Sample records for valuable treatment modality

  1. Platelet-rich plasma: combinational treatment modalities for musculoskeletal conditions.

    PubMed

    Andia, Isabel; Abate, Michele

    2018-04-01

    Current research on common musculoskeletal problems, including osteoarticular conditions, tendinopathies, and muscle injuries, focuses on regenerative translational medicine. Platelet-rich plasma therapies have emerged as a potential approach to enhance tissue repair and regeneration. Platelet-rich plasma application aims to provide supraphysiological concentrations of platelets and optionally leukocytes at injured/pathological tissues mimicking the initial stages of healing. However, the efficacy of platelet-rich plasma is controversial in chronic diseases because patients' outcomes show partial improvements. Platelet-rich plasma can be customized to specific conditions by selecting the most appropriate formulation and timing for application or by combining platelet-rich plasma with synergistic or complementary treatments. To achieve this goal, researchers should identify and enhance the main mechanisms of healing. In this review, the interactions between platelet-rich plasma and healing mechanisms were addressed and research opportunities for customized treatment modalities were outlined. The development of combinational platelet-rich plasma treatments that can be used safely and effectively to manipulate healing mechanisms would be valuable and would provide insights into the processes involved in physiological healing and pathological failure.

  2. Treatment modalities and evaluation models for periodontitis

    PubMed Central

    Tariq, Mohammad; Iqbal, Zeenat; Ali, Javed; Baboota, Sanjula; Talegaonkar, Sushama; Ahmad, Zulfiqar; Sahni, Jasjeet K

    2012-01-01

    Periodontitis is the most common localized dental inflammatory disease related with several pathological conditions like inflammation of gums (gingivitis), degeneration of periodontal ligament, dental cementum and alveolar bone loss. In this perspective, the various preventive and treatment modalities, including oral hygiene, gingival irrigations, mechanical instrumentation, full mouth disinfection, host modulation and antimicrobial therapy, which are used either as adjunctive treatments or as stand-alone therapies in the non-surgical management of periodontal infections, have been discussed. Intra-pocket, sustained release systems have emerged as a novel paradigm for the future research. In this article, special consideration is given to different locally delivered anti-microbial and anti inflammatory medications which are either commercially available or are currently under consideration for Food and Drug Administration (FDA) approval. The various in vitro dissolution models and microbiological strain investigated to impersonate the infected and inflamed periodontal cavity and to predict the in vivo performance of treatment modalities have also been thrashed out. Animal models that have been employed to explore the pathology at the different stages of periodontitis and to evaluate its treatment modalities are enlightened in this proposed review. PMID:23373002

  3. Continuation of Weight Loss Treatment Is Associated with the Number of Self-Selected Treatment Modalities

    ERIC Educational Resources Information Center

    Martin, Corby K.; Drab-Hudson, Danae L.; York-Crowe, Emily; Mayville, Stephen B.; Yu, Ying; Greenway, Frank L.

    2007-01-01

    Behavior therapy is a cornerstone of weight loss treatment and behaviorists help direct patients' treatment. A novel design was used that allowed participants to choose different treatment modalities during behavioral weight loss treatment. The association between the selection of different treatment modalities and program completion was examined…

  4. Treatment modalities of palmoplantar lichen planus: a brief review.

    PubMed

    Feily, Amir; Yaghoobi, Reza; Nilforoushzadeh, Mohammad Ali

    2016-12-01

    Palmoplantar lichen planus is a localized and uncommon variant of lichen planus which is mostly resistant to treatment. Our purpose was to discuss all treatment modalities proposed and tested for palmoplantar lichen planus in the literature. A systematic review of the literature was conducted to evaluate evidence regarding all treatment modalities proposed and tested for palmoplantar lichen planus in the literature. Two major databases (PubMed, Google scholar) were searched. The review included all case reports, letters and original articles reporting any treatment for palmoplantar lichen planus but not treatment used in the other type of lichen planus, generalized lichen planus or other type of palmoplantar dermatoses. We have gone over more than 50 articles. There are many drugs that have been used in the treatment of lichen planus and generalized lichen planus but the palmoplantar type is a rare variety of lichen planus. That is why we could not find any clinical trial on the subject and just case reports have been described in this manuscript. In spite of plentiful investigations carried out on lichen planus, there is no treatment modality that has proved to be utterly satisfactory in treatment of palmoplantar lichen planus.

  5. Treatment of sentence comprehension and production in aphasia: is there cross-modal generalisation?

    PubMed

    Adelt, Anne; Hanne, Sandra; Stadie, Nicole

    2016-09-09

    Exploring generalisation following treatment of language deficits in aphasia can provide insights into the functional relation of the cognitive processing systems involved. In the present study, we first review treatment outcomes of interventions targeting sentence processing deficits and, second report a treatment study examining the occurrence of practice effects and generalisation in sentence comprehension and production. In order to explore the potential linkage between processing systems involved in comprehending and producing sentences, we investigated whether improvements generalise within (i.e., uni-modal generalisation in comprehension or in production) and/or across modalities (i.e., cross-modal generalisation from comprehension to production or vice versa). Two individuals with aphasia displaying co-occurring deficits in sentence comprehension and production were trained on complex, non-canonical sentences in both modalities. Two evidence-based treatment protocols were applied in a crossover intervention study with sequence of treatment phases being randomly allocated. Both participants benefited significantly from treatment, leading to uni-modal generalisation in both comprehension and production. However, cross-modal generalisation did not occur. The magnitude of uni-modal generalisation in sentence production was related to participants' sentence comprehension performance prior to treatment. These findings support the assumption of modality-specific sub-systems for sentence comprehension and production, being linked uni-directionally from comprehension to production.

  6. Pathogenesis and treatment modalities of localized scleroderma.

    PubMed

    Valančienė, Greta; Jasaitienė, Daiva; Valiukevičienė, Skaidra

    2010-01-01

    Localized scleroderma is a chronic inflammatory disease primarily of the dermis and subcutaneous fat that ultimately leads to a scar-like sclerosis of connective tissue. The disorder manifests as various plaques of different shape and size with signs of skin inflammation, sclerosis, and atrophy. This is a relatively rare inflammatory disease characterized by a chronic course, unknown etiology, and insufficiently clear pathogenesis. Many factors may influence its appearance: trauma, genetic factors, disorders of the immune system or hormone metabolism, viral infections, toxic substances or pharmaceutical agents, neurogenic factors, and Borrelia burgdorferi infection. Various therapeutic modalities are being used for the treatment of localized scleroderma. There is no precise treatment scheme for this disease. A majority of patients can be successfully treated with topical pharmaceutical agents and phototherapy, but some of them with progressive, disseminated, and causing disability localized scleroderma are in need of systemic treatment. The aim of this article is not only to dispute about the clinical and morphological characteristics of localized scleroderma, but also to present the newest generalized data about the possible origin, pathogenesis, and treatment modalities of this disease.

  7. Current and Under Development Treatment Modalities of Psoriasis: A Review.

    PubMed

    Albaghdadi, Abdullah

    2017-01-01

    Psoriasis is a chronic and complex autoimmune inflammatory skin disease that affects over 125 million people worldwide. It can exhibit at any age, in spite of the fact that children are less normally influenced than adults. It is characterized by distinct erythematous plaques shielded with conspicuous silvery scales that shows up in different areas of the skin. Knowledge of pathophysiology, especially the pathogenesis of psoriasis, has significantly progressed in the recent decade. Advancement in molecular knowledge leads to better understanding of the disease, thus influencing the development of efficient treatment modalities. However, even with the availability of various options of treatment most of the efficient treatment modalities are costly. Expenses of health care bring about major financial weight to the patients as well as to health care systems. Thus, it was important to review the available current treatment options and those which are under development, in terms of efficacy, safety and cost to assist in selecting the most appropriate treatment for psoriasis patients. Literatures were searched by using key words psoriasis, topical treatment, systemic treatment, biologics and phototherapies, on Embase, Medline, Jstor, Cochrane and Merck Index databases. Life-style choices such as smoking, alcohol consumption, obesity and stress are recognised as risk factors and triggers associated with psoriasis. Psoriasis poses psycho-social and economic burden on affected patients that sometimes leads to depression, reduced social interaction and suicidal tendencies in patients. Depending on the type, severity and extent of the disease, comorbidities, patient preference, efficacy and safety profile, numerous treatment modalities and therapeutic agents are available such as topical, systemic, biologic and phototherapeutic treatments. However, it was found that among all the current available treatments for psoriasis, biologic agents and phototherapeutic modalities are

  8. Dosimetric comparison of different treatment modalities for stereotactic radiotherapy.

    PubMed

    Hsu, Shih-Ming; Lai, Yuan-Chun; Jeng, Chien-Chung; Tseng, Chia-Ying

    2017-09-16

    The modalities for performing stereotactic radiotherapy (SRT) on the brain include the cone-based linear accelerator (linac), the flattening filter-free (FFF) volumetric modulated arc therapy (VMAT) linac, and tomotherapy. In this study, the cone-based linac, FFF-VMAT linac, and tomotherapy modalities were evaluated by measuring the differences in doses delivered during brain SRT and experimentally assessing the accuracy of the output radiation doses through clinical measurements. We employed a homemade acrylic dosimetry phantom representing the head, within which a thermoluminescent dosimeter (TLD) and radiochromic EBT3 film were installed. Using the conformity/gradient index (CGI) and Paddick methods, the quality of the doses delivered by the various SRT modalities was evaluated. The quality indicators included the uniformity, conformity, and gradient indices. TLDs and EBT3 films were used to experimentally assess the accuracy of the SRT dose output. The dose homogeneity indices of all the treatment modalities were lower than 1.25. The cone-based linac had the best conformity for all tumors, regardless of the tumor location and size, followed by the FFF-VMAT linac; tomography was the worst-performing treatment modality in this regard. The cone-based linac had the best gradient, regardless of the tumor location and size, whereas the FFF-VMAT linac had a better gradient than tomotherapy for a large tumor diameter (28 mm). The TLD and EBT3 measurements of the dose at the center of tumors indicated that the average difference between the measurements and the calculated dose was generally less than 4%. When the 3% 3-mm gamma passing rate metric was used, the average passing rates of all three treatment modalities exceeded 98%. Regarding the dose, the cone-based linac had the best conformity and steepest dose gradient for tumors of different sizes and distances from the brainstem. The results of this study suggest that SRT should be performed using the cone

  9. Predictors of treatment with dialysis modalities in observational studies for comparative effectiveness research*

    PubMed Central

    Kuttykrishnan, Sooraj; Kalantar-Zadeh, Kamyar; Arah, Onyebuchi A.; Cheung, Alfred K.; Brunelli, Steve; Heagerty, Patrick J.; Katz, Ronit; Molnar, Miklos Z.; Nissenson, Allen; Ravel, Vanessa; Streja, Elani; Himmelfarb, Jonathan; Mehrotra, Rajnish

    2015-01-01

    Background The Institute of Medicine has identified the comparative effectiveness of renal replacement therapies as a kidney-related topic among the top 100 national priorities. Given the importance of ensuring internal and external validity, the goal of this study was to identify potential sources of bias in observational studies that compare outcomes with different dialysis modalities. Methods This observational cohort study used data from the electronic medical records of all patients that started maintenance dialysis in the calendar years 2007–2011 and underwent treatment for at least 60 days in any of the 2217 facilities operated by DaVita Inc. Each patient was assigned one of six dialysis modalities for each 91-day period from the date of first dialysis (thrice weekly in-center hemodialysis (HD), peritoneal dialysis (PD), less-frequent HD, home HD, frequent HD and nocturnal in-center HD). Results Of the 162 644 patients, 18% underwent treatment with a modality other than HD for at least one 91-day period. Except for PD, patients started treatment with alternative modalities after variable lengths of treatment with HD; the time until a change in modality was shortest for less-frequent HD (median time = 6 months) and longest for frequent HD (median time = 15 months). Between 30 and 78% of patients transferred to another dialysis facility prior to change in modality. Finally, there were significant differences in baseline and time-varying clinical characteristics associated with dialysis modality. Conclusions This analysis identified numerous potential sources of bias in studies of the comparative effectiveness of dialysis modalities. PMID:25883196

  10. Predictors of treatment with dialysis modalities in observational studies for comparative effectiveness research.

    PubMed

    Kuttykrishnan, Sooraj; Kalantar-Zadeh, Kamyar; Arah, Onyebuchi A; Cheung, Alfred K; Brunelli, Steve; Heagerty, Patrick J; Katz, Ronit; Molnar, Miklos Z; Nissenson, Allen; Ravel, Vanessa; Streja, Elani; Himmelfarb, Jonathan; Mehrotra, Rajnish

    2015-07-01

    The Institute of Medicine has identified the comparative effectiveness of renal replacement therapies as a kidney-related topic among the top 100 national priorities. Given the importance of ensuring internal and external validity, the goal of this study was to identify potential sources of bias in observational studies that compare outcomes with different dialysis modalities. This observational cohort study used data from the electronic medical records of all patients that started maintenance dialysis in the calendar years 2007-2011 and underwent treatment for at least 60 days in any of the 2217 facilities operated by DaVita Inc. Each patient was assigned one of six dialysis modalities for each 91-day period from the date of first dialysis (thrice weekly in-center hemodialysis (HD), peritoneal dialysis (PD), less-frequent HD, home HD, frequent HD and nocturnal in-center HD). Of the 162 644 patients, 18% underwent treatment with a modality other than HD for at least one 91-day period. Except for PD, patients started treatment with alternative modalities after variable lengths of treatment with HD; the time until a change in modality was shortest for less-frequent HD (median time = 6 months) and longest for frequent HD (median time = 15 months). Between 30 and 78% of patients transferred to another dialysis facility prior to change in modality. Finally, there were significant differences in baseline and time-varying clinical characteristics associated with dialysis modality. This analysis identified numerous potential sources of bias in studies of the comparative effectiveness of dialysis modalities. © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  11. Comparative analysis of success of psoriasis treatment with standard therapeutic modalities and balneotherapy.

    PubMed

    Baros, Duka Ninković; Gajanin, Vesna S; Gajanin, Radoslav B; Zrnić, Bogdan

    2014-01-01

    Psoriasis is a chronic, inflammatory, immune-mediated skin disease. In addition to standard therapeutic modalities (antibiotics, cytostatics, phototherapy, photochemotherapy and retinoids), nonstandard methods can be used in the treatment of psoriasis. This includes balneotherapy which is most commonly used in combination with therapeutic resources. The aim of this research was to determine the length of remission of psoriasis in patients treated with standard therapeutic modalities, balneotherapy, and combined treatment (standard therapeutic modalities and balneotherapy). The study analyzed 60 adult patients, of both sexes, with different clinical forms of psoriasis, who were divided into three groups according to the applied therapeutic modalities: the first group (treated with standard therapeutic modalities), the second group (treated with balneotherapy) and the third group (treated with combined therapy-standard methods therapy and balneotherapy). The Psoriasis Area and Severity Index was determined in first, third and sixth week of treatment for all patients. The following laboratory analysis were performed and monitored: C reactive protein, iron with total iron binding capacity, unsaturated iron binding capacity and ferritin, uric acid, rheumatoid factors and antibodies to streptolysin O in the first and sixth week of treatment. The average length of remission in patients treated with standard therapeutic modalities and in those treated with balneotherapy was 1.77 +/- 0.951 months and 1.79 +/- 0.918 months, respectively. There was a statistically significant difference in the duration of remission between the patients treated with combination therapy and patients treated with standard therapeutic modalities (p = 0.019) and balneotherapy (p = 0.032). The best results have been achieved when the combination therapy was administered.

