C; Rion, A C; Ducottet, E; Séchaud, M; Mollard, E; Grillet, P R; Dang, C; Cottraux, J

1999-08-01

The present study was carried out in France to evaluate the reliability and validity of the Scale for Interpersonal Behavior (SIB), a multidimensional measure of difficulty and distress in assertiveness that was originally developed in The Netherlands. This appraisal was conducted with a clinical sample (N = 166) and a general population sample (N = 150). The clinical series comprised 115 patients with social phobia and 51 patients with personality disorder, 28 of whom were of the avoidant type. Support was found for internal consistency and test-retest reliability of the French SIB. Compared to controls, both social phobics and patients with an avoidant personality disorder had significantly lower mean scores on all performance scales and significantly higher ones on all distress scales, with the social phobics occupying a position in between. Findings in relation to convergent and divergent validity were quite satisfactory. Sensitivity of the French SIB for detecting change was demonstrated in a subgroup of the clinical Ss who had undergone 15 sessions of cognitive-behavioral group therapy for underassertiveness.

Generic tacrolimus in solid organ transplantation.

PubMed

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.

Countermeasure development : Specific Immunoprophylaxis and Immunotherapy of Combined Acute Radiation Syndromes.

NASA Astrophysics Data System (ADS)

Popov, Dmitri; Maliev, Slava

Introduction: Combined Acute Radiation Syndromes (CARS) are extremely severe injuries. Combination of Radiation and Thermal factors induce development of the acute pathologi-cal processes in irradiated mammals: systemic inflammatory response syndrome (SIRS), toxic multiple organ injury (TMOI), toxic multiple organ dysfunction syndromes (TMOD), toxic multiple organ failure (TMOF). Also, high doses of Radiation and Thermal injury induce for-mation of following Toxin groups: A. Specific Radiation Toxins; B. Specific Thermal Toxins; C. Nonspecific Histiogenic Pro-inflammatory and Inflammatory Toxins (NHIT). Specific Radi-ation Toxins (SRT) include four major group of Toxins: Cerebrovascular Radiation Toxins (Cv RT), Cardiovascular Radiation Toxins (Cr RT), Gastrointestinal Radiation Toxins (Gi RT), and Hematopoietic Radiation Toxins (Hp RT). CvRT, Cr RT, Gi RT groups of toxins are defined as Neurotoxins and Hp RT group is defined as Hematotoxins. Specific Thermal Toxins (STT) were isolated from the burned skin (Voul S., Colker I. 1972). The group of Nonspecific Histio-genic Inflammatory Toxins (NHIT) includes high amount of tissue toxins which are peptides with medium molecular weight. This group of polypeptides can be a significant factor as a part of developing of the general inflammation reaction. However, NHIT toxins can't induce many reactions and changes which are specific for radiation. Specific Radiation Toxins (SRT) can induce specific processes and reactions such as clonogenic cell death -programmed apoptotic necrosis. Although besides high doses of radiation, other forms of cell death such as Pyroptosis or Oncosis should be considered. We postulate that NHIT toxins are similar for high doses of radiation and thermal injury. Specific Radiation Toxins (SRT) are induced by high doses of radiation. Specific Thermal Toxins (STT) toxins which formation is induced by a Thermal Factor are different from SRT. Administration of STT toxins or NHIT toxins (IV or IM) to healthy mammals induces development of lymphocytosis, leukocytosis, trombocytosis, and ac-tivation of blood coagulation cascade. Administration of SRT (IV or IM) to radiation naive animals induces leukopeina, thrombopenia, lymphopenia as a result of clonogenic programmed cell death. Blood coagulation cascade suppression is registered. Materials and Methods: Cows, horses, rabbits, rats, mice were used for different stages of our experiments. Animals were quarantined at laboratory conditions for three weeks prior to experimentation. Isolation of the SRT was provided from the central lymphatic duct of irradiated cows. Immunization of horses and rabbits to obtain Antiradiation Antibodies (Specific Antiradiation Antidote -SAR) was provided. Animals: cows, mice, rats were irradiated in the VSRI (Kazan), Academy of Vet-erinary Medicine (Moscow), Scientific Research Institute of Radiobiology (Gomel), Scientific Research Nuclear Center (Dubna). Equipment for gamma-irradiation: " Pyma", "Panorama" -Co gamma radiation source. Irradiation was performed by different doses corresponding to induction of severe forms of the Acute Radiation Syndromes (ARS). Mice and rats were re-ceiving the combined radiation and thermal injury. Model of the thermal injury: Burns -10% of total body surface. Third grade of burns was used as a model. Thermal Injury was given after irradiation. Preparations of Antiradiation Vaccine -contained a toxoid form of Radiation Toxins were used for immune-prophylaxis. Preparations of Antiradiation Antidote IgG con-tained antibodies to Radiation Toxins was used for immune-therapy. Scheme of experiments: I. Control: Group A. Animals with the ARS not received any treatment. Group B. Animals with the thermal injury not received any treatment. Group C. Animals with combined forms of the ARS not received any treatment. II. Specific Immune-prophylaxis with Antiradiation Vaccine (AV): Group D. Animals undergone immune-prophylaxis by AV. Irradiation was provided 24 days after vaccination. Group E. Animals undergone immune-prophylaxis by AV. Thermal injury was provided 24 days after vaccination. Group F. Animals undergone vaccination by AV and with combined injury. Irradiation was provided 24 days after vaccination. Thermal injury was provided immediately after irradiation. III. Specific Immune-therapy with Antiradiation Antidote IgG (AA IgG): Group G. Animals with ARS undergone immune-therapy by AA IgG. Group H. Animals with the thermal injury undergone immune-therapy by AA IgG. Group I. Animals with the combined radiation thermal injury undergone treatment by AA IgG. Results: The Lethality Doses (LD) 100/30 of radiation caused 100 % mortality rate in next 30 days after irradiation with development of different forms of the ARS in all groups. The thermal injury induced the third degree burns with area of dry necrosis in Group B. Mortality rate in this group with thermal injury without treatment was almost 100 % within next 30 days. Lethality rate at Combined Radiation and Thermal injury without any treatment in group C was 100 % within next 30 days. Immune-prophylaxis by the specific AV was most effective for animals with the ARS and survival rate was up to 70 %. Although, immune-therapy by the specific AA IgG demonstrated less effectiveness and demonstrated survival rate 50%-60% in different groups of irradiated animals. For animals with the thermal injury only, immune-therapy by the AV and immune-prophylaxis by AA IgG were significantly ineffective and the survival rate had not exceeded 15 %. Results of specific immune-therapy and immune-prophylaxis provided at combined radiation thermal injury (CRTI) had demonstrated 30% of survival rate. Conclusion: Effects of Different Biological Response to specific immune-prophylaxis with AV and specific immune-therapy with AA IgG had demonstrated effective radio-protection for irradiated ani-mals with different forms of the ARS. The recovery phases demonstrated a shorter period of reconvalescence. Effects of the specific immune-prophylaxis by the AV and immune-therapy by AA IgG provided for animals with thermal and combined injury were less effective although use-ful. However,Immune-prophylaxis and Immune-therapy by the Specific Immune-modifiers used at combined and Thermal injury demonstrated a prolonged life time after immune-prophylaxis. Demarcation zone of burns and necrotic tissues rejection were more expressed after immune-therapy. Additional specific Immune-prophylaxis with the Thermal Injury Toxins and Specific Immune-therapy with the specific anti-thermal injury antibodies (serum of IgG preparation) can significantly improve results of therapy of thermal and combined injury.

Etiological involvement of Helicobacter pylori in "reflux" gastritis after gastrectomy.

PubMed

Nagahata, Y; Kawakita, N; Azumi, Y; Numata, N; Yano, M; Saitoh, Y

1996-10-01

"Reflux" gastritis after gastrectomy is associated with various symptoms that are often detrimental to the patients' quality of life. However, prevention of the reflux does not always bring relief from the symptoms of gastritis. Helicobacter pylori (H. pylori) is now considered one of the most important pathogenetic factors in gastritis. The association between H. pylori infection and reflux gastritis after gastrectomy was investigated in the present study. In total, 115 patients who had undergone gastrectomy were entered in this study. Five biopsy specimens from the gastric remnant were taken during upper GI endoscopy. One specimen was examined pathohistologically, and the remaining four were examined for H. pylori infection. The histological degree of gastritis was determined according to the score system of Rauws et al. Forty-six patients (40%) demonstrated H. pylori infection in their stomachs. The prevalence of the infection was significantly higher in patients with conventional gastrectomy than in those with subtotal gastrectomy. The prevalence of H. pylori infection was significantly lower in patients who had undergone gastrectomy more than 4 yr ago. The histological gastritis score in patients with H. pylori infection was significantly higher than in those without H. pylori infection. Furthermore, the eradication of H. pylori in patients with both serious gastritis symptoms and no bile reflux improved the symptoms and significantly decreased the histological gastritis score. The results suggest that H. pylori is a factor in the pathogenesis of reflux gastritis after gastrectomy.

Charting the trajectory of domestic violence policy change in the Republic of Ireland since the mid-1990s - a path towards integration?

PubMed

Kearns, Noreen; Coen, Liam

2014-07-01

This paper assesses the policy developments pertaining to the implementation of an integrated approach to domestic violence over the past 15 years. The contextual setting is outlined in terms of the international policy response to the problem of domestic violence based on an ecological perspective. Periods of core strategic policy and related structural developments are considered illustrating the Irish experience of domestic violence policy-making and service provision. The value of adopting an integrated approach to domestic violence based on the rationale of improving strategic policy formulation, coordinating service provision and facilitating joined-up governance is set out. The core facilitators and challenges associated with such an approach are described. The policy framework and restructured landscape of domestic violence in Ireland has undergone significant change over the past decade and a half. The paper uses a three-dimensional matrix of domestic violence policy development and service integration as a means of addressing horizontal, vertical and resource aspects of collaboration and integration. While the changes have been characterised by significant phases of fluctuation in terms of coordinated action and the situation currently appears promising, however it is too early to judge the outcomes of the most recent reforms.

Charting the trajectory of domestic violence policy change in the Republic of Ireland since the mid-1990s – a path towards integration?

PubMed Central

Kearns, Noreen; Coen, Liam

2014-01-01

Introduction This paper assesses the policy developments pertaining to the implementation of an integrated approach to domestic violence over the past 15 years. The contextual setting is outlined in terms of the international policy response to the problem of domestic violence based on an ecological perspective. Description of policy and case Periods of core strategic policy and related structural developments are considered illustrating the Irish experience of domestic violence policy-making and service provision. The value of adopting an integrated approach to domestic violence based on the rationale of improving strategic policy formulation, coordinating service provision and facilitating joined-up governance is set out. The core facilitators and challenges associated with such an approach are described. Analysis and conclusion The policy framework and restructured landscape of domestic violence in Ireland has undergone significant change over the past decade and a half. The paper uses a three-dimensional matrix of domestic violence policy development and service integration as a means of addressing horizontal, vertical and resource aspects of collaboration and integration. While the changes have been characterised by significant phases of fluctuation in terms of coordinated action and the situation currently appears promising, however it is too early to judge the outcomes of the most recent reforms. PMID:25337062

The role of patent ductus arteriosus ligation in bronchopulmonary dysplasia: reexamining a randomized controlled trial.

PubMed

Clyman, Ronald; Cassady, George; Kirklin, James K; Collins, Monica; Philips, Joseph B

2009-06-01

To reexamine data from a randomized controlled trial of prophylactic ductus ligation to determine whether ligation contributes directly to the development of bronchopulmonary dysplasia (BPD) in extremely low birth weight infants. The control group underwent ligation only if they had development of a symptomatic patent ductus arteriosus (PDA). The Prophylactic Ligation group underwent ligation within 24 hours of birth regardless of the presence or absence of symptoms of a PDA. We hypothesized that the incidence of BPD would be higher in the prophylactic ligation group because more ligations were performed than in the control group. Prophylactic ligation significantly increased the incidence of BPD (defined as a supplemental oxygen requirement at 36 weeks postmenstrual age) and the incidence of mechanical ventilation at 36 weeks. The groups were statistically similar in gestation, sex, race, fluid administration, intraventricular hemorrhage, pulmonary air leaks, and survival to 36 weeks. The lower incidence of BPD in the control group occurred despite the fact that the incidence of necrotizing enterocolitis (a known risk factor for BPD) was significantly elevated in the control group. Only infants who had previously undergone a PDA ligation had development of BPD in the control group. Prophylactic ligation, while eliminating the PDA, increases the risk for BPD.

Obesity surgery and Ramadan: a prospective analysis of nutritional intake, hunger and satiety and adaptive behaviours during fasting.

PubMed

Al-Ozairi, Ebaa; Al Kandari, Jumana; AlHaqqan, Dalal; AlHarbi, Obaid; Masters, Yusuf; Syed, Akheel A

2015-03-01

Fasting for religious or lifestyle reasons poses a challenge to people who have undergone bariatric surgery. A total fast (abstaining from all forms of nourishment including liquids) during long summer days puts these patients at risk of dehydration and poor calorie and nutrient intake. We undertook telephone surveys of 24-h food recall, hunger and satiety scores, medication use, adverse symptoms and depression scores on a fasting day in Ramadan and a non-fasting day subsequently. We studied 207 participants (166 women) who had undergone sleeve gastrectomy. The mean (standard error) age was 35.2 (0.7) years. Men and women consumed 20.4 % (P = 0.018) and 16.9 % (P < 0.001) fewer calories and 44.8 % (P < 0.001) and 32.4 % (P < 0.001) less protein during fasting, respectively. There was no significant difference in the intake of fluids or incidence of adverse gastrointestinal, hypoglycaemic and sympathoadrenal symptoms. Of participants on pharmacotherapy, 89.5 % took their prescribed medications; 86.3 % made no changes to the doses, but 80.4 % changed the timing of the medications. Both women and men reported feeling less hungry and a preference for savoury foods during Ramadan. There was no difference in depression and work impairment scores. Fasting was well tolerated in persons who had undergone sleeve gastrectomy. It may be advisable to raise awareness about dietary protein intake and managing medications appropriately during fasting.

Married women's negotiation for safer sexual intercourse in Kenya: Does experience of female genital mutilation matter?

PubMed

Chai, Xiangnan; Sano, Yujiro; Kansanga, Moses; Baada, Jemima; Antabe, Roger

2017-12-01

Married women's ability to negotiate for safer sex is important for HIV prevention in sub-Saharan Africa, including Kenya. Yet, its relationship to female genital mutilation is rarely explored, although female genital mutilation has been described as a social norm and marker of womanhood that can control women's sexuality. Drawing on the social normative influence theory, this study addressed this void in the literature. We analysed data from the 2014 Kenya Demographic and Health Survey using logistic regression. Our sample included 8,602 married women. Two indicators of safer sex, namely the ability to refuse sex and the ability to ask for condom use, were explored. We found that women who had undergone genital mutilation were significantly less likely to report that they can refuse sex (OR=0.87; p<.05) and that they can ask for condom use during sexual intercourse (OR=0.62; p<.001) than their counterparts who had not undergone genital mutilation, while controlling for theoretically relevant variables. Our findings indicate that the experience of female genital mutilation may influence married women's ability to negotiate for safer sex through gendered socialization and expectations. Based on these findings, several policy implications are suggested. For instance, culturally sensitive programmes are needed that target both married women who have undergone genital mutilation and their husbands to understand the importance of safer sexual practices within marriage. Copyright © 2017. Published by Elsevier B.V.

Role of adrenal vein sampling in primary aldosteronism: Impact of imaging, localization, and age.

PubMed

Wachtel, Heather; Zaheer, Salman; Shah, Parth K; Trerotola, Scott O; Karakousis, Giorgos C; Roses, Robert E; Cohen, Debbie L; Fraker, Douglas L

2016-04-01

The role of adrenal vein sampling (AVS) has been debated, with some authorities advocating selective use in younger patients (≤40 years), and those localized by preoperative imaging. We examined our experience to determine the impact of AVS in patients who routinely underwent AVS with a high success rate. A retrospective cohort study was performed using a prospectively maintained database of patients referred for evaluation of PA (1997-2013). Patients were classified as localized (L) if a unilateral mass was identified on imaging, and non-localized (NL) otherwise. Of 367 patients, 94% (n = 345) underwent successful AVS. Seventy-two percent (n = 265) were L; AVS was lateralizing 58% (n = 214). AVS changed management in 43% of patients (n = 158). In patients ≤40 years, AVS changed management in 30% (n = 15). In patients ≤40 years with a ≥1 cm adrenal mass, 12% (n = 3) would have undergone unnecessary surgery based on imaging results alone; in patients >40 years with a ≥1 cm adrenal mass, 3% (n = 5) would have undergone wrong-side surgery, and 30% (n = 50) would have undergone unnecessary surgery based on imaging. AVS changed management in a significant minority of patients regardless of age and imaging findings. AVS should be routinely recommended in all patients with PA, to direct operative therapy. J. Surg. Oncol. 2016;113:532-537. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Longitudinal Study of Intestinal Symptoms and Fecal Continence in Patients With Conformal Radiotherapy for Prostate Cancer

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

Geinitz, Hans, E-mail: hans.geinitz@lrz.tu-muenchen.d; Thamm, Reinhard; Keller, Monika

2011-04-01

Purpose: To prospectively assess the intestinal symptoms and fecal continence in patients who had undergone conformal radiotherapy (CRT) for prostate cancer. Methods and Materials: A total of 78 men who had undergone definitive CRT for prostate cancer were evaluated. The patients were assessed before, during (treatment Weeks 4 and 6), and 2, 12, and 24 months after CRT completion. The intestinal symptoms and fecal continence were evaluated with comprehensive standardized questionnaires. Results: The intestinal symptoms were mostly intermittent, with only a small minority of patients affected daily. Defecation pain, fecal urge, and rectal mucous discharge increased significantly during therapy. Defecationmore » pain and rectal mucous discharge had returned to baseline levels within 8 weeks and 1 year after CRT, respectively. However, fecal urge remained significantly elevated for {<=}1 year and then returned toward the pretreatment values. The prevalence of rectal bleeding was significantly elevated 2 years after CRT. Fecal continence deteriorated during CRT and remained impaired at 1 year after treatment. Incontinence was mostly minor, occurring less than once per week and predominantly affecting incontinence for gas. Conclusion: Intestinal symptoms and fecal incontinence increased during prostate CRT. Except for rectal bleeding, the intestinal symptoms, including fecal incontinence, returned to baseline levels within 1-2 years after CRT. Thus, the rate of long-term late radiation-related intestinal toxicity was low.« less

A century later: Long-term change of an inshore temperate marine fish assemblage

NASA Astrophysics Data System (ADS)

McHugh, Matthew; Sims, David W.; Partridge, Julian C.; Genner, Martin J.

2011-02-01

There is compelling evidence that European marine fish assemblages have undergone extensive changes in composition over the last century. However, our knowledge of which species have changed in abundance and body size distributions, and the reasons for these changes, is limited due to a paucity of historical data. Here we report a study of long-term change in a marine fish assemblage from the inshore waters of the Western English Channel, near Plymouth. We compiled data from historic trawls undertaken between 1913 and 1922, and resurveyed those sites in 2008 and 2009. Our results revealed highly significant temporal differences in assemblage composition, but the scale of change was not consistent among taxonomic groups. Dramatic changes were recorded within the elasmobranchs, characterised by a reduction in abundance of all skate (Rajiidae) species, apparent extirpation of the angel shark ( Squatina squatina), and large increases in the abundance of lesser-spotted catshark ( Scyliorhinus canicula). By contrast we observed less evidence of change among 'flatfishes' (Pleuronectiformes) or 'roundfishes' (other teleosts). Changes were also observed in length-frequency distributions, with a significant decline in the size distribution of elasmobranchs (excluding S. canicula), but no significant change in size distributions of either group of teleosts. These data provide further evidence that larger, slow-maturing species have undergone declines in UK waters over the last century, and form useful benchmarks for assessment of future changes in this coastal faunal assemblage.

Early-seral stand age and forest structural changes in public and private forestlands in Western Oregon and Washington

Treesearch

Robert L Deal; Sharon Stanton; Matthew Betts; Zhiqiang. Yang

2015-01-01

Federal forests in the Pacific Northwest region have undergone exceptional changes in management over the past 20 years, and these changes have led to a reduction in regional timber production and significant changes in the management and current age structure of forests. Public lands include large areas of older forests with relatively little younger early-seral...

Transformational Autonomy and Personal Transportation: Synergies and Differences Between Cars and Planes

NASA Technical Reports Server (NTRS)

Goodrich, Kenneth H.; Nickolaou, Jim; Moore, Mark D.

2016-01-01

Highly automated cars have undergone tremendous investment and progress over the past ten years with speculation about fully-driverless cars within the foreseeable, or even near future, becoming common. If a driverless future is realized, what might be the impact on personal aviation? Would self-piloting airplanes be a relatively simple spin-off, possibly making travel by personal aircraft also commonplace? What if the technology for completely removing human drivers turns out to be further in the future rather than sooner; would such a delay suggest that transformational personal aviation is also somewhere over the horizon or can transformation be achieved with less than full automation? This paper presents a preliminary exploration of these questions by comparing the operational, functional, and implementation requirements and constraints of cars and small aircraft for on-demand mobility. In general, we predict that the mission management and perception requirements of self-piloting aircraft differ significantly from self-driving cars and requires the development of aviation specific technologies. We also predict that the highly-reliable control and system automation technology developed for conditionally and highly automated cars can have a significant beneficial effect on personal aviation, even if full automation is not immediately feasible.

Stratigraphic and Earth System approaches to defining the Anthropocene

NASA Astrophysics Data System (ADS)

Steffen, Will; Leinfelder, Reinhold; Zalasiewicz, Jan; Waters, Colin N.; Williams, Mark; Summerhayes, Colin; Barnosky, Anthony D.; Cearreta, Alejandro; Crutzen, Paul; Edgeworth, Matt; Ellis, Erle C.; Fairchild, Ian J.; Galuszka, Agnieszka; Grinevald, Jacques; Haywood, Alan; Ivar do Sul, Juliana; Jeandel, Catherine; McNeill, J. R.; Odada, Eric; Oreskes, Naomi; Revkin, Andrew; Richter, Daniel deB.; Syvitski, James; Vidas, Davor; Wagreich, Michael; Wing, Scott L.; Wolfe, Alexander P.; Schellnhuber, H. J.

2016-08-01

Stratigraphy provides insights into the evolution and dynamics of the Earth System over its long history. With recent developments in Earth System science, changes in Earth System dynamics can now be observed directly and projected into the near future. An integration of the two approaches provides powerful insights into the nature and significance of contemporary changes to Earth. From both perspectives, the Earth has been pushed out of the Holocene Epoch by human activities, with the mid-20th century a strong candidate for the start date of the Anthropocene, the proposed new epoch in Earth history. Here we explore two contrasting scenarios for the future of the Anthropocene, recognizing that the Earth System has already undergone a substantial transition away from the Holocene state. A rapid shift of societies toward the UN Sustainable Development Goals could stabilize the Earth System in a state with more intense interglacial conditions than in the late Quaternary climate regime and with little further biospheric change. In contrast, a continuation of the present Anthropocene trajectory of growing human pressures will likely lead to biotic impoverishment and a much warmer climate with a significant loss of polar ice.

Possible risk factors for Down syndrome and sex chromosomal aneuploidy in Mysore, South India

PubMed Central

Malini, Suttur S.; Ramachandra, Nallur B.

2007-01-01

BACKGROUND: Down syndrome (DS) and sex chromosomal aneuploidy (SA) are common chromosomal anomalies causing congenital malformations and mental retardation in humans. The well-established risk factor, advanced maternal age, was not found in many of the DS and SA cases in India, while the other possible risk factors have not been well studied. In view of this, the present study has been made. MATERIALS AND METHODS: During the last 5 years, 150 clinically suspected DS and 25 SA cases were referred to our laboratory for chromosome investigation from major hospitals of Mysore city. Chromosome preparations were made from these patients after informed consent was obtained. Well-spread G-banded metaphase plates were analyzed by automated LEICA KARYO software. Two hundred and 100 randomly selected families belonging to different religions were used as controls for the DS and SA cases, respectively. Statistical analysis was carried out using logistic regression RESULTS: Out of the 150 cases of DS, 122 had free trisomy 21, two were mosaic trisomy 21, and one had translocation. Logistic regression of case-control study of DS children revealed that the odds ratio of uncle-niece marriages, or second cousin marriages, or parents lived in rural region, or exposure of the parents to chemicals, or parents education status, or habits (tobacco/ alcohol used) of father, or mother not undergone prenatal scanning, or mothers with previous abortions were significant when all the variables of that category were used one at a time. Exposure of the parents to chemicals, parents’ educational status, habits (tobacco/alcohol use) of the father, mother not undergone prenatal scanning, and history of previous abortions were significant when all the variables of that category were used one at a time. Similarly, except for consanguinity, history of previous abortions, and mother not undergone prenatal scanning, all other factors showed significant odds ratios in SA cases. CONCLUSION: Besides the known risk factors, consanguinity, region (rural/urban) of residence of parents, exposure of parents to chemicals, educational status of parents, habits of father, prenatal scanning, and reproductive performance of mother are possible risk factors for chromosomal aneuploidy. PMID:21957357

Developing a neurosurgical simulation-based educational curriculum: an overview.

PubMed

Harrop, James; Lobel, Darlene A; Bendok, Bernard; Sharan, Ashwini; Rezai, Ali R

2013-10-01

The science of medicine has undergone rapid advancement and expansion as a result of significant technological innovations, and this has affected the training of neurosurgical residents. To develop a simulation-based neurosurgical educational curriculum to improve resident education. The Congress of Neurological Surgeons established a Simulation Committee to explore the use of this technology in maximizing neurosurgical education. Simulators were incorporated into an educational curriculum with both a didactic and a technical component. The simulators and didactic portions were validated with objective pretests and posttests. The Simulator Committee has continued to expand the use of simulators in neurosurgical education and has organized several practical courses. The simulator use continues to expand into vasculature, spinal, and cranial modules. Each module has independently shown improved training scores in both didactic and technical skills. The Congress of Neurological Surgeons has successfully incorporated simulation into an educational curriculum with both didactic and technical components. This appears to be a powerful educational tool, and its uses are being further expanded.

Evolution of medical education in the Department of Medicine of the Complutense University of Madrid in the last decade.

PubMed

Collado-Yurrita, L; Ciudad-Cabañas, M J; Cuadrado-Cenzual, M A

2018-03-11

This paper aims to show changes in Medical Education in the Department of Medicine at the Complutense University of Madrid in the last 10-15 years. Medical education in the Department of Medicine at the Complutense University of Madrid has undergone significant changes in the last 10-15 years. An attempt to summarize these shows that radical change in the teaching of medicine for both teachers and students has taken place in three areas: 1. Progressive development of Patient-centered medical education. 2. Development of a competency-based training concerned with the mastering of knowledge and skills and their evaluation through objective and structured clinical assessment tests. 3. Introducing simulation techniques and virtual reality in the teaching of clinical practice aimed at improving our students' training and enhancing patient safety. We believe that the changes applied have pleased students as well as teachers and even patients and are helping to improve the training of our students.

The significance and scope of evolutionary developmental biology: a vision for the 21st century.

PubMed

Moczek, Armin P; Sears, Karen E; Stollewerk, Angelika; Wittkopp, Patricia J; Diggle, Pamela; Dworkin, Ian; Ledon-Rettig, Cristina; Matus, David Q; Roth, Siegfried; Abouheif, Ehab; Brown, Federico D; Chiu, Chi-Hua; Cohen, C Sarah; Tomaso, Anthony W De; Gilbert, Scott F; Hall, Brian; Love, Alan C; Lyons, Deirdre C; Sanger, Thomas J; Smith, Joel; Specht, Chelsea; Vallejo-Marin, Mario; Extavour, Cassandra G

2015-01-01

Evolutionary developmental biology (evo-devo) has undergone dramatic transformations since its emergence as a distinct discipline. This paper aims to highlight the scope, power, and future promise of evo-devo to transform and unify diverse aspects of biology. We articulate key questions at the core of eleven biological disciplines-from Evolution, Development, Paleontology, and Neurobiology to Cellular and Molecular Biology, Quantitative Genetics, Human Diseases, Ecology, Agriculture and Science Education, and lastly, Evolutionary Developmental Biology itself-and discuss why evo-devo is uniquely situated to substantially improve our ability to find meaningful answers to these fundamental questions. We posit that the tools, concepts, and ways of thinking developed by evo-devo have profound potential to advance, integrate, and unify biological sciences as well as inform policy decisions and illuminate science education. We look to the next generation of evolutionary developmental biologists to help shape this process as we confront the scientific challenges of the 21st century. © 2015 Wiley Periodicals, Inc.

Improved CPAS Photogrammetric Capabilities for Engineering Development Unit (EDU) Testing

NASA Technical Reports Server (NTRS)

Ray, Eric S.; Bretz, David R.

2013-01-01

This paper focuses on two key improvements to the photogrammetric analysis capabilities of the Capsule Parachute Assembly System (CPAS) for the Orion vehicle. The Engineering Development Unit (EDU) system deploys Drogue and Pilot parachutes via mortar, where an important metric is the muzzle velocity. This can be estimated using a high speed camera pointed along the mortar trajectory. The distance to the camera is computed from the apparent size of features of known dimension. This method was validated with a ground test and compares favorably with simulations. The second major photogrammetric product is measuring the geometry of the Main parachute cluster during steady-state descent using onboard cameras. This is challenging as the current test vehicles are suspended by a single-point attachment unlike earlier stable platforms suspended under a confluence fitting. The mathematical modeling of fly-out angles and projected areas has undergone significant revision. As the test program continues, several lessons were learned about optimizing the camera usage, installation, and settings to obtain the highest quality imagery possible.

The continuing decline of coral reefs in Bahrain.

PubMed

Burt, John A; Al-Khalifa, Khalifa; Khalaf, Ebtesam; Alshuwaikh, Bassem; Abdulwahab, Ahmed

2013-07-30

Historically coral reefs of Bahrain were among the most extensive in the southern basin of the Arabian Gulf. However, Bahrain's reefs have undergone significant decline in the last four decades as a result of large-scale coastal development and elevated sea surface temperature events. Here we quantitatively surveyed six sites including most major coral reef habitats around Bahrain and a reef located 72 km offshore. Fleshy and turf algae now dominate Bahrain's reefs (mean: 72% cover), and live coral cover is low (mean: 5.1%). Formerly dominant Acropora were not observed at any site. The offshore Bulthama reef had the highest coral cover (16.3%) and species richness (22 of the 23 species observed, 13 of which were exclusive to this site). All reefs for which recent and historical data are available show continued degradation, and it is unlikely that they will recover under continuing coastal development and projected climate change impacts. Copyright © 2012 Elsevier Ltd. All rights reserved.

Expression of rabbit IL-4 by recombinant myxoma viruses enhances virulence and overcomes genetic resistance to myxomatosis.