  12. Different treatment modalities of fusiform basilar trunk aneurysm: study on computational hemodynamics.

    PubMed

    Wu, Chen; Xu, Bai-Nan; Sun, Zheng-Hui; Wang, Fu-Yu; Liu, Lei; Zhang, Xiao-Jun; Zhou, Ding-Biao

    2012-01-01

    Unclippable fusiform basilar trunk aneurysm is a formidable condition for surgical treatment. The aim of this study was to establish a computational model and to investigate the hemodynamic characteristics in a fusiform basilar trunk aneurysm. The three-dimensional digital model of a fusiform basilar trunk aneurysm was constructed using MIMICS, ANSYS and CFX software. Different hemodynamic modalities and border conditions were assigned to the model. Thirty points were selected randomly on the wall and within the aneurysm. Wall total pressure (WTP), wall shear stress (WSS), and blood flow velocity of each point were calculated and hemodynamic status was compared between different modalities. The quantitative average values of the 30 points on the wall and within the aneurysm were obtained by computational calculation point by point. The velocity and WSS in modalities A and B were different from those of the remaining 5 modalities; and the WTP in modalities A, E and F were higher than those of the remaining 4 modalities. The digital model of a fusiform basilar artery aneurysm is feasible and reliable. This model could provide some important information to clinical treatment options.

  13. Outcome of transarterial chemoembolization-based multi-modal treatment in patients with unresectable hepatocellular carcinoma.

    PubMed

    Song, Do Seon; Nam, Soon Woo; Bae, Si Hyun; Kim, Jin Dong; Jang, Jeong Won; Song, Myeong Jun; Lee, Sung Won; Kim, Hee Yeon; Lee, Young Joon; Chun, Ho Jong; You, Young Kyoung; Choi, Jong Young; Yoon, Seung Kew

    2015-02-28

    To investigate the efficacy and safety of transarterial chemoembolization (TACE)-based multimodal treatment in patients with large hepatocellular carcinoma (HCC). A total of 146 consecutive patients were included in the analysis, and their medical records and radiological data were reviewed retrospectively. In total, 119 patients received TACE-based multi-modal treatments, and the remaining 27 received conservative management. Overall survival (P<0.001) and objective tumor response (P=0.003) were significantly better in the treatment group than in the conservative group. After subgroup analysis, survival benefits were observed not only in the multi-modal treatment group compared with the TACE-only group (P=0.002) but also in the surgical treatment group compared with the loco-regional treatment-only group (P<0.001). Multivariate analysis identified tumor stage (P<0.001) and tumor type (P=0.009) as two independent pre-treatment factors for survival. After adjusting for significant pre-treatment prognostic factors, objective response (P<0.001), surgical treatment (P=0.009), and multi-modal treatment (P=0.002) were identified as independent post-treatment prognostic factors. TACE-based multi-modal treatments were safe and more beneficial than conservative management. Salvage surgery after successful downstaging resulted in long-term survival in patients with large, unresectable HCC.

  14. Outcome of transarterial chemoembolization-based multi-modal treatment in patients with unresectable hepatocellular carcinoma

    PubMed Central

    Song, Do Seon; Nam, Soon Woo; Bae, Si Hyun; Kim, Jin Dong; Jang, Jeong Won; Song, Myeong Jun; Lee, Sung Won; Kim, Hee Yeon; Lee, Young Joon; Chun, Ho Jong; You, Young Kyoung; Choi, Jong Young; Yoon, Seung Kew

    2015-01-01

    AIM: To investigate the efficacy and safety of transarterial chemoembolization (TACE)-based multimodal treatment in patients with large hepatocellular carcinoma (HCC). METHODS: A total of 146 consecutive patients were included in the analysis, and their medical records and radiological data were reviewed retrospectively. RESULTS: In total, 119 patients received TACE-based multi-modal treatments, and the remaining 27 received conservative management. Overall survival (P < 0.001) and objective tumor response (P = 0.003) were significantly better in the treatment group than in the conservative group. After subgroup analysis, survival benefits were observed not only in the multi-modal treatment group compared with the TACE-only group (P = 0.002) but also in the surgical treatment group compared with the loco-regional treatment-only group (P < 0.001). Multivariate analysis identified tumor stage (P < 0.001) and tumor type (P = 0.009) as two independent pre-treatment factors for survival. After adjusting for significant pre-treatment prognostic factors, objective response (P < 0.001), surgical treatment (P = 0.009), and multi-modal treatment (P = 0.002) were identified as independent post-treatment prognostic factors. CONCLUSION: TACE-based multi-modal treatments were safe and more beneficial than conservative management. Salvage surgery after successful downstaging resulted in long-term survival in patients with large, unresectable HCC. PMID:25741147

  15. [Physical treatment modalities for chronic leg ulcers].

    PubMed

    Dissemond, J

    2010-05-01

    An increasing numbers of physical treatment options are available for chronic leg ulcer. In this review article, compression therapy, therapeutic ultrasound, negative pressure therapy, extracorporeal shock wave therapy, electrostimulation therapy, electromagnetic therapy, photodynamic therapy, water-filtered infrared-A-radiation and hydrotherapy are discussed in terms of their practical applications and the underlying evidence. With the exception of compression therapy for most of these treatments, good scientific data are not available. However this is a widespread problem in the treatment of chronic wounds. Nevertheless, several of the described methods such as negative pressure therapy represent one of the gold standards in practical treatment of patients with chronic leg ulcers. Although the use of physical treatment modalities may improve healing in patients with chronic leg ulcers, the diagnosis and treatment of the underlying causes are essential for long-lasting success.

  16. Social networking sites: an adjunctive treatment modality for psychological problems.

    PubMed

    Menon, Indu S; Sharma, Manoj Kumar; Chandra, Prabha S; Thennarasu, K

    2014-07-01

    Social networking is seen as a way to enhance social support and feeling of well-being. The present work explores the potentials of social networking sites as an adjunctive treatment modality for initiating treatment contact as well as for managing psychological problems. Interview schedule, Facebook intensity questionnaire were administered on 28 subjects with a combination of 18 males and 10 females. They were taken from the in-patient and out-patient psychiatry setting of the hospital. Facebook was the most popular sites and used to seek emotional support on the basis of the frequent updates of emotional content that users put in their profile; reconciliations, escape from the problems or to manage the loneliness; getting information about illness and its treatment and interaction with experts and also manifested as problematic use. It has implications for developing social networking based adjunctive treatment modality for psychological problems.

  17. Effectiveness of Psychotherapy in Personality Disorders Not Otherwise Specified: A Comparison of Different Treatment Modalities.

    PubMed

    Horn, Eva K; Bartak, Anna; Meerman, Anke M M A; Rossum, Bert V; Ziegler, Uli M; Thunnissen, Moniek; Soons, Mirjam; Andrea, Helene; Hamers, Elisabeth F M; Emmelkamp, Paul M G; Stijnen, Theo; Busschbach, Jan J V; Verheul, Roel

    2015-01-01

    Although personality disorder not otherwise specified (PDNOS) is highly prevalent and associated with a high burden of disease, only a few treatment studies in this patient group exist. This study is the first to investigate the effectiveness of different modalities of psychotherapy in patients with PDNOS, i.e., short-term (up to 6 months) and long-term (more than 6 months) outpatient, day hospital, and inpatient psychotherapy. A total of 205 patients with PDNOS were assigned to one of six treatment modalities. Effectiveness was assessed over 60 months after baseline. The primary outcome measure was symptom severity, and the secondary outcome measures included psychosocial functioning and quality of life. The study design was quasi-experimental, and the multiple propensity score was used to control for initial differences between treatment groups. All treatment modalities showed positive outcomes, especially in terms of improvements of symptom severity and social role functioning. At 12-month follow-up, after adjustment for initial differences between the treatment groups, short-term outpatient psychotherapy and short-term inpatient psychotherapy showed most improvement and generally outperformed the other modalities concerning symptom severity. At 60 months after baseline, effectiveness remained but observed differences between modalities mostly diminished. Patients with PDNOS benefit from psychotherapy both at short-term and long-term follow-up. Short-term outpatient psychotherapy and short-term inpatient psychotherapy seem to be superior to the other treatment modalities at 12-month follow-up. At 60-month follow-up, treatments showed mostly comparable effectiveness. The effectiveness of different modalities of psychotherapy in patients with PDNOS (i.e., short-term vs long-term; outpatient versus day hospital versus inpatient psychotherapy) has not yet been compared. Different modalities of psychotherapy are effective for patients with PDNOS, and positive

  18. Social Networking Sites: An Adjunctive Treatment Modality for Psychological Problems

    PubMed Central

    Menon, Indu S.; Sharma, Manoj Kumar; Chandra, Prabha S.; Thennarasu, K.

    2014-01-01

    Background: Social networking is seen as a way to enhance social support and feeling of well-being. The present work explores the potentials of social networking sites as an adjunctive treatment modality for initiating treatment contact as well as for managing psychological problems. Materials and Methods: Interview schedule, Facebook intensity questionnaire were administered on 28 subjects with a combination of 18 males and 10 females. They were taken from the in-patient and out-patient psychiatry setting of the hospital. Results: Facebook was the most popular sites and used to seek emotional support on the basis of the frequent updates of emotional content that users put in their profile; reconciliations, escape from the problems or to manage the loneliness; getting information about illness and its treatment and interaction with experts and also manifested as problematic use. Conclusions: It has implications for developing social networking based adjunctive treatment modality for psychological problems. PMID:25035548

  19. Effectiveness and Cost-effectiveness of Four Treatment Modalities for Substance Disorders: A Propensity Score Analysis

    PubMed Central

    Mojtabai, Ramin; Graff Zivin, Joshua

    2003-01-01

    Objective To assess the effectiveness and cost-effectiveness of four treatment modalities for substance abuse. Data Sources The study used data from the Services Research Outcomes Study (SROS), a survey of 3,047 clients in a random sample of 99 drug treatment facilities across the United States. Detailed sociodemographic, substance use, and clinical data were abstracted from treatment records. Substance abuse outcome and treatment history following discharge from index facilities were assessed using a comprehensive interview with 1,799 of these individuals five years after discharge. Treatment success was defined in two ways: as abstinence and as any reduction in substance use. Study Design Effectiveness and cost-effectiveness of four modalities were compared: inpatient, residential, outpatient detox/methadone, and outpatient drug-free. Clients were stratified based on propensity scores and analyses were conducted within these strata. Sensitivity analyses examined the impact of future substance abuse treatment on effectiveness and cost-effectiveness estimates. Principal Findings Treatment of substance disorders appears to be cost-effective compared to other health interventions. The cost per successfully treated abstinent case in the least costly modality, the outpatient drug-free programs, was $6,300 (95 percent confidence intervals: $5,200–$7,900) in 1990 dollars. There were only minor differences between various modalities of treatment with regard to effectiveness. However, modalities varied considerably with regard to cost-effectiveness. Outpatient drug-free programs were the most cost-effective. There was little evidence that relative effectiveness or cost-effectiveness of programs varied according to factors that were associated with selection into different programs. Conclusions Substance disorders can be treated most cost-effectively in outpatient drug-free settings. Savings from transitioning to the most cost-effective treatment modality may free

  20. Combined modality treatment of aromatherapy, footsoak, and reflexology relieves fatigue in patients with cancer.

    PubMed

    Kohara, Hiroyuki; Miyauchi, Takako; Suehiro, Yoko; Ueoka, Hiroshi; Takeyama, Hiroyasu; Morita, Tatsuya

    2004-12-01

    Fatigue is one of the most distressful symptoms experienced by patients with advanced cancer. Aromatherapy, footsoak, and reflexology are popular health care modality treatments in Japan, however, the effectiveness of each treatment for cancer-related fatigue has not been fully established. To investigate the effectiveness of combined modality treatment consisting of aromatherapy, footsoak, and reflexology against fatigue, an open study was performed in 20 terminally ill patients with cancer. After a patch test was performed, patients received aromatherapy that was accompanied with footsoak in warm water containing lavender essential oil for 3 minutes, followed by reflexology treatment with jojoba oil containing lavender for 10 min. Fatigue was evaluated using the Cancer Fatigue Scale (CFS) before, 1 hour after, and 4 hours after treatment. Total CFS scores improved significantly after this treatment (from 25.6 +/- 11.0 to 18.1 +/- 10.0, p < 0.001). Among three CFS subscales, physical and cognitive subscale scores were reduced significantly (11.3 +/- 6.1 to 6.7 +/- 6.1, p < 0.001; 4.5 +/- 3.2 to 2.4 +/- 2.4, p < 0.001). No adverse effects were experienced. Because all patients desired to continue this treatment, they received treatment eight times on average. Combined modality treatment consisting of aromatherapy, footsoak, and reflexology appears to be effective for alleviating fatigue in terminally ill cancer patients. To confirm safety and effectiveness of this combined modality treatment, further investigation including randomized treatment assignment is warranted.

  1. Comparison of various treatment modalities for acute tinnitus.

    PubMed

    Shim, Hyun Joon; Song, Seong Jun; Choi, A Young; Hyung Lee, Rae; Yoon, Sang Won

    2011-12-01

    Because in most cases the development of tinnitus is triggered by cochlear damage, there exists the opportunity to eliminate tinnitus while the cochlear lesion is still reversible. Therefore, we evaluated the therapeutic effects of various treatment modalities on acute subjective idiopathic tinnitus (SIT) and investigated prognostic factors affecting the treatment outcome. Prospective, controlled, double-blind trial. A total 107 patients who underwent treatment for unilateral SIT that had developed within the previous 3 months completed the study. The patients were randomly assigned into three groups according to the treatment modality: group I (n = 32), alprazolam orally for 3 months; group II (n = 35), as for group I plus four intratympanic dexamethasone (ITD) injections; and group III (n = 40), as for group II plus four intravenous injections of lipo-prostaglandin E(1) . The improvement rate of group II (75.8%) was significantly higher than that of group I (40.3%; P < .05), and there was no significant difference in the improvement rate of group III (50.0%) compared with groups I and II (P > .05). The cure rates of group II (25.8%) and group III (20.0%) were significantly higher than that of group I (9.8%; P < .05). There was a significant correlation between the cure rate and duration of symptoms. The results of the present study indicate that ITD injection plus alprazolam medication is the best treatment choice for acute SIT within 3 months of development. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

  2. Assessing Instructional Modalities: Individualized Treatment Effects for Personalized Learning

    ERIC Educational Resources Information Center

    Beemer, Joshua; Spoon, Kelly; Fan, Juanjuan; Stronach, Jeanne; Frazee, James P.; Bohonak, Andrew J.; Levine, Richard A.

    2018-01-01

    Estimating the efficacy of different instructional modalities, techniques, and interventions is challenging because teaching style covaries with instructor, and the typical student only takes a course once. We introduce the individualized treatment effect (ITE) from analyses of personalized medicine as a means to quantify individual student…

  3. Nonpharmacological, somatic treatments of depression: electroconvulsive therapy and novel brain stimulation modalities

    PubMed Central

    Eitan, Renana; Lerer, Bernard

    2006-01-01

    Until recently, a review of nonpharmacological, somatic treatments of psychiatric disorders would have included only electroconvulsive therapy (ECT). This situation is now changing very substantially Although ECT remains the only modality in widespread clinical use, several new techniques are under investigation. Their principal indication in the psychiatric context is the treatment of major depression, but other applications are also being studied. All the novel treatments involve brain stimulation, which is achieved by different technological methods. The treatment closest to the threshold of clinical acceptability is transcranial magnetic stimulation (TMS). Although TMS is safe and relatively easy to administer, its efficacy has still to be definitively established. Other modalities, at various stages of research development, include magnetic seizure therapy (MST), deep brain stimulation (DBS), and vagus nerve stimulation (VNS). We briefly review the development and technical aspects of these treatments, their potential role in the treatment of major depression, adverse effects, and putative mechanism of action. As the only one of these treatment modalities that is in widespread clinical use, more extended consideration is given to ECT. Although more than half a century has elapsed since ECT was first introduced, it remains the most effective treatment for major depression, with efficacy in patients refractory to antidepressant drugs and an acceptable safety profile. Although they hold considerable promise, the novel brain stimulation techniques reviewed here will be need to be further developed before they achieve clinical acceptability. PMID:16889109

  4. Orthodontic Treatment Timing and Modalities in Anterior Open Bite: Case Series Study

    PubMed Central

    Al Hamadi, Wisam; Saleh, Fayez; Kaddouha, Mohamad

    2017-01-01

    Objective: The purpose of this study was to present early and adult cases of anterior open bite that were treated efficiently using different treatment approaches and mechanics. Materials and Methods: Five patients of different age groups (from 7 to 27 years), suffering from a clear Anterior open bite deformity, were properly diagnosed and relevant treatment modality for each was selected. Results: Positive overbite was efficiently achieved for all patients. Conclusion: Patient compliance is a key factor in using removable habit breakers. However, fixed palatal crib gave the same results but in shorter time. Anterior open bite of skeletal components should be thoroughly evaluated before selecting camouflage or orthognathic surgery treatment modality. PMID:29299074

  5. Physician perceptions of the value of physical modalities in the treatment of musculoskeletal disease.

    PubMed

    Rush, P J; Shore, A

    1994-06-01

    We randomly surveyed 100 specialists in rehabilitation medicine and 100 rheumatologists concerning their perceptions of the value of 11 different physical modalities--cold, active and passive exercise, interferential current, laser, magnetotherapy, microwave, shortwave diathermy, traction, ultrasound and transcutaneous nerve stimulation in the treatment of seven different musculoskeletal conditions--acute arthritis, joint contracture, neck pain, back pain, tendinitis, reflex sympathetic dystrophy and frozen shoulder. There were significant differences in the perceived benefits of modalities which varied by modality and condition. Overall, rehabilitation medicine specialists regarded modalities to be helpful more often than rheumatologists (P < 0.001).