PubMed

Kerr, P J; Perkins, H D; Inglis, B; Stagg, R; McLaughlin, E; Collins, S V; Van Leeuwen, B H

2004-06-20

Rabbit IL-4 was expressed in the virulent standard laboratory strain (SLS) and the attenuated Uriarra (Ur) strain of myxoma virus with the aim of creating a Th2 cytokine environment and inhibiting the development of an antiviral cell-mediated response to myxomatosis in infected rabbits. This allowed testing of a model for genetic resistance to myxomatosis in wild rabbits that have undergone 50 years of natural selection for resistance to myxomatosis. Expression of IL-4 significantly enhanced virulence of both virulent and attenuated virus strains in susceptible (laboratory) and resistant (wild) rabbits. SLS-IL-4 completely overcame genetic resistance in wild rabbits. The pathogenesis of SLS-IL-4 was compared in susceptible and resistant rabbits. The results support a model for resistance to myxomatosis of an enhanced innate immune response controlling virus replication and allowing an effective antiviral cell-mediated immune response to develop in resistant rabbits. Expression of IL-4 did not overcome immunity to myxomatosis induced by immunization.

Historical and contemporary cultural ecosystem service values in the rapidly urbanizing city state of Singapore.

PubMed

Thiagarajah, Jharyathri; Wong, Shermaine K M; Richards, Daniel R; Friess, Daniel A

2015-11-01

Cultural ecosystem services are a function of people and place, so may change as a location transitions from rural to urban. Singapore has undergone rapid urbanization after its independence in 1965, with a concomitant decline in natural habitat extent and accessibility. Using coastal mangrove forests as a case study habitat, changing cultural values were explored with a novel array of techniques, including qualitative archival analysis (photographs, oral histories), current sources (publically uploaded social media photographs), and surveys of (a) the general public and (b) visitors to publically accessible mangroves. Cultural value changed through time, with a significant transition from intrinsic, intrapersonal values (spiritual, cultural heritage) to instrumental, interpersonal values (recreation, education). Additionally, cultural value varied between different mangroves depending on their public accessibility, and the evolving degree of human interaction with the ecosystem as urban development occured. Cultural values change as development transitions, though mangroves still play an important cultural role in a heavily urbanized environment.

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…

Advances in yeast systematics and phylogeny and their use as predictors of biotechnologically important metabolic pathways

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…

The Challenges to Human Resources Development of Libraries in Times of Radical and Generational Changes.

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…

Music Education and Minority Groups Cultural and Musical Identities in the "Newer" South Africa: White Afrikaners and Indians

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…

Navajo Participation in Labor Unions. Lake Powell Research Project Bulletin Number 15, December 1975.

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…

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…

Salivary Gland Tumors Treated With Adjuvant Intensity-Modulated Radiotherapy With or Without Concurrent Chemotherapy

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

Comparison of Floaters after Cataract Surgery with Different Viscoelastics.

PubMed

Kim, Jinsoo; Lee, Hak Jun; Park, In Won; Kwon, Soon Il

2018-01-01

Purpose : To investigate whether there is a difference between symptoms of floaters according to the type of ophthalmic viscosurgical devices(OVDs) used during phacoemulsification. Methods: A total of 112 eyes had undergone standard phacosurgery with the dispersive OVDs(Group1). Group2 comprised 117 eyes that underwent phacosurgery with the dispersive OVDs, but between continuous curvilinear capsulorhexis and hydrodissection, some OVDs had been removed. Group3 included 120 eyes that had undergone phacosurgery with the cohesive OVDs. Results: 14 eyes (12.5%) of Group1 had new-onset floater after surgery whereas 6 eyes (5.13%) in Group2, and 7 eyes (5.83%) in Group3 at the day after and a week after surgery. This was significantly higher in Group1 than Group2 and Group3, respectively (p=0.047,0.049). Conclusion: Cataract surgery with dispersive OVD can predispose the eye to an increased floater symptom. Therefore, surgeons should consider release some OVDs during hydrodissection with dispersive viscoelastics and keep trying to avoid IOP surge during surgery.

Comparison of Floaters after Cataract Surgery with Different Viscoelastics

PubMed Central

Kim, Jinsoo; Lee, Hak Jun; Park, In Won; Kwon, Soon Il

2018-01-01

Purpose: To investigate whether there is a difference between symptoms of floaters according to the type of ophthalmic viscosurgical devices(OVDs) used during phacoemulsification. Methods: A total of 112 eyes had undergone standard phacosurgery with the dispersive OVDs(Group1). Group2 comprised 117 eyes that underwent phacosurgery with the dispersive OVDs, but between continuous curvilinear capsulorhexis and hydrodissection, some OVDs had been removed. Group3 included 120 eyes that had undergone phacosurgery with the cohesive OVDs. Results: 14 eyes (12.5%) of Group1 had new-onset floater after surgery whereas 6 eyes (5.13%) in Group2, and 7 eyes (5.83%) in Group3 at the day after and a week after surgery. This was significantly higher in Group1 than Group2 and Group3, respectively (p=0.047,0.049). Conclusion: Cataract surgery with dispersive OVD can predispose the eye to an increased floater symptom. Therefore, surgeons should consider release some OVDs during hydrodissection with dispersive viscoelastics and keep trying to avoid IOP surge during surgery. PMID:29483813

Correlates of having never been HIV tested among entrants to substance abuse treatment clinics: empiric findings from real-world New England settings.

PubMed

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.

Evaluation of the clinical supervision and professional development of student nurses.

PubMed

Severinsson, Elisabeth; Sand, Ase

2010-09-01

The aim of the present study was to evaluate the clinical supervision and professional development of student nurses during their undergraduate education. Nursing education has undergone radical changes as a result of improvements in the academic-based clinical education required for the Bachelor's degree. The sample consisted of student nurses (n = 147) and data were collected by means of questionnaires. The results demonstrated that the frequency of sessions and the supervision model employed influence the student nurses' professional development. Several significant correlations were found, most of which were related to the development of the student nurses' professional relationships with their supervisors and reflection on the development of their skills. From the patients' perspective, a high correlation was found between the factors 'preserving integrity' and 'protecting participation by patients and family members'. Clinical supervision strongly influences the student nurses' development of a professional identity, enhancing decision-making ability and personal growth. However, development of documentation skills should include a greater level of user involvement. The findings highlight the need for management and staff nurses to engage in on-going professional development. Transformative leadership, which is value driven, can facilitate and enhance the supervision and development of student nurses. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

Febrile neutropenia and refeeding syndrome.

PubMed

Jahn, H K; Barraclough, S; Currell, S; Tighe, M P

2016-12-01

We describe the management of a 4-year-old child with acute lymphoblastic leukaemia (ALL) who presented with febrile neutropenia, Cryptosporidium and subsequently developed refeeding syndrome. Febrile neutropenia is common and can be life-threatening and we highlight the identification of well low-risk neutropenic children with resolved febrile illnesses suitable for early discharge. We also discuss the potential management strategies for Cryptosporidium Refeeding syndrome is not common, but should be considered as a cause of acute inpatient deterioration and is a significant risk, with potential morbidity, in children who have undergone a period of catabolism. This article reviews the current literature and provides useful guidance on these issues. 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/.

Detection of white matter injury in concussion using high-definition fiber tractography.

PubMed

Shin, Samuel S; Pathak, Sudhir; Presson, Nora; Bird, William; Wagener, Lauren; Schneider, Walter; Okonkwo, David O; Fernandez-Miranda, Juan C

2014-01-01

Over the last few decades, structural imaging techniques of the human brain have undergone significant strides. High resolution provided by recent developments in magnetic resonance imaging (MRI) allows improved detection of injured regions in patients with moderate-to-severe traumatic brain injury (TBI). In addition, diffusion imaging techniques such as diffusion tensor imaging (DTI) has gained much interest recently due to its possible utility in detecting structural integrity of white matter pathways in mild TBI (mTBI) cases. However, the results from recent DTI studies in mTBI patients remain equivocal. Also, there are important shortcomings for DTI such as limited resolution in areas of multiple crossings and false tract formation. The detection of white matter damage in concussion remains challenging, and development of imaging biomarkers for mTBI is still in great need. In this chapter, we discuss our experience with high-definition fiber tracking (HDFT), a diffusion spectrum imaging-based technique. We also discuss ongoing developments and specific advantages HDFT may offer concussion patients. © 2014 S. Karger AG, Basel.

ISAC's Gating-ML 2.0 data exchange standard for gating description.

PubMed

Spidlen, Josef; Moore, Wayne; Brinkman, Ryan R

2015-07-01

The lack of software interoperability with respect to gating has traditionally been a bottleneck preventing the use of multiple analytical tools and reproducibility of flow cytometry data analysis by independent parties. To address this issue, ISAC developed Gating-ML, a computer file format to encode and interchange gates. Gating-ML 1.5 was adopted and published as an ISAC Candidate Recommendation in 2008. Feedback during the probationary period from implementors, including major commercial software companies, instrument vendors, and the wider community, has led to a streamlined Gating-ML 2.0. Gating-ML has been significantly simplified and therefore easier to support by software tools. To aid developers, free, open source reference implementations, compliance tests, and detailed examples are provided to stimulate further commercial adoption. ISAC has approved Gating-ML as a standard ready for deployment in the public domain and encourages its support within the community as it is at a mature stage of development having undergone extensive review and testing, under both theoretical and practical conditions. © 2015 International Society for Advancement of Cytometry.

Guidelines for health technology assessment in Thailand (second edition)--the development process.

PubMed

Chaikledkaew, Usa; Kittrongsiri, Kankamon

2014-05-01

The first Thai-specific HTA guidelines were completed in 2008 with the aim of ensuring that all HTA data was accurate, of high quality, and relevant for making decisions pertaining to healthcare resource allocation. Based on a quality assessment of 89 economic evaluation studies in the Thai context published in international academic journals between 1982 and 2012, the analysis revealed a significant increase in quality of data sources and result reporting in studies published after the dissemination of the first Thai HTA guidelines. As the first Thai HTA guidelines were developed in 2008, a number of areas for improvement have been identified. Therefore, the objective of this chapter is to describe the development process of this second edition of HTA guidelines for Thailand which builds on the success of the first edition, while attempting to address some of the identified limitations of the first edition and reflect the changes that the health care and policy contexts have undergone in the intervening years. It is hoped that this second edition will continue to build on these successes so that policy decision making becomes increasingly evidence-based.

Cohort study examining long-term respiratory health, career duration and racing performance in racehorses that undergo left-sided prosthetic laryngoplasty and ventriculocordectomy surgery for treatment of left-sided laryngeal hemiplegia.

PubMed

Mason, B J; Riggs, C M; Cogger, N

2013-03-01

The risk of respiratory conditions, such as inflammatory airway disease (IAD) and exercise-induced pulmonary haemorrhage (EIPH), are thought to be higher in racehorses that undergo prosthetic laryngoplasty with ventriculocordectomy (PLVC) surgery to treat left-sided laryngeal hemiplegia (LLH) than in racehorses with normal laryngeal function. However, this has not been investigated formally owing to the difficulty of obtaining reliable follow-up data. To determine the incidence of respiratory conditions (IAD and EIPH), duration of racing career, number of starts and number of starts for which stakes money was earned in racehorses that had undergone PLVC surgery to treat LLH, compared with racehorses that did not have LLH or undergo any laryngeal surgery. A retrospective cohort study design was used, with surgical, clinical and race data of Thoroughbred racehorses obtained from the time of importation until retirement. The surgical cohort consisted of racehorses that had undergone PLVC for LLH and met specific inclusion criteria. Every surgical case was matched, according to trainer, year of import into Hong Kong and pre-import international handicap rating, to 2 unexposed racehorses. Respiratory conditions, such as excessive tracheal mucus and epistaxis due to severe EIPH, were significantly increased in the surgical cohort, compared with the matched unexposed cohort (P values <0.001 and <0.004, respectively). Racing career duration in the surgical cohort was significantly shorter than in the unexposed cohort, which was primarily due to retirement because of epistaxis. The number of race starts was fewer in the surgical than in the unexposed cohort after surgery/matching, but the number of starts for which stakes money was earned was not significantly different. Owners and trainers should be advised that racehorses with LLH that undergo PLVC surgery are at an increased risk of respiratory conditions (IAD and severe EIPH), which is likely to shorten their racing career compared to racehorses with normal laryngeal function. Racing performance in terms of race starts was significantly less in racehorses that had undergone PLVC surgery; however, the number of starts for which stakes money was earned was similar to those racehorses that were unexposed. © 2012 EVJ Ltd.

Clinical privileges for laparoscopic surgery.

PubMed

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.

PubMed

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

PubMed Central

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.

PubMed

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.

Cholecystectomy after breast reconstruction with a pedicled autologous tram flap. Types of surgical access

PubMed Central

Kostro, Justyna; Jankau, Jerzy; Bigda, Justyna; Skorek, Andrzej

2014-01-01

The number of breast reconstruction procedures has been increasing in recent years. One of the suggested treatment methods is breast reconstruction with a pedicled skin and muscle TRAM flap (transverse rectus abdominis muscle – TRAM). Surgical incisions performed during a cholecystectomy procedure may be located in the areas significant for flap survival. The aim of this paper is to present anatomical changes in abdominal walls secondary to pedicled skin and muscle (TRAM) flap breast reconstruction, which influence the planned access in cholecystectomy procedures. The authors present 2 cases of cholecystectomy performed due to cholelithiasis in female patients with a history of TRAM flap breast reconstruction procedures. The first patient underwent a traditional method of surgery 14 days after the reconstruction due to acute cholecystitis. The second patient underwent a laparoscopy due to cholelithiasis 7 years after the TRAM procedure. In both cases an abdominal ultrasound scan was performed prior to the operation, and surgical access was determined following consultation with a plastic surgeon. The patient who had undergone traditional cholecystectomy developed an infection of the postoperative wound. The wound was treated with antibiotics, vacuum therapy and skin grafting. After 7 weeks complete postoperative wound healing and correct healing of the TRAM flap were achieved. The patient who had undergone laparoscopy was discharged home on the second postoperative day without any complications. In order to plan a safe surgical access, it is necessary to know the changes in the anatomy of abdominal walls following a pedicled TRAM flap breast reconstruction procedure. PMID:25337177

Gallbladder mucin production and calcium carbonate gallstones in children.

PubMed

Sayers, Craig; Wyatt, Judy; Soloway, Roger D; Taylor, Donald R; Stringer, Mark D

2007-03-01

In contrast to adults, calcium carbonate gallstones are relatively common in children. Their pathogenesis is poorly understood. Cystic duct obstruction promotes calcium carbonate formation in bile and increases gallbladder mucin production. We tested the hypothesis that mucin producing epithelial cells would be increased in gallbladders of children with calcium carbonate gallstones. Archival gallbladder specimens from 20 consecutive children who had undergone elective cholecystectomy for cholelithiasis were examined. In each case, gallstone composition was determined by Fourier transform infrared microspectroscopy. Gallbladder specimens from six children who had undergone cholecystectomy for conditions other than cholelithiasis during the same period were used as controls. Multiple sections were examined in a blinded fashion and scored semiquantitatively for mucin production using two stains (alcian blue and periodic acid-Schiff). Increased mucin staining was observed in 50% or more epithelial cells in five gallbladder specimens from seven children with calcium carbonate stones, compared to 5 of 13 with other stone types (P = 0.17) and none of the control gallbladders (P = 0.02). Gallbladders containing calcium carbonate stones were significantly more likely than those containing other stone types or controls to contain epithelial cells with the greatest mucin content (P = 0.03). Gallbladders containing calcium carbonate stones were also more likely to show the ulcer-associated cell lineage. These results demonstrate an increase in mucin producing epithelial cells in gallbladders from children containing calcium carbonate stones. This supports the hypothesis that cystic duct obstruction leading to increased gallbladder mucin production may play a role in the development of calcium carbonate gallstones in children.

Penile Improvement Protocol in Postoperative Management of Patients Undergoing Metoidioplasty.

PubMed

Cohanzad, Shahryar

2016-12-01

To introduce a postoperative protocol to optimize the final size of the penis in patients undergoing metoidioplasty. Fourteen patients with the mean age of 29.3 years (8-40 ± 11.7), ten female transsexuals (46 xx karyotype) and four with 5-alpha-reductase deficiency syndrome (5ARDS) who had undergone extensive metoidioplasty entered a penile improvement protocol (PIP) between 2007 and 2015 at a specialized clinic in a general hospital in Tehran, Iran. Subjects were thoroughly instructed, rehearsed on the protocol and closely followed for 24 weeks. Written informed consent was obtained from all participants. We adapted a popular device, the so-called penile traction device, to accommodate the size of the neo-penis. All patients achieved an increase in their penile length with a mean of 28.42 mm (21-47 ± 6.86). Two subjects developed penile bruises and edema during the protocol implementation. No significant procedural complications were detected in the remaining 12 participants. PIP can be an effective step in increasing the size of the neo-penis in patients who have undergone metoidioplasty. We suggest this procedure to be seriously considered in postoperative management of well-informed and motivated patients to improve the final penile length and function in this population. Larger studies are needed to further validate this protocol. This journal requires that the authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Promoting factors of physical and mental development in early infancy: a comparison of preterm delivery/low birth weight infants and term infants.

PubMed

Hayashida, Kaori; Nakatsuka, Mikiya

2014-03-01

The aim of this study was to assess correlations between various factors and the physical and mental development of 4-month-old infants using a multi-faceted evaluation approach. A total of 1,402 self-administered questionnaires were distributed to consenting mothers of infants who had undergone a 4-month health checkup in Hiroshima prefecture, Japan. The questionnaires included items from the Japan Child and Family Research Institute Child Rearing Support Questionnaire and the KIDS type A test. Of the 421 completed questionnaires on mother-child pairs that were returned, 318 met the inclusion criteria and were eligible for further analysis. Comparison between infants in a preterm delivery or low birth weight (LBW) group (preterm and/or LBW group; n = 31) and a term delivery appropriate-weight for date (AFD) infant group (term AFD group; n =287) revealed that the preterm and/or LBW group had significantly higher mother child-rearing anxiety and difficult baby scores, along with significantly lower infant development and motor skill scores. Within the term AFD group, infants of primiparous mothers had significantly higher scores for motor skill and sociability with adults than those of multiparous mothers. Language comprehension scores were significantly higher in infants that were exclusively breast-fed than those formula-fed or combined breast-fed and formula-fed. Verbalization scores of infants whose mothers worked were significantly higher than those of infants whose mothers did not work. Infants with siblings aged <4 years exhibited significantly lower scores for motor skills, verbalization, and sociability with adults than infants without siblings or with siblings aged at least 5 years. In particular, we found that a mother's child-rearing anxiety was related to many areas of infant development. Evaluating the absence or presence of such factors and conducting preventive treatment could promote healthy infant development.

A comparison of apixaban and dabigatran etexilate for thromboprophylaxis following hip and knee replacement surgery.

PubMed

Mayer, Adriane; Schuster, Philipp; Fink, Bernd

2017-06-01

Patients who have undergone hip or knee replacement surgery are exposed to a high risk of developing a post-operative venous thromboembolus and so have a need for an effective, medication-based, thrombosis prophylaxis. New orally active anticoagulants have been available for a few years now. These specific substances directly block either thrombin (e.g., dabigatran etexilate) or Factor Xa (e.g., apixaban). It is not clear whether there are any efficacy differences between these two substances because there have never been any head-to-head studies carried out. We have carried out a study comparing two new orally active anticoagulants dabigatran etexilate (Pradaxa ® ) and apixaban (Eliquis ® ) that were each given to two groups of 200 patients respectively, who had undergone elective hip or knee arthroplasty (100 each). Each patient was assessed for pre- and post-operative hemoglobin concentrations, post-operative blood loss, the number of transfused erythrocyte concentrates, the duration of wound secretion, clinical thromboembolic complications (deep vein thrombosis, pulmonary embolism, myocardial infarct), as well as gastrointestinal, intracranial or wound-related bleeding complications. Dabigatran etexilate treatment led to a significant increase in the duration of wound secretion in both arthroplasty groups when compared to apixaban: wound secretion lasted 1.2 days longer on average in the dabigatran etexilate group than in the apixaban group (4.1 ± 2.1 vs. 2.9 ± 1.8 days). There were no significant differences observed between the two anticoagulant groups when comparing pre- and post-operative Hb values, post-operative blood loss and the other clinical parameters. Thus, it appears that the direct thrombin inhibitor, dabigatran etexilate, is associated with a longer period of wound secretion following the implantation of hip and knee endoprostheses than that associated with the Factor Xa inhibitor, apixaban.

The Evolution of Gene Regulatory Networks that Define Arthropod Body Plans.

PubMed

Auman, Tzach; Chipman, Ariel D

2017-09-01

Our understanding of the genetics of arthropod body plan development originally stems from work on Drosophila melanogaster from the late 1970s and onward. In Drosophila, there is a relatively detailed model for the network of gene interactions that proceeds in a sequential-hierarchical fashion to define the main features of the body plan. Over the years, we have a growing understanding of the networks involved in defining the body plan in an increasing number of arthropod species. It is now becoming possible to tease out the conserved aspects of these networks and to try to reconstruct their evolution. In this contribution, we focus on several key nodes of these networks, starting from early patterning in which the main axes are determined and the broad morphological domains of the embryo are defined, and on to later stage wherein the growth zone network is active in sequential addition of posterior segments. The pattern of conservation of networks is very patchy, with some key aspects being highly conserved in all arthropods and others being very labile. Many aspects of early axis patterning are highly conserved, as are some aspects of sequential segment generation. In contrast, regional patterning varies among different taxa, and some networks, such as the terminal patterning network, are only found in a limited range of taxa. The growth zone segmentation network is ancient and is probably plesiomorphic to all arthropods. In some insects, it has undergone significant modification to give rise to a more hardwired network that generates individual segments separately. In other insects and in most arthropods, the sequential segmentation network has undergone a significant amount of systems drift, wherein many of the genes have changed. However, it maintains a conserved underlying logic and function. © The Author 2017. Published by Oxford University Press on behalf of the Society for Integrative and Comparative Biology. All rights reserved. For permissions please email: journals.permissions@oup.com.

Marketing medical devices in Japan.

PubMed

Ohashi, J

1998-01-01

The control of medical devices in Japan has recently undergone significant changes as the country brings its systems into line with those of the United States and Europe. This article discusses pre-market approval, quality system requirements and post-market surveillance. Many technical issues have been harmonized but language is likely to continue to be a barrier to trade. Details of information services that are available to foreign manufacturers and importers are supplied.

Ethanol and Mesolimbic Serotonin/Dopamine Interactions Via 5-HT1B Receptors

DTIC Science & Technology

2006-03-01

baclofen , a GABAB receptor agonist, into the VTA probe and the response of extracellular DA in the ipsilateral NACC was determined. A significant...decrease (50% deduction) in extracellular DA in the ipsilateral NACC after perfusion with baclofen was considered an appropriate implantation of the...the VTA with baclofen were included in data analyses. Approximately 70% of the animals that had undergone surgery had both probes correctly implanted

"That's Not the Way I Was Taught Science at School!" How Preservice Primary Teachers in Abu Dhabi, United Arab Emirates Are Affected by Their Own Schooling Experiences

ERIC Educational Resources Information Center

Dickson, M.; Kadbey, H.

2014-01-01

Government schools in Abu Dhabi, as part of widescale educational reforms undertaken in the whole of the United Arab Emirates (UAE), have undergone significant change since 2007 across cycles and across subjects including science. Science had been taught historically in the UAE using fairly traditional "chalk and talk", teacher-centered…

Reasons for tubal sterilisation, regret and depressive symptoms

PubMed Central

Shreffler, Karina M.; Greil, Arthur L.; McQuillan, Julia; Gallus, Kami L.

2016-01-01

Objective To examine the associations between sterilisation reasons, regret, and depressive symptoms. Study Design Black, Hispanic, and non-Hispanic White US women ages 25–45 who participated in the National Survey of Fertility Barriers (NSFB) and reported a tubal sterilisation surgery were included in the sample for this study (n=837). Logistic regression was used to examine how characteristics of the sterilisation surgery (reasons for sterilisation, time since sterilisation, and new relationship since sterilisation) are associated with the odds of sterilisation regret, and linear regression was used to examine associations between sterilisation regret, sociodemographic factors, and depressive symptoms. Results Findings revealed that 28 percent of U.S. women who have undergone tubal sterilisation report regret. Time since sterilisation and having a reason for sterilisation other than simply not wanting (more) children (e.g., situational factors, health problems, encouragement by others, and other reasons) are associated with significantly higher odds of sterilisation regret. Finally, sterilisation regret is significantly associated with depressive symptoms after controlling for sociodemographic characteristics. Conclusion Sterilisation regret is relatively common among women who have undergone tubal sterilisation, and regret is linked to elevated, but not necessarily clinical depressive symptoms. The reasons for sterilisation can have important implications for women’s sterilisation regret and associated depressive symptoms. PMID:28133405

Nutritional supplementation with arginine protects radiation-induced effects. An experimental study.

PubMed

Pinto, Flavia Cristina Morone; Campos-Silva, Pamella; Souza, Diogo Benchimol de; Costa, Waldemar Silva; Sampaio, Francisco José Barcellos

2016-10-01

To investigate the protective effect of L-arginine on the prostate (nonneoplasic) of rats with radiation-induced injury. Twenty-nine Wistar rats, male adult, allocated into three groups: Control group (C) was not exposed to irradiation (n=10); Radiated group (R) had undergone pelvic irradiation (n=10); Supplemented and radiated group (R+S) had undergone pelvic irradiation plus L-arginine supplementation (n=9). The animals were observed for signs of toxicity. After euthanization, the prostate was dissected under magnification and stained by hematoxylin and eosin to study acinar structures and stained with Picrosirius red for collagen analysis. After radiation exposure, all animals presented diarrhea, but supplementation with L-arginine reduced this effect. The weight gain in the R+S group was significantly higher than in the C and R groups. In the R+S group the collagen density and the prostate acinar area was similar to the R and C groups. Epithelial height was significantly reduced in group R compared with group C (p<0.0001). When comparing the group R+S with R, a statistical difference was observed to be present (p<0.0001). Pelvic radiation promotes systemic effects and some structural modifications in the ventral prostate of rats. These modifications can be prevented by oral supplementation with L-arginine.

Empowering clinical supervisors to flourish though critical companionship.

PubMed

Mackay, Maria; Stephens, Moira; Wragg, Siobhan; Ebejer, Saskia; Bourgeois, Sharon

2018-01-01

Education for professional nursing practice has undergone a significant shift over the last few decades impacting nursing practice and the relationship between nurses. Enhancing professional practice and acting as a conduit for empowering nurses to be active participants in their learning and development is Practice Development. This action research project with philosophical premises of critical companionship and human flourishing aimed to develop the knowledge and skills of registered nurses in their ability to provide clinical supervision of nursing students in practice. The overall project consisted of two action research cycles in two different health facilities. Participants in both projects identified similar issues and common learning needs including; how to better understand and develop skills in reflective practice; how to provide a positive learning and enabling environment; and how to provide effective solution focused feedback. Workshop facilitators witnessed the flourishing of participants as they were enabled to negotiate their learning requirements; grow and develop in their roles over the workshop series. Participants themselves identified personal growth in skills, knowledge and confidence in being a preceptor as a result of the workshops in the study. Overall, this study has resulted in the development and capacity building of the nursing workforce clinical placement capacity through the development of clinical supervisors. Copyright © 2017 Elsevier Ltd. All rights reserved.

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.

DTIC Science & Technology

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

Two psammophilic noctuids (Lepidoptera) newly associated with beach plum Prunus maritima: The Dune Noctuid (Sympistis riparia) and Coastal Heathland Cutworm (Abagrotis nefascia) in Northeastern North America

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...

JPRS Report, East Europe

DTIC Science & Technology

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

PubMed Central

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.

PubMed

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.

Current developments and challenges in the assessment of negative symptoms.

PubMed

Lincoln, Tania M; Dollfus, Sonia; Lyne, John

2017-08-01

Reliable and valid assessment of negative symptoms is crucial to further develop etiological models and improve treatments. Our understanding of the concept of negative symptoms has undergone significant advances since the introduction of quantitative assessments of negative symptoms in the 1980s. These include the conceptualization of cognitive dysfunction as separate from negative symptoms and the distinction of two main negative symptom factors (avolition and diminished expression). In this review we provide an overview of existing negative symptom scales, focusing on both observer-rated and self-rated measurement of negative symptoms. We also distinguish between measures that assess negative symptoms as part of a broader assessment of schizophrenia symptoms, those specifically developed for negative symptoms and those that assess specific domains of negative symptoms within and beyond the context of psychotic disorders. We critically discuss strengths and limitations of these measures in the light of some existing challenges, i.e. observed and subjective symptom experiences, the challenge of distinguishing between primary and secondary negative symptoms, and the overlap between negative symptoms and related factors (e.g. personality traits and premorbid functioning). This review is aimed to inform the ongoing development of negative symptom scales. Copyright © 2016 Elsevier B.V. All rights reserved.

Composition and Variation of Macronutrients, Immune Proteins, and Human Milk Oligosaccharides in Human Milk From Nonprofit and Commercial Milk Banks.

PubMed

Meredith-Dennis, Laura; Xu, Gege; Goonatilleke, Elisha; Lebrilla, Carlito B; Underwood, Mark A; Smilowitz, Jennifer T

2018-02-01

When human milk is unavailable, banked milk is recommended for feeding premature infants. Milk banks use processes to eliminate pathogens; however, variability among methods exists. Research aim: The aim of this study was to compare the macronutrient (protein, carbohydrate, fat, energy), immune-protective protein, and human milk oligosaccharide (HMO) content of human milk from three independent milk banks that use pasteurization (Holder vs. vat techniques) or retort sterilization. Randomly acquired human milk samples from three different milk banks ( n = 3 from each bank) were analyzed for macronutrient concentrations using a Fourier transform mid-infrared spectroscopy human milk analyzer. The concentrations of IgA, IgM, IgG, lactoferrin, lysozyme, α-lactalbumin, α antitrypsin, casein, and HMO were analyzed by mass spectrometry. The concentrations of protein and fat were significantly ( p < .05) less in the retort sterilized compared with the Holder and vat pasteurized samples, respectively. The concentrations of all immune-modulating proteins were significantly ( p < .05) less in the retort sterilized samples compared with vat and/or Holder pasteurized samples. The total HMO concentration and HMOs containing fucose, sialic acid, and nonfucosylated neutral sugars were significantly ( p < .05) less in retort sterilized compared with Holder pasteurized samples. Random milk samples that had undergone retort sterilization had significantly less immune-protective proteins and total and specific HMOs compared with samples that had undergone Holder and vat pasteurization. These data suggest that further analysis of the effect of retort sterilization on human milk components is needed prior to widespread adoption of this process.

Sleep Quality, Sleep EEG Pattern, Mental Well-Being and Cortisol Secretion in Patients with Ruptured Aneurysm Post-Treatment: A Comparison with Post-Surgery Meningioma Patients and Controls.