  6. A Comparison of Therapeutic Factors in Two Group Treatment Modalities: Verbal and Art Therapy.

    ERIC Educational Resources Information Center

    Shechtman, Zipora; Perl-Dekel, Ofra

    2000-01-01

    Compares therapeutic factors in verbal and art group psychotherapy in a psychiatric day-treatment clinic in Israel. Results only partly support the differences between modalities, but do reveal significant differences between participants with only a few interactions between participants and modalities. All therapeutic factors appear in both…

  7. Stem cell transplant in inflammatory bowel disease: a promising modality of treatment for a complicated disease course.

    PubMed

    Salem, George A; Selby, George B

    2017-01-01

    Inflammatory bowel disease (IBD) is a complex, relapsing and remitting, disease characterized by an exaggerated immune response in a susceptible host. The symptoms and complications of the disease can be debilitating. Advances in medical treatment in the last decade changed the course of the disease in many patients. Despite the use of novel agents for controlling disease, a proportion of patients' disease courses continue to be either refractory, or become resistant, to available therapeutic options. Stem-cell therapy, with hematopoietic stem cells (HSCs) or mesenchymal stem cells (MSCs), is a promising modality of treatment for severe refractory cases, mainly Crohn's disease (CD) patients. HSCs have the ability to migrate to damaged tissue, which provides them with further properties to differentiate to epithelial or immune-modulatory cells to restore normal mucosal tissue and integrity. MSCs therapy is a promising model for patients with perianal CD due to their immunosuppressive properties, ability to migrate to areas of injury, and demonstration of colonic healing, including fistulizing tracts. The results from ongoing clinical trials will provide a valuable understanding of the future of stem-cell therapy as a treatment option in refractory cases of IBD, a disease whose pathogenesis remains unknown, and is notoriously difficult to treat.

  8. Light and laser treatment modalities for disseminated superficial actinic porokeratosis: a systematic review.

    PubMed

    Aird, Gregory A; Sitenga, Jenna L; Nguyen, Austin Huy; Vaudreuil, Adam; Huerter, Christopher J

    2017-05-01

    Treatment of disseminated superficial actinic porokeratosis (DSAP) is poorly standardized. The present review seeks to comprehensively discuss the potential for laser and light modalities in the treatment of DSAP. A systematic review of light and laser treatment modalities was conducted to include 26 cases of patients with DSAP. Systematic review resulted in 14 articles to be included. Photodynamic therapy (PDT) overall was the least successful treatment modality, with clinical improvement seen in a minority of patients (MAL-PDT: N = 9 patients, 33.3% showed improvement; ALA-PDT: N = 3 patients, 0% improvement; hypericin-PDT: N = 2 patients, 0% improvement) after numerous post-procedural side effects of hyperpigmentation, inflammation, erythema, and discomfort. Overall, in the available reports, PDT demonstrates poor outcomes with greater incidence of side effects. The response rates of DSAP lesions treated with lasers were as follows: (Q-switched ruby lasers: N = 2, 100%; CO 2 laser: N = 1, 100%; PDT and CO 2 combination therapy: N = 2, 0-50%; erbium and neodymium YAG lasers: N = 2, 100%; fractional 1927-nm thulium fiber lasers: N = 2, 100%; Grenz rays: N = 1, 100%; and fractional photothermolysis: N = 2, 100%). The side effects of laser therapy were minimal and included mild erythema, slight hyperpigmentation, and moderate edema. Laser therapy is a promising treatment option for DSAP with an excellent side effect profile. However, higher power studies are required to determine optimal guidelines for laser treatment of DSAP.

  9. An overview of clinical and experimental treatment modalities for port wine stains

    PubMed Central

    Chen, Jennifer K.; Ghasri, Pedram; Aguilar, Guillermo; van Drooge, Anne Margreet; Wolkerstorfer, Albert; Kelly, Kristen M.; Heger, Michal

    2014-01-01

    Port wine stains (PWS) are the most common vascular malformation of the skin, occurring in 0.3% to 0.5% of the population. Noninvasive laser irradiation with flashlamp-pumped pulsed dye lasers (selective photothermolysis) currently comprises the gold standard treatment of PWS; however, the majority of PWS fail to clear completely after selective photothermolysis. In this review, the clinically used PWS treatment modalities (pulsed dye lasers, alexandrite lasers, neodymium:yttrium-aluminum-garnet lasers, and intense pulsed light) and techniques (combination approaches, multiple passes, and epidermal cooling) are discussed. Retrospective analysis of clinical studies published between 1990 and 2011 was performed to determine therapeutic efficacies for each clinically used modality/technique. In addition, factors that have resulted in the high degree of therapeutic recalcitrance are identified, and emerging experimental treatment strategies are addressed, including the use of photodynamic therapy, immunomodulators, angiogenesis inhibitors, hypobaric pressure, and site-specific pharmaco-laser therapy. PMID:22305042

  10. Physical modalities in the treatment of neurological dysfunction.

    PubMed

    Galea, Mary P

    2012-06-01

    This chapter presents modalities of physical therapy used in optimizing sensorimotor recovery from nervous system injury. A brief historical perspective, rationale, indications for application, and evidence of effectiveness of various physical treatment modalities is provided. Many of the facilitatory and inhibitory techniques used in the past are no longer used, as they were based on an understanding of recovery after nervous system injury that is now outdated. There has been a paradigm shift in the management of people with neurological dysfunction. In particular there has been a reduction in focus on the positive features or the upper motor neuron syndrome, such as spasticity, and an increasing emphasis on active, task-related practice of functional tasks. Physical therapy for people with neurological disorders has undergone a paradigm shift as a result of new knowledge about motor control, skill acquisition, and recovery of function after injury. Future research should address new applications of electrical stimulation and whole body vibration as well as the optimal dosage and timing of interventions. Copyright © 2012 Elsevier B.V. All rights reserved.

  11. Trismus following different treatment modalities for head and neck cancer: a systematic review of subjective measures.

    PubMed

    Loh, Sook Y; Mcleod, Robert W J; Elhassan, Hassan A

    2017-07-01

    The aim of this review was to compare systematically the subjective measure of trismus between different interventions to treat head and neck cancer, particularly those of the oropharynx. Using The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) Guidelines, Six databases were searched for the text using various terms which include "oropharyngeal/head and neck cancer", "trismus/mouth opening" and the various treatment modalities. Included in the review were clinical studies (> or =10 patients). Three observers independently assessed the papers identified. Among the six studies reviewed, five showed a significantly worst outcome with regard to the quality-of-life questionnaire scores for a radiotherapy or surgery and radiotherapy (RT) ± chemotherapy or chemoradiotherapy when compared to surgery alone. Only one study showed no significant difference between surgery alone and other treatment modalities. Subjective quality-of-life measures are a concurrent part of modern surgical practice. Although subjective measures were utilised to measure post operative trismus successfully, there was no consensus as to which treatment modality had overall better outcomes, with conflicting studies in keeping with the current debate in this field. Larger and higher quality studies are needed to compare all three treatment modalities.

  12. MO-B-BRC-00: Prostate HDR Treatment Planning - Considering Different Imaging Modalities

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

    NONE

    2016-06-15

    Brachytherapy has proven to be an effective treatment option for prostate cancer. Initially, prostate brachytherapy was delivered through permanently implanted low dose rate (LDR) radioactive sources; however, high dose rate (HDR) temporary brachytherapy for prostate cancer is gaining popularity. Needle insertion during prostate brachytherapy is most commonly performed under ultrasound (U/S) guidance; however, treatment planning may be performed utilizing several imaging modalities either in an intra- or post-operative setting. During intra-operative prostate HDR, the needles are imaged during implantation, and planning may be performed in real time. At present, the most common imaging modality utilized for intra-operative prostate HDR ismore » U/S. Alternatively, in the post-operative setting, following needle implantation, patients may be simulated with computed tomography (CT) or magnetic resonance imaging (MRI). Each imaging modality and workflow provides its share of benefits and limitations. Prostate HDR has been adopted in a number of cancer centers across the nation. In this educational session, we will explore the role of U/S, CT, and MRI in HDR prostate brachytherapy. Example workflows and operational details will be shared, and we will discuss how to establish a prostate HDR program in a clinical setting. Learning Objectives: Review prostate HDR techniques based on the imaging modality Discuss the challenges and pitfalls introduced by the three imagebased options for prostate HDR brachytherapy Review the QA process and learn about the development of clinical workflows for these imaging options at different institutions.« less

  13. An overview of clinical and experimental treatment modalities for port wine stains.

    PubMed

    Chen, Jennifer K; Ghasri, Pedram; Aguilar, Guillermo; van Drooge, Anne Margreet; Wolkerstorfer, Albert; Kelly, Kristen M; Heger, Michal

    2012-08-01

    Port wine stains (PWS) are the most common vascular malformation of the skin, occurring in 0.3% to 0.5% of the population. Noninvasive laser irradiation with flashlamp-pumped pulsed dye lasers (selective photothermolysis) currently comprises the gold standard treatment of PWS; however, the majority of PWS fail to clear completely after selective photothermolysis. In this review, the clinically used PWS treatment modalities (pulsed dye lasers, alexandrite lasers, neodymium:yttrium-aluminum-garnet lasers, and intense pulsed light) and techniques (combination approaches, multiple passes, and epidermal cooling) are discussed. Retrospective analysis of clinical studies published between 1990 and 2011 was performed to determine therapeutic efficacies for each clinically used modality/technique. In addition, factors that have resulted in the high degree of therapeutic recalcitrance are identified, and emerging experimental treatment strategies are addressed, including the use of photodynamic therapy, immunomodulators, angiogenesis inhibitors, hypobaric pressure, and site-specific pharmaco-laser therapy. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  14. The effectiveness of psychosocial modalities in the treatment of alcohol problems in adults: a review of the evidence.

    PubMed

    Martin, Garth W; Rehm, Jürgen

    2012-06-01

    Our objectives were to review the effectiveness of psychosocial modalities in the treatment of alcohol use disorders and problems, and to examine the impact of therapists on treatment outcome, the evidence on best practices for comorbid conditions, and the evidence on treatment matching. We based our review on published systematic reviews of this topic after 2000. There is strong evidence that some, but not all, psychosocial treatments are effective in treating alcohol problems. Those with the strongest empirical support are motivational enhancement therapy, various cognitive-behavioural interventions, and brief interventions. Meta-analyses for several of these modalities suggest typical effect sizes in the low-to-moderate range. When these modalities have been compared with one another in well-designed clinical trials, they have been shown to be of comparable effectiveness. There is little basis on which to recommend one of these modalities over another but good reason to select from among them.

  15. Non-invasive different modalities of treatment for temporomandibular disorders: review of literature

    PubMed Central

    2018-01-01

    Temporomandibular disorders (TMDs) are diseases that affect the temporomandibular joint and supporting structures. The goal of treatment for TMDs is elimination or reduction of pain and return to normal temporomandibular joint function. Initial treatment for TMDs is non-invasive and conservative, not surgical. Oral and maxillofacial surgeons should fully understand and actively care about non-invasive treatments for TMDs. The purpose of this study is to review the validity and outcomes of non-invasive and surgical treatment modalities for TMDs. PMID:29732308

  16. A geriatrician's guide to the use of the physical modalities in the treatment of pain and dysfunction.

    PubMed

    Perret, Danielle Marie; Rim, Josephine; Cristian, Adrian

    2006-05-01

    The use of the physical modalities in the treatment of musculoskeletal conditions has a long and rich history. This article explores the various physical modalities and their indications, precautions, and contraindications, especially in their applied use in pain management. It also highlights the role of the physical modalities as agents for the management of pain in the geriatric population.

  17. Non-pharmacological treatment options for refractory epilepsy: an overview of human treatment modalities and their potential utility in dogs.

    PubMed

    Martlé, Valentine; Van Ham, Luc; Raedt, Robrecht; Vonck, Kristl; Boon, Paul; Bhatti, Sofie

    2014-03-01

    Refractory epilepsy is a common disorder both in humans and dogs and treatment protocols are difficult to optimise. In humans, different non-pharmacological treatment modalities currently available include surgery, the ketogenic diet and neurostimulation. Surgery leads to freedom from seizures in 50-75% of patients, but requires strict patient selection. The ketogenic diet is indicated in severe childhood epilepsies, but efficacy is limited and long-term compliance can be problematic. In the past decade, various types of neurostimulation have emerged as promising treatment modalities for humans with refractory epilepsy. Currently, none of these treatment options are used in routine daily clinical practice to treat dogs with the condition. Since many dogs with poorly controlled seizures do not survive, the search for alternative treatment options for canine refractory epilepsy should be prioritised. This review provides an overview of non-pharmacological treatment options for human refractory epilepsy. The current knowledge and limitations of these treatments in canine refractory epilepsy is also discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Opinions about Treatment Modalities among Patients Involuntarily Committed to a Forensic Psychiatric Hospital in Finland

    ERIC Educational Resources Information Center

    Repo-Tiihonen, Eila; Vuorio, Osmo; Koivisto, Hanna; Paavola, Paula; Hakola, Panu

    2004-01-01

    Patient satisfaction studies concerning various treatment modalities are few among involuntary forensic psychiatric treatment. They indicate general satisfaction with medication, interactive treatment and occupational therapy but dissatisfaction with lack of privacy, insufficiently explained rules and inadequately explained reasons of seclusion.…

  19. Advances in diagnostic and treatment modalities for intracranial tumors.

    PubMed

    Dickinson, P J

    2014-01-01

    Intracranial neoplasia is a common clinical condition in domestic companion animals, particularly in dogs. Application of advances in standard diagnostic and therapeutic modalities together with a broad interest in the development of novel translational therapeutic strategies in dogs has resulted in clinically relevant improvements in outcome for many canine patients. This review highlights the status of current diagnostic and therapeutic approaches to intracranial neoplasia and areas of novel treatment currently in development. Copyright © 2014 by the American College of Veterinary Internal Medicine.

  20. Choice of treatment modalities was not influenced by pain, severity or co-morbidity in patients with knee osteoarthritis.

    PubMed

    Jamtvedt, Gro; Dahm, Kristin Thuve; Holm, Inger; Odegaard-Jensen, Jan; Flottorp, Signe

    2010-03-01

    Patients with knee osteoarthritis (OA) are commonly treated by physiotherapists in primary care. The physiotherapists use different treatment modalities. In a previous study, we identified variation in the use of transcutaneous electrical nerve stimulation (TENS), low level laser or acupuncture, massage and weight reduction advice for patients with knee OA. The purpose of this study was to examine factors that might explain variation in treatment modalities for patients with knee OA. Practising physiotherapists prospectively collected data for one patient with knee osteoarthritis each through 12 treatment sessions.We chose to examine factors that might explain variation in the choice of treatment modalities supported by high or moderate quality evidence, and modalities which were frequently used but which were not supported by evidence from systematic reviews. Experienced clinicians proposed factors that they thought might explain the variation in the choice of these specific treatments. We used these factors in explanatory analyses. Using TENS, low level laser or acupuncture was significantly associated with having searched databases to help answer clinical questions in the last six months (odds ratio [OR] = 1.93, 95% confidence interval [CI] = 1.08-3.42). Not having Internet access at work and using more than four treatment modalities were significant determinants for giving massage (OR = 0.36, 95% CI = 0.19-0.68 and OR = 8.92, 95% CI = 4.37-18.21, respectively). Being a female therapist significantly increased the odds for providing weight reduction advice (OR = 3.60, 95% CI = 1.12-11.57). No patient characteristics, such as age, pain or co-morbidity, were significantly associated with variation in practice. Factors related to patient characteristics, such as pain severity and co-morbidity, did not seem to explain variation in treatment modalities for patients with knee OA. Variation was associated with the following factors: physiotherapists having Internet

  1. Non-ablative fractional resurfacing in combination with topical tretinoin cream as a field treatment modality for multiple actinic keratosis: a pilot study and a review of other field treatment modalities.

    PubMed

    Prens, Sebastiaan P; de Vries, Karin; Neumann, H A Martino; Prens, Errol P

    2013-06-01

    Actinic keratoses (AK) are premalignant lesions occurring mainly in sun-damaged skin. Current topical treatment options for AK and photo-damaged skin such as liquid nitrogen and electrosurgery are not suitable for field treatment. Otherwise, therapies suitable for field treatment bring along considerable patient discomfort. Non-ablative fractional resurfacing has emerged as a logical treatment option especially for field treatment of AK. To evaluate the clinical efficacy of fractional laser therapy for clearing AK and improving skin quality. To compare patient friendliness of the "fractional" therapy with those reported for other field treatment modalities. Ten patients with Fitzpatrick skin type I to III with multiple AK and extensive sun-damaged skin, received 5-10 sessions with a 4-week interval using a 1550 nm Erbium-Glass Fractionated laser (Sellas, Korea). Four weeks and 24 weeks after the last treatment the clinical results were evaluated by an independent physician. The mean degree of improvement, in terms of reduction in the number of AK and improvement of skin texture, was 54% on a 4 point PGA scale, and persisted for approximately 6 months. The biggest advantage of fractional laser treatment, besides the eradication of AK and a clear rejuvenation effect, is the absence of "downtime". Fractional non-ablative resurfacing induces significant reduction in the number of AK and improves the skin quality. Also all patients preferred fractional laser therapy above other AK treatment modalities.

  2. Treatment modality preferences and adherence to group treatment for panic disorder with agoraphobia.

    PubMed

    Perreault, Michel; Julien, Dominic; White, Noé Djawn; Bélanger, Claude; Marchand, André; Katerelos, Theodora; Milton, Diana

    2014-06-01

    To examine the relationship between preference for group psychotherapy and adherence to group cognitive-behavioral therapy (CBT) for clients with panic disorder with agoraphobia (PDA), 109 participants experiencing PDA completed a questionnaire measuring preference for group treatment (PGTQ) before beginning CBT groups. A t test was used to compare preference scores for group treatment to investigate whether participants who completed treatment differed from those who abandoned treatment. Participants who completed group therapy expressed higher preference for group treatment than participants who dropped out of treatment (t[107] = 1.99; p < 0.05). The PGTQ-4 presented adequate psychometric properties. Reliability analyses of the items retained after factorization demonstrated an acceptable level of internal consistency (Cronbach's alpha of 0.76). Preference for individual or group therapy appears to impact treatment retention for patients with PDA. Matching patients' preferences to the type of treatment modality used appears to be pertinent, especially for the treatment of anxiety disorders. In terms of practical implications, the rationale and benefits of group therapy should be explained to participants reluctant to engage in group therapy. Individual intervention or a combination of group and individual treatment could be considered for clients who are likely to drop out of group therapy.

  3. Treatment modalities and medication recommended by health care professionals for treating recurrent herpes labialis.

    PubMed

    Raborn, G Wayne; Chan, Karen S; Grace, Michael

    2004-01-01

    The authors conducted a survey to determine how health care professionals respond to patients' inquiries about cold sores, also known as recurrent herpes labialis, and their choices of treatment modalities and medications. The authors mailed a one-page, pretested survey to a random sample of dentists, pharmacists and family physicians in Alberta, Canada. After receiving ethics approval from the University of Alberta, Edmonton, the authors mailed 998 surveys. The response rate was 51 percent. Topical antiviral medication was the most common treatment recommended (63 percent). Over-the-counter medication was the first choice for pharmacists (83 percent) as compared with dentists (15 percent) and physicians (16 percent). Emotional stress (60 percent) was reported by patients to be the most common trigger, and pain or discomfort (81 percent) was their primary concern. Acyclovir ointment was the most common antiviral drug recommended or prescribed by health care professionals (60 percent), and cost was the major reason they gave for not recommending or prescribing antiviral drugs (73 percent). The authors found variation in treatment modalities and recommendations by each health profession, despite the fact that patients reported similar triggers and concerns. This may be due to individual patient need and the health care professional's lack of knowledge. Survey results may serve as a reference for health care professionals to use to determine how their choices of medications and treatment modalities compare with those of other practitioners. Professionals should know the benefits and limitations of all therapies, discuss them with the patients and select a treatment.

  4. Hyperbaric Oxygen Therapy—A Novel Treatment Modality in Oral Submucous Fibrosis: A Review

    PubMed Central

    Kumar, M. Ashwini; Radhika, Besta; Reddy, Satya Prakash; Yaga, Uday Shankar

    2015-01-01

    Oral submucous fibrosis (OSMF) is a chronic, debilitating disease characterized by juxta epithelial fibrosis of the oral cavity and regarded as a potentially malignant disorder. Numerous treatment modalities ranging from various drugs to behavioral therapy have been tried with inconsistent results with varying degrees of success reflecting low predictability, requiring further evaluation and standardization. Novel treatment modality such as Hyperbaric oxygen therapy (HBOT) involves inhalation of 100% oxygen at increased atmospheric pressure usually ranging between 2.0 and 2.5 atmospheres for periods between 60 and 120 min. HBOT which can increase oxygen tension and delivery to oxygen-deficient tissue, is a supplementary therapy to improve hypoxic environment of OSMF and also possesses potent anti-inflammatory properties. This article enlightens on possible beneficial effects of HBOT in the management of OSMF at cellular and molecular level. PMID:26155590

  5. A Novel Therapeutic Modality for Advanced Stage Prostate Cancer Treatment

    DTIC Science & Technology

    2017-10-01

    Unlimited The views, opinions and/or findings contained in this report are those of the author(s) and should not be construed as an official Department of...PrCa are non-selective and provide only limited response rate Thus, novel treatment modalities are needed to treat advanced stage PrCa. In this...of ORM on MTA1 protein. Considering effective therapeutic index of ORM, we are also making more potent analogues of ORM. These findings suggest that

  6. Treatment modalities for burning mouth syndrome: a systematic review.

    PubMed

    de Souza, Isadora Follak; Mármora, Belkiss Câmara; Rados, Pantelis Varvaki; Visioli, Fernanda

    2018-06-01

    In the burning mouth syndrome (BMS), patients experience a burning sensation in the oral cavity with no associated injury or clinical manifestation. The etiology of this condition is still poorly understood, and therefore, treatment is challenging. The aim of this study is to perform a systematic review of treatment possibilities described in the literature for BMS. PubMed, Embase, and SciELO databases were searched for randomized clinical trials published between 1996 and 2016. Following application of inclusion and exclusion criteria, 29 papers were analyzed and divided into five subcategories according to the type of treatment described: antidepressants, alpha-lipoic acid, phytotherapeutic agents, analgesic and anti-inflammatory agents, and non-pharmacological therapies. In each category, the results found were compared with regard to the methodology employed, sample size, assessment method, presence or absence of adverse effects, and treatment outcomes. The analysis revealed that the use of antidepressants and alpha-lipoic acid has been showing promising results; however, more studies are necessary before we can have a first-line treatment strategy for patients with BMS. To review systematically the literature about Burning Mouth Syndrome treatment may aid the clinicians to choose the treatment modality to improve patients symptoms based on the best evidence.

  7. Different treatment modalities for refractory vaginismus in western Saudi Arabia.

    PubMed

    Fageeh, Wafa M K

    2011-06-01

    Although vaginismus is a common sexual dysfunction in Saudi Arabia, there are limited data concerning the treatment modalities associated with patients with symptoms of vaginismus. This study is aimed to evaluate the presentation and different modalities of management in patients with severe refractory vaginismus in western Saudi Arabia. Successful penetrative sexual intercourse suggesting that common elements of the therapies used were successful. A retrospective study of patients presenting with severe refractory vaginismus treated in Jeddah, Saudi Arabia. The subjects were 15 women with third to fourth degree vaginismus who presented to King Abdulazziz University Hospital between January 1, 2008 and January 1, 2009. The mean age of the participants was 23 years. The mean duration of marriage before seeking medical advice was 12 months. Six patients had undergone conventional therapy successfully. The other six cases, four of which had a previous history of treatment failure, and two who were unresponsive to 4 months of conventional therapy were offered botulinum toxin type A. Five patients who received the Botox therapy had satisfactory intercourse on the same day of the treatment. One patient required a repeat injection after 2 months for recurrent vaginismus. Three of the 15 patients refused the treatment as they were already divorced and had only come in to exclude organic causes for their condition. Vaginismus is an overlooked topic in conservative societies such as Saudi Arabia. For most patients, not knowing who to confide in or where to turn to plays a major role in the under diagnosis of vaginismus. Conventional therapy proved effective in mild and moderate cases, while botulinum toxin has a more rapid effect and was thus more effective in severe cases. © 2011 International Society for Sexual Medicine.

  8. Ocular sarcoidosis: new diagnostic modalities and treatment.

    PubMed

    Yang, Sung J; Salek, Sherveen; Rosenbaum, James T

    2017-09-01

    Ocular involvement in sarcoidosis is present in up to 80% of patients and is frequently manifested before diagnosis of the underlying systemic disease. Considering the therapeutic consequences, early diagnosis of the underlying disease is advantageous in patients presenting with ocular inflammation. There are several ocular findings suggestive of underlying sarcoidosis, such as granulomatous keratic precipitates, iris nodules, cells in the vitreous humor known as snowballs and snowbanks, and retinal periphlebitis. High suspicion is crucial for the diagnosis of sarcoidosis. This review on ocular sarcoidosis will mainly focus on new diagnostic and treatment modalities. Recent studies found possible new diagnostic indicators for the diagnosis of ocular sarcoidosis which include not only serum profiles but also vitreous sample analysis. Ophthalmologic imaging techniques have improved to investigate the ocular structure in detail. Results from recent uveitis clinical trials have included sarcoidosis as an underlying cause and have reported positive results. The diagnosis of ocular sarcoidosis can be challenging in some cases. High suspicion is important to diagnose ocular sarcoidosis with various laboratory and ophthalmic tools. There are many possible options for the treatment of ocular sarcoidosis including various biologic agents.

  9. Motivation and Readiness for Drug Treatment: Differences by Modality and Special Populations

    PubMed Central

    Melnick, Gerald; Hawke, Josephine; De Leon, George

    2014-01-01

    The purpose of this research is to expand our knowledge of motivational factors among admissions to various substance abuse treatment modalities and among those entering special programs. Differences in motivation are reported in a convenience sample of over 6000 admissions to 38 programs. Results from multilevel analyses show (1) an ordered increase in motivation by settings from referral to out patient, to methadone maintenance, to highest levels in residential programs; (2) significantly lower motivation among admissions to programs for special populations. Results are discussed in relation to the demand characteristics of treatment and non-recovery reasons for entering treatment. PMID:24735224

  10. Motivation and readiness for drug treatment: differences by modality and special populations.

    PubMed

    Melnick, Gerald; Hawke, Josephine; De Leon, George

    2014-01-01

    The purpose of this research is to expand our knowledge of motivational factors among admissions to various substance abuse treatment modalities and among those entering special programs. Differences in motivation are reported in a convenience sample of more than 6,000 admissions to 38 programs. Results from multilevel analyses show (a) an ordered increase in motivation by settings from referral to outpatient, to methadone maintenance, and to the highest levels in residential programs and (b) significantly lower motivation among admissions to programs for special populations. Results are discussed in relation to the demand characteristics of treatment and non-recovery reasons for entering treatment.

  11. Childhood Enuresis: Current Diagnostic Formulations, Salient Findings, and Effective Treatment Modalities.

    PubMed

    Thurber, Steven

    2017-06-01

    Enuresis constitutes a frequently encountered problem area for children that may adversely affect social and emotional adjustment. This type of incontinence has been of concern to the human family for centuries. A brief history of enuresis is presented followed by current conceptualizations, diagnostic criteria, prevalence rates and psychiatric comorbidities. Historic notions of causation together with ineffective, sometimes barbaric treatments are then discussed, ending with a presentation of evidence-based treatment modalities, with the urine alarm being an essential element of effective treatment. An intervention termed dry bed training combines the urine alarm with a series of procedures designed in part to reduce relapse potential and should be a primary consideration for implementation by treatment professionals. Finally, a brief case study is presented illustrating special etiological and treatment considerations with juvenile psychiatric patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Current and emerging therapeutic modalities for hyperhidrosis, part 1: conservative and noninvasive treatments.

    PubMed

    Ram, Ramin; Lowe, Nicholas J; Yamauchi, Paul S

    2007-03-01

    Approximately 1% to 3% of the US population has hyperhidrosis (HH). HH can be an incapacitating medical condition because it not only hinders patient quality of life but also causes the secondary effect of excess cutaneous sweat. There is a broad spectrum of treatment modalities including topical and systemic therapies, iontophoresis, localized neuroinhibitory injections, and surgical interventions. This article reviews HH and the conservative treatments for the condition.

  13. Kinesio taping compared to physical therapy modalities for the treatment of shoulder impingement syndrome.

    PubMed

    Kaya, Erkan; Zinnuroglu, Murat; Tugcu, Ilknur

    2011-02-01

    The purpose of this study was to determine and compare the efficacy of kinesio tape and physical therapy modalities in patients with shoulder impingement syndrome. Patients (n = 55) were treated with kinesio tape (n = 30) three times by intervals of 3 days or a daily program of local modalities (n = 25) for 2 weeks. Response to treatment was evaluated with the Disability of Arm, Shoulder, and Hand scale. Patients were questioned for the night pain, daily pain, and pain with motion. Outcome measures except for the Disability of Arm, Shoulder, and Hand scale were assessed at baseline, first, and second weeks of the treatment. Disability of Arm, Shoulder, and Hand scale was evaluated only before and after the treatment. Disability of Arm, Shoulder, and Hand scale and visual analog scale scores decreased significantly in both treatment groups as compared with the baseline levels. The rest, night, and movement median pain scores of the kinesio taping (20, 40, and 50, respectively) group were statistically significantly lower (p values were 0.001, 0.01, and 0.001, respectively) at the first week examination as compared with the physical therapy group (50, 70, and 70, respectively). However, there was no significant difference in the same parameters between two groups at the second week (0.109, 0.07, and 0.218 for rest, night, and movement median pain scores, respectively). Disability of Arm, Shoulder, and Hand scale scores of the kinesio taping group were significantly lower at the second week as compared with the physical therapy group. No side effects were observed. Kinesio tape has been found to be more effective than the local modalities at the first week and was similarly effective at the second week of the treatment. Kinesio taping may be an alternative treatment option in the treatment of shoulder impingement syndrome especially when an immediate effect is needed.

  14. Psychological trauma symptoms and Type 2 diabetes prevalence, glucose control, and treatment modality among American Indians in the Strong Heart Family Study

    PubMed Central

    Jacob, Michelle M.; Gonzales, Kelly L.; Calhoun, Darren; Beals, Janette; Muller, Clemma Jacobsen; Goldberg, Jack; Nelson, Lonnie; Welty, Thomas K.; Howard, Barbara V.