PubMed

Gerber, Markus; Colledge, Flora; Pühse, Uwe; Holsboer-Trachsler, Edith; Zimmerer, Stefan; Brand, Serge

2016-01-01

Although the chance of surviving an aneurysmal subarachnoid haemorrhage (aSAH) has increased steadily, disturbed sleep and persistent psychological complaints are frequently experienced post-ictus. To date, however, few studies have sought to determine whether physiological parameters, such as objectively measured sleep and cortisol secretion, interrelate significantly with low sleep quality and psychological complaints such as depression. Furthermore, there is little evidence as to whether post-ictal complaints differ between aSAH patients and other groups who have experienced stressful medical intervention. Data on objective and subjective sleep, sleep-related dysfunctional cognitions, psychological functioning and cortisol secretion were collected from 15 patients who had undergone medical intervention for aSAH. Data were also collected from a group of 16 individuals who had undergone surgery for a meningioma and a third group made up of 17 healthy participants. aSAH patients and meningioma patients had significantly poorer subjective sleep than healthy controls and reported more sleep-related dysfunctional cognitions and hypochondriacal beliefs. They also had a significantly higher morning cortisol response. Finally, a non-significant trend was found showing that aSAH patients and meningioma patients reported poorer psychological functioning than healthy controls. Following treatment, aSAH patients and meningioma patients experience poorer subjective sleep and some differences in objectively measured sleep, which might be attributable to increased sleep-related dysfunctional cognitions and poorer overall psychological functioning. Differences in cortisol production were also observed, suggesting that some physiological imbalances are still present post-ictus. © 2016 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.

PubMed

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.

Relaxed evolution in the tyrosine aminotransferase gene tat in old world fruit bats (Chiroptera: Pteropodidae).

PubMed

Shen, Bin; Fang, Tao; Yang, Tianxiao; Jones, Gareth; Irwin, David M; Zhang, Shuyi

2014-01-01

Frugivorous and nectarivorous bats fuel their metabolism mostly by using carbohydrates and allocate the restricted amounts of ingested proteins mainly for anabolic protein syntheses rather than for catabolic energy production. Thus, it is possible that genes involved in protein (amino acid) catabolism may have undergone relaxed evolution in these fruit- and nectar-eating bats. The tyrosine aminotransferase (TAT, encoded by the Tat gene) is the rate-limiting enzyme in the tyrosine catabolic pathway. To test whether the Tat gene has undergone relaxed evolution in the fruit- and nectar-eating bats, we obtained the Tat coding region from 20 bat species including four Old World fruit bats (Pteropodidae) and two New World fruit bats (Phyllostomidae). Phylogenetic reconstructions revealed a gene tree in which all echolocating bats (including the New World fruit bats) formed a monophyletic group. The phylogenetic conflict appears to stem from accelerated TAT protein sequence evolution in the Old World fruit bats. Our molecular evolutionary analyses confirmed a change in the selection pressure acting on Tat, which was likely caused by a relaxation of the evolutionary constraints on the Tat gene in the Old World fruit bats. Hepatic TAT activity assays showed that TAT activities in species of the Old World fruit bats are significantly lower than those of insectivorous bats and omnivorous mice, which was not caused by a change in TAT protein levels in the liver. Our study provides unambiguous evidence that the Tat gene has undergone relaxed evolution in the Old World fruit bats in response to changes in their metabolism due to the evolution of their special diet.

Factors Influencing Complications of Percutaneous Nephrolithotomy: A Single-Center Study.

PubMed

Oner, Sedat; Okumus, Muhammed Masuk; Demirbas, Murat; Onen, Efe; Aydos, Mustafa Murat; Ustun, Mehmet Hakan; Kilic, Metin; Avci, Sinan

2015-11-14

Percutaneous nephrolithotomy (PNL) is a minimally invasive procedure used for successful treatment of renal calculi. However, it is associated with various complications. We assessed the complications and their potential influencing factors in patients who had undergone PNL. In total, 1750 patients who had undergone PNL from November 2003 to June 2011 were evaluated retrospectively. PNL complications and possible contributing risk factors (age, sex, serum creatinine level, previous operations, hydronephrosis, calculi size, localization, opacity, surgeon's experience, accessed calyxes, number of accesses, and costal entries) were determined. Receiver operating characteristic (ROC) analysis was used to investigate the cutoff values of the data. Ideal cutoff value was determined by Youden's J statistic. All the demographic and clinical variables were examined using backward stepwise logistical regression analysis. Continuous variables were categorized with logistic regression analysis according to the cutoff values. Complications occurred in 396 (24.4%) patients who had undergone PNL. Hemorrhage requiring blood transfusion occurred in 221 (12.6%) patients, hemorrhage requiring arterial embolization occurred in 7 (0.4%) patients, perirenal hematoma occurred in 17 (0.97%) patients, hemo-pneumothorax occurred in 32 (1.8%) patients, and colon perforation occurred in 4 (0.22%) patients. Three patients (0.06%) died of severe urosepsis, and one patient (0.02%) died of severe bleeding. The calculus size, localization, access site, number of accesses, presence of staghorn stones, surgeon's experience, and duration of the operation significantly affected the complication risk. Our retrospective evaluation of this large patient series reveals that, PNL is a very effective treatment modality for kidney stones. However, although rare, serious complications including death can occur.

Stem cell implantation for osteonecrosis of the femoral head.

PubMed

Lim, Young Wook; Kim, Yong Sik; Lee, Jong Wook; Kwon, Soon Yong

2013-11-15

What is the most effective treatment for the early stages of osteonecrosis of the femoral head? We assessed multiple drilling and stem cell implantation to treat the early stages of osteonecrosis of the femoral head. We report the clinical and radiological results of stem cell implantation and core decompression. In total, 128 patients (190 hips) who had undergone surgery were divided into two groups based on which treatment they had received: (1) multiple drilling and stem cell implantation or (2) core decompression, curettage and a bone graft. The clinical and radiographic results of the two groups were compared. At 5-year follow-up, in the stem cell implantation group, 64.3% (27/42) of the patients with Stage IIa disease, 56.7% (21/37) of the patients with Stage IIb disease and 42.9% (21/49) of the patients with Stage III disease had undergone no additional surgery. In the conventional core decompression group, 64.3% (9/14) of the patients with Stage IIa disease, 55.6% (5/9) of the patients with Stage IIb disease and 37.5% (3/8) of the patients with Stage III disease had undergone no additional surgery. Success rates were higher in patients with Ficat Stage I or II lesions than in those with Stage III lesions. There were no statistically significant differences between the groups in terms of success rate or in the clinical and radiographic results of the two methods. Essentially the same results were found with stem cell implantation as with the conventional method of core decompression.

Fluctuation of Bacteria on Bleb Surface After Trabeculectomy With Adjunctive Mitomycin C.

PubMed

Takahashi, Nobumichi; Sawada, Akira; Mochizuki, Kiyofumi; Katada, Toshihiko; Yamamoto, Tetsuya

2016-05-01

To determine whether the bacterial and floral patterns on the bleb surface are affected by the season in eyes that had undergone trabeculectomy with adjunctive mitomycin C. Forty-four glaucoma patients who had an avascular or a hypovascular cystic filtering bleb were studied. Swabs of the bleb surface were taken 4 times in 1 year. The samples were cultured, and all organisms isolated were identified and tested for antibiotic sensitivity and resistance. Of the 176 specimens, 48 tested positive in cultures. Out of the 44 glaucoma eyes that had undergone trabeculectomy, 30 (68.2%) eyes were culture positive. A total of 58 strains were isolated. The organisms isolated were 22 strains of Staphylococcus epidermidis, 21 strains of Propionibacterium acnes, 8 strains of Corynebacterium sp., 5 strains of Staphylococcus sp., and 1 strain of both Neisseria sp., and Candida parapsilosis. Fifteen eyes had a positive culture ≥2 times, and in 10 of these eyes, the same strain was isolated. There was no resistance to vancomycin by S. epidermidis, P. acnes, and Corynebacterium sp. All of the isolates of S.epidermidis were sensitive to minocycline and amikacin. The rate of bacterial detection in the spring was 13.6%, summer was 20.5%, autumn was 45.5%, and winter was 29.5%. The increase in the incidence of bacterial presence during autumn was significant (P=0.006; the Fisher exact probability test). It is not rare to detect the bacterial organisms on the bleb surface in glaucomatous eyes that had undergone trabeculectomy. The prevalence varied with the season and was highest in the autumn.

Topical Application of Arnica and Mucopolysaccharide Polysulfate Attenuates Periorbital Edema and Ecchymosis in Open Rhinoplasty: A Randomized Controlled Clinical Study.

PubMed

Simsek, Gokce; Sari, Elif; Kilic, Rahmi; Bayar Muluk, Nuray

2016-03-01

The purpose of this study was to investigate the effects of local arnica and mucopolysaccharide polysulfate treatment on the regression of postoperative edema and ecchymosis in patients who have undergone open technique rhinoplasty. One hundred eight patients were included in the study. Participants were randomized into three groups, all of whom had undergone rhinoplasty. Group 1 (n = 36) received postoperative arnica cream treatment, and group 2 (n = 36) received postoperative mucopolysaccharide polysulfate cream treatment. Group 3 (n = 36, control group) consisted of patients who received no postoperative local treatments. Patients were evaluated for 24 hours on days 2, 5, 7, and 10 after the operation. For the evaluation of postoperative edema and ecchymosis, a scale ranging from 0 to 4 was used, and the groups were compared. In groups 1 and 2, postoperative ecchymosis was significantly less than in the control group during postoperative days 1, 5, and 7 (p < 0.005). The regression of the edema was also more rapid in groups 1 and 2 than in the control group during evaluations on postoperative days 1, 5, and 7 (p < 0.005). Neither edema nor ecchymosis was significantly different between groups 1 and 2 (p > 0.005). The authors' results suggest that a rapid regression of edema and ecchymosis may be achieved by local treatments of arnica and mucopolysaccharide polysulfate cream. In addition, there are no significant differences between these two treatment regimens. Therapeutic, II.

Evaluation of swallowing ability using swallowing sounds in maxillectomy patients.

PubMed

Kamiyanagi, A; Sumita, Y; Ino, S; Chikai, M; Nakane, A; Tohara, H; Minakuchi, S; Seki, Y; Endo, H; Taniguchi, H

2018-02-01

Maxillectomy for oral tumours often results in debilitating oral hypofunction, which markedly decreases quality of life. Dysphagia, in particular, is one of the most serious problems following maxillectomy. This study used swallowing sounds as a simple evaluation method to evaluate swallowing ability in maxillectomy patients with and without their obturator prosthesis placed. Twenty-seven maxillectomy patients (15 men, 12 women; mean age 66.0 ± 12.1 years) and 30 healthy controls (14 men, 16 women; mean age 44.9 ± 21.3 years) were recruited for this study. Participants were asked to swallow 4 mL of water, and swallowing sounds were recorded using a throat microphone. Duration of the acoustic signal and duration of peak intensity (DPI) were measured. Duration of peak intensity was significantly longer in maxillectomy patients without their obturator than with it (P < .05) and was significantly longer in maxillectomy patients without their obturator than in healthy controls (P < .025 after Bonferroni correction). With the obturator placed, DPI was significantly longer in maxillectomy patients who had undergone soft palate resection than in those who had not (P < .05). These results suggest swallowing ability in maxillectomy patients could be improved by wearing an obturator prosthesis, particularly during the oral stage. However, it is difficult to improve the oral stage of swallowing in patients who have undergone soft palate resection even with obturator placement. © 2017 John Wiley & Sons Ltd.

Male infertility after mesh hernia repair: A prospective study.

PubMed

Hallén, Magnus; Sandblom, Gabriel; Nordin, Pär; Gunnarsson, Ulf; Kvist, Ulrik; Westerdahl, Johan

2011-02-01

Several animal studies have raised concern about the risk for obstructive azoospermia owing to vasal fibrosis caused by the use of alloplastic mesh prosthesis in inguinal hernia repair. The aim of this study was to determine the prevalence of male infertility after bilateral mesh repair. In a prospective study, a questionnaire inquiring about involuntary childlessness, investigation for infertility and number of children was sent by mail to a group of 376 men aged 18-55 years, who had undergone bilateral mesh repair, identified in the Swedish Hernia Register (SHR). Questionnaires were also sent to 2 control groups, 1 consisting of 186 men from the SHR who had undergone bilateral repair without mesh, and 1 consisting of 383 men identified in the general population. The control group from the SHR was matched 2:1 for age and years elapsed since operation. The control group from the general population was matched 1:1 for age and marital status. The overall response rate was 525 of 945 (56%). Method of approach (anterior or posterior), type of mesh, and testicular status at the time of the repair had no significant impact on the answers to the questions. Nor did subgroup analysis of the men ≤40 years old reveal any significant differences. The results of this prospective study in men do not support the hypothesis that bilateral inguinal hernia repair with alloplastic mesh prosthesis causes male infertility at a significantly greater rate than those operated without mesh. Copyright © 2011 Mosby, Inc. All rights reserved.

Gender Inequality: Is the National Population Policy's Objective of Two Child Norm Heading the Correct Way?

PubMed

Patrikar, S R; Bhalwar, R; Datta, A; Basannar, D R

2008-07-01

Male Preference is well known phenomena world wide from ancient ages. A descriptive study was carried out to assess the attitude of women towards birth of son, use of contraception methods and sex determination methods in rural village Kasurdi in Pune district. Univariate analysis was carried out by considering each factor determining sex preference separately as well as using a Logistic Regression Model. Adequacy of fit of the model has also been tested. Out of 110 respondents interviewed, 62.7% felt that male child is necessary in the family. Univariate analysis revealed that sex of first child, concern undergone for second pregnancy with regards to sex of the child, number of children in family and type of family were significant factors contributing to the son preference. The analysis under the logistic regression model revealed that sex of the first child and concern undergone in second pregnancy with respect to the sex of the second child are the most dominating and significant factors in the causation of son preference. The difference between family sizes when compared with the sex of first child was statistically significant signifying that if the first child is a male then it hardly matters whether the second child is male or female, but if the sex of first child is female then the families land up with bigger family size. On an average most of the respondents favour two children with an equal share of male and female children.

Estimating the prevalence of female genital mutilation in Portugal.

PubMed

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.

Laparoscopic bilateral salpingo-oophorectomy in breast cancer patients after transverse rectus abdominus myocutaneous flap reconstructive surgery.

PubMed

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.

Evaluation of the Effect of Diagnostic Molecular Testing on the Surgical Decision-Making Process for Patients With Thyroid Nodules.

PubMed

Noureldine, Salem I; Najafian, Alireza; Aragon Han, Patricia; Olson, Matthew T; Genther, Dane J; Schneider, Eric B; Prescott, Jason D; Agrawal, Nishant; Mathur, Aarti; Zeiger, Martha A; Tufano, Ralph P

2016-07-01

Diagnostic molecular testing is used in the workup of thyroid nodules. While these tests appear to be promising in more definitively assigning a risk of malignancy, their effect on surgical decision making has yet to be demonstrated. To investigate the effect of diagnostic molecular profiling of thyroid nodules on the surgical decision-making process. A surgical management algorithm was developed and published after peer review that incorporated individual Bethesda System for Reporting Thyroid Cytopathology classifications with clinical, laboratory, and radiological results. This algorithm was created to formalize the decision-making process selected herein in managing patients with thyroid nodules. Between April 1, 2014, and March 31, 2015, a prospective study of patients who had undergone diagnostic molecular testing of a thyroid nodule before being seen for surgical consultation was performed. The recommended management undertaken by the surgeon was then prospectively compared with the corresponding one in the algorithm. Patients with thyroid nodules who did not undergo molecular testing and were seen for surgical consultation during the same period served as a control group. All pertinent treatment options were presented to each patient, and any deviation from the algorithm was recorded prospectively. To evaluate the appropriateness of any change (deviation) in management, the surgical histopathology diagnosis was correlated with the surgery performed. The study cohort comprised 140 patients who underwent molecular testing. Their mean (SD) age was 50.3 (14.6) years, and 75.0% (105 of 140) were female. Over a 1-year period, 20.3% (140 of 688) had undergone diagnostic molecular testing before surgical consultation, and 79.7% (548 of 688) had not undergone molecular testing. The surgical management deviated from the treatment algorithm in 12.9% (18 of 140) with molecular testing and in 10.2% (56 of 548) without molecular testing (P = .37). In the group with molecular testing, the surgical management plan of only 7.9% (11 of 140) was altered as a result of the molecular test. All but 1 of those patients were found to be overtreated relative to the surgical histopathology analysis. Molecular testing did not significantly affect the surgical decision-making process in this study. Among patients whose treatment was altered based on these markers, there was evidence of overtreatment.

Assessment of the incidence of GDV following splenectomy in dogs.

PubMed

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.

PubMed

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.

Social disparities in access to breast and cervical cancer screening by women living in Spain.

PubMed

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.

Call for shared decision making in China: Challenges and opportunities.

PubMed

Yao, Mi; Finnikin, Samuel; Cheng, K K

2017-06-01

China's healthcare system has undergone extensive changes over recent years and the most recent reforms are designed to shift the emphasis away from hospital based services towards a more primary care based system. There is an increasing recognition that shared decision making needs to play a central role in the delivery of healthcare in China, but there are several significant barriers to overcome before this aspiration becomes a reality. Doctor-patient relationships in China are poor, consultations are often brief transactions and levels of trust are low. Implementing a shared decision making process developed in the Western World may be hampered by cultural differences, although this remains an under-researched area. There is, however, a suggestion that the academic community is starting to take an interest in encouraging shared decision making in practice and indications that the Chinese public may be willing to consider this new approach to healthcare. Copyright © 2017. Published by Elsevier GmbH.

Metastatic Neuroendocrine Tumour in a Renal Transplant Recipient: Dual-Tracer PET-CT with (18)F-FDG and (68)Ga-DOTANOC in This Rare Setting.

PubMed

Karunanithi, Sellam; Roy, Shambo Guha; Sharma, Punit; Yadav, Rajni; Bal, Chandrasekhar; Kumar, Rakesh

2015-03-01

Recipients of renal transplant are at increased risk of developing various malignancies, especially post-transplant lymphoproliferative disorder (PTLD) and skin cancers. Neuroendocrine tumours (NET) of the gastrointestinal tract have not been reported in this setting. Here we describe the case of a 75-year-old male who had undergone renal transplant 8 years back and now presented with significant weight loss and backache, clinically suspected as PTLD. (18)F-Fluordeoxyglucose ((18)F-FDG) positron emission tomography-computed tomography (PET-CT) showed hypermetabolic lesions in the liver and rectum, raising the suspicion of PTLD. However, biopsy from the liver lesion showed poorly differentiated NET. (68)Ga-labelled [1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid]-1-NaI(3)-octreotide ((68)Ga-DOTANOC) PET-CT was then done, which confirmed the primary lesion in the rectum with liver metastases.

Gut microbiota and oxalate homeostasis

PubMed Central

2017-01-01

This perspective focuses on how the gut microbiota can impact urinary oxalate excretion in the context of hyperoxaluria, a major risk factor in kidney stone disease. In the genetic disease of Primary Hyperoxaluria Type 1 (PH1), an increased endogenous production of oxalate, due to a deficiency of the liver enzyme alanine-glyoxylate aminotransferase (AGT), results in hyperoxaluria and oxalate kidney stones. The constant elevation in urinary oxalate in PH1 patients ultimately leads to tissue deposition of oxalate, renal failure and death and the only known cure for PH1 is a liver or liver-kidney transplant. The potential impact of a probiotic/therapeutic approach may be clinically significant in PH1 and could also extend to a much larger population of idiopathic oxalate stone formers who comprise ~12% of Americans, individuals with enteric hyperoxaluria, and an emerging population of hyperoxaluric patients who have undergone bariatric surgery and develop kidney stone disease as a consequence. PMID:28217701

Gut microbiota and oxalate homeostasis.

PubMed

Hatch, Marguerite

2017-01-01

This perspective focuses on how the gut microbiota can impact urinary oxalate excretion in the context of hyperoxaluria, a major risk factor in kidney stone disease. In the genetic disease of Primary Hyperoxaluria Type 1 (PH1), an increased endogenous production of oxalate, due to a deficiency of the liver enzyme alanine-glyoxylate aminotransferase (AGT), results in hyperoxaluria and oxalate kidney stones. The constant elevation in urinary oxalate in PH1 patients ultimately leads to tissue deposition of oxalate, renal failure and death and the only known cure for PH1 is a liver or liver-kidney transplant. The potential impact of a probiotic/therapeutic approach may be clinically significant in PH1 and could also extend to a much larger population of idiopathic oxalate stone formers who comprise ~12% of Americans, individuals with enteric hyperoxaluria, and an emerging population of hyperoxaluric patients who have undergone bariatric surgery and develop kidney stone disease as a consequence.

Biocompatibility of metal injection molded versus wrought ASTM F562 (MP35N) and ASTM F1537 (CCM) cobalt alloys.

PubMed

Chen, Hao; Sago, Alan; West, Shari; Farina, Jeff; Eckert, John; Broadley, Mark

2011-01-01

We present a comparative analysis between biocompatibility test results of wrought and Metal Injection Molded (MIM) ASTM F562-02 UNS R30035 (MP35N) and F1537 UNS R31538 (CCM) alloy samples that have undergone the same generic orthopedic implant's mechanical, chemical surface pre-treatment, and a designed pre-testing sample preparation method. Because the biocompatibility properties resulting from this new MIM cobalt alloy process are not well understood, we conducted tests to evaluate cytotoxicity (in vitro), hemolysis (in vitro), toxicity effects (in vivo), tissue irritation level (in vivo), and pyrogenicity count (in vitro) on such samples. We show that our developed MIM MP35N and CCM materials and treatment processes are biocompatible, and that both the MIM and wrought samples, although somewhat different in microstructure and surface, do not show significant differences in biocompatibility.

Kinesiology taping as an adjunct for pain management in cancer?

PubMed

Banerjee, Gourav; Rebanks, Jonathan; Briggs, Michelle; Johnson, Mark I

2016-07-14

We present the case of a 46-year-old woman who developed severe pain described as 'tearing' and 'searing' in the left side of the mid-trapezius region near the thoracic 8 vertebra (T8). The patient had undergone surgery for T8 fracture which had resulted from metastasis (secondary breast cancer). A community nurse referred the patient for physiotherapy assessment and treatment for her musculoskeletal pain and related symptoms that had affected her mobility and functional activities. The patient was treated with soft tissue therapy with the addition of kinesiology taping on follow-up visits. Kinesiology tape was applied over her left side trapezius region and left shoulder. The patient reported significant reductions in pain severity and felt greater control and stability over her left shoulder region, which resulted in better function and overall quality of life measures. She did not report any adverse effects. 2016 BMJ Publishing Group Ltd.

Assessing T cell clonal size distribution: a non-parametric approach.

PubMed

Bolkhovskaya, Olesya V; Zorin, Daniil Yu; Ivanchenko, Mikhail V

2014-01-01

Clonal structure of the human peripheral T-cell repertoire is shaped by a number of homeostatic mechanisms, including antigen presentation, cytokine and cell regulation. Its accurate tuning leads to a remarkable ability to combat pathogens in all their variety, while systemic failures may lead to severe consequences like autoimmune diseases. Here we develop and make use of a non-parametric statistical approach to assess T cell clonal size distributions from recent next generation sequencing data. For 41 healthy individuals and a patient with ankylosing spondylitis, who undergone treatment, we invariably find power law scaling over several decades and for the first time calculate quantitatively meaningful values of decay exponent. It has proved to be much the same among healthy donors, significantly different for an autoimmune patient before the therapy, and converging towards a typical value afterwards. We discuss implications of the findings for theoretical understanding and mathematical modeling of adaptive immunity.

Recent advancements of wide-angle polarization analysis with 3He neutron spin filters

NASA Astrophysics Data System (ADS)

Chen, W. C.; Gentile, T. R.; Ye, Q.; Kirchhoff, A.; Watson, S. M.; Rodriguez-Rivera, J. A.; Qiu, Y.; Broholm, C.

2016-09-01

Wide-angle polarization analysis with polarized 3He based neutron spin filters (NSFs) has recently been employed on the Multi-Axis Crystal Spectrometer (MACS) at the National Institute of Standards and Technology Center for Neutron Research (NCNR). Over the past several years, the apparatus has undergone many upgrades to address the fundamental requirements for wide angle polarization analysis using spin exchange optical pumping based 3He NSFs. In this paper, we report substantial improvements in the on-beam-line performance of the apparatus and progress toward routine user capability. We discuss new standard samples used for 3He NSF characterization and the flipping ratio measurement on MACS. We further discuss the management of stray magnetic fields produced by operation of superconducting magnets on the MACS instrument, which can significantly reduce the 3He polarization relaxation time. Finally, we present the results of recent development of horseshoe-shaped wide angle cells.

[Management of Acute Cholecystitis].

PubMed

Lee, Seung Ok; Yim, Sung Kyun

2018-05-25

Acute cholecystitis is a common serious complication of gallstones. The reported mortality of acute cholecystitis is approximately 3%, but the rate increases with age or comorbidity of the patient. If appropriate treatment is delayed, complications can develop as a consequence with a grave prognosis. The current standard of care in acute cholecystitis is an early laparoscopic cholecystectomy with the appropriate administration of fluid, electrolyte, and antibiotics. On the other hand, the severity of the disease and patient's operational risk must be considered. In those with high operational risks, gall bladder drainage can be performed as an alternative. Currently percutaneous and endoscopic drainage are available and show clinical success in most cases. After recovering from acute cholecystitis, the patients who have undergone drainage should be considered for cholecystectomy as a definitive treatment. However, in elderly patients or patients with significant comorbidity, operational risks may still be high, making cholecystectomy inappropriate. In these patients, gallstone removal using the percutaneous tract or endoscopy may be considered.

Fragment-based lead discovery: challenges and opportunities

NASA Astrophysics Data System (ADS)

Sun, Chaohong; Petros, Andrew M.; Hajduk, Philip J.

2011-07-01

Fragment-based lead discovery has undergone remarkable changes over the last 15 years. During this time, the pharmaceutical industry has changed dramatically as well, and continued evolution of the industry is assured. These changes present many challenges but also several opportunities for executing fragment-based drug design. This article will explore some of the more significant changes in the industry and how they may affect future discovery efforts related to fragment-based initiatives.

What are the experiences of seeking, receiving and providing FGM-related healthcare? Perspectives of health professionals and women/girls who have undergone FGM: protocol for a systematic review of qualitative evidence.

PubMed

Evans, Catrin; Tweheyo, Ritah; McGarry, Julie; Eldridge, Jeanette; McCormick, Carol; Nkoyo, Valentine; Higginbottom, Gina Marie Awoko

2017-12-14

Female genital mutilation (FGM) is an issue of global concern. High levels of migration mean that healthcare systems in higher-income western countries are increasingly being challenged to respond to the care needs of affected communities. Research has identified significant challenges in the provision of, and access to, FGM-related healthcare. There is a lack of confidence and competence among health professionals in providing appropriate care, suggesting an urgent need for evidence-based service development in this area. This study will involve two systematic reviews of qualitative evidence to explore the experiences, needs, barriers and facilitators to seeking and providing FGM-related healthcare in high-income (Organisation for Economic Cooperation and Development) countries, from the perspectives of: (1) women and girls who have undergone FGM and (2) health professionals. Twelve databases including MEDLINE, EMBASE, PsycINFO, ASSIA, Web of Science, ERIC, CINAHL, and POPLINE will be searched with no limits on publication year. Relevant grey literature will be identified from digital sources and professional networks.Two reviewers will independently screen, select and critically appraise the studies. Study quality will be assessed using the Joanna Briggs Institute Qualitative Assessment and Review Instrument appraisal tool. Findings will be extracted into NVivo software. Synthesis will involve inductive thematic analysis, including in-depth reading, line by line coding of the findings, development of descriptive themes and re-coding to higher level analytical themes. Confidence in the review findings will be assessed using the CERQual approach. Findings will be integrated into a comprehensive set of recommendations for research, policy and practice. The syntheses will be reported as per the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement. Two reviews will be published in peer-reviewed journals and an integrated report disseminated at stakeholder engagement events. CRD42015030001: 2015 and CRD42015030004: 2015. © 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.

SEM contour based metrology for microlens process studies in CMOS image sensor technologies

NASA Astrophysics Data System (ADS)

Lakcher, Amine; Ostrovsky, Alain; Le-Gratiet, Bertrand; Berthier, Ludovic; Bidault, Laurent; Ducoté, Julien; Jamin-Mornet, Clémence; Mortini, Etienne; Besacier, Maxime

2018-03-01

From the first digital cameras which appeared during the 70s to cameras of current smartphones, image sensors have undergone significant technological development in the last decades. The development of CMOS image sensor technologies in the 90s has been the main driver of the recent progresses. The main component of an image sensor is the pixel. A pixel contains a photodiode connected to transistors but only the photodiode area is light sensitive. This results in a significant loss of efficiency. To solve this issue, microlenses are used to focus the incident light on the photodiode. A microlens array is made out of a transparent material and has a spherical cap shape. To obtain this spherical shape, a lithography process is performed to generate resist blocks which are then annealed above their glass transition temperature (reflow). Even if the dimensions to consider are higher than in advanced IC nodes, microlenses are sensitive to process variability during lithography and reflow. A good control of the microlens dimensions is key to optimize the process and thus the performance of the final product. The purpose of this paper is to apply SEM contour metrology [1, 2, 3, 4] to microlenses in order to develop a relevant monitoring methodology and to propose new metrics to engineers to evaluate their process or optimize the design of the microlens arrays.

Wavefront propagation from one plane to another with the use of Zernike polynomials and Taylor monomials.

PubMed

Dai, Guang-ming; Campbell, Charles E; Chen, Li; Zhao, Huawei; Chernyak, Dimitri

2009-01-20

In wavefront-driven vision correction, ocular aberrations are often measured on the pupil plane and the correction is applied on a different plane. The problem with this practice is that any changes undergone by the wavefront as it propagates between planes are not currently included in devising customized vision correction. With some valid approximations, we have developed an analytical foundation based on geometric optics in which Zernike polynomials are used to characterize the propagation of the wavefront from one plane to another. Both the boundary and the magnitude of the wavefront change after the propagation. Taylor monomials were used to realize the propagation because of their simple form for this purpose. The method we developed to identify changes in low-order aberrations was verified with the classical vertex correction formula. The method we developed to identify changes in high-order aberrations was verified with ZEMAX ray-tracing software. Although the method may not be valid for highly irregular wavefronts and it was only proven for wavefronts with low-order or high-order aberrations, our analysis showed that changes in the propagating wavefront are significant and should, therefore, be included in calculating vision correction. This new approach could be of major significance in calculating wavefront-driven vision correction whether by refractive surgery, contact lenses, intraocular lenses, or spectacles.

The Development of Statistical Models for Predicting Surgical Site Infections in Japan: Toward a Statistical Model-Based Standardized Infection Ratio.