    2013-01-01

    Aims The aims of this paper are to examine the relationship between psychological trauma symptoms and Type 2 diabetes prevalence, glucose control, and treatment modality among 3,776 American Indians in Phase V of the Strong Heart Family Study. Methods This cross-sectional analysis measured psychological trauma symptoms using the National Anxiety Disorder Screening Day instrument, diabetes by American Diabetes Association criteria, and treatment modality by four categories: no medication, oral medication only, insulin only, or both oral medication and insulin. We used binary logistic regression to evaluate the association between psychological trauma symptoms and diabetes prevalence. We used ordinary least squares regression to evaluate the association between psychological trauma symptoms and glucose control. We used binary logistic regression to model the association of psychological trauma symptoms with treatment modality. Results Neither diabetes prevalence (22-31%; p = 0.19) nor control (8.0-8.6; p = 0.25) varied significantly by psychological trauma symptoms categories. However, diabetes treatment modality was associated with psychological trauma symptoms categories, as people with greater burden used either no medication, or both oral and insulin medications (odds ratio = 3.1, p < 0.001). Conclusions The positive relationship between treatment modality and psychological trauma symptoms suggests future research investigate patient and provider treatment decision making. PMID:24051029

  15. Effect of Treatment Modality on Long-Term Outcomes in Attention-Deficit/Hyperactivity Disorder: A Systematic Review

    PubMed Central

    Arnold, L. Eugene; Hodgkins, Paul; Caci, Hervé; Kahle, Jennifer; Young, Susan

    2015-01-01

    Background Evaluation of treatments for attention-deficit/hyperactivity disorder (ADHD) previously focused on symptom control, but attention has shifted to functional outcomes. The effect of different ADHD treatment periods and modalities (pharmacological, non-pharmacological, and combination) on long-term outcomes needs to be more comprehensively understood. Methods A systematic search of 12 literature databases using Cochrane’s guidelines yielded 403 English-language peer-reviewed, primary studies reporting long-term outcomes (≥2 years). We evaluated relative effects of treatment modalities and durations and effect sizes of outcomes reported as statistically significantly improved with treatment. Results The highest proportion of improved outcomes was reported with combination treatment (83% of outcomes). Among significantly improved outcomes, the largest effect sizes were found for combination treatment. The greatest improvements were associated with academic, self-esteem, or social function outcomes. A majority of outcomes improved regardless of age of treatment initiation (60%–75%) or treatment duration (62%–72%). Studies with short treatment duration had shorter follow-up times (mean 3.2 years total study length) than those with longer treatment durations (mean 7.1 years total study length). Studies with follow-up times <3 years reported benefit with treatment for 93% of outcomes, whereas those with follow-up times ≥3 years reported treatment benefit for 57% of outcomes. Post-hoc analysis indicated that this result was related to the measurement of outcomes at longer periods (3.2 versus 0.4 years) after treatment cessation in studies with longer total study length. Conclusions While the majority of long-term outcomes of ADHD improve with all treatment modalities, the combination of pharmacological and non-pharmacological treatment was most consistently associated with improved long-term outcomes and large effect sizes. Older treatment initiation age

  16. [Pay attention to the application of the international intraocular retinoblastoma classification and sequential multiple modality treatment].

    PubMed

    Fan, X Q

    2017-08-11

    Retinoblastoma (RB) is the most common intraocular malignancy in childhood. It may seriously affect vision, and even threaten the life. The early diagnosis rate of RB in China remains low, and the majority of patients are at late phase with high rates of enucleation and mortality. The International Intraocular Retinoblastoma Classification and TNM staging system are guidances for therapeutic choices and bases for prognosis evaluation. Based on the sequential multi-method treatment modality, chemotherapy combined with local therapy is the mainstream in dealing with RB, which may maximize the results of eye saving and even vision retaining. New therapeutic techniques including supra-selective ophthalmic artery interventional chemotherapy and intravitreal chemotherapy can further improve the efficacy of treatment, especially the eye salvage rate. The overall level of RB treatment should be improved by promoting the international staging, new therapeutic techniques, and the sequential multiple modality treatment. (Chin J Ophthalmol, 2017, 53: 561 - 565) .

  17. Efficacy of ozone and other treatment modalities for retained placenta in dairy cows.

    PubMed

    Zobel, R; Tkalčić, S

    2013-02-01

    Retained placenta is a worldwide recognized clinical condition in puerperal cows, which can significantly affect their health and fertility. Available treatment modalities are often of questionable efficacy or associated with time constraints, practicality or monetary considerations for their wide application in a routine dairy practice. The objective of this study was to compare and assess the efficacy of different treatment options, including a novel ozone treatment, for the retained placenta. Two hundred cows diagnosed with retained placenta were divided into five treatment groups, each receiving a different treatment option. Group A (n = 40) was given a combination treatment of intrauterine ozone and parenteral cephalexin; group B (n = 40) was given intrauterine ozone; group C (n = 40) was given a combination of parenteral cephalexin and intrauterine antibiotic tablets; group D (n = 40) was given only parenteral cephalexin and group E (n = 40) was given parenteral prostaglandins in 11-day intervals. The control group (group Z, n = 200) included cows that gave birth without assistance and were not diagnosed with a retained placenta. The ozone treatment (groups A and B) was found to be the most effective modality resulting in the shortest period of days open, the smallest number of artificial inseminations until pregnancy, the smallest number of animals diagnosed with fever within 10 days post-calving, the highest percentage of animals pregnant within 200 days after calving and the smallest number of animals culled because of infertility, when compared to the other treatment groups. The intrauterine ozone flush therefore has a potential as an efficacious and cost-effective treatment option for retained placenta, with an overall positive effect on puerperal health and fertility in cows. © 2012 Blackwell Verlag GmbH.

  18. A refined surgical treatment modality for bromhidrosis: Subcutaneous scissor with micropore.

    PubMed

    Dai, Yeqin; Xu, Ai-E; He, Junhua

    2017-05-01

    Axillary bromhidrosis has a strong negative effect on one's social life. A high success rate and few complications are criteria for a surgical treatment. The objective of this study was to evaluate a new surgical treatment modality for bromhidrosis: subcutaneous scissor with micropore. Twenty patients with bromhidrosis were treated. Patients were placed in a supine position with their treated arms abducted to 110°. After injection of 60 mL of tumescent solution into each axilla, one small incision was made at the middle axillary of the hair-bearing area. The whole hair-bearing skin was undermined at the level of the superficial fat to obtain adequate skin eversion. The flaps were everted to offer full exposure of the apocrine glands, and meticulous excision of each gland was performed. Both sides were punctured with scalpel. The micropore was used for drainage, and whose width was just 3 mm. Finally, the incisions were re-approximated, and bulky compressive dressings were applied to the area for 72 hours. Of the 40 axillae (20 patients), 34 (85.0%) showed excellent results, and six (15.0%) had good results. Malodor was significantly decreased. There were no serious complications. This technique can produce excellent results with a lower complication rate than most other surgical modalities and can be performed without costly equipment. © 2017 Wiley Periodicals, Inc.

  19. Pseudofolliculitis barbae: review and update on new treatment modalities.

    PubMed

    Garcia-Zuazaga, Jorge

    2003-07-01

    Pseudofolliculits barbae, PFB, is a common cutaneous disease encountered frequently in medical practice. PFB represents a chronic inflammatory condition of the hair follicle caused by ingrown hairs producing an inflammatory foreign body reaction. The pathogenesis of PFB is multifactorial. Factors such as hair type and direction of hair growth play a role in the initial inflammatory reaction. In the armed forces, PFB represents a real challenge for both the physician and the patient. The combat environment, with the recent threat of biological and chemical weapons, requires the servicemen to be clean-shaven for appropriate gas mask fitting around the face. This article will review the etiology, pathogenesis, classification, and newer treatment modalities in the management of PFB.

  20. Current concepts for the combined treatment modality of ionizing radiation with anticancer agents.

    PubMed

    Oehler, Christoph; Dickinson, Daniel J; Broggini-Tenzer, Angela; Hofstetter, Barbara; Hollenstein, Andreas; Riesterer, Oliver; Vuong, Van; Pruschy, Martin

    2007-01-01

    In current applied radiobiology, there exists a tremendous effort in basic and translational research to identify novel treatment modalities combining ionizing radiation with anticancer agents. This is mainly due to the highly improved molecular understanding of intrinsic radioresistance and the profiling of cellular stress responses to irradiation during recent years. Ionizing radiation not only damages DNA but also affects multiple cellular components that induce a multi-layered stress response. The treatment responses can be restricted to the individual cell level but might also be part of an intercellular stress communication network. Both DNA damage-induced signaling (which results in cell cycle arrest and induction of the DNA-repair machinery) and also ionizing radiation-induced signal transduction cascades, which are generated at cellular sites distant from and independent of DNA-damage, represent interesting targets for anticancer treatment modalities to sensitize for ionizing radiation. Due to the lack of molecular knowledge classic radiobiology assembled the cellular and tissue responses into four groups (4 R's of radiotherapy) which describe biological factors influencing the treatment response to fractionated radiotherapy. These classic 4 R's are Repair, Reassortment, Repopulation and Reoxygenation. With the tremendous progress in molecular oncology we now begin to understand theses factors on the molecular level. At the same time this classification may guide modern molecular radiobiologists to identify novel pharmaceuticals and antisignaling agents which can modulate the treatment response to irradiation. In this review we describe current approaches to sensitize tumor cells with novel anticancer agents along the lines of these 4 R's.

  1. A modal parameter extraction procedure applicable to linear time-invariant dynamic systems

    NASA Technical Reports Server (NTRS)

    Kurdila, A. J.; Craig, R. R., Jr.

    1985-01-01

    Modal analysis has emerged as a valuable tool in many phases of the engineering design process. Complex vibration and acoustic problems in new designs can often be remedied through use of the method. Moreover, the technique has been used to enhance the conceptual understanding of structures by serving to verify analytical models. A new modal parameter estimation procedure is presented. The technique is applicable to linear, time-invariant systems and accommodates multiple input excitations. In order to provide a background for the derivation of the method, some modal parameter extraction procedures currently in use are described. Key features implemented in the new technique are elaborated upon.

  2. Retrospective study of the physical therapy modalities applied in head and neck l ymphedema treatment.

    PubMed

    Tacani, Pascale Mutti; Franceschini, Juliana Pereira; Tacani, Rogério Eduardo; Machado, Aline Fernanda Perez; Montezello, Débora; Góes, João Carlos Guedes Sampaio; Marx, Angela

    2016-02-01

    Secondary lymphedema after head and neck cancer treatment is a serious complication and its management can be a challenge. The purpose of this study was to verify which physical therapy modalities were applied in the treatment of head and neck lymphedema through a retrospective analysis. A retrospective study was developed, based on the analysis of medical records of 32 patients treated in the physiotherapy outpatient department of the Brazilian Institute of Cancer Control (IBCC). The physiotherapy included manual lymphatic drainage, massage, exercises, patient education, and compression therapy with an average of 23.9 ± 14.8 sessions. Measurement results showed a significant reduction of face and neck lymphedema (p < .05) and pain (from 7.8 ± 2.2 to 3.6 ± 1.6; p < .001). The physical therapy modalities based on strategic manual lymphatic drainage, shoulder girdle massage, facial, tongue and neck exercises, compressive therapy at home, and patient education showed reduction of the lymphedema and pain, both of them secondary to head and neck cancer treatment. © 2014 Wiley Periodicals, Inc.

  3. Characterizing smoking, cessation services, and quit interest across outpatient substance abuse treatment modalities

    PubMed Central

    McClure, Erin A.; Acquavita, Shauna P.; Dunn, Kelly E.; Stoller, Kenneth B.; Stitzer, Maxine L.

    2013-01-01

    The majority of individuals seeking treatment for substance use disorders are cigarette smokers, yet smoking cessation is rarely addressed during treatment. Conducting a detailed smoking-related characterization of substance abuse treatment patients across treatment modalities may facilitate the development of tailored treatment strategies. This study administered a battery of self-report instruments to compare tobacco use, quit attempts, smoking knowledge and attitudes, program services, and interest in quitting among smoking patients enrolled in opioid replacement therapy (ORT) vs. non-opioid replacement (non-ORT). ORT compared with non-ORT participants smoked more heavily, had greater tobacco dependence, and endorsed greater exposure to smoking cessation services at their treatment programs. Favorable attitudes towards cessation during treatment were found within both groups. These data identify several potential clinical targets, most notably including confidence in abstaining and attitudes toward cessation pharmacotherapies that may be addressed by substance abuse treatment clinics. PMID:23988192

  4. Therapeutic outcomes of mandibular advancement devices as an initial treatment modality for obstructive sleep apnea.

    PubMed

    Park, Pona; Jeon, Hyoung Won; Han, Doo Hee; Won, Tae-Bin; Kim, Dong-Young; Rhee, Chae-Seo; Kim, Hyun Jik

    2016-11-01

    Although continuous positive airway pressure (CPAP) is a highly efficacious treatment for obstructive sleep apnea (OSA), there is a need for alternative treatment options, such as sleep surgeries and mandibular advancement devices (MADs), to overcome the limitations of CPAP.This study aimed to analyze the therapeutic outcomes of OSA subjects who were treated with a MAD, and to estimate the clinical impact of MAD as a first-line treatment for OSA.Forty-seven patients diagnosed with OSA received an adjustable MAD as an initial treatment. Drug-induced sleep endoscopic findings and sleep parameters (both pre-MAD and post-MAD treatment), such as apnea index, oxygen saturation, and degree of daytime sleepiness, were assessed retrospectively.The MAD treatment resulted in a significant reduction in apnea-hypopnea index, and also a significant elevation in lowest oxygen saturation. Satisfactory results of MAD treatment as a first treatment modality were observed in 27 patients, and a successful outcome was reached in approximately 72% of patients. The OSA patients who had lower body mass index and upper airway narrowing at the level of palate and tongue base showed relatively higher rates of a satisfactory outcome even in cases of moderate or severe OSA.These results suggest that the use of a MAD may be an alternative treatment option in OSA patients with retropalatal and retroglossal area narrowing regardless of disease severity. Additionally, MADs can be recommended as an initial treatment modality, and the effectiveness of MADs in achieving success may not be inferior to CPAP.

  5. Therapeutic outcomes of mandibular advancement devices as an initial treatment modality for obstructive sleep apnea

    PubMed Central

    Park, Pona; Jeon, Hyoung Won; Han, Doo Hee; Won, Tae-Bin; Kim, Dong-Young; Rhee, Chae-Seo; Kim, Hyun Jik

    2016-01-01

    Abstract Although continuous positive airway pressure (CPAP) is a highly efficacious treatment for obstructive sleep apnea (OSA), there is a need for alternative treatment options, such as sleep surgeries and mandibular advancement devices (MADs), to overcome the limitations of CPAP. This study aimed to analyze the therapeutic outcomes of OSA subjects who were treated with a MAD, and to estimate the clinical impact of MAD as a first-line treatment for OSA. Forty-seven patients diagnosed with OSA received an adjustable MAD as an initial treatment. Drug-induced sleep endoscopic findings and sleep parameters (both pre-MAD and post-MAD treatment), such as apnea index, oxygen saturation, and degree of daytime sleepiness, were assessed retrospectively. The MAD treatment resulted in a significant reduction in apnea–hypopnea index, and also a significant elevation in lowest oxygen saturation. Satisfactory results of MAD treatment as a first treatment modality were observed in 27 patients, and a successful outcome was reached in approximately 72% of patients. The OSA patients who had lower body mass index and upper airway narrowing at the level of palate and tongue base showed relatively higher rates of a satisfactory outcome even in cases of moderate or severe OSA. These results suggest that the use of a MAD may be an alternative treatment option in OSA patients with retropalatal and retroglossal area narrowing regardless of disease severity. Additionally, MADs can be recommended as an initial treatment modality, and the effectiveness of MADs in achieving success may not be inferior to CPAP. PMID:27861349

  6. TLD linearity vs. beam energy and modality.

    PubMed

    Troncalli, Andrew J; Chapman, Jane

    2002-01-01

    Thermoluminescent dosimetry (TLD) is considered to be a valuable dosimetric tool in determining patient dose. Lithium fluoride doped with magnesium and titanium (TLD-100) is widely used, as it does not display widely divergent energy dependence. For many years, we have known that TLD-100 shows supralinearity to dose. In a radiotherapy clinic, there are multiple energies and modality beams. This work investigates whether individual linearity corrections must be used for each beam or whether a single correction can be applied to all beams. The response of TLD as a function of dose was measured from 25 cGy to 1000 cGy on both electrons and photons from 6 to 18 MeV. This work shows that, within our measurement uncertainty, TLD-100 exhibits supralinearity at all megavoltage energies and modalities.