PubMed

Fukuda, Haruhisa; Kuroki, Manabu

2016-03-01

To develop and internally validate a surgical site infection (SSI) prediction model for Japan. Retrospective observational cohort study. We analyzed surveillance data submitted to the Japan Nosocomial Infections Surveillance system for patients who had undergone target surgical procedures from January 1, 2010, through December 31, 2012. Logistic regression analyses were used to develop statistical models for predicting SSIs. An SSI prediction model was constructed for each of the procedure categories by statistically selecting the appropriate risk factors from among the collected surveillance data and determining their optimal categorization. Standard bootstrapping techniques were applied to assess potential overfitting. The C-index was used to compare the predictive performances of the new statistical models with those of models based on conventional risk index variables. The study sample comprised 349,987 cases from 428 participant hospitals throughout Japan, and the overall SSI incidence was 7.0%. The C-indices of the new statistical models were significantly higher than those of the conventional risk index models in 21 (67.7%) of the 31 procedure categories (P<.05). No significant overfitting was detected. Japan-specific SSI prediction models were shown to generally have higher accuracy than conventional risk index models. These new models may have applications in assessing hospital performance and identifying high-risk patients in specific procedure categories.

Utilization of the Seven Principles for Good Practice in Undergraduate Education in General Chemistry by Community College Instructors

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…

Developing a unified monitoring and reporting system: a key to successful restoration of mixed-oak forests throughout the central hardwood region

Treesearch

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)...

Patterns of Career Development and Their Role in the Advancement of Female Faculty at Austrian Universities: New Roads to Success?

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…

Professional Development during a Period of Change: A Small-Scale Case Study Exploring the Effect of Context on Practice in a South African Rural School

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…

Questioning the "Politicization of Education": Development Education and Citizenship Education in the Context of Japanese Education Policies

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.

Image Acquisition and Quality in Digital Radiography.

PubMed

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.

The 10 micrometer transmitter

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.

PubMed

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.

School Belonging: Listening to the Voices of Secondary School Students Who Have Undergone Managed Moves

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

PubMed Central

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

Modeling Chemical and Isotopic Variations in Lab Formed Hydrothermal Carbonates

NASA Technical Reports Server (NTRS)

Niles, P. B.; Leshin, L. A.; Golden, D. C.; Socki, R. A.; Guan, Y.; Ming, D. W.

2005-01-01

Chemical and mineralogical data (e.g. [1]) from Mars suggest that the history of liquid water on the planet was more sporadic in nature than long-lived. The non-equilibrium chemical and isotopic compositions of the carbonates preserved in the martian meteorite ALH84001 are direct evidence of ancient secondary minerals that have not undergone significant diagenesis or stabilization processes typical of long-lived aqueous systems on Earth. Thus secondary minerals and sediments on Mars may primarily record the characteristics of the aqueous environment in which they formed without being significantly overprinted by subsequent diagenetic processes during burial.

Development and Feasibility of an Interactive Smartphone App for Early Assessment and Management of Symptoms Following Pancreaticoduodenectomy.

PubMed

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.

Associations Among Quadriceps Strength and Rate of Torque Development 6 Weeks Post Anterior Cruciate Ligament Reconstruction and Future Hop and Vertical Jump Performance: A Prospective Cohort Study.

PubMed

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.

[Corneal transparency: anatomical basis and evaluation methods].

PubMed

Avetisov, S E; Narbut, M N

Being just a relatively small part of the fibrous tunic of the eyeball, the cornea is, nevertheless, unique in terms of the variety of its functions. Because the cornea differs significantly from other protective frames in its structure, it provides the possibility of light transmission and strong refraction that largely contributes to the total refraction of the eye. The development of ophthalmology is impossible without improving methods of adequate anatomical and functional assessment of the eye not only as a whole, but also as a collection of interacting structures.In this regard, examination methods of the cornea have undergone significant advances in recent years. So far, the level of corneal transparency has been judged by biomicroscopy findings or indirect characteristics (thickness, structure, etc.). Confocal microscopy of the cornea and wave-based examinations involving one of the available laser interferometers (OCT or HRT) are also used. However, the data obtained with these methods resembles that of layer-specific reflectometry, i.e. the magnitude of directed reflection of the light beam from corneal corpuscles, which does not completely agree with the classical idea of transparency.

Persistent air leaks: a review with an emphasis on bronchoscopic management

PubMed Central

Lazarus, Donald R.

2017-01-01

Persistent air leak (PAL) is a cause of significant morbidity in patients who have undergone lung surgery and those with significant parenchymal lung disease suffering from a pneumothorax. Its management can be complex and challenging. Although conservative treatment with chest drain and observation is usually effective, other invasive techniques are needed when conservative treatment fails. Surgical management and medical pleurodesis have long been the usual treatments for PAL. More recently numerous bronchoscopic procedures have been introduced to treat PAL in those patients who are poor candidates for surgery or who decline surgery. These techniques include bronchoscopic use of sealants, sclerosants, and various types of implanted devices. Recently, removable one-way valves have been developed that are able to be placed bronchoscopically in the affected airways, ameliorating air-leaks in patients who are not candidates for surgery. Future comparative trials are needed to refine our understanding of the indications, effectiveness, and complications of bronchoscopic techniques for treating PAL. The following article will review the basic principles of management of PAL particularly focusing on bronchoscopic techniques. PMID:29268535

The recent breakup of an asteroid in the main-belt region.

PubMed

Nesvorný, David; Bottke, William F; Dones, Luke; Levison, Harold F

2002-06-13

The present population of asteroids in the main belt is largely the result of many past collisions. Ideally, the asteroid fragments resulting from each impact event could help us understand the large-scale collisions that shaped the planets during early epochs. Most known asteroid fragment families, however, are very old and have therefore undergone significant collisional and dynamical evolution since their formation. This evolution has masked the properties of the original collisions. Here we report the discovery of a family of asteroids that formed in a disruption event only 5.8 +/- 0.2 million years ago, and which has subsequently undergone little dynamical and collisional evolution. We identified 39 fragments, two of which are large and comparable in size (diameters of approximately 19 and approximately 14 km), with the remainder exhibiting a continuum of sizes in the range 2-7 km. The low measured ejection velocities suggest that gravitational re-accumulation after a collision may be a common feature of asteroid evolution. Moreover, these data can be used to check numerical models of larger-scale collisions.

Methylated arginine analogues: their potential role in atherosclerosis and cognition using the poloxamer-407-induced mouse model of dyslipidemia.

PubMed

Gilinsky, Michael A; Johnston, Thomas P; Zhukova, Natalia A; Dubrovina, Nina I; Latysheva, Tatyana V; Naumenko, Sergey E; Sukhovershin, Roman A

2016-07-25

An experimental mouse model of dyslipidemia and atherosclerosis was utilized to study the generation of methylarginines in vivo, as well as any potential behavioral changes in mice associated with the production of excess methylarginines. Following 14 weeks of poloxamer 407 treatment, mice developed atherosclerosis and the plasma concentrations of monomethylarginine and asymmetric dimethylarginine were found to be significantly greater than corresponding concentrations in control mice. This finding may have contributed to the development of aortic atherosclerotic lesions in poloxamer-treated mice by interfering with nitric oxide availability and, hence, normal function of vascular endothelium. Poloxamer-407-treated mice also showed a significant decrease in locomotor and exploratory activity, together with signs of emotional stress and anxiety relative to controls. Passive avoidance testing to assess learning and memory provided suggestive evidence that poloxamer-treated mice could potentially be characterized as having undergone a disruption in the process of forgetting about an aversive event, specifically, a foot shock, when compared with control mice. Thus, it is also suggested that the increase in both plasma monomethylarginine and asymmetric dimethylarginine in poloxamer-407-treated mice may somehow influence learning and memory, because endothelial dysfunction caused by reduced nitric oxide availability has been hypothesized to negatively influence cognitive function.

The impact of European harmonisation on Norwegian drug policy.

PubMed

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.

Association of periodontal disease, oral procedures, and other clinical findings with bacterial endocarditis in dogs.

PubMed

Peddle, Gordon D; Drobatz, Kenneth J; Harvey, Colin E; Adams, Allison; Sleeper, Meg M

2009-01-01

To identify risk factors potentially associated with the development of bacterial endocarditis in dogs and determine whether periodontal disease and surgical procedures (oral and nonoral) were associated with bacterial endocarditis. Retrospective case-control study. 76 dogs with (cases) and 80 dogs without (controls) bacterial endocarditis. Medical records were reviewed for information on signalment, physical examination findings, recent medical history, and results of echocardiography, clinicopathologic testing, and necropsy. None of the dogs with endocarditis had a history of undergoing any dental or oral procedure in the 3 months prior to the diagnosis of endocarditis, and no significant difference was found between groups with regard to the prevalence of oral infection. Dogs with endocarditis were significantly more likely to have undergone a nonoral surgical procedure that required general anesthesia in the preceding 3 months or to have developed a new heart murmur or a change in intensity of an existing heart murmur. Preexisting cardiac dis-ease (congenital or acquired) was not found to be a risk factor. Results did not provide any evidence of an association between bacterial endocarditis in dogs and either dental or oral surgical procedures or oral infection. Findings suggested that the routine use of prophylactic antimicrobial administration in dogs undergoing oral procedures needs to be reevaluated.

Development and Validation of the Agency for Healthcare Research and Quality Measures of Potentially Preventable Emergency Department (ED) Visits: The ED Prevention Quality Indicators for General Health Conditions.

PubMed

Davies, Sheryl; Schultz, Ellen; Raven, Maria; Wang, Nancy Ewen; Stocks, Carol L; Delgado, Mucio Kit; McDonald, Kathryn M

2017-10-01

To develop and validate rates of potentially preventable emergency department (ED) visits as indicators of community health. Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project 2008-2010 State Inpatient Databases and State Emergency Department Databases. Empirical analyses and structured panel reviews. Panels of 14-17 clinicians and end users evaluated a set of ED Prevention Quality Indicators (PQIs) using a Modified Delphi process. Empirical analyses included assessing variation in ED PQI rates across counties and sensitivity of those rates to county-level poverty, uninsurance, and density of primary care physicians (PCPs). ED PQI rates varied widely across U.S. communities. Indicator rates were significantly associated with county-level poverty, median income, Medicaid insurance, and levels of uninsurance. A few indicators were significantly associated with PCP density, with higher rates in areas with greater density. A clinical and an end-user panel separately rated the indicators as having strong face validity for most uses evaluated. The ED PQIs have undergone initial validation as indicators of community health with potential for use in public reporting, population health improvement, and research. © Health Research and Educational Trust.

Refinement of Generalized Born Implicit Solvation Parameters for Nucleic Acids and their Complexes with Proteins

PubMed Central

Nguyen, Hai; Pérez, Alberto; Bermeo, Sherry; Simmerling, Carlos

2016-01-01

The Generalized Born (GB) implicit solvent model has undergone significant improvements in accuracy for modeling of proteins and small molecules. However, GB still remains a less widely explored option for nucleic acid simulations, in part because fast GB models are often unable to maintain stable nucleic acid structures, or they introduce structural bias in proteins, leading to difficulty in application of GB models in simulations of protein-nucleic acid complexes. Recently, GB-neck2 was developed to improve the behavior of protein simulations. In an effort to create a more accurate model for nucleic acids, a similar procedure to the development of GB-neck2 is described here for nucleic acids. The resulting parameter set significantly reduces absolute and relative energy error relative to Poisson Boltzmann for both nucleic acids and nucleic acid-protein complexes, when compared to its predecessor GB-neck model. This improvement in solvation energy calculation translates to increased structural stability for simulations of DNA and RNA duplexes, quadruplexes, and protein-nucleic acid complexes. The GB-neck2 model also enables successful folding of small DNA and RNA hairpins to near native structures as determined from comparison with experiment. The functional form and all required parameters are provided here and also implemented in the AMBER software. PMID:26574454

Hyperparathyroidism after irradiation for childhood malignancy.

PubMed

McMullen, Todd; Bodie, Greg; Gill, Anthony; Ihre-Lundgren, Catharina; Shun, Albert; Bergin, Mary; Stevens, Graham; Delbridge, Leigh

2009-03-15

To examine the occurrence of hyperparathyroidism in a cohort of patients undergoing combined parathyroid and thyroid surgery after previous head-and-neck irradiation for childhood malignancy. This is a retrospective cohort study for the years 1996 to 2007. The study group comprised patients undergoing surgery in the University of Sydney Endocrine Surgical Unit who had received previous head-and-neck irradiation in childhood and who were identified as having pathologic thyroid and parathyroid characteristics. A total of 53 patients were identified in whom head-and-neck irradiation for the treatment of childhood malignancy had been documented. In each of the cases, thyroid disease was the primary reason for referral for surgery. Five of these patients (10%) were found to exhibit coexisting hyperparathyroidism. The latency period for hyperparathyroidism was less than 20 years in 4 of the 5 cases. There were four conventional parathyroid adenomas and one parathyroid lipoadenoma. All patients exhibited a significant decrease in postoperative calcium levels after surgery. To our knowledge, this is the first study to document the significant risk of hyperparathyroidism after radiation exposure for childhood malignancy. The timeframe for development of disease is much shorter than that published for individuals who have undergone irradiation for benign diseases. High doses of therapeutic radiation at a young age make childhood survivors of malignancy at especially high risk for developing hyperparathyroidism.

Late-onset Epstein-Barr virus-related disease in acute leukemia patients after haploidentical hematopoietic stem cell transplantation is associated with impaired early recovery of T and B lymphocytes.

PubMed

Liu, Jiangying; Yan, Chenhua; Zhang, Chunli; Xu, Lanping; Liu, Yanrong; Huang, Xiaojun

2015-10-01

Epstein-Barr virus-related disease (EBVD) is a serious clinical complication in patients who have undergone haploidentical hematopoietic stem cell transplantation (haploHSCT). Some recipients develop EBVD relatively late after haploHSCT, and most of these patients suffer a poor outcome. This retrospective cohort study characterized the early adaptive immune recovery of patients with acute leukemia presenting with EBVD more than 100 d after haploHSCT. Patients with acute leukemia who received haploHSCT and developed EBVD 100 d later (n = 8) were compared with a matched control group without EBVD (n = 24) with regard to peripheral WBC, lymphocytes, and neutrophils (at 30, 60, and 90 d) and recoveries of B and T lymphocytes (at 30 and 90 d, via immunophenotyping/flow cytometry). Ninety days after haploHSCT, the median values of WBCs and lymphocytes, and the recoveries of CD19(+) B cells and CD4(+) , CD8(+) , and CD4(+) CD45RO(+) T cells, were significantly lower in patients who developed EBVD, relative to the control group. These results suggest a significant association between deficient early recovery of B and T lymphocytes and the development of late-onset EBVD after haploHSCT. Our observation could facilitate clinical intervention and the improvement of overall survival of patients undergoing haploHSCT. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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.

Biomaterials and Advanced Technologies for Hemostatic Management of Bleeding.

PubMed

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.

Comparative study of the nutritional status of vitamin A in pregnant women and in women who became pregnant or did not after Roux-en-Y gastric bypass.

PubMed

Cruz, Sabrina; Machado, Suzana; Cruz, Suelem; Pereira, Sílvia; Saboya, Carlos; Ramalho, Andréa

2018-01-18

the changes in digestive physiology after Roux-en-Y gastric bypass (RYGB), as well as pregnancy, maximizes the risk of vitamin A deficiency (VAD) and both can result in harm to the mother and child health. to compare the nutritional status of vitamin A among women who became pregnant or did not after RYGB and in pregnant women who did not undergo surgery, and to assess the impact of VAD on the mother and child health. this is a cross-sectional study of the analytical type. The women were divided into: group 1 (G1) with 80 pregnant women; group 2 (G2) with 40 pregnant women who had previously undergone RYGB, both in their third trimester of pregnancy; and group 3 (G3) with 77 non-pregnant women who had previously undergone RYGB. Serum concentrations of retinol and β-carotene, night blindness (NB), gestational and neonatal intercurrences were investigated. The significance level adopted was p < 0.05. RYGB, per se,had a greater impact on the inadequacy of retinol, β-carotene, and on the increased percentage of NB when compared to non-surgical pregnant women. When surgery was associated with pregnancy, more than 75% of inadequacy of retinol and β-carotene was noted, as well as a higher percentage of individuals with NB. G2 also showed increased prevalence ratio for developing gestational and neonatal intercurrences, when compared to G1. RYGB provides greater negative impact on the nutritional status of vitamin A compared to pregnancy, and surgery associated with pregnancy can create even greater risks.

Percutaneous Intraductal Radiofrequency Ablation for Extrahepatic Distal Cholangiocarcinoma: A Method for Prolonging Stent Patency and Achieving Better Functional Status and Quality of Life

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

Wu, Tian-tian, E-mail: matthewwu1979@hotmail.com; Li, Wei-min, E-mail: weimin-li-surgery@126.com; Li, Hu-cheng, E-mail: hucheng-li-surgery@126.com

PurposeThe clinical efficacy of intraductal radiofrequency ablation (RFA) with Habib™ EndoHPB catheter, a newly developed intervention for malignant extrahepatic biliary obstruction, remains uncertain. The aim of this study was to investigate the clinical efficacy of intraductal RFA.MethodsData from 71 patients with extrahepatic distal cholangiocarcinoma were retrospectively analyzed. The study patients were divided into RFA and control groups. The RFA group had undergone percutaneous transhepatic intraductal RFA with a Habib™ EndoHPB catheter, followed by placement of covered or uncovered biliary self-expandable metallic stents (SEMs) whereas the control group had undergone percutaneous transhepatic covered or uncovered SEMs placement. Procedure-related complications, stent patency,more » patient survival, and postoperative serum bilirubin concentrations were compared between the two groups. The Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) questionnaire was administered to evaluate functional status, improvement in clinical manifestations, and quality of life.ResultsThe RFA group had a longer median stent patency than the control group (p = 0.001 for uncovered SEMs placement). Higher functional well-being, hepatobiliary-specific cancer subscale, Trial Outcome Index, and total FACT-Hep scores were observed during post-procedure follow-up in the RFA group. However, median survival did not differ significantly between the two groups (p > 0.05).ConclusionsProlongation of stent patency and better functional status and quality of life, which are all important clinical endpoints, were observed in patients treated with intraductal RFA. Prospective randomized controlled clinical trials are necessary to further investigate the clinical efficacy and long-term benefits of intraductal RFA.« less

Developing the Maternity Portfolio to promote maternal role attainment in women who have undergone artificial reproductive treatment.

PubMed

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.

A retrospective analysis of 34 potentially missed cases of female genital mutilation in the emergency department.

PubMed

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.

The treatment of systemic lupus proliferative nephritis.

PubMed

Punaro, Marilynn G

2013-11-01

Lupus nephritis is one of the most common and serious complications of systemic lupus erythematosus (SLE) in childhood affecting more than 80% of patients. Treatment of this complication has undergone significant evolution in recent years. A series of randomized controlled trials has clarified the role of a variety of immunomodulating regimens including some novel biologic medications. This review touches on the major trials that have influenced practice and shaped current thinking about the treatment of proliferative lupus glomerulonephritis.

The 2014 ASCENDS Field Campaign - a Carbon Dioxide Laser Absorption Spectrometer Perspective

NASA Astrophysics Data System (ADS)

Spiers, G. D.; Menzies, R. T.; Jacob, J. C.; Geier, S.; Fregoso, S. F.

2014-12-01

NASA's ASCENDS mission has been flying several candidate lidar instruments on board the NASA DC-8 aircraft to obtain column integrated measurements of Carbon Dioxide. Each instrument uses a different approach to making the measurement and combined they have allowed for the informed development of the ASCENDS mission measurement requirements(1). The JPL developed Carbon Dioxide Laser Absorption Spectrometer, CO2LAS is one of these instruments. The CO2LAS measures the weighted, column averaged carbon dioxide between the aircraft and the ground using a continuous-wave heterodyne technique. The instrument operates at a 2.05 micron wavelength optimized for enhancing sensitivity to boundary layer carbon dioxide. Since the 2013 field campaign the instrument has undergone significant upgrades that improve the data collection efficiency and instrument stability and has recently been re-integrated onto the NASA DC-8 for the August 2014 ASCENDS field campaign. This presentation will summarize the instrument and algorithm improvements and review the 2014 field campaign flights and preliminary results. (1) Abshire, J.B. et al., "An overview of NASA's ASCENDS Mission lidar measurement requirements", submitted to 2014 Fall AGU Conference.

Company Profile: Selventa, Inc.

PubMed

Fryburg, David A; Latino, Louis J; Tagliamonte, John; Kenney, Renee D; Song, Diane H; Levine, Arnold J; de Graaf, David

2012-08-01

Selventa, Inc. (MA, USA) is a biomarker discovery company that enables personalized healthcare. Originally founded as Genstruct, Inc., Selventa has undergone significant evolution from a technology-based service provider to an active partner in the development of diagnostic tests, functioning as a molecular dashboard of disease activity using a unique platform. As part of that evolution, approximately 2 years ago the company was rebranded as Selventa to reflect its new identity and mission. The contributions to biomedical research by Selventa are based on in silico, reverse-engineering methods to determine biological causality. That is, given a set of in vitro or in vivo biological observations, which biological mechanisms can explain the measured results? Facilitated by a large and carefully curated knowledge base, these in silico methods generated new insights into the mechanisms driving a disease. As Selventa's methods would enable biomarker discovery and be directly applicable to generating novel diagnostics, the scientists at Selventa have focused on the development of predictive biomarkers of response in autoimmune and oncologic diseases. Selventa is presently building a portfolio of independent, as well as partnered, biomarker projects with the intention to create diagnostic tests that predict response to therapy.

Pre-operative serum alkaline phosphatase as a predictive indicator of post-operative hypocalcaemia in patients undergoing total thyroidectomy.

PubMed

Miah, M S; Mahendran, S; Mak, C; Leese, G; Smith, D

2015-11-01

This study aimed to evaluate whether a pre-operative elevated serum alkaline phosphatase level is a potential predictor of post-operative hypocalcaemia after total thyroidectomy. Data was retrospectively collected from the case notes of patients who had undergone total thyroidectomy. Patients were divided into Graves' disease and non-Graves' groups. Pre-operative and post-operative biochemical markers, including serum calcium, alkaline phosphatase and parathyroid hormone levels, were reviewed. A total of 225 patients met the inclusion criteria. Graves' disease was the most common indication (n = 134; 59.5 per cent) for thyroidectomy. Post-operative hypocalcaemia developed in 48 patients (21.3 per cent) and raised pre-operative serum alkaline phosphatase was noted in 94 patients (41.8 per cent). Raised pre-operative serum alkaline phosphatase was significantly associated with post-operative hypocalcaemia, particularly in Graves' disease patients (p < 0.05). Pre-operative serum alkaline phosphatase measurements help to predict post-thyroidectomy hypocalcaemia, especially in patients who do not develop hypoparathyroidism. Ascertaining the pre-operative serum alkaline phosphatase level in patients undergoing total thyroidectomy may help surgeons to identify at-risk patients.

Extrusion-spheronization: process variables and characterization.

PubMed

Sinha, V R; Agrawal, M K; Agarwal, A; Singh, G; Ghai, D

2009-01-01

Multiparticulate systems have undergone great development in the past decade fueled by the better understanding of their multiple roles as a suitable delivery system. With the passage of time, significant advances have been made in the process of pelletization due to the incorporation of specialized techniques for their development. Extrusion-spheronization seems to be the most promising process for the optimum delivery of many potent drugs having high systemic toxicity. It also offers immense pharmaceutical applicability due to the benefits of high loading capacity of active ingredient(s), narrow size distribution, and cost-effectiveness. On application of a specific coat, these systems can also aid in site-specific delivery, thereby enhancing the bioavailability of many drugs. The current review focuses on the process of extrusion-spheronization and the operational (extruder types, screen pressure, screw speed, temperature, moisture content, spheronization load, speed and time) and formulation (excipients and drugs) variables, which may affect the quality of the final pellets. Various methods for the evaluation of the quality of the pellets with regard to the size distribution, shape, friability, granule strength, density, porosity, flow properties, and surface texture are discussed.

Targeted Endoscopic Imaging

PubMed Central

Li, Meng; Wang, Thomas D

2011-01-01

Summary Endoscopy has undergone explosive technological growth in over recent years, and with the emergence of targeted imaging, its truly transformative power and impact in medicine lies just over the horizon. Today, our ability to see inside the digestive tract with medical endoscopy is headed toward exciting crossroads. The existing paradigm of making diagnostic decisions based on observing structural changes and identifying anatomical landmarks may soon be replaced by visualizing functional properties and imaging molecular expression. In this novel approach, the presence of intracellular and cell surface targets unique to disease are identified and used to predict the likelihood of mucosal transformation and response to therapy. This strategy can result in the development of new methods for early cancer detection, personalized therapy, and chemoprevention. This targeted approach will require further development of molecular probes and endoscopic instruments, and will need support from the FDA for streamlined regulatory oversight. Overall, this molecular imaging modality promises to significantly broaden the capabilities of the gastroenterologist by providing a new approach to visualize the mucosa of the digestive tract in a manner that has never been seen before. PMID:19423025

Image Quality Analysis of Various Gastrointestinal Endoscopes: Why Image Quality Is a Prerequisite for Proper Diagnostic and Therapeutic Endoscopy

PubMed Central

Ko, Weon Jin; An, Pyeong; Ko, Kwang Hyun; Hahm, Ki Baik; Hong, Sung Pyo

2015-01-01

Arising from human curiosity in terms of the desire to look within the human body, endoscopy has undergone significant advances in modern medicine. Direct visualization of the gastrointestinal (GI) tract by traditional endoscopy was first introduced over 50 years ago, after which fairly rapid advancement from rigid esophagogastric scopes to flexible scopes and high definition videoscopes has occurred. In an effort towards early detection of precancerous lesions in the GI tract, several high-technology imaging scopes have been developed, including narrow band imaging, autofocus imaging, magnified endoscopy, and confocal microendoscopy. However, these modern developments have resulted in fundamental imaging technology being skewed towards red-green-blue and this technology has obscured the advantages of other endoscope techniques. In this review article, we have described the importance of image quality analysis using a survey to consider the diversity of endoscope system selection in order to better achieve diagnostic and therapeutic goals. The ultimate aims can be achieved through the adoption of modern endoscopy systems that obtain high image quality. PMID:26473119

Cell-Free Fetal DNA Testing for Prenatal Diagnosis.

PubMed

Drury, S; Hill, M; Chitty, L S

Prenatal diagnosis and screening have undergone rapid development in recent years, with advances in molecular technology driving the change. Noninvasive prenatal testing (NIPT) for Down syndrome as a highly sensitive screening test is now available worldwide through the commercial sector with many countries moving toward implementation into their publically funded maternity systems. Noninvasive prenatal diagnosis (NIPD) can now be performed for definitive diagnosis of some recessive and X-linked conditions, rather than just paternally inherited dominant and de novo conditions. NIPD/T offers pregnant couples greater choice during their pregnancy as these safer methods avoid the risk of miscarriage associated with invasive testing. As the cost of sequencing falls and technology develops further, there may well be potential for whole exome and whole genome sequencing of the unborn fetus using cell-free DNA in the maternal plasma. How such assays can or should be implemented into the clinical setting remain an area of significant debate, but it is clear that the progress made to date for safer prenatal testing has been welcomed by expectant couples and their healthcare professionals. © 2016 Elsevier Inc. All rights reserved.

Mustard Gas: Its Pre-World War I History

NASA Astrophysics Data System (ADS)

Duchovic, Ronald J.; Vilensky, Joel A.

2007-06-01

Mustard gas is perhaps the best-known chemical warfare agent and is commonly associated with World War I, both in its first use in warfare and its first synthesis. Although the former is correct, the latter is not. We review here the history of the repeated synthesis of mustard gas by 19th century European chemists. The techniques developed by these chemists were the ones relied upon by both the Central Powers and the Allies to manufacture this agent during World War I. Further, a historical review of mustard gas synthesis highlights the increasing sophistication of the chemical sciences. In particular, during the latter half of the 19th century, the concepts of atomic mass, chemical periodicity, and chemical structure underwent a rapid development that culminated in the application of quantum mechanics to chemistry in the 20th century. A comparison is made of the molecular formula for mustard gas from the 19th century with that of the 21st century, demonstrating that the concept of atomic mass has undergone significant refinement over this period of time.

Delayed Gastric Emptying in Side-to-Side Gastrojejunostomy in Pancreaticoduodenectomy: Result of a Propensity Score Matching.

PubMed

Tsutaho, Akio; Nakamura, Toru; Asano, Toshimichi; Okamura, Keisuke; Tsuchikawa, Takahiro; Noji, Takehiro; Nakanishi, Yoshitsugu; Tanaka, Kimitaka; Murakami, Soichi; Kurashima, Yo; Ebihara, Yuma; Shichinohe, Toshiaki; Ito, Yoichi M; Hirano, Satoshi

2017-10-01

Delayed gastric emptying (DGE) is one of the most common morbidities of pancreaticoduodenectomy (PD). The aim of this study was to clarify whether the incidence of DGE can be reduced by side-to-side gastric greater curvature-to-jejunal anastomosis in subtotal stomach-preserving pancreaticoduodenectomy (SSPPD). The clinical data of 253 patients who had undergone PD were examined. Of a total of 188 patients who had undergone SSPPD, a gastrojejunostomy (GJ) was performed with end-to-side anastomosis in 87 patients (SSPPD-ETS group), and a GJ was performed with a greater curvature side-to-jejunal side anastomosis in 101 patients (SSPPD-STS group). After propensity score matching, the matched cohort consisted of 74 patients in each group. The postoperative data were evaluated according to the International Study Group of Pancreatic Surgery grade of DGE. The total incidence of DGE was 9.4% in the SSPPD-ETS group and 4% in the SSPPD-STS group, with no significant difference (p = 0.1902). A significant difference was observed between the two groups in the incidence of DGE grade C (p = 0.0426). The incidence of total DGE was not reduced statistically in the STS group compared with the ETS group, but reduced DGE grade C. Side-to-side anastomosis might be associated with a reduced incidence of DGE grade C.

Treatment outcomes and dental anxiety in 18-year-olds with MIH, comparisons with healthy controls - a longitudinal study.

PubMed

Jälevik, Birgitta; Klingberg, Gunilla

2012-03-01

In a previous study, 9-year-old children with severe Molar Incisor Hypomineralization (MIH) had undergone dental treatment of their first molars nearly ten times as often as children in a control group. They also showed more management problems (BMP) and fear and anxiety (DFA). To assess the long-term outcomes of dental treatments, dental anxiety, and patients' satisfaction in adolescents with MIH. Sixty-seven patients, identical with those in the baseline study, were studied at age 18-years. The participants answered the Children's Fear Survey Schedule - Dental Subscale the Dental Visit Satisfaction Scale (DVSS). Data were compiled from the dental records concerning dental health, number of restorative treatments and BMP. Molar Incisor Hypomineralization group had a significantly higher DMFT, and had undergone treatment of their permanent first molars 4.2 times as often as the controls. BMP was still significantly more common in the MIH group. However, DFS was reduced in MIH group and increased in the control groups. The DVSS scores did not differ between the groups. Conclusions.  Patients with severe MIH had a poorer dental health and were still more treatment consuming at age 18-years. However, their dental fear was now at the same level as the controls. © 2011 The Authors. International Journal of Paediatric Dentistry © 2011 BSPD, IAPD and Blackwell Publishing Ltd.

Conversion in laparoscopic colorectal cancer surgery: impact on short- and long-term outcome.

PubMed

Scheidbach, Hubert; Garlipp, Benjamin; Oberländer, Henrik; Adolf, Daniela; Köckerling, Ferdinand; Lippert, Hans

2011-12-01

Despite the well-documented safety and effectiveness of laparoscopic colorectal surgery in curative intention, the role of conversion and its impact on short- and long-term outcome after resection of a carcinoma are unclear and continue to give rise to controversial discussion. Within the framework of a prospective, multicenter observational study (Laparoscopic Colorectal Surgery Study Group), into which a total of 5,863 patients from 69 hospitals were recruited over a period of 10 years, a subgroup of all patients who had undergone curative resection was analyzed with regard to the effects of conversion. Of the 1409 patients who had undergone curative resection for colorectal carcinoma, conversion had to be performed in 80 (5.7%) cases for the most diverse reasons. The duration of surgery (median: 183 vs. 241 minutes; P<.001) was significantly longer in the conversion group. Perioperatively, significant disadvantages were noted in converted patients in terms of intraoperative blood loss (median: 243 vs. 573 mL, P<.001), need for perioperative blood transfusion (10.8% vs. 33.8%; P<.001), and resumption of bowel movement (median: after 3 vs. 4 days; P<.001). With regard to postoperative morbidity, significant disadvantages were observed in converted patients, in particular in terms of specific surgical complications, including a higher rate of anastomotic insufficiency (5.0% vs. 13.8%; P=.003) and a higher reoperation rate (4.9% vs. 15.0%; P=.001). In the long term, conversion was associated with lower overall survival, but not with poorer disease-free survival. Significantly higher postoperative morbidity was observed in patients after conversion, in particular in terms of specific surgical complications. In addition, conversion is associated with overall lower survival but not with poorer disease-free survival.

Relaxed Evolution in the Tyrosine Aminotransferase Gene Tat in Old World Fruit Bats (Chiroptera: Pteropodidae)

PubMed Central

Shen, Bin; Fang, Tao; Yang, Tianxiao; Jones, Gareth; Irwin, David M.; Zhang, Shuyi

2014-01-01

Frugivorous and nectarivorous bats fuel their metabolism mostly by using carbohydrates and allocate the restricted amounts of ingested proteins mainly for anabolic protein syntheses rather than for catabolic energy production. Thus, it is possible that genes involved in protein (amino acid) catabolism may have undergone relaxed evolution in these fruit- and nectar-eating bats. The tyrosine aminotransferase (TAT, encoded by the Tat gene) is the rate-limiting enzyme in the tyrosine catabolic pathway. To test whether the Tat gene has undergone relaxed evolution in the fruit- and nectar-eating bats, we obtained the Tat coding region from 20 bat species including four Old World fruit bats (Pteropodidae) and two New World fruit bats (Phyllostomidae). Phylogenetic reconstructions revealed a gene tree in which all echolocating bats (including the New World fruit bats) formed a monophyletic group. The phylogenetic conflict appears to stem from accelerated TAT protein sequence evolution in the Old World fruit bats. Our molecular evolutionary analyses confirmed a change in the selection pressure acting on Tat, which was likely caused by a relaxation of the evolutionary constraints on the Tat gene in the Old World fruit bats. Hepatic TAT activity assays showed that TAT activities in species of the Old World fruit bats are significantly lower than those of insectivorous bats and omnivorous mice, which was not caused by a change in TAT protein levels in the liver. Our study provides unambiguous evidence that the Tat gene has undergone relaxed evolution in the Old World fruit bats in response to changes in their metabolism due to the evolution of their special diet. PMID:24824435

[Quality of 3D magnetic resonance imaging of coronary arteries in patients with D-transposition of the great arteries after the Jatene switch procedure].

PubMed

Marín Rodríguez, C; Lancharro Zapata, Á; Rodríguez Ogando, A; Carrasco Muñoz, S; Ruiz Martín, Y; Sánchez Alegre, M L; Maroto Alvaro, E

2015-01-01

To evaluate the quality of images obtained with 3D balanced fast-field echo whole heart (WH3D) MRI sequences for assessing the coronary anastomosis and coronary stenosis in patients with D-transposition of the great arteries who have undergone the Jatene switch procedure. We retrieved 100 WH3D studies done in 83 patients who had undergone the Jatene switch procedure from our pediatric cardiac MRI database; 84 of these studies fulfilled the criteria for inclusion in the study. We evaluated coronary stenoses on WH3D MR images and their correlation with coronary CT or angiography images. We retrospectively studied the quality of the images of the proximal coronary arteries using a four-point scale and correlating the findings with age, heart rate, and heart size. Of the 84 studies, 4 (4.8%) were of a quality considered «insufficient for diagnosis», 7 (8.3%) were considered «fair», 23 (27.4%) «good», and 50 (59.5%) «excellent». The quality of the image of the coronary arteries was significantly correlated with heart rate. MRI detected stenosis in the origin of the coronary arteries in 9 (10.7%) studies. Images obtained with the WH3D MRI sequence in patients who had undergone the Jatene procedure were of diagnostic quality in most cases and were better in patients with lower heart rates. In 10.7%, stenosis in the origin of the coronary arteries that required new studies was detected. Copyright © 2014 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

Trephine Transverse Colostomy Is Effective for Patients Who Have Previously Undergone Rectal Surgery

PubMed Central

Yeom, Seung-Seop; Jung, Sung Woo; Oh, Se Heon; Lee, Jong Lyul; Yoon, Yong Sik; Park, In Ja; Lim, Seok-Byung; Yu, Chang Sik; Kim, Jin Cheon

2018-01-01

Purpose Colostomy creation is an essential procedure for colorectal surgeons, but the preferred method of colostomy varies by surgeon. We compared the outcomes of trephine colostomy creation with open those for the (laparotomy) and laparoscopic methods and evaluated appropriate indications for a trephine colostomy and the advantages of the technique. Methods We retrospectively evaluated 263 patients who had undergone colostomy creation by trephine, open and laparoscopic approaches between April 2006 and March 2016. We compared the clinical features and the operative and postoperative outcomes according to the approach used for stoma creation. Results One hundred sixty-three patients (62%) underwent colostomy surgery for obstructive causes and 100 (38%) for fistulous problems. The mean operative time was significantly shorter with the trephine approach (trephine, 46.0 ± 1.9 minutes; open, 78.7 ± 3.9 minutes; laparoscopic, 63.5 ± 5.0 minutes; P < 0.001), as was the time to flatus (1.8 ± 0.1 days, 2.1 ± 0.1 days, 2.2 ± 0.3 days, P = 0.025). Postoperative complications (<30 days) were not different among the 3 approaches (trephine, 4.3%; open, 1.2%; laparoscopic, 0%; P = 0.828). In patients who underwent rectal surgery, a trephine colostomy was feasible for a diversion colostomy (P < 0.001). Conclusion The trephine colostomy is safe and can be implemented quickly in various situations, and compared to other colostomy procedures, the patient’s recovery is faster. Previous laparotomy history was not a contraindication for a trephine colostomy, and a trephine transverse colostomy is feasible for patients who have undergone previous rectal surgery. PMID:29742862

The Preoperative Composite Physiologic Index May Predict Mortality in Lung Cancer Patients with Combined Pulmonary Fibrosis and Emphysema.

PubMed

Ueno, Fumika; Kitaguchi, Yoshiaki; Shiina, Takayuki; Asaka, Shiho; Miura, Kentaro; Yasuo, Masanori; Wada, Yosuke; Yoshizawa, Akihiko; Hanaoka, Masayuki

2017-01-01

It remains unclear whether the preoperative pulmonary function parameters and prognostic indices that are indicative of nutritional and immunological status are associated with prognosis in lung cancer patients with combined pulmonary fibrosis and emphysema (CPFE) who have undergone surgery. The aim of this study is to identify prognostic determinants in these patients. The medical records of all patients with lung cancer associated with CPFE who had undergone surgery at Shinshu University Hospital were retrospectively reviewed to obtain clinical data, including the results of preoperative pulmonary function tests and laboratory examinations, chest high-resolution computed tomography (HRCT), and survival. Univariate Cox proportional hazards regression analysis showed that a high pathological stage of the lung cancer, a higher preoperative serum carcinoembryonic antigen level, and a higher preoperative composite physiologic index (CPI) were associated with a high risk of death. Multivariate analysis showed that a high pathological stage of the lung cancer (HR: 1.579; p = 0.0305) and a higher preoperative CPI (HR: 1.034; p = 0.0174) were independently associated with a high risk of death. In contrast, the severity of fibrosis or emphysema on chest HRCT, the individual pulmonary function parameters, the prognostic nutritional index, the neutrophil-to-lymphocyte ratio, and the platelet-to-lymphocyte ratio were not associated with prognosis. In the Kaplan-Meier analysis, the log-rank test showed significant differences in survival between the high-CPI and the low-CPI group (p = 0.0234). The preoperative CPI may predict mortality and provide more powerful prognostic information than individual pulmonary function parameters in lung cancer patients with CPFE who have undergone surgery. © 2017 S. Karger AG, Basel.

Tuberculosis screening prior to anti-tumor necrosis factor therapy among patients with immune-mediated inflammatory diseases in Japan: a longitudinal study using a large-scale health insurance claims database.

PubMed

Tomio, Jun; Yamana, Hayato; Matsui, Hiroki; Yamashita, Hiroyuki; Yoshiyama, Takashi; Yasunaga, Hideo

2017-11-01

Tuberculosis screening is recommended for patients with immune-mediated inflammatory diseases (IMIDs) prior to anti-tumor necrosis factor (TNF) therapy. However, adherence to the recommended practice is unknown in the current clinical setting in Japan. We used a large-scale health insurance claims database in Japan to conduct a longitudinal observational study. Of more than two million beneficiaries in the database between 2013 and 2014, we enrolled those with IMIDs aged 15-69 years who had initiated anti-TNF therapy. We defined tuberculosis screening primarily as tuberculin skin test and/or interferon-gamma release assay (TST/IGRA) within 2 months before commencing anti-TNF therapy. We analyzed the proportions of the patients who had undergone tuberculosis screening and the associations with primary disease, type of anti-TNF agent, methotrexate prescription prior to anti-TNF therapy, and treatment for latent tuberculosis infection (LTBI). Of 385 patients presumed to have initiated anti-TNF therapy, 252 (66%) had undergone tuberculosis screening by TST/IGRA (22% TST, 56% IGRA, and 12% both TST and IGRA), and 231 (60%) had undergone TST/IGRA and radiography. Patients with psoriasis tended to be more likely to undergo tuberculosis screening than those with other diseases; however, this association was not statistically significant. Treatment for LTBI was provided to 43 (11%) patients; 123 (32%) received neither TST/IGRA nor LTBI treatment. Tuberculosis screening was often not performed prior to anti-TNF therapy despite the guidelines' recommendations; thus, patients could be put at unnecessary risk of reactivation of tuberculosis. © 2017 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

Evolution of speech-specific cognitive adaptations.

PubMed

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.

Primary care needs of patients who have undergone gender reassignment.

PubMed

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.

Emergency medicine in Dubai, UAE.

PubMed

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

PubMed Central

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.

PubMed

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].

PubMed

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

Heterosis in rice seedlings: its relationship to gibberellin content and expression of gibberellin metabolism and signaling genes.

PubMed

Ma, Qian; Hedden, Peter; Zhang, Qifa

2011-08-01

Despite the accumulation of data on the genetic and molecular understanding of heterosis, there is little information on the regulation of heterosis at the physiological level. In this study, we performed a quantitative analysis of endogenous gibberellin (GA) content and expression profiling of the GA metabolism and signaling genes to investigate the possible relationship between GA signaling and heterosis for seedling development in rice (Oryza sativa). The materials used were an incomplete diallele set of 3 × 3 crosses and the six parents. In the growing shoots of the seedlings at 20 d after sowing, significant positive correlations between the contents of some GA species and performance and heterosis based on shoot dry mass were detected. Expression analyses of GA-related genes by real-time reverse transcription-polymerase chain reaction revealed that 13 out of the 16 GA-related genes examined exhibited significant differential expression among the F1 hybrid and its parents, acting predominantly in the modes of overdominance and positive dominance. Expression levels of nine genes in the hybrids displayed significant positive correlations with the heterosis of shoot dry mass. These results imply that GAs play a positive role in the regulation of heterosis for rice seedling development. In shoots plus root axes of 4-d-old germinating seeds that had undergone the deetiolation, mimicking normal germination in soil, the axis dry mass was positively correlated with the content of GA₂₉ but negatively correlated with that of GA₁₉. Our findings provide supporting evidence for GAs playing an important regulatory role in heterosis for rice seedling development.

MRI-Targeted or Standard Biopsy for Prostate-Cancer Diagnosis.

PubMed

Kasivisvanathan, Veeru; Rannikko, Antti S; Borghi, Marcelo; Panebianco, Valeria; Mynderse, Lance A; Vaarala, Markku H; Briganti, Alberto; Budäus, Lars; Hellawell, Giles; Hindley, Richard G; Roobol, Monique J; Eggener, Scott; Ghei, Maneesh; Villers, Arnauld; Bladou, Franck; Villeirs, Geert M; Virdi, Jaspal; Boxler, Silvan; Robert, Grégoire; Singh, Paras B; Venderink, Wulphert; Hadaschik, Boris A; Ruffion, Alain; Hu, Jim C; Margolis, Daniel; Crouzet, Sébastien; Klotz, Laurence; Taneja, Samir S; Pinto, Peter; Gill, Inderbir; Allen, Clare; Giganti, Francesco; Freeman, Alex; Morris, Stephen; Punwani, Shonit; Williams, Norman R; Brew-Graves, Chris; Deeks, Jonathan; Takwoingi, Yemisi; Emberton, Mark; Moore, Caroline M

2018-05-10

Multiparametric magnetic resonance imaging (MRI), with or without targeted biopsy, is an alternative to standard transrectal ultrasonography-guided biopsy for prostate-cancer detection in men with a raised prostate-specific antigen level who have not undergone biopsy. However, comparative evidence is limited. In a multicenter, randomized, noninferiority trial, we assigned men with a clinical suspicion of prostate cancer who had not undergone biopsy previously to undergo MRI, with or without targeted biopsy, or standard transrectal ultrasonography-guided biopsy. Men in the MRI-targeted biopsy group underwent a targeted biopsy (without standard biopsy cores) if the MRI was suggestive of prostate cancer; men whose MRI results were not suggestive of prostate cancer were not offered biopsy. Standard biopsy was a 10-to-12-core, transrectal ultrasonography-guided biopsy. The primary outcome was the proportion of men who received a diagnosis of clinically significant cancer. Secondary outcomes included the proportion of men who received a diagnosis of clinically insignificant cancer. A total of 500 men underwent randomization. In the MRI-targeted biopsy group, 71 of 252 men (28%) had MRI results that were not suggestive of prostate cancer, so they did not undergo biopsy. Clinically significant cancer was detected in 95 men (38%) in the MRI-targeted biopsy group, as compared with 64 of 248 (26%) in the standard-biopsy group (adjusted difference, 12 percentage points; 95% confidence interval [CI], 4 to 20; P=0.005). MRI, with or without targeted biopsy, was noninferior to standard biopsy, and the 95% confidence interval indicated the superiority of this strategy over standard biopsy. Fewer men in the MRI-targeted biopsy group than in the standard-biopsy group received a diagnosis of clinically insignificant cancer (adjusted difference, -13 percentage points; 95% CI, -19 to -7; P<0.001). The use of risk assessment with MRI before biopsy and MRI-targeted biopsy was superior to standard transrectal ultrasonography-guided biopsy in men at clinical risk for prostate cancer who had not undergone biopsy previously. (Funded by the National Institute for Health Research and the European Association of Urology Research Foundation; PRECISION ClinicalTrials.gov number, NCT02380027 .).

Prevalence of female genital mutilation and its effect on women's health in Bale zone, Ethiopia: a cross-sectional study.

PubMed

Bogale, Daniel; Markos, Desalegn; Kaso, Muhammedawel

2014-10-16

Females' genital mutilation (FGM) is one of the harmful traditional practices affecting the health of women and children. It has a long-term physiological, sexual and psychological effect on women. It remains still a serious problem for large proportion of women in most sub-Saharan Africa countries including Ethiopia. A community based cross sectional study design which is supplemented by qualitative method was conducted in 2014. A total of 634 reproductive age women were involved in the quantitative part of the study. The respondents were drawn from five randomly selected districts of Bale zone. The total sample was allocated proportionally to each district based on the number of reproductive age women it has. Purposive sampling method was used for qualitative study. Then, data were collected using pre-tested and structured questionnaire. The collected data were analyzed by SPSS for windows version 16.0. Multiple logistic regressions were carried out to examine the existence of relationship between FGM and selected determinant factors. Variables significant in the bivariate analysis were then entered into a multiple logistic regression analysis. In this study, 486 (78.5%) of women had undergone some form of FGM with 75% lower and 82% upper confidence interval. To get married, to get social acceptance, to safeguard virginity, to suppress sexual desire and religious recommendations were the main reasons of FGM. The reported immediate complications were excessive bleeding at the time of the procedure, infection, urine retention and swelling of genital organ. Muslim women and women from rural areas were significantly more likely to have undergone the procedure. In addition to these, compared to women 15-20 years old older women were more likely to report themselves having undergone FGM. Although younger women, those from urban residence and some religions are less likely to have had FGM it is still extremely common in this zone. Deep cultural issues and strongly personally held beliefs which are not simple to predict or quantify are likely to be involved in the perpetuation of FGM. Efforts to eradicate the practice should incorporate a human rights approach rather than rely solely on the damaging health consequences.

Translation and cross-cultural adaptation of the anterior cruciate ligament-return to sport after injury (ACL-RSI) scale into Turkish.

PubMed

Harput, Gulcan; Tok, Damla; Ulusoy, Burak; Eraslan, Leyla; Yildiz, Taha Ibrahim; Turgut, Elif; Demirci, Serdar; Duzgun, Irem; Tunay, Volga Bayrakci; Baltaci, Gul; Ergun, Nevin

2017-01-01

To translate and culturally adapt the anterior cruciate ligament-return to sport after injury (ACL-RSI) scale into Turkish (ACL-RSI-Tr) and examine and evaluate the psychometric properties of the Turkish version in individuals who have undergone anterior cruciate ligament (ACL) reconstruction. The ACL-RSI was forward- and back-translated, culturally adapted and validated on ninety-three Turkish individuals who had undergone ACL reconstruction (5 females, 88 males; age 28.7 ± 8.6 years; body mass 80.1 ± 13.9 kg; height 178.8 ± 6.9 cm; body mass index 25.0 ± 3.7 kg/m 2 ). All patients completed the translated ACL-RSI, Tampa Scale of Kinesiophobia (TSK), Knee injury and Osteoarthritis Outcome Score (KOOS) and International Knee Documentary Committee (IKDC) and Lysholm questionnaires. We then analysed the internal consistency, reliability and validity of the newly formed ACL-RSI-Tr scale. The ACL-RSI-Tr showed good internal consistency (Cronbach's alpha 0.86) and test-retest reliability (ICC 0.92) and was significantly correlated with the KOOS 'quality of life' (r = 0.58, p < 0.002), 'symptoms and stiffness' (r = 0.35, p = 0.001), 'pain' (r = 0.49, p < 0.001), 'sports' (r = 0.44, p < 0.001) and 'daily life' (r = 0.42, p < 0.001) subscales. The ACL-RSI-Tr also correlated significantly with the TSK (r = - 0.45, p < 0.001), Lysholm (r = 0.45, p < 0.001) and IKDC (r = 0.44, p < 0.001) scores. The Turkish version of the ACL-RSI scale was valid, discriminant, consistent and reliable in patients who had undergone ACL reconstruction. This score could be useful to evaluate the effect of psychological factors on return to sport following ACL surgery. Diagnostic study, Level I.

A meta-analysis and model of the relationship between sleep and depression in adolescents: recommendations for future research and clinical practice.

PubMed

Lovato, Nicole; Gradisar, Michael

2014-12-01

The purpose of this review was to quantify the strength of evidence for a directional relationship between sleep disturbance and depression in adolescents. A literature search was conducted to identify research investigating the relationship between sleep disturbance and depression in adolescent samples (12-20 y). Twenty-three studies were identified; 13 explored associations between depression and sleep disturbance; seven examined the prospective role of sleep disturbance in the development of depression; and three investigated the role of adolescent depression in the development of subsequent sleep disturbance. Average weighted mean differences in sleep/depression-related outcome variables were calculated between adolescents with depression, and non-clinical adolescents, or those in remission. Adolescents with depression experienced significantly more wakefulness in bed (sleep onset latency, wake after sleep onset, number of awakenings and sleep efficiency), lighter sleep (more stage 1), and reported more subjective sleep disturbance. Overall effect sizes from longitudinal and treatment studies suggest sleep disturbance acts as a precursor to the development of depression. At follow-up, depressed adolescents had significantly longer sleep onset, more wake after sleep onset, and lower sleep efficiency compared to adolescents who were non-clinical, or had undergone remission. Little support was found for a predictive role of depressive symptoms in the development of sleep disturbance. Based on these findings we propose a model to understand the development of depression from initial sleep disturbance, provide recommendations for clinicians and recommendations for future research. Copyright © 2014 Elsevier Ltd. All rights reserved.

Significance of occipitoaxial angle in subaxial lesion after occipitocervical fusion.

PubMed

Matsunaga, S; Onishi, T; Sakou, T

2001-01-15

The significance of occipitoaxial angle in the development of subaxial subluxation after occipitocervical fusion was determined in a minimum 5-year follow-up study performed retrospectively. To clarify the association between the position of the fixed occipital bone and axis and the development of subaxial subluxation. There have been few reports describing the association between the position of fixation of the occipital bone and axis and subaxial lesion in occipitocervical fusion. Thirty-eight patients with rheumatoid arthritis who underwent occipitocervical fusion for irreducible atlantoaxial dislocation were reviewed. The angle between the McGregor line and the inferior surface of the axis (O-C2) was measured in healthy volunteers and patients who had undergone occipitocervical fusion. The association between any changes in the alignment of the cervical vertebrae and the development of subaxial subluxation during follow-up periods was studied. The number of the patients in whom postoperative kyphosis and swan neck deformity developed was only five, but in four (80%) of them, retroversion of the occipital bone was used to increase the O-C2 angle. In 14 patients, in whom anteversion of the occipital bone against the axis was excessive, 12 (86%) patients experienced subaxial subluxation after surgery. In the patients in whom fixed O-C2 angles were in normal range, only one patient developed such abnormal changes in the middle and lower cervical vertebrae. It is necessary to give attention to the position of the fixed occipital bone and axis during procedures of occipitoaxial fusion for patients with rheumatoid arthritis.

Clinical outcomes of trabeculectomy vs. Ahmed glaucoma valve implantation in patients with penetrating keratoplasty : (Trabeculectomy vs. Ahmed galucoma valve in patients with penetrating keratoplasty).

PubMed

Akdemir, Mehmet Orcun; Acar, Banu Torun; Kokturk, Furuzan; Acar, Suphi

2016-08-01

The aim of this study was to compare the visual outcomes, intraocular pressure (IOP), and endothelial cell loss caused by trabeculectomy (TRAB) and Ahmed glaucoma valve (AGV) implantation in patients who had previously undergone penetrating keratoplasty (PKP). The data from all patients who underwent surgical treatment of glaucoma after PKP were reviewed at the Cornea Department of Haydarpasa Numune Education and Research Hospital. Eighteen patients who had undergone surgical treatment of glaucoma after PKP were included in this retrospective study. Time between PKP and glaucoma surgeries, visual acuity results, IOP results, endothelial cell counts (ECC) before the surgery, at 1st, 6th, and 12th month of surgery were recorded. Differences between two groups were evaluated. Mean loss of ECC was 315 cells/mm(2) in the AGV group and 197 cells/mm(2) in TRAB group at 12th month of glaucoma surgery. The difference between endothelial cell loss at 12th month of surgery was statistically significant and higher in AGV group (p < 0.001). The decrease in IOP was 64.2 % in AGV group and 46.9 % in TRAB group at 12th month of surgery. Both differences were statistically significant between 2 groups (p = 0.001, 0.001). TRAB successfully decreased both the IOP and endothelial cell loss in patients with post-PKP glaucoma. Ahmed glaucoma valve had a significantly better IOP lowering but higher endothelial cell loss effect.

Balance, mobility and gaze stability deficits remain following surgical removal of vestibular schwannoma (acoustic neuroma): an observational study.

PubMed

Choy, Nancy Low; Johnson, Natalie; Treleaven, Julia; Jull, Gwendolen; Panizza, Benedict; Brown-Rothwell, David

2006-01-01

Are there residual deficits in balance, mobility, and gaze stability after surgical removal of vestibular schwannoma? Observational study. Twelve people with a mean age of 52 years who had undergone surgical removal of vestibular schwannoma at least three months previously and had not undergone vestibular rehabilitation. Twelve age- and gender-matched healthy people who acted as controls. Handicap due to dizziness, balance, mobility, and gaze stability was measured. Handicap due to dizziness was moderate for the clinical group. They swayed significantly more than the controls in comfortable stance: firm surface eyes open and visual conflict (p < 0.05); foam surface eyes closed (p < 0.05) and visual conflict (p < 0.05); and feet together: firm surface, eyes closed (p < 0.05), foam surface, eyes open (p < 0.05) and eyes closed (p < 0.01). They displayed a higher rate of failure for timed stance and gaze stability (p < 0.05) than the controls. Step Test (p < 0.01), Tandem Walk Test (p < 0.05) and Dynamic Gait Index (p < 0.01) scores were also significantly reduced compared with controls. There was a significant correlation between handicap due to dizziness and the inability to maintain balance in single limb and tandem stance (r = 0.68, p = 0.02) and the ability to maintain gaze stability during passive head movement (r = 0.78; p = 0.02). A prospective study is required to evaluate vestibular rehabilitation to ameliorate dizziness and to improve balance, mobility, and gaze stability for this clinical group.

Histopathologic and Immunohistochemical Sequelae of Bariatric Embolization in a Porcine Model

PubMed Central

Paxton, Ben E.; Alley, Christopher L.; Crow, Jennifer H.; Burchette, James; Weiss, Clifford R.; Kraitchman, Dara L.; Arepally, Aravind; Kim, Charles Y.

2014-01-01

Purpose To evaluate the histopathologic sequelae of bariatric embolization on the gastric mucosa and to correlate with immunohistochemical evaluation of the gastric fundus, antrum, and duodenum. Materials and Methods This study was performed on 12 swine stomach and duodenum specimens after necropsy. Of the 12 swine, 6 had previously undergone bariatric embolization of the gastric fundus, and the 6 control swine had undergone a sham procedure with saline. Gross pathologic, histopathologic, and immunohistochemical examinations of the stomach and duodenum were performed. Specifically, mucosal integrity, fibrosis, ghrelin-expressing cells, and gastrin-expressing cells were assessed. Results Gross and histopathologic evaluation of treatment animals showed healing or healed mucosal ulcers in 50% of animals, with gastritis in 100% of treatment animals and in five of six control animals. The ghrelin-immunoreactive mean cell density was significantly lower in the gastric fundus in the treated animals compared with control animals (15.3 vs 22.0, P < .01) but similar in the gastric antrum (9.3 vs 14.3, P = .08) and duodenum (8.5 vs 8.6, P = .89). The gastrin-expressing cell density was significantly lower in the antrum of treated animals compared with control animals (82.2 vs 126.4, P = .03). A trend toward increased fibrosis was suggested in the gastric fundus of treated animals compared with controls (P = .07). Conclusions Bariatric embolization resulted in a significant reduction in ghrelin-expressing cells in the gastric fundus without evidence of upregulation of ghrelin-expressing cells in the duodenum. Healing ulcerations in half of treated animals underscores the need for additional refinement of this procedure. PMID:24462005

Blood transfusion and risk of atrial fibrillation after coronary artery bypass graft surgery

PubMed Central

Liu, Shengqun; Li, Zhanwen; Liu, Zhe; Hu, Zhenhua; Zheng, Gaifang

2018-01-01

Abstract The aim of this study was to systematically evaluate the effect of blood transfusion (BT) on postoperative atrial fibrillation (AF) in adult patients who had undergone coronary artery bypass grafting (CABG) surgery. PubMed, Embase, and Cochrane Library databases from inception to January 2017 were searched. Cohort studies were searched that evaluated the association between BT and the risk of postoperative AF in adult patients who had undergone CABG surgery. Study quality was assessed by using the Newcastle–Ottawa scale (NOS). A meta-analysis was performed with the random-effect model. Eight cohort studies involving 7401 AF cases and 31,069 participants were identified and included in our data analysis. The pooled odds ratio of postoperative AF in patients with BT was 1.45 (95% confidence interval, 1.26–1.67), with significant heterogeneity (P < .0001, I2 = 79%). Excluding one study that had an off-pump CABG did not significantly impact this result (odds ratio, 1.36; 95% confidence interval, 1.23–1.50; n = 7). To examine the stability of the primary results, we performed subgroup analyses. The association between BT and the risk of postoperative AF was similar, as determined in the stratified analyses conducted according to study design, type of surgery, and country. The findings of the present meta-analysis demonstrated a statistically significant increase in postoperative AF risk among adult patients with BT. Further prospective large-scale studies are needed to establish causality and to elucidate the underlying mechanisms. PMID:29517692

Phacoemulsification with intravitreal bevacizumab injection in diabetic patients with macular edema and cataract.

PubMed

Akinci, Arsen; Batman, Cosar; Ozkilic, Ersel; Altinsoy, Ali

2009-01-01

The purpose of this study was to evaluate the results of phacoemulsification with intravitreal bevacizumab injection in patients with diabetic clinically significant macular edema and cataract. The records of 31 patients with diabetic clinically significant macular edema and cataract, which would interfere with macular laser photocoagulation, who have undergone phacoemulsification with intravitreal injection of 1.25 mg bevacizumab were retrospectively evaluated. All patients had undergone focal or modified grid laser photocoagulation 1 month after the surgery. All patients were evaluated by spectral optical coherence tomography/optical coherence tomography SLO before and 1 and 3 months after the surgery beyond complete ophthalmologic examination. The best-corrected visual acuity (BCVA) levels and central macular thickness (CMT) recorded at the first and third months after the surgery were compared with the initial values. Paired samples t test was used for statistical analysis. The mean initial BCVA was 0.10 +/- 0.04 (range, 0.05-0.2). The mean BCVA at the first and third months after the surgery were 0.47 +/- 0.16 (standard deviation) (range, 0.2-0.5) and 0.51 +/- 0.12 (standard deviation) (range, 0.3-0.6), respectively. The BCVA level recorded at the first and third months after the surgery were significantly higher than the initial BCVA (P = 0.004). The mean initial CMT was 387.5 +/- 109.5 microm. The mean CMT at the first and third months after the surgery were 292.7 +/- 57.2 and 275.5 +/- 40.3. The CMT recorded at the first and third months after the surgery were significantly lower than the initial CMT (P < 0.001, P < 0.001). Phacoemulsification with intravitreal injection of bevacizumab provides improvement in clinically significant macular edema with a gain in BCVA in patients with diabetes with clinically significant macular edema and cataract.