  7. High energy devices versus low energy devices in orthopedics treatment modalities

    NASA Astrophysics Data System (ADS)

    Schultheiss, Reiner

    2003-10-01

    The orthopedic consensus group defined in 1997 the 42 most likely relevant parameters of orthopedic shock wave devices. The idea of this approach was to correlate the different clinical outcomes with the physical properties of the different devices with respect to their acoustical waves. Several changes in the hypothesis of the dose effect relationship have been noticed since the first orthopedic treatments. The relation started with the maximum pressure p+, followed by the total energy, the energy density; and finally the single treatment approach using high, and then the multiple treatment method using low energy. Motivated by the reimbursement situation in Germany some manufacturers began to redefine high and low energy devices independent of the treatment modality. The OssaTron as a high energy, single treatment electro hydraulic device gained FDA approval as the first orthopedic ESWT device for plantar fasciitis and, more recently, for lateral epicondylitis. Two low energy devices have now also gained FDA approval based upon a single treatment. Comparing the acoustic data, differences between the OssaTron and the other devices are obvious and will be elaborated upon. Cluster analysis of the outcomes and the acoustical data are presented and new concepts will be suggested.

  8. Derivation of mean dose tolerances for new fractionation schemes and treatment modalities

    NASA Astrophysics Data System (ADS)

    Perkó, Zoltán; Bortfeld, Thomas; Hong, Theodore; Wolfgang, John; Unkelbach, Jan

    2018-02-01

    Avoiding toxicities in radiotherapy requires the knowledge of tolerable organ doses. For new, experimental fractionation schemes (e.g. hypofractionation) these are typically derived from traditional schedules using the biologically effective dose (BED) model. In this report we investigate the difficulties of establishing mean dose tolerances that arise since the mean BED depends on the entire spatial dose distribution, rather than on the dose level alone. A formula has been derived to establish mean physical dose constraints such that they are mean BED equivalent to a reference treatment scheme. This formula constitutes a modified BED equation where the influence of the spatial dose distribution is summarized in a single parameter, the dose shape factor. To quantify effects we analyzed 24 liver cancer patients for whom both proton and photon IMRT treatment plans were available. The results show that the standard BED equation—neglecting the spatial dose distribution—can overestimate mean dose tolerances for hypofractionated treatments by up to 20%. The shape difference between photon and proton dose distributions can cause 30-40% differences in mean physical dose for plans having identical mean BEDs. Converting hypofractionated, 5/15-fraction proton doses to mean BED equivalent photon doses in traditional 35-fraction regimens resulted in up to 10 Gy higher doses than applying the standard BED formula. The dose shape effect should be accounted for to avoid overestimation of mean dose tolerances, particularly when estimating constraints for hypofractionated regimens. Additionally, tolerances established for one treatment modality cannot necessarily be applied to other modalities with drastically different dose distributions, such as proton therapy. Last, protons may only allow marginal (5-10%) dose escalation if a fraction-size adjusted organ mean dose is constraining instead of a physical dose.

  9. SU-E-T-410: Evaluation of Treatment Modalities for Stereotactic Lung Radiation Therapy: A Phantom Study

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

    Mohatt, D; Malhotra, H

    Purpose: To evaluate and verify the accuracy of alternative treatment modalities for stereotactic lung therapy with end-to-end testing. We compared three dimensional conformal therapy (3DCRT), dynamic conformal arc therapy (DCAT), intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) treatment using 6 MV, 6 MV flattening filter free (FFF) and 10 MV FFF photons. Methods: A QUASAR respiratory motion phantom was utilized with custom ion chamber and gafchromatic EBT2 film inserts. The phantom contained a low density lung medium with a cylindrical polystyrene tumor (35 cc). Pseudo representative structures for various organs at risk (OAR) were created. Allmore » treatment plans were created using Eclipse ver. 11 using the same image and structure sets, and delivered via Varian TrueBeam STx linear accelerator equipped with high definition MLC. Evaluation of plan quality followed ROTG 0813 criterion for conformity index (CI100%), high dose spillage, D2cm, and R50%. Results: All treatment plans met the OAR dose constraints per protocol and could be delivered without any beam hold offs or other interlocks and hence were deemed clinically safe. For equivalent beam energies, target conformity was improved for all modalities when switching to FFF mode. Treatment efficiency increased for VMAT FFF by a factor of 3–4 over IMRT, and up to factor of 7 when compared to 3DCRT. Pass rates were > 97% for all treatment using gamma criteria of 3%, 3mm. Absolute dose at iso-center was verified with ion chamber, and found to be within 2% of the treatment planning system. Conclusion: The higher dose rate associated with FFF not only reduces delivery times, but in most cases enhances plan quality. The one modality with succeeding best results for all RTOG criterions was VMAT 6 MV FFF. This end-to-end testing provides necessary confidence in the entire dose delivery chain for lung SBRT patients.« less

  10. [Modalities in the treatment of obstructive breathing in sleep].

    PubMed

    Vukčević, Miodrag

    2011-01-01

    The goals of OSAS therapy are to improve daytime symptoms especially excessive sleepiness, prevent neurocognitve, metabolic and cardiovascular consequences and quality of life in patients with sleep apnea. A variety of therapy exist starting from general measures that include weight reduction, change in life style, postional therapy, oral devices, upper airway surgery and pharmacotherapy. However, CPAP has been demonstrated to be the most important and highly effective therapy in these disorders. CPAP therapy dramatically improves symptoms and decreases cadriovascular and metabolic consequences stoping the occurence of the apneas. Hoewer, not all patients tolerate CPAP especially patients with milder forms of the disease. The individualised approach wich pay attention to different phenotypes and genotype could select patients for selecitively acting treatment modalities such us mandibular advancement devices and electical stimulation of the upper airway muscles.

  11. Successful testing and treating of HIV/AIDS in Indonesia depends on the addiction treatment modality.

    PubMed

    Iskandar, Shelly; de Jong, Cor Aj; Hidayat, Teddy; Siregar, Ike Mp; Achmad, Tri H; van Crevel, Reinout; van der Ven, Andre

    2012-01-01

    In many settings, people who inject drugs (PWID) have limited access to human immunodeficiency virus (HIV) care which is provided in several hospitals and primary health centers in big cities. Substance abuse treatment (SAT) can be used as the entry-point to HIV programs. The aim of this study is to describe the characteristics of the PWID who had accessed SAT and determine which SAT modality associates significantly with HIV programs. PWID were recruited by respondent-driven sampling in an urban setting in Java, Indonesia and interviewed with the Addiction Severity Index (ASI), Blood-Borne Virus Transmission Risk Assessment Questionnaires, and Knowledge Questionnaire on HIV/AIDS. The information regarding the use of substance abuse treatment and HIV program were based on questions in ASI. Seventy-seven percent of 210 PWID had accessed SAT at least once. PWID who had accessed a SAT modality reported more severe drug problems. The most widely used SAT were opioid substitution (57%) and traditional/faith-based treatment (56%). Accessing substitution treatment (adjusted odds ratio [OR] = 5.8; 95% confidence interval [CI]: 2.5-13.9) or residential drug-free treatment (adjusted OR = 3.7; 95% CI: 1.4-9.7) was significantly associated with HIV testing, whereas accessing substitution treatment (adjusted OR = 3.8; 95% CI: 1.9-7.5) or other medical services (adjusted OR = 3.1; 95% CI: 1.1-8.7) was significantly associated with HIV treatment. There was no significant association between accessing traditional/faith-based treatment and HIV testing and treatment. Efforts should be made to link HIV services with traditional/faith-based treatment to increase the coverage of HIV programs.

  12. Spatial Analysis of Case-Mix and Dialysis Modality Associations

    PubMed Central

    Phirtskhalaishvili, Tamar; Bayer, Florian; Edet, Stephane; Bongiovanni, Isabelle; Hogan, Julien; Couchoud, Cécile

    2016-01-01

    ♦ Background: Health-care systems must attempt to provide appropriate, high-quality, and economically sustainable care that meets the needs and choices of patients with end-stage renal disease (ESRD). France offers 9 different modalities of dialysis, each characterized by dialysis technique, the extent of professional assistance, and the treatment site. The aim of this study was 1) to describe the various dialysis modalities in France and the patient characteristics associated with each of them, and 2) to analyze their regional patterns to identify possible unexpected associations between case-mixes and dialysis modalities. ♦ Methods: The clinical characteristics of the 37,421 adult patients treated by dialysis were described according to their treatment modality. Agglomerative hierarchical cluster analysis was used to aggregate the regions into clusters according to their use of these modalities and the characteristics of their patients. ♦ Result: The gradient of patient characteristics was similar from home hemodialyis (HD) to in-center HD and from non-assisted automated peritoneal dialysis (APD) to assisted continuous ambulatory peritoneal dialysis (CAPD). Analyzing their spatial distribution, we found differences in the patient case-mix on dialysis across regions but also differences in the health-care provided for them. The classification of the regions into 6 different clusters allowed us to detect some unexpected associations between case-mixes and treatment modalities. ♦ Conclusions: The 9 modalities of treatment available make it theoretically possible to adapt treatment to patients' clinical characteristics and abilities. However, although we found an overall appropriate association of dialysis modalities to the case-mix, major inter-region heterogeneity and the low rate of peritoneal dialysis (PD) and home HD suggest that factors besides patients' clinical conditions impact the choice of dialysis modality. The French organization should now be

  13. Spatial Analysis of Case-Mix and Dialysis Modality Associations.

    PubMed

    Phirtskhalaishvili, Tamar; Bayer, Florian; Edet, Stephane; Bongiovanni, Isabelle; Hogan, Julien; Couchoud, Cécile

    2016-01-01

    ♦ Health-care systems must attempt to provide appropriate, high-quality, and economically sustainable care that meets the needs and choices of patients with end-stage renal disease (ESRD). France offers 9 different modalities of dialysis, each characterized by dialysis technique, the extent of professional assistance, and the treatment site. The aim of this study was 1) to describe the various dialysis modalities in France and the patient characteristics associated with each of them, and 2) to analyze their regional patterns to identify possible unexpected associations between case-mixes and dialysis modalities. ♦ The clinical characteristics of the 37,421 adult patients treated by dialysis were described according to their treatment modality. Agglomerative hierarchical cluster analysis was used to aggregate the regions into clusters according to their use of these modalities and the characteristics of their patients. ♦ The gradient of patient characteristics was similar from home hemodialyis (HD) to in-center HD and from non-assisted automated peritoneal dialysis (APD) to assisted continuous ambulatory peritoneal dialysis (CAPD). Analyzing their spatial distribution, we found differences in the patient case-mix on dialysis across regions but also differences in the health-care provided for them. The classification of the regions into 6 different clusters allowed us to detect some unexpected associations between case-mixes and treatment modalities. ♦ The 9 modalities of treatment available make it theoretically possible to adapt treatment to patients' clinical characteristics and abilities. However, although we found an overall appropriate association of dialysis modalities to the case-mix, major inter-region heterogeneity and the low rate of peritoneal dialysis (PD) and home HD suggest that factors besides patients' clinical conditions impact the choice of dialysis modality. The French organization should now be evaluated in terms of patients' quality of

  14. Transperineal ultrasonography in perianal Crohn disease: A valuable imaging modality.

    PubMed

    Wright, Emily K; Novak, Kerri L; Lu, Cathy; Panaccione, Remo; Ghosh, Subrata; Wilson, Stephanie R

    2015-01-01

    Aims of treatment for Crohn disease have moved beyond the resolution of clinical symptoms to objective end points including endoscopic and radiological normality. Regular re-evaluation of disease status to safely, readily and reliably detect the presence of inflammation and complications is paramount. Improvements in sonographic technology over recent years have facilitated a growing enthusiasm among radiologists and gastroenterologists in the use of ultrasound for the assessment of inflammatory bowel disease. Transabdominal intestinal ultrasound is accurate, affordable and safe for the assessment of luminal inflammation and complications in Crohn disease, and can be performed with or without the use of intravenous contrast enhancement. Perianal fistulizing disease is a common, complex and often treatment-refractory complication of Crohn disease, which requires regular radiological monitoring. Endoanal ultrasound is invasive, uncomfortable and yields limited assessment of the perineal region. Although magnetic resonance imaging of the pelvis is established, timely access may be a problem. Transperineal ultrasound has been described in small studies, and is an accurate, painless and cost-effective method for documenting perianal fluid collections, fistulas and sinus tracts. In the present article, the authors review the literature regarding perineal ultrasound for the assessment of perianal Crohn disease and use case examples to illustrate its clinical utility.

  15. Multi-Modality Phantom Development

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

    Huber, Jennifer S.; Peng, Qiyu; Moses, William W.

    2009-03-20

    Multi-modality imaging has an increasing role in the diagnosis and treatment of a large number of diseases, particularly if both functional and anatomical information are acquired and accurately co-registered. Hence, there is a resulting need for multi modality phantoms in order to validate image co-registration and calibrate the imaging systems. We present our PET-ultrasound phantom development, including PET and ultrasound images of a simple prostate phantom. We use agar and gelatin mixed with a radioactive solution. We also present our development of custom multi-modality phantoms that are compatible with PET, transrectal ultrasound (TRUS), MRI and CT imaging. We describe bothmore » our selection of tissue mimicking materials and phantom construction procedures. These custom PET-TRUS-CT-MRI prostate phantoms use agargelatin radioactive mixtures with additional contrast agents and preservatives. We show multi-modality images of these custom prostate phantoms, as well as discuss phantom construction alternatives. Although we are currently focused on prostate imaging, this phantom development is applicable to many multi-modality imaging applications.« less

  16. Systematic review of treatment modalities for gingival depigmentation: a random-effects poisson regression analysis.

    PubMed

    Lin, Yi Hung; Tu, Yu Kang; Lu, Chun Tai; Chung, Wen Chen; Huang, Chiung Fang; Huang, Mao Suan; Lu, Hsein Kun

    2014-01-01

    Repigmentation variably occurs with different treatment methods in patients with gingival pigmentation. A systemic review was conducted of various treatment modalities for eliminating melanin pigmentation of the gingiva, comprising bur abrasion, scalpel surgery, cryosurgery, electrosurgery, gingival grafts, and laser techniques, to compare the recurrence rates (Rrs) of these treatment procedures. Electronic databases, including PubMed, Web of Science, Google, and Medline were comprehensively searched, and manual searches were conducted for studies published from January 1951 to June 2013. After applying inclusion and exclusion criteria, the final list of articles was reviewed in depth to achieve the objectives of this review. A Poisson regression was used to analyze the outcome of depigmentation using the various treatment methods. The systematic review was based on case reports mainly. In total, 61 eligible publications met the defined criteria. The various therapeutic procedures showed variable clinical results with a wide range of Rrs. A random-effects Poisson regression showed that cryosurgery (Rr = 0.32%), electrosurgery (Rr = 0.74%), and laser depigmentation (Rr = 1.16%) yielded superior result, whereas bur abrasion yielded the highest Rr (8.89%). Within the limit of the sampling level, the present evidence-based results show that cryosurgery exhibits the optimal predictability for depigmentation of the gingiva among all procedures examined, followed by electrosurgery and laser techniques. It is possible to treat melanin pigmentation of the gingiva with various methods and prevent repigmentation. Among those treatment modalities, cryosurgery, electrosurgery, and laser surgery appear to be the best choices for treating gingival pigmentation. © 2014 Wiley Periodicals, Inc.

  17. Cold atmospheric plasma, a novel promising anti-cancer treatment modality.

    PubMed

    Yan, Dayun; Sherman, Jonathan H; Keidar, Michael

    2017-02-28

    Over the past decade, cold atmospheric plasma (CAP), a near room temperature ionized gas has shown its promising application in cancer therapy. Two CAP devices, namely dielectric barrier discharge and plasma jet, show significantly anti-cancer capacity over dozens of cancer cell lines in vitro and several subcutaneous xenograft tumors in vivo. In contrast to conventional anti-cancer approaches and drugs, CAP is a selective anti-cancer treatment modality. Thus far establishing the chemical and molecular mechanism of the anti-cancer capacity of CAP is far from complete. In this review, we provide a comprehensive introduction of the basics of CAP, state of the art research in this field, the primary challenges, and future directions to cancer biologists.

  18. Characteristics and use of treatment modalities of patients with binge-eating disorder in the Department of Veterans Affairs.

    PubMed

    Bellows, Brandon K; DuVall, Scott L; Kamauu, Aaron W C; Supina, Dylan; Pawaskar, Manjiri; Babcock, Thomas; LaFleur, Joanne

    2016-04-01

    In 2013 binge-eating disorder (BED) was recognized as a formal diagnosis, but was historically included under the diagnosis code for eating disorder not otherwise specified (EDNOS). This study compared the characteristics and use of treatment modalities in BED patients to those with EDNOS without BED (EDNOS-only) and to matched-patients with no eating disorders (NED). Patients were identified for this study from electronic health records in the Department of Veterans Affairs from 2000 to 2011. Patients with BED were identified using natural language processing and patients with EDNOS-only were identified by ICD-9 code (307.50). First diagnosis defined index date for these groups. NED patients were frequency matched to BED patients up to 4:1, as available, on age, sex, BMI, depression, and index month encounter. Baseline characteristics and use of treatment modalities during the post-index year were compared using t-tests or chi-square tests. There were 593 BED, 1354 EDNOS-only, and 1895 matched-NED patients identified. Only 68 patients with BED had an EDNOS diagnosis. BED patients were younger (48.7 vs. 49.8years, p=0.04), more were male (72.2% vs. 62.8%, p<0.001) and obese (BMI 40.2 vs. 37.0, p<0.001) than EDNOS-only patients. In the follow-up period fewer BED (68.0%) than EDNOS-only patients (87.6%, p<0.001), but more BED than NED patients (51.9%, p<0.001) used at least one treatment modality. The characteristics of BED patients were different from those with EDNOS-only and NED as was their use of treatment modalities. These differences highlight the need for a separate identifier of BED. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Physical modalities in chronic pain management.

    PubMed

    Rakel, Barbara; Barr, John O

    2003-09-01

    The following conclusions can be made based on review of the evidence: There is limited but positive evidence that select physical modalities are effective in managing chronic pain associated with specific conditions experienced by adults and older individuals. Overall, studies have provided the most support for the modality of therapeutic exercise. Different physical modalities have similar magnitudes of effects on chronic pain. Therefore, selection of the most appropriate physical modality may depend on the desired functional outcome for the patient, the underlying impairment, and the patient's preference or prior experience with the modality. Certain patient characteristics may decrease the effectiveness of physical modalities, as has been seen with TENS. These characteristics include depression, high trait anxiety, a powerful others locus of control, obesity, narcotic use, and neuroticism. The effect on pain by various modalities is generally strongest in the short-term period immediately after the intervention series, but effects can last as long as 1 year after treatment (e.g., with massage). Most research has tested the effect of physical modalities on chronic low back pain and knee OA. The effectiveness of physical modalities for other chronic pain conditions needs to be evaluated more completely. Older and younger adults often experience similar effects on their perception of pain from treatment with physical modalities. Therefore, use of these modalities for chronic pain in older adults is appropriate, but special precautions need to be taken. Practitioners applying physical modalities need formal training that includes the risks and precautions for these modalities. If practitioners lack formal training in the use of physical modalities, or if modality use is not within their scope of practice, it is important to consult with and refer patients to members of the team who have this specialized training. Use of a multidisciplinary approach to chronic pain

  20. Ego mechanisms of defense are associated with patients' preference of treatment modality independent of psychological distress in end-stage renal disease.

    PubMed

    Hyphantis, Thomas; Katsoudas, Spiros; Voudiclari, Sonia

    2010-03-24

    Several parameters mediate the selection of treatment modality in end-stage renal disease (ESRD). The nephrology community suggests that patient preference should be the prime determinant of modality choice. We aimed to test whether ego mechanisms of defense are associated with patients' treatment modality preferences, independent of psychological distress. In 58 eligible ESRD patients who had themselves chosen their treatment modality, we administered the Symptom Distress Checklist-90-R and the Defense Style Questionnaire. Thirty-seven patients (53.4%) had chosen hemodialysis and 21 (46.6%) peritoneal dialysis. Patients who preferred peritoneal dialysis were younger (odds ratio [OR], 0.89; 95% confidence interval [CI]: 0.804-0.988), had received more education (OR, 8.84; 95% CI: 1.301-60.161), and were twice as likely to adopt an adaptive defense style as compared to patients who preferred hemodialysis (57.1% vs 27.0%, respectively; P < 0.033). On the contrary, the latter were more likely to adopt an image-distorting defense style (35.1% vs 14.3%; P = 0.038) and passive-aggressive defenses (OR, 0.73: 95% CI: 0.504-1.006). These results were independent of psychological distress. Our findings indicate that the patient's personality should be taken into account, if we are to better define which modalities are best suited to which patients. Also, physicians should bear in mind passive-aggressive behaviors that warrant attention and intervention in patients who preferred hemodialysis.

  1. Equivalence in Dose Fall-Off for Isocentric and Nonisocentric Intracranial Treatment Modalities and Its Impact on Dose Fractionation Schemes

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

    Ma Lijun, E-mail: lijunma@radonc.ucsf.ed; Sahgal, Arjun; Descovich, Martina

    2010-03-01

    Purpose: To investigate whether dose fall-off characteristics would be significantly different among intracranial radiosurgery modalities and the influence of these characteristics on fractionation schemes in terms of normal tissue sparing. Methods and Materials: An analytic model was developed to measure dose fall-off characteristics near the target independent of treatment modalities. Variations in the peripheral dose fall-off characteristics were then examined and compared for intracranial tumors treated with Gamma Knife, Cyberknife, or Novalis LINAC-based system. Equivalent uniform biologic effective dose (EUBED) for the normal brain tissue was calculated. Functional dependence of the normal brain EUBED on varying numbers of fractions (1more » to 30) was studied for the three modalities. Results: The derived model fitted remarkably well for all the cases (R{sup 2} > 0.99). No statistically significant differences in the dose fall-off relationships were found between the three modalities. Based on the extent of variations in the dose fall-off curves, normal brain EUBED was found to decrease with increasing number of fractions for the targets, with alpha/beta ranging from 10 to 20. This decrease was most pronounced for hypofractionated treatments with fewer than 10 fractions. Additionally, EUBED was found to increase slightly with increasing number of fractions for targets with alpha/beta ranging from 2 to 5. Conclusion: Nearly identical dose fall-off characteristics were found for the Gamma Knife, Cyberknife, and Novalis systems. Based on EUBED calculations, normal brain sparing was found to favor hypofractionated treatments for fast-growing tumors with alpha/beta ranging from 10 to 20 and single fraction treatment for abnormal tissues with low alpha/beta values such as alpha/beta = 2.« less

  2. Successful testing and treating of HIV/AIDS in Indonesia depends on the addiction treatment modality

    PubMed Central

    Iskandar, Shelly; de Jong, Cor AJ; Hidayat, Teddy; Siregar, Ike MP; Achmad, Tri H; van Crevel, Reinout; van der Ven, Andre

    2012-01-01

    Background In many settings, people who inject drugs (PWID) have limited access to human immunodeficiency virus (HIV) care which is provided in several hospitals and primary health centers in big cities. Substance abuse treatment (SAT) can be used as the entry-point to HIV programs. The aim of this study is to describe the characteristics of the PWID who had accessed SAT and determine which SAT modality associates significantly with HIV programs. Methods PWID were recruited by respondent-driven sampling in an urban setting in Java, Indonesia and interviewed with the Addiction Severity Index (ASI), Blood-Borne Virus Transmission Risk Assessment Questionnaires, and Knowledge Questionnaire on HIV/AIDS. The information regarding the use of substance abuse treatment and HIV program were based on questions in ASI. Results Seventy-seven percent of 210 PWID had accessed SAT at least once. PWID who had accessed a SAT modality reported more severe drug problems. The most widely used SAT were opioid substitution (57%) and traditional/faith-based treatment (56%). Accessing substitution treatment (adjusted odds ratio [OR] = 5.8; 95% confidence interval [CI]: 2.5–13.9) or residential drug-free treatment (adjusted OR = 3.7; 95% CI: 1.4–9.7) was significantly associated with HIV testing, whereas accessing substitution treatment (adjusted OR = 3.8; 95% CI: 1.9–7.5) or other medical services (adjusted OR = 3.1; 95% CI: 1.1–8.7) was significantly associated with HIV treatment. There was no significant association between accessing traditional/faith-based treatment and HIV testing and treatment. Conclusion Efforts should be made to link HIV services with traditional/faith-based treatment to increase the coverage of HIV programs. PMID:23293529

  3. Combined treatment modalities for age related macular degeneration.

    PubMed

    Das, R A; Romano, A; Chiosi, F; Menzione, M; Rinaldi, M

    2011-02-01

    Age-related macular degeneration (AMD) is a condition that accounts for 75% of cases of legal blindness in individuals over the age of 50. The objective of this review has been to evaluate the clinical effectiveness of available combined treatments modalities in the treatment of neovascular AMD. Central and Medline were searched for original research studies (Phase I, II, III), abstracts, and review articles concerning combination therapies for the control of neovascular AMD. We included randomized controlled trials (RCTs). The results of therapeutic trials focused on the actual options in the management of neovascular AMD are discussed. Intravitreal treatment with substances targeting all isotypes of vascular endothelial growth factor (VEGF) results in a significant increase in visual acuity in patients with neovascular AMD. The combination with occlusive therapies like verteporfin photodynamic therapy (V-PDT) potentially offers a reduction of re-treatment frequency rate and long-term maintenance of the benefit reached. Despite the promise from combining anti-VEGF therapies with V-PDT, other combinations to improve outcomes with V-PDT deserve attention. Corticosteroids demonstrated an antiangiogenic effect and targeted the extravascular components of CNV, such as inflammatory cells and fibrocytes. Nevertheless, the study on the clinical application of corticosteroids will require a better understanding of the potential complications. Further developments interacting with various steps in the angiogenic cascade are under clinical or preclinical evaluation and may soon become available. In AMD the goal of a combination regimen is to address the therapy toward neovascular, inflammatory, and proliferative components of the disease. Combined treatments strategies are an obvious step providing disease control when it is not achieved with a single therapeutic approach. One risk of using a single therapy to control AMD is a rebound induced by compensatory stimulation of

  4. Solitary plasmacytoma: population-based analysis of survival trends and effect of various treatment modalities in the USA.

    PubMed

    Thumallapally, Nishitha; Meshref, Ahmed; Mousa, Mohammed; Terjanian, Terenig

    2017-01-05

    Solitary plasmacytoma (SP) is a localized neoplastic plasma cell disorder with an annual incidence of less than 450 cases. Given the rarity of this disorder, it is difficult to conduct large-scale population studies. Consequently, very limited information on the disorder is available, making it difficult to estimate the incidence and survival rates. Furthermore, limited information is available on the efficacy of various treatment modalities in relation to primary tumor sites. The data for this retrospective study were drawn from the Surveillance, Epidemiology and End Results (SEER) database, which comprises 18 registries; patient demographics, treatment modalities and survival rates were obtained for those diagnosed with SP from 1998 to 2007. Various prognostic factors were analyzed via Kaplan-Meier analysis and log-rank test, with 5-year relative survival rate defined as the primary outcome of interest. Cox regression analysis was employed in the multivariate analysis. The SEER search from 1998 to 2007 yielded records for 1691 SP patients. The median age at diagnosis was 63 years. The patient cohort was 62.4% male, 37.6% female, 80% Caucasian, 14.6% African American and 5.4% other races. Additionally, 57.8% had osseous plasmacytoma, and 31.9% had extraosseous involvement. Unspecified plasmacytoma was noted in 10.2% of patients. The most common treatment modalities were radiotherapy (RT) (48.8%), followed by combination surgery with RT (21.2%) and surgery alone (11.6%). Univariate analysis of prognostic factors revealed that the survival outcomes were better for younger male patients who received RT with surgery (p < 0.05). Additionally, patients who received neoadjuvant RT had increased survival rates compared to those receiving adjuvant RT (86% vs 73%, p < 0.05). Furthermore, the analyses revealed that 5-year survival rates for patients with axial plasmacytoma were superior when RT was combined with surgery (p < 0.05). In the multivariate analysis

  5. Novel minimally invasive multi-modality monitoring modalities in neurocritical care.

    PubMed

    Al-Mufti, Fawaz; Smith, Brendan; Lander, Megan; Damodara, Nitesh; Nuoman, Rolla; El-Ghanem, Mohammad; Kamal, Naveed; Al-Marsoummi, Sarmad; Alzubaidi, Basim; Nuoaman, Halla; Foreman, Brandon; Amuluru, Krishna; Gandhi, Chirag D

    2018-07-15

    Elevated intracranial pressure (ICP) following brain injury contributes to poor outcomes for patients, primarily by reducing the caliber of cerebral vasculature, and thereby reducing cerebral blood flow. Careful monitoring of ICP is critical in these patients in order to determine prognosis, implement treatment when ICP becomes elevated, and to judge responsiveness to treatment. Currently, the gold standard for monitoring is invasive pressure transducers, usually an intraventricular monitor, which presents significant risk of infection and hemorrhage. These risks made discovering non-invasive methods for monitoring ICP and cerebral perfusion a priority for researchers. Herein we sought to review recent publications on novel minimally invasive multi-modality monitoring techniques that provide surrogate data on ICP, cerebral oxygenation, metabolism and blood flow. While limitations in various forms preclude them from supplanting the use of invasive monitors, these modalities represent useful screening tools within our armamentarium that may be invaluable when the risks of invasive monitoring outweigh the associated benefits. Copyright © 2018 Elsevier B.V. All rights reserved.

  6. Pressure ulcers: Current understanding and newer modalities of treatment

    PubMed Central

    Bhattacharya, Surajit; Mishra, R. K.

    2015-01-01

    This article reviews the mechanism, symptoms, causes, severity, diagnosis, prevention and present recommendations for surgical as well as non-surgical management of pressure ulcers. Particular focus has been placed on the current understandings and the newer modalities for the treatment of pressure ulcers. The paper also covers the role of nutrition and pressure-release devices such as cushions and mattresses as a part of the treatment algorithm for preventing and quick healing process of these wounds. Pressure ulcers develop primarily from pressure and shear; are progressive in nature and most frequently found in bedridden, chair bound or immobile people. They often develop in people who have been hospitalised for a long time generally for a different problem and increase the overall time as well as cost of hospitalisation that have detrimental effects on patient's quality of life. Loss of sensation compounds the problem manifold, and failure of reactive hyperaemia cycle of the pressure prone area remains the most important aetiopathology. Pressure ulcers are largely preventable in nature, and their management depends on their severity. The available literature about severity of pressure ulcers, their classification and medical care protocols have been described in this paper. The present treatment options include various approaches of cleaning the wound, debridement, optimised dressings, role of antibiotics and reconstructive surgery. The newer treatment options such as negative pressure wound therapy, hyperbaric oxygen therapy, cell therapy have been discussed, and the advantages and disadvantages of current and newer methods have also been described. PMID:25991879

  7. Treatment of Lipoma by Injection Lipolysis

    PubMed Central

    Nanda, Soni

    2011-01-01

    Injection lipolysis or lipodissolve is the practice of injecting phosphatidyl choline/ sodium deoxycholate (PDC/DC) compounds in the subcutaneous fat. Though this practice is being used extensively for nonsurgical contouring of body and dissolving localized collections of excess fat, it's use as a treatment modality for lipomas needs further evaluation. We present a case where this technique was used for treating a lipoma, with no recurrence after 9 months of follow up. Injection lipolysis as a treatment modality for lipomas needs to be evaluated for safety and efficacy in trials on larger population. This could prove to be a very valuable adjunct to the current practice of excision, if done by a trained person in a properly selected patient. Also the side effects and the controversies regarding this procedure have been discussed in detail in the present paper. PMID:21976907

  8. [Comparative evaluation of the effectiveness of various treatment modalities for accommodation disorders and acquired progressive myopia].