Clinical outcomes of Roux-en-Y and Billroth I reconstruction after a distal gastrectomy for gastric cancer: What is the optimal reconstructive procedure?

PubMed

Tanaka, Shinnosuke; Matsuo, Katsuichi; Matsumoto, Hisanobu; Maki, Takanobu; Nakano, Masahiko; Sasaki, Takamitsu; Yamashita, Yuichi

2011-01-01

The aim of this study was to evaluate the clinical advantages of Roux-en-Y (R-Y) and Billroth-I (B-I) reconstruction after distal gastrectomy for gastric cancer by examining the postoperative symptoms based on a patient questionnaire and patient nutrition. In addition, this study determined which of the R-Y or B-I procedures is preferable following distal gastrectomy. Fifty-one patients who had undergone R-Y reconstruction and 50 patients who had undergone B-I reconstruction were retrospectively enrolled in this study. The operative and postoperative findings such as operating time, blood loss, complications, and postoperative hospital stay were evaluated as short-term clinical outcomes. Postoperative serum nutrition parameters, transition of body weight, incidence of residual gastritis, and clinical symptoms were evaluated as mid-term clinical outcomes. An assessment of symptoms was based on a questionnaire concerning dumping symptoms, reflux symptoms, food intake, and satisfaction with the operation. No significant differences were observed in the operative and postoperative clinical parameters without stage grouping. The transition of serum nutrition parameters revealed no significant differences between the two groups for the preoperative and postoperative states. Dumping symptoms, reflux symptoms, and abdominal symptoms were less frequent in R-Y patients, but there were no significant differences between the two groups. Moreover, the differences in body weight recovery rates were not found to be statistically significant between two groups. However, the incidence of residual gastritis was significantly less in R-Y patients (21.2%) than in B-I patients (68.8%) (p < 0.05). The questionnaire results regarding food intake and surgery satisfaction were not significantly different between the two groups. Definite clinical advantages were not recognized in patients with R-Y reconstruction. B-I and R-Y reconstructive procedures should be selected according to the condition of each patient. However, the advantages of these reconstruction procedures following distal gastrectomy would only be revealed in large randomized controlled trials.

Radiofrequency treatment enhances the catalytic function of an immobilized nanobiohybrid catalyst

NASA Astrophysics Data System (ADS)

San, Boi Hoa; Ha, Eun-Ju; Paik, Hyun-Jong; Kim, Kyeong Kyu

2014-05-01

Biocatalysis, the use of enzymes in chemical transformation, has undergone intensive development for a wide range of applications. As such, maximizing the functionality of enzymes for biocatalysis is a major priority to enable industrial use. To date, many innovative technologies have been developed to address the future demand of enzymes for these purposes, but maximizing the catalytic activity of enzymes remains a challenge. In this study, we demonstrated that the functionality of a nanobiocatalyst could be enhanced by combining immobilization and radiofrequency (RF) treatment. Aminopeptidase PepA-encapsulating 2 nm platinum nanoparticles (PepA-PtNPs) with the catalytic activities of hydrolysis and hydrogenation were employed as multifunctional nanobiocatalysts. Immobilizing the nanobiocatalysts in a hydrogel using metal chelation significantly enhanced their functionalities, including catalytic power, thermal-stability, pH tolerance, organic solvent tolerance, and reusability. Most importantly, RF treatment of the hydrogel-immobilized PepA-PtNPs increased their catalytic power by 2.5 fold greater than the immobilized PepA. Our findings indicate that the catalytic activities and functionalities of PepA-PtNPs are greatly enhanced by the combination of hydrogel-immobilization and RF treatment. Based on our findings, we propose that RF treatment of nanobiohybrid catalysts immobilized on the bulk hydrogel represents a new strategy for achieving efficient biocatalysis.Biocatalysis, the use of enzymes in chemical transformation, has undergone intensive development for a wide range of applications. As such, maximizing the functionality of enzymes for biocatalysis is a major priority to enable industrial use. To date, many innovative technologies have been developed to address the future demand of enzymes for these purposes, but maximizing the catalytic activity of enzymes remains a challenge. In this study, we demonstrated that the functionality of a nanobiocatalyst could be enhanced by combining immobilization and radiofrequency (RF) treatment. Aminopeptidase PepA-encapsulating 2 nm platinum nanoparticles (PepA-PtNPs) with the catalytic activities of hydrolysis and hydrogenation were employed as multifunctional nanobiocatalysts. Immobilizing the nanobiocatalysts in a hydrogel using metal chelation significantly enhanced their functionalities, including catalytic power, thermal-stability, pH tolerance, organic solvent tolerance, and reusability. Most importantly, RF treatment of the hydrogel-immobilized PepA-PtNPs increased their catalytic power by 2.5 fold greater than the immobilized PepA. Our findings indicate that the catalytic activities and functionalities of PepA-PtNPs are greatly enhanced by the combination of hydrogel-immobilization and RF treatment. Based on our findings, we propose that RF treatment of nanobiohybrid catalysts immobilized on the bulk hydrogel represents a new strategy for achieving efficient biocatalysis. Electronic supplementary information (ESI) available. See DOI: 10.1039/c4nr00407h

A-waves increase the risk of developing neuropathy.

PubMed

Srotova, Iva; Vlckova, Eva; Dusek, Ladislav; Bednarik, Josef

2017-08-01

A-waves, which are observed following the M-wave during motor nerve conduction studies (NCS), are late responses that are frequently found in many types of neurogenic disorders. However, A-waves are also common in healthy individuals, where their significance remains unclear. The aim of this study was to examine whether the occurrence of A-waves does in fact represent an increased risk for the future development of changes upon NCS or needle electromyography (EMG) in the corresponding nerve. Nerve conduction studies/needle electromyography findings at control examination were evaluated in relation to the occurrence of initial A-waves in 327 individuals who had undergone repeated NCS/EMG examination and exhibited normal initial findings, with or without the occurrence of A-waves as the only acceptable abnormality. The odds ratio, which reflects the predictive power of the occurrence of A-waves at the initial testing for the development of an abnormality (neuropathy or radiculopathy) at the follow-up examination, ranged from 2.7 ( p  = .041) in the tibial nerve and 3.9 ( p  = .034) in peroneal one, to 30.0 ( p  = .002) in the ulnar nerve. A-waves constitute an initial abnormality in all nerves, and they may be predictive for the future development of broader NCS/EMG abnormalities in the corresponding nerve.

Energy Efficiency of the Outotec® Ausmelt Process for Primary Copper Smelting

NASA Astrophysics Data System (ADS)

Wood, Jacob; Hoang, Joey; Hughes, Stephen

2017-03-01

The global, non-ferrous smelting industry has witnessed the continual development and evolution of processing technologies in a bid to reduce operating costs and improve the safety and environmental performance of processing plants. This is particularly true in the copper industry, which has seen a number of bath smelting technologies developed and implemented during the past 30 years. The Outotec® Ausmelt Top Submerged Lance Process is one such example, which has been widely adopted in the modernisation of copper processing facilities in China and Russia. Despite improvements in the energy efficiency of modern copper smelting and converting technologies, additional innovation and development is required to further reduce energy consumption, whilst still complying with stringent environmental regulations. In response to this challenge, the Ausmelt Process has undergone significant change and improvement over the course of its history, in an effort to improve its overall competitiveness, particularly with respect to energy efficiency and operating costs. This paper covers a number of recent advances to the technology and highlights the impacts of these developments in reducing energy consumptions for a range of different copper flowsheets. It also compares the energy efficiency of the Ausmelt Process against the Bottom Blown Smelting process, which has become widely adopted in China over the past 5-10 years.

Neutrophil chemotaxis in sickle cell anaemia, sickle cell beta zero thalassaemia, and after splenectomy.

PubMed Central

Donadi, E A; Falcão, R P

1987-01-01

Neutrophil chemotaxis was evaluated in 28 patients with sickle cell anaemia, 10 patient with sickle cell beta zero thalassaemia, 25 patients who had undergone splenectomy, and 38 controls. The mean distance migrated by patients' neutrophils was not significantly different from that of neutrophils from controls. Although several immunological variables have been reported to be changed after loss of splenic function, we were unable to show a defect in neutrophil chemotaxis that could account for the increased susceptibility to infection. PMID:3611395

CLINICAL EVALUATION OF SAHACHARADI AND NIRGUNDI TAILAS IN SAISAVEEYAVATA (POLIOMYELITIS)

PubMed Central

Nair, P. Ramachandran; Vijayan, N. P.; Madhavikutty, P.; Nair, C. N. B.; Chandrika, A.

1988-01-01

A research trial was conducted at in-patient level to compare the efficacy of Sahacharadi taila with that of Nirgundi taila in Saisaveeyavata (Poliomyelitis). Forty cases were selected for the trial and grouped into two at random and treated with Sahacharadi taila and Nirgundi taila respectively. Results in both groups were highly encouraging and statistically significant. The study also revealed that 25% of patients had undergone Polio vaccination and it was not helpful to prevent the disease. PMID:22557625

Identification and expression analysis of the SQUAMOSA promoter-binding protein (SBP)-box gene family in Prunus mume.

PubMed

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.

Degradation product characterization of therapeutic oligonucleotides using liquid chromatography mass spectrometry.

PubMed

Elzahar, N M; Magdy, N; El-Kosasy, Amira M; Bartlett, Michael G

2018-05-01

Synthetic antisense phosphorothioate oligonucleotides (PS) have undergone rapid development as novel therapeutic agents. The increasing significance of this class of drugs requires significant investment in the development of quality control methods. The determination of the many degradation pathways of such complex molecules presents a significant challenge. However, an understanding of the potential impurities that may arise is necessary to continue to advance these powerful new therapeutics. In this study, four different antisense oligonucleotides representing several generations of oligonucleotide therapeutic agents were evaluated under various stress conditions (pH, thermal, and oxidative stress) using ion-pairing reversed-phase liquid chromatography tandem mass spectrometry (IP-RPLC-MS/MS) to provide in-depth characterization and identification of the degradation products. The oligonucleotide samples were stressed under different pH values at 45 and 90 °C. The main degradation products were observed to be losses of nucleotide moieties from the 3'- and 5'-terminus, depurination, formation of terminal phosphorothioates, and production of ribose, ribophosphorothioates (Rp), and phosphoribophosphorothioates (pRp). Moreover, the effects of different concentrations of hydrogen peroxide were studied resulting in primarily extensive desulfurization and subsequent oxidation of the phosphorothioate linkage to produce the corresponding phosphodiester. The reaction kinetics for the degradation of the oligonucleotides under the different stress conditions were studied and were found to follow pseudo-first-order kinetics. Differences in rates exist even for oligonucleotides of similar length but consisting of different sequences. Graphical abstract Identification of degradation products across several generations of oligonucleotide therapeutics using LC-MS.

Morphometric Measurements of Bony Nasolacrimal Canal in Children.

PubMed

Ela, Araz Server; Cigdem, Kalaycik Ertugay; Karagoz, Yesim; Yigit, Ozgur; Longur, Ecem Sevim

2018-05-01

Morphology and dimensions of the bony nasolacrimal canal duct (BNLD) as a key factor in the development of primary acquired nasolacrimal duct obstruction. We aimed to obtain detailed morphometric analysis of BNLD in children without nasolacrimal duct pathology by using computed tomography and provide standard measurements by means of age which could be utilized in planning management or in invasive interventions. Picture Archiving Communication Systems database of our hospital's radiology department was searched for this retrospective study. Subjects were under 18 years of age who had undergone a paranasal, maxillofacial, or temporal bone high-resolution computed tomography scan in last 2 years with various indications. Those with fractures including facial bones and/or nasolacrimal canal or history of nasolacrimal duct pathology were excluded from the study. We measured the diameter, angle, and surface area of BNLD. A total number of 136 subjects (86 boys, 50 girls) were included in the study. The average age was 7.3 ± 5.1 years. We documented statistically significantly positive correlation between all measured diameters and ages (P < 0.001), whereas there was a negative association between mean angle and age (P < 0.001). Mean angle is defined as the angle between BNLD and nasal floor. The surface area of BNLD was found to be significantly increasing depending on age (P < 0.001). However, we could not find any significant association between gender and measured parameters (P > 0.050). Our study demonstrated that development of BNLD continues during childhood, regardless of gender.

Skeletal effects in Angle Class II/1 patients treated with the functional regulator type II : Cephalometric and tensor analysis.

PubMed

Schulz, Simone; Koos, Bernd; Duske, Kathrin; Stahl, Franka

2016-11-01

The purpose of this work was to employ both cephalometric and tensor analysis in characterizing the skeletal changes experienced by patients with Angle Class II/1 malocclusion during functional orthodontic treatment with the functional regulator type II. A total of 23 patients with Class II/1 malocclusion based on lateral cephalograms obtained before and after treatment with the functional regulator type II were analyzed. Another 23 patients with Angle Class II/1 malocclusion who had not undergone treatment were included as controls. Our cephalometric data attest to significant therapeutic effects of the functional regulator type II on the skeletal mandibular system, including significant advancement of the mandible, increases in effective mandibular length with enhancement of the chin profile, and reduction of growth-related bite deepening. No treatment-related effects were observed at the cranial-base and midface levels. In addition, tensor analysis revealed significant stimulation of mandibular growth in sagittal directions, without indications of growth effects on the maxilla. Its growth-pattern findings differed from those of cephalometric analysis by indicating that the appliance did promote horizontal development, which supports the functional orthodontic treatment effect in Angle Class II/1 cases. Tensor analysis yielded additional insights into sagittal and vertical growth changes not identifiable by strictly cephalometric means. The functional regulator type II was an effective treatment modality for Angle Class II/1 malocclusion and influenced the skeletal development of these patients in favorable ways.

Low Testosterone Correlates with Delayed Development in Male Orangutans

PubMed Central

Emery Thompson, Melissa; Zhou, Amy; Knott, Cheryl D.

2012-01-01

Male orangutans (Pongo spp.) display an unusual characteristic for mammals in that some adult males advance quickly to full secondary sexual development while others can remain in an adolescent-like form for a decade or more past the age of sexual maturity. Remarkably little is understood about how and why differences in developmental timing occur. While fully-developed males are known to produce higher androgen levels than arrested males, the longer-term role of steroid hormones in male life history variation has not been examined. We examined variation in testosterone and cortisol production among 18 fully-developed (“flanged”) male orangutans in U.S. captive facilities. Our study revealed that while testosterone levels did not vary significantly according to current age, housing condition, and species origin, males that had undergone precocious development had higher testosterone levels than males that had experienced developmental arrest. While androgen variation had previously been viewed as a state-dependent characteristic of male developmental status, our study reveals that differences in the physiology of early and late developing males are detectable long past the developmental transition and may instead be trait-level characteristics associated with a male’s life history strategy. Further studies are needed to determine how early in life differences in testosterone levels emerge and what consequences this variation may have for male behavioral strategies. PMID:23077585

Desertification in Russia: Problems and solutions (an example in the Republic of Kalmykia-Khalmg Tangch).

PubMed

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.

Deep lateral wall orbital decompression following strabismus surgery in patients with Type II ophthalmic Graves' disease.

PubMed

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.

A Model Midshipman: Factors Related to Academic and Military Success of Prior Enlisted Midshipmen at the United States Naval Academy

DTIC Science & Technology

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

Development of Augmented Leukemia/Lymphoma-Specific T-Cell Immunotherapy for Deployment with Haploidentical Hematopoietic Progenitor-Cell Transplant

DTIC Science & Technology

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

Effects and effectiveness of telemedicine.

PubMed

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.

Application of improved technology to a preprototype vapor compression distillation /VCD/ water recovery subsystem

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.

Platelet-to-Lymphocyte Ratio: A New Factor for Predicting Systemic Inflammatory Response Syndrome after Percutaneous Nephrolithotomy.

PubMed

Cetinkaya, Mehmet; Buldu, Ibrahim; Kurt, Omer; Inan, Ramazan

2017-08-29

The first purpose of this study was to reveal factors affecting the postoperative development of systemic inflammatory response syndrome (SIRS) in patients undergoing standard percutaneous nephrolithotomy (PNL) for renal stones. The second purpose was to determine the role of the preoperative platelet-to-lymphocyte ratio (PLR) and the neutrophil-to-lymphocyte ratio (NLR) in the prediction of SIRS.Matarials and Methods: In total, 192 patients who had undergone conventional PNL for renal stones from 2013 to 2015 were included in the study. SIRS developed postoperatively in 41 (21.3%) patients. The patients were divided into SIRS and non-SIRS groups, and the effects of the PLR, NLR, and other demographic and operative data were investigated to predict the development of SIRS. Variables significant in the univariate analysis were evaluated using a multiple logistic regression model to determine the independent risk factors for developing SIRS after PNL. Univariate analysis revealed significant differences in the preoperative PLR (P < .001), preoperative NLR (P = .018), number of access sites (P < .001), mean renal parenchymal thickness (P = .02), operative time (P < .001), decrease in hemoglobin (P = .016), length of hospital stay (P < .001), stone-free status (P = .023), and complication rate between the two groups of patients. However, multivariate analysis showed that only the PLR and the number of access sites were independent factors affecting the development of SIRS. When the PLR cut-off value was 114.1, development of SIRS was predicted with 80.4% sensitivity and 60.2% specificity. The preoperative PLR is an effective and inexpensive biomarker with which to predict SIRS after PNL. In particular, we recommend close monitoring of patients with a PLR of >114.1 because of the possibledevelopment of serious complications.

Evaluating an automated haptic simulator designed for veterinary students to learn bovine rectal palpation.

PubMed

Baillie, Sarah; Crossan, Andrew; Brewster, Stephen A; May, Stephen A; Mellor, Dominic J

2010-10-01

Simulators provide a potential solution to some of the challenges faced when teaching internal examinations to medical or veterinary students. A virtual reality simulator, the Haptic Cow, has been developed to teach bovine rectal palpation to veterinary students, and significant training benefits have been demonstrated. However, the training needs to be delivered by an instructor, a requirement that limits availability. This article describes the development and evaluation of an automated version that students could use on their own. An automated version was developed based on a recording of an expert's examination. The performance of two groups of eight students was compared. All students had undergone the traditional training in the course, namely lectures and laboratory practicals, and then group S used the simulator whereas group R had no additional training. The students were set the task of finding the uterus when examining cows. The simulator was then made available to students, and feedback about the "usability" was gathered with a questionnaire. The group whose training had been supplemented with a simulator session were significantly better at finding the uterus. The questionnaire feedback was positive and indicated that students found the simulator easy to use. The automated simulator equipped students with useful skills for examining cows. In addition, a simulator that does not need the presence of an instructor will increase the availability of training for students and be a more sustainable option for institutions.

The role of HATCH score in predicting the success rate of sinus rhythm following electrical cardioversion of atrial fibrillation.

PubMed

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

PubMed Central

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

A saltwater flotation technique to identify unincubated eggs

USGS Publications Warehouse

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.

A Structural Equation Modeling Approach to Examining Factors Influencing Outcomes with Cochlear Implant in Mandarin-Speaking Children

PubMed Central

Chen, Yuan; Wong, Lena L. N.; Zhu, Shufeng; Xi, Xin

2015-01-01

Objective To examine the direct and indirect effects of demographical factors on speech perception and vocabulary outcomes of Mandarin-speaking children with cochlear implants (CIs). Methods 115 participants implanted before the age of 5 and who had used CI before 1 to 3 years were evaluated using a battery of speech perception and vocabulary tests. Structural equation modeling was used to test the hypotheses proposed. Results Early implantation significantly contributed to speech perception outcomes while having undergone a hearing aid trial (HAT) before implantation, maternal educational level (MEL), and having undergone universal newborn hearing screening (UNHS) before implantation had indirect effects on speech perception outcomes via their effects on age at implantation. In addition, both age at implantation and MEL had direct and indirect effects on vocabulary skills, while UNHS and HAT had indirect effects on vocabulary outcomes via their effects on age at implantation. Conclusion A number of factors had indirect and direct effects on speech perception and vocabulary outcomes in Mandarin-speaking children with CIs and these factors were not necessarily identical to those reported among their English-speaking counterparts. PMID:26348360

The association between glomus tumors and neurofibromatosis.

PubMed

Harrison, Bridget; Moore, Amy M; Calfee, Ryan; Sammer, Douglas M

2013-08-01

To determine whether an epidemiologic association exists between glomus tumors and neurofibromatosis. Using a pathology database, we established a study cohort consisting of all patients who had undergone excision of a glomus tumor of the hand between 1995 and 2010. We created a control cohort by randomly selecting 200 patients who had undergone excision of a ganglion cyst over the same period. We reviewed medical records for each cohort to identify patients with a diagnosis of neurofibromatosis. We calculated the odds ratio was calculated and performed Fisher's exact test to determine the significance of the association. We identified 21 patients with glomus tumors of the hand. Six of these patients carried the diagnosis of neurofibromatosis (29%). In contrast, no patients in the control group carried the diagnosis of neurofibromatosis. The odds ratio for a diagnosis of neurofibromatosis in association with a glomus tumor compared with controls was 168:1. This study provides evidence of a strong epidemiologic association between glomus tumors and neurofibromatosis. Glomus tumor should be included in the differential diagnosis in neurofibromatosis patients who present with a painful lesion of the hand or finger. Diagnostic III. Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Children's concepts of the urinary tract.

PubMed

Equit, Monika; Sambach, Heike; Niemczyk, Justine; von Gontard, Alexander

2013-10-01

To assess children's body concepts about anatomy and physiology of the urinary tract, children drew pictures responding to the question 'Where do you believe urine comes from?' A total of 152 children in three groups were examined. 81 children were out-patients. Of these, 36 children were being seen for the first time and 45 children had previously undergone bladder and bowel group training. They were compared to 71 continent controls. Children were given a body silhouette, in which they drew their view of the urinary tract. Half of the children (52.6%) drew a bladder and other organs; nearly 43% drew a tube or other anatomically incorrect pictures. Significant differences were found for group and age. Children who had undergone the group training more often drew a bladder and other organs (80%). Correct pictures and pictures of bladder and other organs were more common from children aged 11-16 years. Children have subjective concepts of the urinary tract which do not follow actual anatomy and physiology. For medical interventions as well as any training programmes, it is essential to understand these concepts and provide instructions in a child-centred and developmentally adequate way. Copyright © 2012 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Vaginal morcellation through the posterior cul-de-sac using an electromechanical morcellator after laparoscopic myomectomy or subtotal hysterectomy: a retrospective, case-control study.

PubMed

Lee, Eun-Ju; Kim, Dong-Ho

2016-11-01

This study aimed to evaluate the feasibility and safety of vaginal morcellation (VM) through the posterior cul-de-sac (PCDS) using an electromechanical morcellator and to compare the perioperative outcomes of VM with those of abdominal morcellation (AM) to remove a single myoma. The characteristics of 245 consecutive patients who had undergone VM after laparoscopic myomectomy or subtotal hysterectomy were summarized. A retrospective, matched, case-control study was performed; 64 patients had a myoma weighting 100 g or more. Cases were matched with controls (ratio 1:2), who had undergone AM, by age, body mass index, specimen weight, surgical type, and surgeon. Body image questionnaires were used to assess the cosmetic outcome. Medians were analyzed using the Mann-Whitney U test. Differences between means were assessed using Student's t test. Dichotomous groupings were analyzed using either the Chi-squared test or Fisher's exact test, as appropriate. All 245 patients underwent VM without complications. The mean weight of the specimens was 197.2 g (range 78.5-1477 g), and the mean duration of morcellation was 13.0 min (range 2.0-45.0 min). Two hours after surgery, the visual analog scale (VAS) score was significantly lower in the VM group than in the AM group (P = 0.03). Moreover, the morcellator used was significantly larger in the VM group (P < 0.001), and morcellation duration was significantly shorter in the VM group (P < 0.001). Finally, cosmetic outcome was significantly better in the VM group (P < 0.02). The two groups did not differ significantly in terms of hospitalization duration, surgery duration or VAS score 24 and 47 h postoperatively. VM through the PCDS using an electromechanical morcellator is a safe and feasible technique for surgical excision. The benefits of the procedure over AM are reduced immediate postoperative pain, shorter morcellation time, and better cosmesis.

Demonstration/Validation of Low Volatile Organic Compound (VOC) Chemical Agent Resistant Coating (CARC)

DTIC Science & Technology

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

Core Community Specifications for Electron Microprobe Operating Systems: Software, Quality Control, and Data Management Issues

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.

[The role of selected risk factors in Barrett's esophagus development].

PubMed

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.

Long-Term Outcome of Laparoscopic Totally Extraperitoneal Repair of Bilateral Inguinal Hernias with a Large Single Mesh.

PubMed

Issa, Nidal; Ohana, Gil; Bachar, Gil Nissim; Powsner, Eldad

2016-02-01

A totally extraperitoneal (TEP) approach is currently the technique of choice for the laparoscopic repair of bilateral inguinal hernias in our institution. Most other surgeons use two meshes for the TEP repair, one for each side. We prefer a large single mesh when possible since it allows for easier correct placement of the mesh in one stage. We compared our long-term results of both techniques in terms of late complications and recurrence rates. This study retrospectively evaluated the medical records of 108 patients who underwent bilateral laparoscopic TEP repair in our institution between January 2002 and December 2003. Excluded were patients who had a conversion to a transabdominal preperitoneal or open approach. A total of 73 (67 %) patients fulfilled study entrance criteria and were enrolled: 39 had undergone single mesh repair and 34 had undergone double mesh repair. There were no significant group differences in demographics, operating time, postoperative morbidity, or hospital stay. Likewise, after a median follow-up of 102 months (range 94–115 months), there were no significant group differences between the single and double mesh groups in persistent pain (5.8 vs 2.5 %, respectively; p = 0.476) and recurrence (7.6 vs 8.8 %, respectively; p = 0.55). The use of a large single mesh is an effective and safe alternative technique for TEP repair of bilateral inguinal hernias, and is technically easy to perform.

Long-term negative impact on quality of life in patients with successfully treated Cushing's disease.

PubMed

Heald, Adrian H; Ghosh, Sandip; Bray, Stephanie; Gibson, Christine; Anderson, Simon G; Buckler, Helen; Fowler, Helen L

2004-10-01

A cohort of pituitary tumour patients, who had undergone definitive treatment within a 15-year period at a single neuroscience centre, were investigated as to whether there were differences in psychological well-being and psychosocial functioning, dependent on endocrine pathology and treatment variables. A detailed assessment of 114 patients with benign pituitary tumours in relation to primary diagnosis and mode of treatment was carried out. Psychological rating scales used were: the Hospital Anxiety and Depression Scale--UK version (HADS-UK), the World Health Organization Quality of Life Scale--abbreviated version (WHOQOL-BREF), General Health Questionnaire 28 (GHQ-28), the Functional Assessment of Cancer Therapy (FACT) and the Social Adjustment Scale--modified (SAS1 and SAS2; the former completed by the patient and the latter by another person who knows the patient well). All Cushing's patients were biochemically cured as defined by a normal 24-h urine free cortisol excretion within the previous 6 months. Patients with treated Cushing's disease had significantly impaired psychological well-being and psychosocial functioning across all tested domains compared with all other pituitary tumours, where scores were similar. When participants with Cushing's disease were excluded, patients who had undergone transfrontal surgery scored significantly higher on GHQ and HADS ratings than transsphenoidally treated patients. Cushing's disease even when biochemically stable has long-term adverse effects on mood and social functioning. We hypothesize that this may be related to irreversible changes in central neural function. Further studies are necessary to define the precise pathways involved.

Bacterial Adhesion on the Titanium and Stainless-Steel Surfaces Undergone Two Different Treatment Methods: Polishing and Ultrafast Laser Treatment

NASA Astrophysics Data System (ADS)

Chik, N.; Zain, W. S. Wan Md; Mohamad, A. J.; Sidek, M. Z.; Ibrahim, W. H. Wan; Reif, A.; Rakebrandt, J. H.; Pfleging, W.; Liu, X.

2018-05-01

Bacterial adhesion has become a significant problem in many industries causing billions of dollars for its complicated removal treatment and maintenance. In this study, metal surfaces undergone treatment with ultrafast laser with varies power. The microstructure produced on its original surfaces were expected to prevent the adhesion of Escherichia coli (E. coli) ATCC 8739 and Staphylococcus aureus (S. aureus) ATCC 6838. The laser treatment was performed at 380 fs pulse duration, 515 µm central wavelength and a repetition rate of 200 kHz. Stainless steel AISI 316L was treated with an average laser power of 0.04 W (SS-0.04) and 0.11 W (SS-0.11), while Grade 5 titanium alloy was tested with high laser power 0.11 W (T-0.11). The adhesion was observed after 16 hours and the number of adhering bacteria was counted per cm2. The result achieved shows that, increasing the average laser power is leading to an enhanced S. aureus adhesion while E. coli adhesion is reduced which is due to the hydrophobicity interaction and difference in surface texture. Meanwhile, the laser treatment showed significant reduction of the bacterial adhesion on its surface compared to the polished surfaces. Thus, ultrafast laser texturing can be suggested as a promising method to reduce the bacterial adhesion, which reduced the adhesion of >80% for E. coli and >20% for S. aureus.

Sociodemographic factors associated with female genital cutting among women of reproductive age in Nigeria.

PubMed

Ojo, T O; Ijadunola, M Y

2017-08-01

The aims of the study were to determine the prevalence of female genital cutting (FGC) among women of reproductive age in Nigeria and identify the sociodemographic factors associated with the practice. A secondary analysis of the 2013 Nigeria Demographic and Health Survey was carried out in 38,948 women of reproductive age (15-49 years). The prevalence of FGC among respondents was almost 25%, most of whom (82%) had undergone the procedure when they were under 5 years of age. Traditional circumcisers performed 72.2% of all procedures. Type 2 was the common form (62.6%) of FGC. Almost a quarter of respondents (23.1%) wanted the practice to continue. Women aged 45-49 years were approximately twice as likely to have undergone FGC compared with women aged 15-19 years (odds ratio [OR] 2.41; 95% confidence interval [CI] 1.99, 2.92; p < .001). Women from parts of Nigeria other than the North East zone were significantly more likely to have experienced FGC (p < .001). Women of Yoruba ethnicity were significantly more likely to have experienced FGC compared with women of Hausa/Fulani ethnicity (OR 4.86; 95% CI 3.03, 8.12; p < .001). Our findings have programmatic implications for ending the practice of FGC in Nigeria. Elimination efforts should be intensified among women of Yoruba ethnicity. To instigate behavioural change, communication interventions should particularly target residents in parts of Nigeria other than the North East zone.

Post-traumatic syringomyelia: CSF hydrodynamic changes following spinal cord injury are the driving force in the development of PTSM.

PubMed

Shields, Christopher B; Zhang, Yi Ping; Shields, Lisa B E

2012-01-01

Post-traumatic syringomyelia (PTSM) is a disorder that occurs infrequently following spinal cord injury (SCI), characterized by progressive neurological deterioration resulting from syrinx expansion originating in proximity to the traumatic epicenter. Several pathogenetic factors are associated with this disorder, however, the precise mechanism of the development of PTSM is controversial. Combined anatomical alterations and molecular changes following trauma to the spinal cord and arachnoid participate in the development of this condition. These factors include narrowing or obstruction of the subarachnoid space (SAS), central canal occlusion, myelomalacia, and alterations in intramedullary water permeability. If a patient sustains a SCI with delayed progressive deterioration in neurological function, in association with the MRI appearance of syringomyelia (SM), the diagnosis of PTSM is straightforward. The treatment of PTSM has not undergone any significant changes recently. The surgical treatment of PTSM consists of reconstructing the SAS or shunting fluid away from the syrinx to other locations. The advantages and disadvantages of each procedure will be discussed. With greater understanding of the mechanisms contributing to the development of SM, including advanced diagnostic methods and further advances in the development of artificial dural and shunting tubing, future therapies of PTSM will be more effective and long-lasting. Incorporation of alterations of AQP4 expression provides an intriguing possibility for future treatment of PTSM. Copyright © 2012 Elsevier B.V. All rights reserved.

An update on the regional organizations of the american burn association.

PubMed

Harrington, David; Holmes, James; Conlon, Kathe; Jeng, James

2014-01-01

In 1985, the American Burn Association (ABA) created 10 regions in the United States and charged the Chiefs of these regions with the development of regional disaster plans. Now more than 25 years after this mandate, the ABA's Organizational and Delivery of Burn Care Committee assessed the status of regional development. The extant region leaders were contacted by email and queried as to the activities of their region and their opinion as to the success or failure of the regionalization initiative. Several regional organizational meetings were attended at the annual ABA meeting and many phone interviews were conducted to clear up any conflicting information. The original map of the burn regions was based on the American College of Surgeons Committee on Trauma regions, but these have undergone significant redistricting. The organizational structure, age, and activities of the regions vary significantly. The financial costs of maintaining a regional organization and holding an annual meeting are a major concern for most regions. For the most part the regional organizations are a good source of professional networking and a cost-effective source of continuing medical education/continuing education units for burn centers. The regionalization experiment of the ABA been reasonably successful in its first 25 years, but the ABA and the regions should take this opportunity to consider the next steps for the regions in the coming 25 years.

Hyperparathyroidism After Irradiation for Childhood Malignancy

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

McMullen, Todd; Bodie, Greg; Gill, Anthony

Purpose: To examine the occurrence of hyperparathyroidism in a cohort of patients undergoing combined parathyroid and thyroid surgery after previous head-and-neck irradiation for childhood malignancy. Methods and Materials: This is a retrospective cohort study for the years 1996 to 2007. The study group comprised patients undergoing surgery in University of Sydney Endocrine Surgical Unit who had received previous head-and-neck irradiation in childhood and who were identified as having pathologic thyroid and parathyroid characteristics. Results: A total of 53 patients were identified in whom head-and-neck irradiation for the treatment of childhood malignancy had been documented. In each of the cases, thyroidmore » disease was the primary reason for referral for surgery. Five of these patients (10%) were found to exhibit coexisting hyperparathyroidism. The latency period for hyperparathyroidism was less than 20 years in 4 of the 5 cases. There were four conventional parathyroid adenomas and one parathyroid lipoadenoma. All patients exhibited a significant decrease in postoperative calcium levels after surgery. Conclusions: To our knowledge, this is the first study to document the significant risk of hyperparathyroidism after radiation exposure for childhood malignancy. The timeframe for development of disease is much shorter than that published for individuals who have undergone irradiation for benign diseases. High doses of therapeutic radiation at a young age make childhood survivors of malignancy at especially high risk for developing hyperparathyroidism.« less

Development and phytochemical content analysis of bun incorporated with Kappaphycus Alvarezii seaweed powder

NASA Astrophysics Data System (ADS)

Sasue, Anita; Kasim, Zalifah Mohd

2016-11-01

Consumer awareness of the importance of functional foods has greatly grown in the past years. Functional foods with elevated levels of antioxidants are of high demand because of its associated health benefits. As bread is a common component in our daily diet, it may be convenient food to deliver antioxidants at a high concentration. The main approach of this study is to incorporate Kappaphycus alvarezii seaweed powder (SWP) and white flour in the bun formulation in order to develop seaweed bun with higher level of phytochemicals. The fresh Kappaphycus alvarezii seaweeds were washed, soaked in distilled water overnight, dried in a cabinet dryer at 40°C for 24 hours and ground into fine powder using universal miller. There were five different percentages of SWP incorporated into bun that were formulation A - control (0% SWP), B (3% SWP), C (6% SWP), D (9% SWP) and E (12% SWP). All the samples were undergone texture, total phenolic content and DPPH analysis. Seaweed concentration had most significant effect on phytochemical constituents of the bun with TPC (35.07 GAE, mg/100g) and DPPH activity (49.02%) maximized when 12% SWP was incorporated into the flour (P<0.05). The incorporation of the SWP also gives significant effects towards the texture of the bun where the bun becomes harder and denser as compared to the control.

Postoperative rhabdomyolysis following robotic renal and adrenal surgery: a cautionary tale of compounding risk factors.

PubMed

Terry, Russell S; Gerke, Travis; Mason, James B; Sorensen, Matthew D; Joseph, Jason P; Dahm, Philipp; Su, Li-Ming

2015-09-01

This study aimed at reviewing a contemporary series of patients who underwent robotic renal and adrenal surgery by a single surgeon at a tertiary referral academic medical center over a 6-year period, specifically focusing on the unique and serious complication of post-operative rhabdomyolysis of the dependent lower extremity. The cases of 315 consecutive patients who underwent robotic upper tract surgery over a 6-year period from August 2008 to June 2014 using a standardized patient positioning were reviewed and analyzed for patient characteristics and surgical variables that may be associated with the development of post-operative rhabdomyolysis. The incidence of post-operative rhabdomyolysis in our series was 3/315 (0.95%). All three affected patients had undergone robotic nephroureterectomy. Those patients who developed rhabdomyolysis had significantly higher mean Body Mass Index, Charlson Comorbidity Index, and median length of stay than those who did not. The mean OR time in the rhabdomyolysis group was noted to be 52 min longer than the non-rhabdomyolysis group, though this value did not reach statistical significance. Given the trends of increasing obesity in the United States and abroad as well as the continued rise in robotic upper tract urologic surgeries, urologists need to be increasingly vigilant for recognizing the risk factors and early treatment of the unique complication of post-operative rhabdomyolysis.

Subsequent vitiligo after hematopoietic stem cell transplantation: A nationwide population-based cohort study from Korea.

PubMed

Bae, Jung Min; Choi, Kwang Hyun; Jung, Han Mi; Kim, Sook Young; Kim, Miri; Kim, Gyung Moon; Yu, Dong Soo; Lee, Young Bok

2017-03-01

Subsequent vitiligo after hematopoietic stem cell transplantation (HSCT) has been described sporadically in case series. To investigate the incidence and risk factors of subsequent vitiligo after HSCT. A nationwide, population-based cohort study was performed using the Korean National Health Insurance Claims Database from 2009 to 2013. All HSCT recipients who had undergone HSCT between 2010 and 2011 and not treatment for vitiligo in 2009 (to exclude preexisting active vitiligo) were included in the HSCT recipient group, and an age- and sex-matched control group without HSCT was also established. A total of 2747 HSCT recipients and 8241 controls were enrolled. Newly acquired vitiligo occurred in 1.06% of HSCT recipients between 2010 and 2013, and there was a significant increase (OR 3.130, 95% CI 1.859-5.271) in cases of vitiligo in HSCT recipients compared with controls (0.34%). Allogeneic HSCT (OR 5.593, 95% CI 1.628-19.213) and bone marrow-sourced stem cells (as compared with peripheral blood-sourced stem cells; OR 2.492, 95% CI 1.114-5.576) were independently associated with the development of vitiligo after HSCT. Medical record review was not available. Vitiligo developed at a significantly increased rate after HSCT compared with controls. Allogeneic HSCT and bone marrow-sourced stem cells were independent risk factors. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Understanding and managing change in health care organizations.

PubMed

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☆

PubMed Central

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

Development of an integrated ecosystem model to determine effectiveness of potential watershed management projects on improving Old Tampa Bay

Treesearch

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 Bay’s recovery relative to improvements in overall water quality and seagrass coverage. In 2011, the Tampa Bay Estuary Program, in...

Exploring the impact of resilience, self-efficacy, optimism and organizational resources on work engagement.

PubMed

Mache, Stefanie; Vitzthum, Karin; Wanke, Eileen; Klapp, Burghard F; Danzer, Gerhard

2014-01-01

The German health care system has undergone radical changes in the last decades. These days health care professionals have to face economic demands, high performance pressure as well as high expectations from patients. To ensure high quality medicine and care, highly intrinsic motivated and work engaged health care professionals are strongly needed. The aim of this study was to examine relations between personal and organizational resources as essential predictors for work engagement of German health care professionals. This investigation has a cross-sectional questionnaire study design. Participants were a sample of hospital doctors. Personal strengths, working conditions and work engagement were measured by using the SWOPE-K9, COPE Brief Questionnaire, Perceived Stress Questionnaire, COPSOQ and Utrecht Work Engagement Scale. Significant relations between physicians' personal strengths (e.g. resilience, optimism) and work engagement were evaluated. Work related factors showed to have a significant influence on work engagement. Differences in work engagement were also found with regard to socio-demographic variables. Results demonstrated important relationships between personal and organizational resources and work engagement. Health care management needs to use this information to maintain or develop work engaging job conditions in hospitals as one key factor to ensure quality health care service.

Soil occupation and atmospheric variations over Sobradinho Lake area. Part one: an observational analysis

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.

Advances in Diagnostic Bronchoscopy

PubMed Central

Haas, Andrew R.; Vachani, Anil; Sterman, Daniel H.

2010-01-01

Diagnostic bronchoscopy has undergone two major paradigm shifts in the last 40 years. First, the advent of flexible bronchoscopy gave chest physicians improved access to the tracheobronchial tree with a rapid learning curve and greater patient comfort compared with rigid bronchoscopy. The second paradigm shift has evolved over the last 5 years with the proliferation of new technologies that have significantly enhanced the diagnostic capabilities of flexible bronchoscopy compared with traditional methods. At the forefront of these new technologies is endobronchial ultrasound. In its various forms, endobronchial ultrasound has improved diagnostic yield for pulmonary masses, nodules, intrathoracic adenopathy, and disease extent, thereby reducing the need for more invasive surgical interventions. Various navigational bronchoscopy systems have become available to increase flexible bronchoscope access to small peripheral pulmonary lesions. Furthermore, various modalities of airway assessment, including optical microscopic imaging technologies, may play significant roles in the diagnosis of a variety of pulmonary diseases in the future. Finally, the combination of new diagnostic bronchoscopy technologies and novel approaches in molecular analysis and biomarker assessment hold promise for enhanced diagnosis and personalized management of many pulmonary disorders. In this review, we provide a contemporary review of diagnostic bronchoscopy developments over the past decade. PMID:20378726

The ambulance services in northern Norway 2004–2008: improved competence, more tasks, better logistics and increased costs

PubMed Central

Elsbak, Trond M.

2010-01-01

Background The ambulance services in northern Norway have undergone significant development during recent years. Aims The objective of this study was to describe these changes in terms of tasks performed, distance driven, resources spent and level of competence in terms of education. Methods A retrospective analysis was performed. The ambulance fleet’s activity during the time period 2004–2008 was analysed. The subject was the ambulance fleet in northern Norway and its crew members. Tasks done, kilometres driven, resources spent per thousand inhabitants and level of competence were the main outcome measures. Results The major findings were almost doubled costs (92%), increasing number of tasks performed (13%) and a stable situation concerning kilometres driven. We also revealed improving competence in terms of education. A 20% absolute increase in crew members having a certificate of competence (fagbrev) was observed. Conclusions Significant economic resources have been invested in the fleet. Improved level of competence and an upgraded coordination system have improved logistics and hopefully treatment outcome. The latter should be further elucidated when the electronic patient record (EPR) system has been implemented. PMID:20606813

Characterization of the Edge Crack Torsion (ECT) Test for Mode III Fracture Toughness Measurement of Laminated Composites

NASA Technical Reports Server (NTRS)

Ratcliffe, James G.

2004-01-01

The edge crack torsion (ECT) test is designed to initiate mode III delamination growth in composite laminates. The test has undergone several design changes during its development. The objective of this paper was to determine the suitability of the current ECT test design a mode III fracture test. To this end, ECT tests were conducted on specimens manufactured from IM7/8552 and S2/8552 tape laminates. Three-dimensional finite element analyses were performed. The analysis results were used to calculate the distribution of mode I, mode II, and mode III strain energy release rate along the delamination front. The results indicated that mode IIIdominated delamination growth would be initiated from the specimen center. However, in specimens of both material types, the measured values of GIIIc exhibited significant dependence on delamination length. Load-displacement response of the specimens exhibited significant deviation from linearity before specimen failure. X-radiographs of a sample of specimens revealed that damage was initiated in the specimens prior to failure. Further inspection of the failure surfaces is required to identify the damage and determine that mode III delamination is initiated in the specimens.

Hypermethylation of brain natriuretic peptide gene is associated with the risk of rheumatic heart disease

PubMed Central

Li, Ni; Zheng, Dawei; Sun, Lebo; Shi, Huoshun; Zhu, Xiuying; Xu, Guodong; Wang, Qinning; Zhu, Caimin

2016-01-01

To investigate the contribution of brain natriuretic peptide (BNP) promoter DNA methylation to the risk of rheumatic heart disease (RHD) and the influence of warfarin anticoagulant therapy on BNP methylation levels for RHD patients after surgery. BNP methylation levels were determined by bisulfite pyrosequencing from plasma samples of RHD patients compared with healthy controls. Several factors influencing the RHD patients were included like age, smoking and cholesterol levels. A fragment of five CG sites (CpG1–5) in the promoter region of BNP gene was measured. BNP gene hypermethylation was found in CpG4 and CpG5 in RHD patients compared with non-RHD controls. A significant difference was also observed between RHD patients with long-term administration of warfarin and RHD patients who had recently undergone an operation. Moreover, single CpG4 and CpG5 analysis revealed a significant increase in methylation levels in men. BNP gene body hypermethylation is associated with the risk of RHD, and also influenced by the warfarin anticoagulant therapy of RHD patients after surgery, which could represent novel and promising targets for therapeutic development. PMID:27920275

Epithelial cell proliferation in human fundic and antral mucosae. Influence of superselective vagotomy and relationship with gastritis

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

Gutierrez, O.; Lehy, T.; Rene, E.

1985-11-01

Epithelial cell proliferation in the fundic and antral mucosae was studied in 19 duodenal ulcer patients, 11 patients having undergone fundic superselective vagotomy for duodenal ulcer, and 10 controls. This was achieved through in vitro incorporation of tritiated thymidine in mucosal biopsies and radioautography. Except for increased fundic mucosal height, duodenal ulcer patients did not differ from controls for all parameters studied. In vagotomized patients, as compared to the other two groups, the labeling index was significantly enhanced in the innervated antral mucosa where atrophic gastritis developed, but there was no change in the labeling index and no worsening ofmore » mucosal inflammation in the denervated fundic mucosa. The only abnormality in the latter was a striking expansion, towards the surface, of the proliferative area within the fundic pit. The labeling indices and the degree of gastritis in gastric mucosae are significantly correlated in control and duodenal ulcer patients. If findings in antral mucosa, after superselective vagotomy, seemed related to gastritis lesions, those in fundic mucosa were not and may indicate an alteration due to the vagotomy per se.« less

DTI-based response-driven modeling of mTLE laterality.

PubMed

Nazem-Zadeh, Mohammad-Reza; Elisevich, Kost; Air, Ellen L; Schwalb, Jason M; Divine, George; Kaur, Manpreet; Wasade, Vibhangini S; Mahmoudi, Fariborz; Shokri, Saeed; Bagher-Ebadian, Hassan; Soltanian-Zadeh, Hamid

2016-01-01

To develop lateralization models for distinguishing between unilateral and bilateral mesial temporal lobe epilepsy (mTLE) and determining laterality in cases of unilateral mTLE. mTLE is the most common form of medically refractory focal epilepsy. Many mTLE patients fail to demonstrate an unambiguous unilateral ictal onset. Intracranial EEG (icEEG) monitoring can be performed to establish whether the ictal origin is unilateral or truly bilateral with independent bitemporal ictal origin. However, because of the expense and risk of intracranial electrode placement, much research has been done to determine if the need for icEEG can be obviated with noninvasive neuroimaging methods, such as diffusion tensor imaging (DTI). Fractional anisotropy (FA) was used to quantify microstructural changes reflected in the diffusivity properties of the corpus callosum, cingulum, and fornix, in a retrospective cohort of 31 patients confirmed to have unilateral (n = 24) or bilateral (n = 7) mTLE. All unilateral mTLE patients underwent resection with an Engel class I outcome. Eleven were reported to have hippocampal sclerosis on pathological analysis; nine had undergone prior icEEG. The bilateral mTLE patients had undergone icEEG demonstrating independent epileptiform activity in both right and left hemispheres. Twenty-three nonepileptic subjects were included as controls. In cases of right mTLE, FA showed significant differences from control in all callosal subregions, in both left and right superior cingulate subregions, and in forniceal crura. Comparison of right and left mTLE cases showed significant differences in FA of callosal genu, rostral body, and splenium and the right posteroinferior and superior cingulate subregions. In cases of left mTLE, FA showed significant differences from control only in the callosal isthmus. Significant differences in FA were identified when cases of right mTLE were compared with bilateral mTLE cases in the rostral and midbody callosal subregions and isthmus. Based on 11 FA measurements in the cingulate, callosal and forniceal subregions, a response-driven lateralization model successfully differentiated all cases (n = 54) into groups of unilateral right (n = 12), unilateral left (n = 12), and bilateral mTLE (n = 7), and nonepileptic control (23). The proposed response-driven DTI biomarker is intended to lessen diagnostic ambiguity of laterality in cases of mTLE and help optimize selection of surgical candidates. Application of this model shows promise in reducing the need for invasive icEEG in prospective cases.

L-dopa decarboxylase (DDC) gene expression is related to outcome in patients with prostate cancer.

PubMed

Koutalellis, Georgios; Stravodimos, Konstantinos; Avgeris, Margaritis; Mavridis, Konstantinos; Scorilas, Andreas; Lazaris, Andreas; Constantinides, Constantinos

2012-09-01

What's known on the subject? and What does the study add? L-dopa decarboxylase (DDC) has been documented as a novel co-activator of androgen receptor transcriptional activity. Recently, it was shown that DDC gene expression is significantly higher in patients with PCa than in those with BPH. In the present study, there was a significant association between the DDC gene expression levels and the pathological stage and Gleason score of patients with prostate cancer (PCa). Moreover, DDC expression was shown to be an unfavourable prognostic marker of biochemical recurrence and disease-free survival in patients with PCa treated by radical prostatectomy. To determine whether L-dopa decarboxylase gene (DDC) expression levels in patients with prostate cancer (PCa) correlate to biochemical recurrence and disease prognosis after radical prostatectomy (RP). The present study consisted of 56 samples with confirmed malignancy from patients with PCa who had undergone RP at a single tertiary academic centre. Total RNA was isolated from tissue specimens and a SYBR Green fluorescence-based quantitative real-time polymerase chain reaction methodology was developed for the determination of DDC mRNA expression levels of the tested tissues. Follow-up time ranged between 1.0 and 62.0 months (mean ± SE, 28.6 ± 2.1 month; median, 31.5 months). Time to biochemical recurrence was defined as the interval between the surgery and the measurement of two consecutive values of prostate-specific antigen (PSA) ≥0.2 ng/mL. DDC expression levels were found to be positively correlated with the tumour-node-metastasis stage (P = 0.021) and Gleason score (P = 0.036) of the patients with PCa. Patients with PCa with raised DDC expression levels run a significantly higher risk of biochemical recurrence after RP, as indicated by Cox proportional regression analysis (P = 0.021). Multivariate Cox proportional regression models revealed the preoperative PSA-, age- and digital rectal examination-independent prognostic value of DDC expression for the prediction of disease-free survival (DFS) among patients with PCa (P = 0.036). Kaplan-Meier survival analysis confirms the significantly shorter DFS after RP of PCa with higher DDC expression levels (P = 0.015). This is the first study indicating the potential of DDC expression as a novel prognostic biomarker in patients with PCa who have undergone RP. For further evaluation and clinical application of the findings of the present study, a direct analysis of mRNA and/or its protein expression level in preoperative biopsy, blood serum and urine should be conducted. © 2012 BJU INTERNATIONAL.

Disasters as an ideological strategy for governing neoliberal urban transformation in Turkey: insights from Izmir/Kadifekale.

PubMed

Saraçoğlu, Cenk; Demirtaş-Milz, Neslihan

2014-01-01

Since the turn of the twenty-first century, Turkish cities have undergone large-scale change through a process referred to as urban transformation, involving, notably, the demolition of inner-city low-income settlements. The official authorities and business circles have resorted to various forms of discourse to justify these projects, which have led to the deportation of a significant number of people to peripheral areas. The discourse of 'natural disasters', for example, suggests that urban transformation is necessary to protect people from some pending event. Probably the most effective application of this discourse has occurred in Izmir, where the risk posed by 'landslides' has played a critical role in the settlement demolitions conducted in the huge inner-city neighbourhood of Kadifekale. By examining the case of Kadifekale, this paper provide some insights into how 'natural disasters' serve as a discourse with which to legitimise the neoliberal logic entrenched in the urban transformation process in Turkey. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

Immunohistochemical analysis of EGFR and hyaluronan in tongue cancer and the development of regional recurrence in patients initially diagnosed N0.

PubMed

Lindell Jonsson, Eva; Nylander, Karin; Hallén, Lars; Laurell, Göran

2017-08-01

To investigate whether the extent of expression of hyaluronan (HA) and epidermal growth factor receptor (EGFR) in squamous cell carcinoma of the mobile tongue can predict the risk of cervical metastasis and survival. Retrospective histopathologic study. Surgical specimens from 64 patients who had undergone surgery for squamous cell carcinoma of the mobile tongue were assessed using immunohistochemistry to investigate the expression of HA and EGFR in the primary tumours, and the data were then correlated to cervical metastasis and survival. There was a significant correlation between the intensity of HA staining and patient survival (p .024), and a weak correlation between the staining proportion of EGFR and the risk for regional recurrence (AUC 66). This study indicates that immunoscoring using HA could be used to provide prognostic tools for tongue cancer, and that it might be of interest to study the prognostic properties of EGFR further concerning the risk for regional recurrence after the primary treatment.

Health Disparity and Cancer Health Disparity in China.

PubMed

Wang, Qi; Jiao, Jie

2016-01-01

China is one of the largest and most populated countries in the world. It has undergone rapid economic growth in recent years. However, the development is not equitable, and the distribution of wealth significantly varies among the regions in China. Geographical and socioeconomic inequalities, together with the lack of an equitable national social support system, cause the high variance of health outcomes among the regions. Furthermore, the fast growth of the economy has evoked many environmental challenges and puts much pressure on the population. The severe environmental deterioration, especially of the atmosphere and water bodies, has affected the health of the people living in China. As a result, cancer has become a major public health issue, and an alarming increase in incidence and mortality has been reported. However, cancer incidence and mortality vary in different areas in China. Cancer and cancer treatment disparities have existed for years. This article will discuss the existing health and cancer disparities associated with the risk factors and how these disparities are managed in China.

Water quality dynamics in an urbanizing subtropical estuary(Oso Bay, Texas).

PubMed

Wetz, Michael S; Hayes, Kenneth C; Fisher, Kelsey V B; Price, Lynn; Sterba-Boatwright, Blair

2016-03-15

Results are presented from a study of water quality dynamics in a shallow subtropical estuary, Oso Bay, Texas, which has a watershed that has undergone extensive urbanization in recent decades. High inorganic nutrient, dissolved organic matter and chlorophyll concentrations, as well as low pH (<8), were observed in a region of Oso Bay that receives wastewater effluent. Despite being shallow (<1 m) and subjected to strong winds on a regular basis, this region also exhibited episodic hypoxia/anoxia. The low oxygen and pH conditions are likely to impose significant stress on benthic organisms and nekton in the affected area. Signatures of eutrophied water were occasionally observed at the mouth of Oso Bay, suggesting that it may be exported to adjacent Corpus Christi Bay and contribute to seasonal hypoxia development in that system as well. These results argue for wastewater nutrient input reductions in order to alleviate the symptoms of eutrophication. Copyright © 2016 Elsevier Ltd. All rights reserved.

2D negative capacitance field-effect transistor with organic ferroelectrics.

PubMed

Zhang, Heng; Chen, Yan; Ding, Shijin; Wang, Jianlu; Bao, Wenzhong; Zhang, David Wei; Zhou, Peng

2018-06-15

In the past fifty years, complementary metal-oxide-semiconductor integrated circuits have undergone significant development, but Moore's law will soon come to an end. In order to break through the physical limit of Moore's law, 2D materials have been widely used in many electronic devices because of their high mobility and excellent mechanical flexibility. And the emergence of a negative capacitance field-effect transistor (NCFET) could not only break the thermal limit of conventional devices, but reduce the operating voltage and power consumption. This paper demonstrates a 2D NCFET that treats molybdenum disulfide as a channel material and organic P(VDF-TrFE) as a gate dielectric directly. This represents a new attempt to prepare NCFETs and produce flexible electronic devices. It exhibits a 10^6 on-/off-current ratio. And the minimum subthreshold swing (SS) of the 21 mV/decade and average SS of the 44 mV/decade in four orders of magnitude of drain current can also be observed at room temperature of 300 K.

Visual Memory in Post-Anterior Right Temporal Lobectomy Patients and Adult Normative Data for the Brown Location Test (BLT)

PubMed Central

Brown, Franklin C.; Tuttle, Erin; Westerveld, Michael; Ferraro, F. Richard; Chmielowiec, Teresa; Vandemore, Michelle; Gibson-Beverly, Gina; Bemus, Lisa; Roth, Robert M.; Blumenfeld, Hal; Spencer, Dennis D.; Spencer, Susan S

2010-01-01

Several large and meta-analytic studies have failed to support a consistent relationship between visual or “nonverbal” memory deficits and right mesial temporal lobe changes. However, the Brown Location Test (BLT) is a recently developed dot location learning and memory test that uses a nonsymmetrical array and provides control over many of the confounding variables (e.g., verbal influence and drawing requirements) inherent in other measures of visual memory. In the present investigation, we evaluated the clinical utility of the BLT in patients who had undergone left or right anterior mesial temporal lobectomies. We also provide adult normative data of 298 healthy adults in order to provide standardized scores. Results revealed significantly worse performance on the BLT in the right as compared to left lobectomy group and the healthy adult normative sample. The present findings support a role for the right anterior-mesial temporal lobe in dot location learning and memory. PMID:20056493

2D negative capacitance field-effect transistor with organic ferroelectrics

NASA Astrophysics Data System (ADS)

Zhang, Heng; Chen, Yan; Ding, Shijin; Wang, Jianlu; Bao, Wenzhong; Zhang, David Wei; Zhou, Peng

2018-06-01

In the past fifty years, complementary metal-oxide-semiconductor integrated circuits have undergone significant development, but Moore’s law will soon come to an end. In order to break through the physical limit of Moore’s law, 2D materials have been widely used in many electronic devices because of their high mobility and excellent mechanical flexibility. And the emergence of a negative capacitance field-effect transistor (NCFET) could not only break the thermal limit of conventional devices, but reduce the operating voltage and power consumption. This paper demonstrates a 2D NCFET that treats molybdenum disulfide as a channel material and organic P(VDF-TrFE) as a gate dielectric directly. This represents a new attempt to prepare NCFETs and produce flexible electronic devices. It exhibits a 106 on-/off-current ratio. And the minimum subthreshold swing (SS) of the 21 mV/decade and average SS of the 44 mV/decade in four orders of magnitude of drain current can also be observed at room temperature of 300 K.

Robotic-assisted percutaneous coronary intervention--filling an unmet need.

PubMed

Carrozza, Joseph P

2012-02-01

Percutaneous coronary intervention (PCI) has undergone a remarkable evolution over the past 25 years. Initially, the procedure was limited to relatively straightforward lesions and was associated with significant risk and unpredictable long-term efficacy. With the incorporation of new technologies such as stents, the safety and efficacy of the procedure has improved dramatically. However, the fundamental way in which the procedure is performed has changed little since the time of Gruntzig's first successful case. Cumulative exposure to ionizing radiation, orthopedic injuries resulting from wearing shielding aprons, and fatigue from standing for hours at the table have made the catheterization laboratory a "high-risk workplace" for the interventional cardiologist. Robotic-assisted PCI was developed to allow the operator to precisely manipulate angioplasty guidewires, balloons, and stents from a radiation-shielded cockpit. A small first-in-man study demonstrated that PCI can be performed with robotic assistance. The pivotal Percutaneous Robotically Enhanced Coronary Intervention Study trial is currently enrolling patients and evaluating the safety and efficacy of the CorPath® robotically assisted PCI system.

NASA's Software Safety Standard

NASA Technical Reports Server (NTRS)

Ramsay, Christopher M.

2005-01-01

NASA (National Aeronautics and Space Administration) relies more and more on software to control, monitor, and verify its safety critical systems, facilities and operations. Since the 1960's there has hardly been a spacecraft (manned or unmanned) launched that did not have a computer on board that provided vital command and control services. Despite this growing dependence on software control and monitoring, there has been no consistent application of software safety practices and methodology to NASA's projects with safety critical software. Led by the NASA Headquarters Office of Safety and Mission Assurance, the NASA Software Safety Standard (STD-18l9.13B) has recently undergone a significant update in an attempt to provide that consistency. This paper will discuss the key features of the new NASA Software Safety Standard. It will start with a brief history of the use and development of software in safety critical applications at NASA. It will then give a brief overview of the NASA Software Working Group and the approach it took to revise the software engineering process across the Agency.

Laparoscopic (endoscopic) radical prostatectomy: techniques and results

NASA Astrophysics Data System (ADS)

Nelius, Thomas; de Riese, Werner T. W.; Reiher, Frank; Lindenmeir, Tobias; Filleur, Stephanie; Allhoff, Ernst P.

2005-04-01

Laparoscopic radical prostatectomy (LRP) is a relatively new technique for treating organ-confined prostate cancer. Recent progress of laparoscopic/endoscopic techniques allow to perform these complex oncological procedure. Since the first description of LRP in the early 1990s the technique has undergone significant technical modifications. Two operation routes were mainly used: the transperitoneal LRP and the extraperitoneal endoscopic radical prostatectomy (EERPE). Here we review the surgical techniques of both operation routes, and highlight results, outcome and complications. The transperitoneal LRP and the EERPE can be used successfully and reproducibly, giving results comparable with those from the open retropubic procedure. Despite many advantages, transperitoneal LRP is associated with potential intraperitoneal complications. The technical improvements of the EERPE completely obviates these complications. The available data are encouraging and promising, but long-term oncological results will define the definitive role of these new techniques. We truly believe that minimally invasive surgery in treating localized prostate cancer has a bright future and that these techniques will continue to be developed.

Long-term development of hypolimnetic oxygen depletion rates in the large Lake Constance.

PubMed

Rhodes, Justin; Hetzenauer, Harald; Frassl, Marieke A; Rothhaupt, Karl-Otto; Rinke, Karsten

2017-09-01

This study investigates over 30 years of dissolved oxygen dynamics in the deep interior of Lake Constance (max. depth: 250 m). This lake supplies approximately four million people with drinking water and has undergone strong re-oligotrophication over the past decades. We calculated depth-specific annual oxygen depletion rates (ODRs) during the period of stratification and found that 50% of the observed variability in ODR was already explained by a simple separation into a sediment- and volume-related oxygen consumption. Adding a linear factor for water depth further improved the model indicating that oxygen depletion increased substantially along the depth. Two other factors turned out to significantly influence ODR: total phosphorus as a proxy for the lake's trophic state and mean oxygen concentration in the respective depth layer. Our analysis points to the importance of nutrient reductions as effective management measures to improve and protect the oxygen status of such large and deep lakes.

Marketing strategies for vascular practitioners.

PubMed

Satiani, Anand; Satiani, Bhagwan

2009-09-01

A common misconception is that marketing is synonymous with advertising. Marketing by physicians has undergone a transformation from the earlier unacceptable slick sales pitches to a more common sense, tasteful, comprehensive, and well thought out plan to reach potential patients. Marketing is a much broader concept comprising four aspects: product, price, promotion, and place. Marketing activities for a medical practice include not only external but internal tactics. Publicly available resources are available to assist physicians in developing and targeting the plan towards a narrow patient demographic. The marketing process includes: determining objectives, identifying resources, defining target population, honing a message, outlining a media plan, implementing the plan, and finally, evaluating the success or failure of the marketing campaign. A basic knowledge of marketing combined with a common sense approach can yield dividends for those practices that need the service. For surgical practices that exist in heavily populated urban areas with significant competition, a well thought out marketing plan can assist the practice in reaching out to new groups of patients and maintaining the existing patient base.

Age at menarche and the reproductive performance of Saudi women.

PubMed

Babay, Zainab A; Addar, Mohammed H; Shahid, Khalida; Meriki, Naema

2004-01-01

Saudi Arabia has undergone substantial development in the recent past with concomitant changes in living conditions, and economic and general health status that have affected the age at menarche in Saudi women. We evaluated the current age at menarche and reproductive events among Saudi women. Age, age at menarche, age at marriage, age of first pregnancy, number of children, and number of abortions were collected for Saudi women attending King Khalid University Hospital (KKUH) over a 3-month period in 2002. For 989 Saudi women, the mean age at menarche was 13.05 years. There was a decrease in the age of menarche over the past 20 years, an increase in the age of marriage, age of first pregnancy, and a decrease in the number of children and abortions. Compared with data from two decades, the age at menarche decreased significantly from 13.22 to 13.05 years. The decrease in the age of menarche among Saudi women indicates better socioeconomic status and improvements in health.

Metabolism in Fungal Pathogenesis

PubMed Central

Ene, Iuliana V.; Brunke, Sascha; Brown, Alistair J.P.; Hube, Bernhard

2014-01-01

Fungal pathogens must assimilate local nutrients to establish an infection in their mammalian host. We focus on carbon, nitrogen, and micronutrient assimilation mechanisms, discussing how these influence host–fungus interactions during infection. We highlight several emerging trends based on the available data. First, the perturbation of carbon, nitrogen, or micronutrient assimilation attenuates fungal pathogenicity. Second, the contrasting evolutionary pressures exerted on facultative versus obligatory pathogens have led to contemporary pathogenic fungal species that display differing degrees of metabolic flexibility. The evolutionarily ancient metabolic pathways are conserved in most fungal pathogen, but interesting gaps exist in some species (e.g., Candida glabrata). Third, metabolic flexibility is generally essential for fungal pathogenicity, and in particular, for the adaptation to contrasting host microenvironments such as the gastrointestinal tract, mucosal surfaces, bloodstream, and internal organs. Fourth, this metabolic flexibility relies on complex regulatory networks, some of which are conserved across lineages, whereas others have undergone significant evolutionary rewiring. Fifth, metabolic adaptation affects fungal susceptibility to antifungal drugs and also presents exciting opportunities for the development of novel therapies. PMID:25190251

Health Disparity and Cancer Health Disparity in China

PubMed Central

Wang, Qi; Jiao, Jie

2016-01-01

China is one of the largest and most populated countries in the world. It has undergone rapid economic growth in recent years. However, the development is not equitable, and the distribution of wealth significantly varies among the regions in China. Geographical and socioeconomic inequalities, together with the lack of an equitable national social support system, cause the high variance of health outcomes among the regions. Furthermore, the fast growth of the economy has evoked many environmental challenges and puts much pressure on the population. The severe environmental deterioration, especially of the atmosphere and water bodies, has affected the health of the people living in China. As a result, cancer has become a major public health issue, and an alarming increase in incidence and mortality has been reported. However, cancer incidence and mortality vary in different areas in China. Cancer and cancer treatment disparities have existed for years. This article will discuss the existing health and cancer disparities associated with the risk factors and how these disparities are managed in China. PMID:28083550

Lower limb amputations: differences between the genders and long-term survival.

PubMed

Heikkinen, M; Saarinen, J; Suominen, V P; Virkkunen, J; Salenius, J

2007-09-01

The purpose of the study was to evaluate possible differences between genders in amputation incidence, revascularization activity before and survival after amputation. This population-based study was carried out in a well-defined geographical area, where all vascular surgical consultations and reconstructions are performed in one university hospital. All amputations performed in the region during 1990 - 1999 were identified from the hospital central registers. According to patient's identity codes, the Cause of Death Registry of Statistics Finland provided death data. Amputation data were cross-linked with the local vascular registry using identity codes. Women were found to be 8 years older than men (p < 0.0001). Major amputations comprised 73.4% in males and 77.7% in females. The age-standardized amputation incidence among males was 338 and among females 226 (per 10(6) inhabitants/year) (p < 0.001). The most prominent difference was seen in amputations due to trauma, where the age-adjusted major amputation incidence was over three-fold among males compared to females. The proportion of patients who had undergone vascular procedure before amputation was 23% in both genders. Median survival after amputation was 943 days in men and 716 in women (p = 0.01). When the higher age of women was considered, there was no significant difference between the genders. Survival was poorer among diabetics in both genders and the difference was significant in males. The amputation incidence was found to be higher in men compared to women in all etiologic subgroups except malignant tumour. Almost one in 4 patients had undergone vascular surgical reconstruction before amputation in both genders. There was no significant difference between the genders in survival after amputation. Subjects with diabetes had a poorer survival after major amputation than those without diabetes.

Electroglottographic Comparison of Voice Outcomes in Patients With Advanced Laryngopharyngeal Cancer Treated by Chemoradiotherapy or Total Laryngectomy

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

Kazi, Rehan; Institute of Cancer Research, London; Venkitaraman, Ramachandran

2008-02-01

Purpose: To conduct prospective electroglottographic analyses of voice outcomes after radical chemoradiotherapy for locally advanced laryngopharyngeal cancers and to compare them with patients who have undergone total laryngectomy (TL). Patients and Methods: Twenty-one patients (19 male, 2 female, median age [range] 65 [50-85] years) with Stage III/IV laryngopharyngeal cancer received induction chemotherapy followed by radical chemoradiotherapy. Electroglottography, using the sustained vowel /i/ and connected speech, was performed before treatment and 1, 6, and 12 months after treatment. In addition, single voice recordings were taken from 21 patients (16 male, 5 female, aged 65 [50-84] years) who had undergone TL andmore » surgical voice restoration and from 21 normal controls (18 male, 3 female, aged 65 [33-80] years). Results: Before treatment the vocal measures for the chemoradiotherapy patients were significantly different from normal controls in jitter (p = 0.02), maximum phonation time (MPT) (p = 0.001), and words per minute (WPM) (p = 0.01). At 12 months after treatment MPT and WPM had normalized, but jitter and normalized noise energy were significantly worse than in normal controls. Comparison of voice outcomes at 12 months for chemoradiotherapy patients revealed superiority over the TL group in all parameters except MPT (18.2 s vs. 10.4 s, p = 0.06). Analysis of the recovery of voice up to 12 months after treatment revealed progressive improvement in most electroglottographic measures. Conclusions: This prospective study demonstrates significantly better outcome for patients treated with chemoradiotherapy as compared with TL. Progressive normalization of many voice parameters occurs over the 12 months following chemoradiotherapy.« less

Histopathologic and immunohistochemical sequelae of bariatric embolization in a porcine model.

PubMed

Paxton, Ben E; Alley, Christopher L; Crow, Jennifer H; Burchette, James; Weiss, Clifford R; Kraitchman, Dara L; Arepally, Aravind; Kim, Charles Y

2014-03-01

To evaluate the histopathologic sequelae of bariatric embolization on the gastric mucosa and to correlate with immunohistochemical evaluation of the gastric fundus, antrum, and duodenum. This study was performed on 12 swine stomach and duodenum specimens after necropsy. Of the 12 swine, 6 had previously undergone bariatric embolization of the gastric fundus, and the 6 control swine had undergone a sham procedure with saline. Gross pathologic, histopathologic, and immunohistochemical examinations of the stomach and duodenum were performed. Specifically, mucosal integrity, fibrosis, ghrelin-expressing cells, and gastrin-expressing cells were assessed. Gross and histopathologic evaluation of treatment animals showed healing or healed mucosal ulcers in 50% of animals, with gastritis in 100% of treatment animals and in five of six control animals. The ghrelin-immunoreactive mean cell density was significantly lower in the gastric fundus in the treated animals compared with control animals (15.3 vs 22.0, P < .01) but similar in the gastric antrum (9.3 vs 14.3, P = .08) and duodenum (8.5 vs 8.6, P = .89). The gastrin-expressing cell density was significantly lower in the antrum of treated animals compared with control animals (82.2 vs 126.4, P = .03). A trend toward increased fibrosis was suggested in the gastric fundus of treated animals compared with controls (P = .07). Bariatric embolization resulted in a significant reduction in ghrelin-expressing cells in the gastric fundus without evidence of upregulation of ghrelin-expressing cells in the duodenum. Healing ulcerations in half of treated animals underscores the need for additional refinement of this procedure. © 2014 Published by SIR on behalf of The Society of Interventional Radiology.

How much do parents know about first aid for burns?

PubMed

Davies, M; Maguire, S; Okolie, C; Watkins, W; Kemp, A M

2013-09-01

Prompt first aid reduces burn morbidity. With an estimated 19,000 children attending emergency departments (ED) with a burn or scald every year in the UK, a parent's knowledge of first aid is particularly important. This study evaluates the extent and source of this knowledge. Parents attending the emergency and antenatal departments of a University Hospital answered a structured questionnaire detailing demographics, knowledge of burns first aid and its source. Knowledge was stratified into 4 categories: contraindicated, poor, inadequate and adequate. Individual chi-squared tests and ordered logistic regressions were performed to relate knowledge to demographic features. The 106 respondents (44% men) reflected a wide range of socio-economic (SE) grouping and educational level. Overall 32% had an adequate knowledge of burns first aid while 43% had poor or no knowledge. There was no significant correlation between gender, educational status or age and knowledge; however those from higher SE groups (p<0.05) and those who had undergone first aid training (p<0.01) had greater knowledge. Among 40% of parents who had undergone first aid training, 74% had adequate knowledge. The logistic regression accounting for all significant variables showed that previous first aid training was the most influential factor in knowledge of first aid (p<0.001). Interestingly, although 2/3 of parents wanted further training, 75% of those who did not had poor or no first-aid knowledge. Overall, the knowledge of burns first aid among parents is inadequate and correlates with lower SE groups. There was a significant association between knowledge and previous first aid training. Results suggest that targeting burns first aid training to all new parents, particularly those in low income households, would be of value. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

Shoulder function and anatomy in complete obstetric brachial plexus palsy: long-term improvement after triangle tilt surgery

PubMed Central

Karicherla, Priyanka; Mahmooduddin, Faiz

2010-01-01

Purpose Untreated complete obstetric brachial plexus injury (COBPI) usually results in limited spontaneous recovery of shoulder function. Older methods used to treat COBPI have had questionable success, with very few studies being published. The purpose of the current study was to examine the results of triangle tilt surgery on shoulder function and development in COBPI individuals. Methods This study was conducted as a retrospective chart review. Inclusion criteria were COBPI patients that had undergone the triangle tilt procedure from 2005 to 2009 and were between the ages of 9 months and 12 years. COBPI was defined as permanent injury to all five nerve roots (C5–T1), with significant degradation in development and function of the hand. Twenty-five patients with a mean age of 5 (0.75–12) years were followed up clinically for more than 2 years. Results The triangle tilt procedure resulted in demonstrable clinical enhancements with appreciable improvements in shoulder function, glenoid version, and humeral head congruity. There was a significant increase in the overall Mallet score (2.4 points, p < 0.0001) following surgical correction in patients that were followed up for more than 2 years. Conclusions The results of this study demonstrate that COBPI patients who develop SHEAR and medial rotation contracture deformities can benefit from the triangle tilt surgery, which improves shoulder function and anatomy across a range of pediatric ages. Despite these patients presenting late for surgery in general (5 years), significant improvements were observed in their glenohumeral (GH) dysplasia and their ability to perform shoulder and arm movements following surgery. PMID:20473676

Surgery for chronic pancreatitis decreases the risk for pancreatic cancer: a multicenter retrospective analysis.

PubMed

Ueda, Junji; Tanaka, Masao; Ohtsuka, Takao; Tokunaga, Shoji; Shimosegawa, Tooru

2013-03-01

Chronic pancreatitis is suggested to be one of the risk factors for the development of pancreatic cancer. The aim of this study was to confirm the high incidence of pancreatic cancer in patients with chronic pancreatitis in Japan and to determine the factors associated with the risk for pancreatic cancer in patients with chronic pancreatitis. The working group of the Research Committee of Intractable Disease supported by the Ministry of Health, Labour and Welfare of Japan carried out a nationwide survey to investigate the relationship between chronic pancreatitis and pancreatic cancer. This retrospective study included patients diagnosed with chronic pancreatitis who had had at least 2 years of follow-up. They were contacted through 22 Japanese referral centers experienced in the management of chronic pancreatitis. The standardized incidence ratio (95 CI) of pancreatic cancer was 11.8 (7.1-18.4). The incidence of pancreatic cancer was significantly lower in patients who had received surgery for chronic pancreatitis than in those who had not undergone surgery (hazard ratio estimated by Cox regression 0.11; 95% CI, 0.0014-0.80; P = .03). Patients who continued to drink alcohol after diagnosis of chronic pancreatitis showed a significantly higher incidence of pancreatic cancer than those who stopped drinking after diagnosis of chronic pancreatitis (hazard ratio, 5.07; 95% CI, 1.13-22.73; P = .03). This study confirmed that chronic pancreatitis is an important risk factor for the development of pancreatic cancer in Japan. Patients who underwent surgery for the treatment of chronic pancreatitis had significantly lower incidences of pancreatic cancer. Surgery for chronic pancreatitis may inhibit the development of pancreatic cancer in patients with chronic pancreatitis. Copyright © 2013 Mosby, Inc. All rights reserved.

Heterosis in Rice Seedlings: Its Relationship to Gibberellin Content and Expression of Gibberellin Metabolism and Signaling Genes1[W][OA

PubMed Central

Ma (马谦), Qian; Hedden, Peter; Zhang (张启发), Qifa

2011-01-01

Despite the accumulation of data on the genetic and molecular understanding of heterosis, there is little information on the regulation of heterosis at the physiological level. In this study, we performed a quantitative analysis of endogenous gibberellin (GA) content and expression profiling of the GA metabolism and signaling genes to investigate the possible relationship between GA signaling and heterosis for seedling development in rice (Oryza sativa). The materials used were an incomplete diallele set of 3 × 3 crosses and the six parents. In the growing shoots of the seedlings at 20 d after sowing, significant positive correlations between the contents of some GA species and performance and heterosis based on shoot dry mass were detected. Expression analyses of GA-related genes by real-time reverse transcription-polymerase chain reaction revealed that 13 out of the 16 GA-related genes examined exhibited significant differential expression among the F1 hybrid and its parents, acting predominantly in the modes of overdominance and positive dominance. Expression levels of nine genes in the hybrids displayed significant positive correlations with the heterosis of shoot dry mass. These results imply that GAs play a positive role in the regulation of heterosis for rice seedling development. In shoots plus root axes of 4-d-old germinating seeds that had undergone the deetiolation, mimicking normal germination in soil, the axis dry mass was positively correlated with the content of GA29 but negatively correlated with that of GA19. Our findings provide supporting evidence for GAs playing an important regulatory role in heterosis for rice seedling development. PMID:21693671

Population pharmacokinetics of busulfan in pediatric and young adult patients undergoing hematopoietic cell transplant: a model-based dosing algorithm for personalized therapy and implementation into routine clinical use.

PubMed

Long-Boyle, Janel R; Savic, Rada; Yan, Shirley; Bartelink, Imke; Musick, Lisa; French, Deborah; Law, Jason; Horn, Biljana; Cowan, Morton J; Dvorak, Christopher C

2015-04-01

Population pharmacokinetic (PK) studies of busulfan in children have shown that individualized model-based algorithms provide improved targeted busulfan therapy when compared with conventional dose guidelines. The adoption of population PK models into routine clinical practice has been hampered by the tendency of pharmacologists to develop complex models too impractical for clinicians to use. The authors aimed to develop a population PK model for busulfan in children that can reliably achieve therapeutic exposure (concentration at steady state) and implement a simple model-based tool for the initial dosing of busulfan in children undergoing hematopoietic cell transplantation. Model development was conducted using retrospective data available in 90 pediatric and young adult patients who had undergone hematopoietic cell transplantation with busulfan conditioning. Busulfan drug levels and potential covariates influencing drug exposure were analyzed using the nonlinear mixed effects modeling software, NONMEM. The final population PK model was implemented into a clinician-friendly Microsoft Excel-based tool and used to recommend initial doses of busulfan in a group of 21 pediatric patients prospectively dosed based on the population PK model. Modeling of busulfan time-concentration data indicates that busulfan clearance displays nonlinearity in children, decreasing up to approximately 20% between the concentrations of 250-2000 ng/mL. Important patient-specific covariates found to significantly impact busulfan clearance were actual body weight and age. The percentage of individuals achieving a therapeutic concentration at steady state was significantly higher in subjects receiving initial doses based on the population PK model (81%) than in historical controls dosed on conventional guidelines (52%) (P = 0.02). When compared with the conventional dosing guidelines, the model-based algorithm demonstrates significant improvement for providing targeted busulfan therapy in children and young adults.

Masticatory function and oral health-related quality of life in patients after partial maxillectomies with closed or open defects.

PubMed

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.

Hyperkalemia develops in some thyroidectomized patients undergoing thyroid hormone withdrawal in preparation for radioactive iodine ablation for thyroid carcinoma.

PubMed

Horie, Ichiro; Ando, Takao; Imaizumi, Misa; Usa, Toshiro; Kawakami, Atsushi

2015-05-01

Hyponatremia is observed in hypothyroidism, but it is not known if hypo- or hyperkalemia is associated with hypothyroidism. To study these questions, we determined serum potassium (K(+)) levels in thyroidectomized patients undergoing levothyroxine withdrawal before radioactive iodine (RAI) therapy for thyroid carcinoma. We retrospectively studied the records of 108 patients who had undergone total thyroidectomy for thyroid carcinoma followed by levothyroxine withdrawal and then ablation with RAI at Nagasaki University Hospital from 2009-2013. Blood samples were analyzed for serum K(+) concentrations when patients were euthyroid just before levothyroxine withdrawal and hypothyroid 21 days after levothyroxine withdrawal. We determined the proportion of patients who developed hyperkalemia (K(+) ≥5 mEq/L) and hypokalemia (K(+) ≤3.5 mEq/L). Five (4.6%) patients developed hyperkalemia and 2 (1.9%) patients developed hypokalemia after levothyroxine withdrawal. The mean serum K(+) level after levothyroxine withdrawal was significantly higher than before levothyroxine withdrawal (4.23 ± 0.50 mEq/L vs. 4.09 ± 0.34 mEq/L; P<.001). After levothyroxine withdrawal, serum K(+) values were significantly correlated with age, serum sodium and creatinine levels, and the estimated glomerular filtration rate but not with serum free thyroxine or thyroid-stimulating hormone concentrations. The finding of an elevated serum K(+) of >0.5 mEq/L after levothyroxine withdrawal was more prevalent with age >60 years (odds ratio [OR], 4.66; P = .026) and with the use of angiotensin-II receptor blockers or angiotensin-converting enzyme inhibitors (OR, 3.53; P = .033) in a multivariate analysis. Hyperkalemia develops in a small percentage of hypothyroid patients after thyroid hormone withdrawal, especially in patients over 60 years of age who are using antihypertensive agents that inhibit the reninangiotensin-aldosterone system.

Adjustment to Work: A Follow Up of Mildly Intellectually Handicapped Adolescents Who Have Undergone Training in a Work Preparation Centre. [The Granville Project].

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%…

Possible prebiotic significance of polyamines in the condensation, protection, encapsulation, and biological properties of DNA

NASA Technical Reports Server (NTRS)

Baeza, Isabel; Ibanez, Miguel; Wong, Carlos; Chavez, Pedro; Gariglio, Patricio; Oro, J.

1992-01-01

While DNA which has undergone ionic condensation with Co(3+)(NH3)6 is resistant to the action of the endonuclase DNAse I, in much the same way as DNA condensed with spermidine, it was significantly less active in transcription with the E. coli RNA polymerase than DNA-spermidine condensed forms. Although both compacted forms of DNA were more efficiently encapsulated into neutral liposomes, negatively charged liposomes were seldom formed in the presence of the present, positive ion-condensed DNA; spermidine is accordingly proposed as a plausible prebiotic DNA-condensing agent. Attention is given to the relevance of the polyimide-nucleic acids complexes in the evolution of life.

Decompressive craniectomy and CSF disorders in children.

PubMed

Manfiotto, Marie; Mottolese, Carmine; Szathmari, Alexandru; Beuriat, Pierre-Aurelien; Klein, Olivier; Vinchon, Matthieu; Gimbert, Edouard; Roujeau, Thomas; Scavarda, Didier; Zerah, Michel; Di Rocco, Federico

2017-10-01

Decompressive craniectomy (DC) is a lifesaving procedure but is associated to several post-operative complications, namely cerebrospinal fluid (CSF) dynamics impairment. The aim of this multicentric study was to evaluate the incidence of such CSF alterations after DC and review their impact on the overall outcome. We performed a retrospective multicentric study to analyze the CSF disorders occurring in children aged from 0 to 17 years who had undergone a DC for traumatic brain injury (TBI) in the major Departments of Pediatric Neurosurgery of France between January 2006 and August 2016. Out of 150 children, ranging in age between 7 months and 17 years, mean 10.75 years, who underwent a DC for TBI in 10 French pediatric neurosurgical centers. Sixteen (6 males, 10 females) (10.67%) developed CSF disorders following the surgical procedure and required an extrathecal CSF shunting. External ventricular drainage increased the risk of further complications, especially cranioplasty infection (p = 0.008). CSF disorders affect a minority of children after DC for TBI. They may develop early after the DC but they may develop several months after the cranioplasty (8 months), consequently indicating the necessity of clinical and radiological close follow-up after discharge from the neurosurgical unit. External ventricular drainage and permanent CSF shunt placement increase significantly the risk of cranioplasty infection.

Transcriptome and proteome analysis of ovaries of arrhenotokous and thelytokous Venturia canescens.

PubMed

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

PubMed Central

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

Molecular evolution and patterns of duplication in the SEP/AGL6-like lineage of the Zingiberales: a proposed mechanism for floral diversification.

PubMed

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.

Hatching late in the season requires flexibility in the timing of song learning

PubMed Central

Leitner, Stefan; Teichel, Johanna; Ter Maat, Andries; Voigt, Cornelia

2015-01-01

Most songbirds learn their songs from adult tutors, who can be their father or other male conspecifics. However, the variables that control song learning in a natural social context are largely unknown. We investigated whether the time of hatching of male domesticated canaries has an impact on their song development and on the neuroendocrine parameters of the song control system. Average age difference between early- and late-hatched males was 50 days with a maximum of 90 days. Song activity of adult tutor males decreased significantly during the breeding season. While early-hatched males were exposed to tutor songs for on average the first 99 days, late-hatched peers heard adult song only during the first 48 days of life. Remarkably, although hatching late in the season negatively affected body condition, no differences between both groups of males were found in song characteristics either in autumn or in the following spring. Similarly, hatching date had no effect on song nucleus size and circulating testosterone levels. Our data suggest that late-hatched males must have undergone accelerated song development. Furthermore, the limited tutor song exposure did not affect adult song organization and song performance. PMID:26311160

Neurology and neurologic practice in China.

PubMed

Shi, Fu-Dong; Jia, Jian-Ping

2011-11-29

In the wake of dramatic economic success during the past 2 decades, the specialized field of neurology has undergone a significant transformation in China. With an increase in life expectancy, the problems of aging and cognition have grown. Lifestyle alterations have been associated with an epidemiologic transition both in the incidence and etiology of stroke. These changes, together with an array of social issues and institution of health care reform, are creating challenges for practicing neurologists throughout China. Notable problems include overcrowded, decrepit facilities, overloaded physician schedules, deteriorating physician-patient relationships, and an insufficient infrastructure to accommodate patients who need specialized neurologic care. Conversely, with the creation of large and sophisticated neurology centers in many cities across the country, tremendous opportunities exist. Developments in neurologic subspecialties enable delivery of high-quality care. Clinical and translational research based on large patient populations as well as highly sophisticated technologies are emerging in many neurologic centers and pharmaceutical companies. Child neurology and neurorehabilitation will be fast-developing subdisciplines. Given China's extensive population, the growth and progress of its neurology complex, and its ever-improving quality control, it is reasonable to anticipate that Chinese neurologists will contribute notably to unraveling the pathogenic factors causing neurologic diseases and to providing new therapeutic solutions.

Vision development over an extended follow-up period in babies after successful vitrectomy for stage 4b retinopathy of prematurity.

PubMed

Gadkari, Salil; Kamdar, Rushita; Kulkarni, Sucheta; Deshpande, Madan; Taras, Sudhir

2015-05-01

To demonstrate improvement in the vision of babies after successful vitrectomy for stage 4b retinopathy of prematurity (ROP) over an extended period of time. This was an observational prospective case series. Eight babies who had undergone successful vitrectomy in either their only seeing eye (or both eyes) with stage 4b ROP were followed up post-operatively for a period of 80 weeks or more. Vision with Teller acuity chart, refraction, binocular indirect ophthalmoscopy, and documentation with RetCam was done at each visit. Vision of the (only/better) seeing operated eye with corrective glasses was graded for the purpose of statistical evaluation. Paired t test was performed to compare the vision prior to 30 weeks and at or after 80 weeks. Statistically significant improvement in vision was noted at or after 80 weeks as compared to the vision recorded before 30 weeks (p = 0.0062). Unlike in adult intraocular surgeries where stable visual acuity is reached well before 30 weeks, continuing improvement at 80 weeks and beyond is noted. Gradual restoration of the retinal architecture and plasticity of the infant's developing brain are thought to be responsible.

Modern Paradigm of Star Formation in the Galaxy

NASA Astrophysics Data System (ADS)

Sobolev, A. M.

2017-06-01

Understanding by the scientific community of the star formation processes in the Galaxy undergone significant changes in recent years. This is largely due to the development of the observational basis of astronomy in the infrared and submillimeter ranges. Analysis of new observational data obtained in the course of the Herschel project, by radio interferometer ALMA and other modern facilities significantly advanced our understanding of the structure of the regions of star formation, young stellar object vicinities and provided comprehensive data on the mass function of proto-stellar objects in a number of star-forming complexes of the Galaxy. Mapping of the complexes in molecular radio lines allowed to study their spatial and kinematic structure on the spatial scales of tens and hundreds of parsecs. The next breakthrough in this field can be achieved as a result of the planned project “Spektr-MM” (Millimetron) which implies a significant improvement in angular resolution and sensitivity. The use of sensitive interferometers allowed to investigate the details of star formation processes at small spatial scales - down to the size of the solar system (with the help of the ALMA), and even the Sun (in the course of the space project “Spektr-R” = RadioAstron). Significant contribution to the study of the processes of accretion is expected as a result of the project “Spektr-UV” (WSO-UV = “World Space Observatory - Ultraviolet”). Complemented with significant theoretical achievements obtained observational data have greatly promoted our understanding of the star formation processes.

Fluoxetine for persistent developmental stuttering.

PubMed

Kumar, Amardeep; Balan, Sabish

2007-01-01

Stuttering is a disturbance in the normal fluency and time patterning of speech. Developmental stuttering (DS), with or without associated psychiatric illness, is the most common form and includes all cases with gradual onset in childhood that are not the result of acquired brain damage. Persistent developmental stuttering (PDS) is DS that has not undergone spontaneous or speech therapy-induced remission. Adults in speech therapy behavioral programs will often show regression and even total relapse if they stop practicing. This case report deals with a patient of PDS who responded significantly to treatment with fluoxetine.

The Importance of Demographic Data in Astronomy

NASA Astrophysics Data System (ADS)

Elmegreen, Debra M.

2014-01-01

The most effective astronomical workforce will be one that comprises a diverse and inclusive community. The “New Worlds, New Horizons in Astronomy and Astrophysics” Decadal Survey, with input from its Infrastructure Study Group on Demographics, provided an overview of recent demographic trends. Demographics in astronomy have undergone significant changes over the past two generations in several, but not all, categories. Maintaining records of demographics regarding age, gender, and minority status, as well as trends by discipline and career choices, is vital in planning for the future training and employment of astronomers.