    PubMed

    Tarutta, E P; Tarasova, N A

    2015-01-01

    To evaluate the effectiveness of non-surgical treatment of accommodation disorders and progressive myopia in children. A total of 190 patients (380 eyes) with myopia aged from 6 to 18 years (10.79±0.18 years on average) were enrolled and divided into 9 groups depending on the treatment prescribed. Comparative evaluation of different hardware-based treatment modalities for progressive myopia allowed to work out their optimal combination: "Visotronic", "MACDEL 09", and magnetophoresis of Taufon 4%. Such courses, provided twice a year, were associated with optimization of accommodative response and 1.9-2.8 times reduction of the rate of myopia progression. On the contrary, pleoptic therapy showed a negative effect on accommodative tonus and the rate of progression of acquired myopia. Comparative evaluation of different hardware-based treatment modalities for progressive myopia and accommodation disorders allowed to work out their optimal combination: "Visotronic", "MACDEL 09" and magnetophoresis of Taufon 4%. This treatment, provided twice a year, allows to increase accommodative reserves and volume, improve objective accommodative response, and reduce accommodative hypertonus as well as the rate of myopia progression (1.9-2.8 times over a 1.5-year period). Under pleoptic therapy (specialized software, near field speckles, color pulse therapy, Ambliokor device), both accommodative tonus and the rate of myopia progression increased (1.3-1.5 and 1.6 times correspondingly).

  9. Differences in Funding Sources of Phase III Oncology Clinical Trials by Treatment Modality and Cancer Type.

    PubMed

    Jairam, Vikram; Yu, James B; Aneja, Sanjay; Wilson, Lynn D; Lloyd, Shane

    2017-06-01

    Given the limited resources available to conduct clinical trials, it is important to understand how trial sponsorship differs among different therapeutic modalities and cancer types and to consider the ramifications of these differences. We searched clinicaltrials.gov for a cross-sectional register of active, phase III, randomized controlled trials (RCTs) studying treatment-related endpoints such as survival and recurrence for the 24 most prevalent malignancies. We classified the RCTs into 7 categories of therapeutic modality: (1) chemotherapy/other cancer-directed drugs, (2) targeted therapy, (3) surgery, (4) radiation therapy (RT), (5) RT with other modalities, (6) multimodality therapy without RT, and (7) other. RCTs were categorized as being funded by one or more of the following groups: (1) government, (2) hospital/university, (3) industry, and (4) other. χ analysis was performed to detect differences in funding source distribution between modalities and cancer types. The percentage of multimodality trials (5%) and radiation RCTs (4%) funded by industry was less than that for chemotherapy (32%, P<0.01) or targeted therapy (48%, P<0.01). Trials studying targeted therapy were less likely to have hospital/university funding than any of the other modalities (P<0.01 in each comparison). Trials of chemotherapy were more likely to be funded by industry if they also studied targeted therapy (P<0.01). RCTs studying targeted therapies are more likely to be funded by industry than trials studying multimodality therapy or radiation. The impact of industry funding versus institutional or governmental sources of funding for cancer research is unclear and requires further study.

  10. Evaluation of the treatment modalities for neurosensory disturbances of the inferior alveolar nerve following retromolar bone harvesting for bone augmentation.

    PubMed

    Nogami, Shinnosuke; Yamauchi, Kensuke; Shiiba, Shunji; Kataoka, Yoshihiro; Hirayama, Bunichi; Takahashi, Tetsu

    2015-03-01

    The purpose of this study was to evaluate the treatment modalities for neurosensory disturbances (NSDs) of the inferior alveolar nerve occurring after retromolar bone harvesting for bone augmentation procedures before implant placement. One hundred four patients, of which 49 and 55 exhibited vertical or horizontal alveolar ridge defects in the mandible and maxilla, respectively, were enrolled. Nineteen patients underwent block bone grafting, 38 underwent guided bone generation or autogenous bone grafting combined with titanium mesh reconstruction, and 47 underwent sinus floor augmentation. Using a visual analog scale, we examined subjective symptoms and discomfort related to sensory alteration within the area of the NSDs in these patients. NSDs were clinically investigated using a two-point discrimination test with blunt-tipped calipers. In addition, neurometry was used for evaluation of trigeminal nerve injury. We tested three treatment modalities for NSDs: follow-up observation (no treatment), medication, and stellate ganglion block (SGB). A week after surgery, 26 patients (25.0%) experienced NSDs. Five patients received no treatment, 10 patients received medication, and 11 patients received SGB. Three months after surgery, patients in the medication and SGB group achieved complete recovery. Current perception threshold values recovered to near-baseline values at 3 months: recovery was much earlier in this group than in the other two groups. SGB can accelerate recovery from NSDs. Our results justify SGB as a reasonable treatment modality for NSDs occurring after the harvesting of retromolar bone grafts. Wiley Periodicals, Inc.

  11. Vibration fatigue using modal decomposition

    NASA Astrophysics Data System (ADS)

    Mršnik, Matjaž; Slavič, Janko; Boltežar, Miha

    2018-01-01

    Vibration-fatigue analysis deals with the material fatigue of flexible structures operating close to natural frequencies. Based on the uniaxial stress response, calculated in the frequency domain, the high-cycle fatigue model using the S-N curve material data and the Palmgren-Miner hypothesis of damage accumulation is applied. The multiaxial criterion is used to obtain the equivalent uniaxial stress response followed by the spectral moment approach to the cycle-amplitude probability density estimation. The vibration-fatigue analysis relates the fatigue analysis in the frequency domain to the structural dynamics. However, once the stress response within a node is obtained, the physical model of the structure dictating that response is discarded and does not propagate through the fatigue-analysis procedure. The structural model can be used to evaluate how specific dynamic properties (e.g., damping, modal shapes) affect the damage intensity. A new approach based on modal decomposition is presented in this research that directly links the fatigue-damage intensity with the dynamic properties of the system. It thus offers a valuable insight into how different modes of vibration contribute to the total damage to the material. A numerical study was performed showing good agreement between results obtained using the newly presented approach with those obtained using the classical method, especially with regards to the distribution of damage intensity and critical point location. The presented approach also offers orders of magnitude faster calculation in comparison with the conventional procedure. Furthermore, it can be applied in a straightforward way to strain experimental modal analysis results, taking advantage of experimentally measured strains.

  12. Optimal Use of Combined Modality Therapy in the Treatment of Esophageal Cancer.

    PubMed

    Shaikh, Talha; Meyer, Joshua E; Horwitz, Eric M

    2017-07-01

    Esophageal cancer is associated with a poor prognosis with 5-year survival rates of approximately 15% to 20%. Although patients with early stage disease may adequately be treated with a single modality, combined therapy typically consisting of neoadjuvant chemoradiation followed by esophagectomy is being adopted increasingly in patients with locally advanced disease. In patients who are not surgical candidates, definitive chemoradiation is the preferred treatment approach. All patients with newly diagnosed esophageal cancer should be evaluated in the multidisciplinary setting by a surgeon, radiation oncologist, and medical oncologist owing to the importance of each specialty in the management of these patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Neural practice effect during cross-modal selective attention: Supra-modal and modality-specific effects.

    PubMed

    Xia, Jing; Zhang, Wei; Jiang, Yizhou; Li, You; Chen, Qi

    2018-05-16

    Practice and experiences gradually shape the central nervous system, from the synaptic level to large-scale neural networks. In natural multisensory environment, even when inundated by streams of information from multiple sensory modalities, our brain does not give equal weight to different modalities. Rather, visual information more frequently receives preferential processing and eventually dominates consciousness and behavior, i.e., visual dominance. It remains unknown, however, the supra-modal and modality-specific practice effect during cross-modal selective attention, and moreover whether the practice effect shows similar modality preferences as the visual dominance effect in the multisensory environment. To answer the above two questions, we adopted a cross-modal selective attention paradigm in conjunction with the hybrid fMRI design. Behaviorally, visual performance significantly improved while auditory performance remained constant with practice, indicating that visual attention more flexibly adapted behavior with practice than auditory attention. At the neural level, the practice effect was associated with decreasing neural activity in the frontoparietal executive network and increasing activity in the default mode network, which occurred independently of the modality attended, i.e., the supra-modal mechanisms. On the other hand, functional decoupling between the auditory and the visual system was observed with the progress of practice, which varied as a function of the modality attended. The auditory system was functionally decoupled with both the dorsal and ventral visual stream during auditory attention while was decoupled only with the ventral visual stream during visual attention. To efficiently suppress the irrelevant visual information with practice, auditory attention needs to additionally decouple the auditory system from the dorsal visual stream. The modality-specific mechanisms, together with the behavioral effect, thus support the visual

  14. Cross-modal plasticity in developmental and age-related hearing loss: Clinical implications.

    PubMed

    Glick, Hannah; Sharma, Anu

    2017-01-01

    This review explores cross-modal cortical plasticity as a result of auditory deprivation in populations with hearing loss across the age spectrum, from development to adulthood. Cross-modal plasticity refers to the phenomenon when deprivation in one sensory modality (e.g. the auditory modality as in deafness or hearing loss) results in the recruitment of cortical resources of the deprived modality by intact sensory modalities (e.g. visual or somatosensory systems). We discuss recruitment of auditory cortical resources for visual and somatosensory processing in deafness and in lesser degrees of hearing loss. We describe developmental cross-modal re-organization in the context of congenital or pre-lingual deafness in childhood and in the context of adult-onset, age-related hearing loss, with a focus on how cross-modal plasticity relates to clinical outcomes. We provide both single-subject and group-level evidence of cross-modal re-organization by the visual and somatosensory systems in bilateral, congenital deafness, single-sided deafness, adults with early-stage, mild-moderate hearing loss, and individual adult and pediatric patients exhibit excellent and average speech perception with hearing aids and cochlear implants. We discuss a framework in which changes in cortical resource allocation secondary to hearing loss results in decreased intra-modal plasticity in auditory cortex, accompanied by increased cross-modal recruitment of auditory cortices by the other sensory systems, and simultaneous compensatory activation of frontal cortices. The frontal cortices, as we will discuss, play an important role in mediating cognitive compensation in hearing loss. Given the wide range of variability in behavioral performance following audiological intervention, changes in cortical plasticity may play a valuable role in the prediction of clinical outcomes following intervention. Further, the development of new technologies and rehabilitation strategies that incorporate brain

  15. Adoption of endovenous laser treatment as the primary treatment modality for varicose veins: the Auckland City Hospital experience.

    PubMed

    Fernando, Ruchira S W; Muthu, Carl

    2014-08-01

    To assess the effectiveness of adopting endovenous laser treatment (EVLT) as the primary treatment modality for varicose veins at Auckland City Hospital (Auckland, New Zealand). The outcomes of 354 consecutive EVLT procedures performed between 2007 and 2013 were reviewed. Data was collected from a prospectively maintained procedural database and by retrospective chart review. Of the 319 patients who had an ultrasound, at 1 month post-procedure there was a saphenous vein occlusion rate of 96%. Side effects were minimal with no cases of DVT or skin burns and one case of self-limiting neuralgia. The procedure was well tolerated with a median pain score of 3. Since the adoption of EVLT there has been a large increase in the number of patients treated for varicose veins (28 in 2007 compared to 176 in 2013). EVLT is a safe and effective treatment for varicose veins and its adoption has allowed a large increase in the number of varicose vein patients treated at Auckland City Hospital.

  16. Carbon-11 radiolabeling of iron-oxide nanoparticles for dual-modality PET/MR imaging

    NASA Astrophysics Data System (ADS)

    Sharma, Ramesh; Xu, Youwen; Kim, Sung Won; Schueller, Michael J.; Alexoff, David; Smith, S. David; Wang, Wei; Schlyer, David

    2013-07-01

    Dual-modality imaging, using Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET) simultaneously, is a powerful tool to gain valuable information correlating structure with function in biomedicine. The advantage of this dual approach is that the strengths of one modality can balance the weaknesses of the other. However, success of this technique requires developing imaging probes suitable for both. Here, we report on the development of a nanoparticle labeling procedure via covalent bonding with carbon-11 PET isotope. Carbon-11 in the form of [11C]methyl iodide was used as a methylation agent to react with carboxylic acid (-COOH) and amine (-NH2) functional groups of ligands bound to the nanoparticles (NPs). The surface coating ligands present on superparamagnetic iron-oxide nanoparticles (SPIO NPs) were radiolabeled to achieve dual-modality PET/MR imaging capabilities. The proof-of-concept dual-modality PET/MR imaging using the radiolabeled SPIO NPs was demonstrated in an in vivo experiment.Dual-modality imaging, using Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET) simultaneously, is a powerful tool to gain valuable information correlating structure with function in biomedicine. The advantage of this dual approach is that the strengths of one modality can balance the weaknesses of the other. However, success of this technique requires developing imaging probes suitable for both. Here, we report on the development of a nanoparticle labeling procedure via covalent bonding with carbon-11 PET isotope. Carbon-11 in the form of [11C]methyl iodide was used as a methylation agent to react with carboxylic acid (-COOH) and amine (-NH2) functional groups of ligands bound to the nanoparticles (NPs). The surface coating ligands present on superparamagnetic iron-oxide nanoparticles (SPIO NPs) were radiolabeled to achieve dual-modality PET/MR imaging capabilities. The proof-of-concept dual-modality PET/MR imaging using the radiolabeled

  17. Treatment Needs of Driving While Intoxicated Offenders: The Need for a Multi-modal Approach to Treatment

    PubMed Central

    Mullen, Jillian; Ryan, Stacy R.; Mathias, Charles W.; Dougherty, Donald M.

    2015-01-01

    Objective This study aimed to characterize and compare the treatment needs of adults with driving while intoxicated (DWI) offenses recruited from a correctional residential treatment facility and the community to provide recommendations for treatment development. Method A total of 119 adults (59 Residential, 60 Community) with at least one DWI offense were administered clinical diagnostic interviews to assess substance use disorders and completed a battery of questionnaires assessing demographic characteristics, legal history, psychiatric diagnoses, medical diagnoses, and health care utilization. Results Almost all (96.6%) DWI offenders met clinical diagnostic criteria for an alcohol use disorder, approximately half of the sample also met diagnostic criteria for co-morbid substance use disorders and a substantial proportion also reported psychiatric and medical co-morbidities. However, a high percentage were not receiving treatment for these issues, most likely as a result of having limited access to care as the majority of participants had no current health insurance (64.45%) or primary care physician (74.0%). The residential sample had more extensive criminal histories compared to the community sample but was generally representative of the community in terms of their clinical characteristics. For instance, the groups did not differ in rates of substance use, psychiatric and medical health diagnoses or in the treatment of such issues, with the exception of alcohol abuse treatment. Conclusions DWI offenders represent a clinical population with high levels of complex and competing treatment needs which are not currently being met. Our findings demonstrate the need for standardized screening of DWI offenders and call for the development of a multi-modal treatment approach in efforts to reduce recidivism. PMID:25664371

  18. On modal cross-coupling in the asymptotic modal limit

    NASA Astrophysics Data System (ADS)

    Culver, Dean; Dowell, Earl

    2018-03-01

    The conditions under which significant modal cross-coupling occurs in dynamical systems responding to high-frequency, broadband forcing that excites many modes is studied. The modal overlap factor plays a key role in the analysis of these systems as the modal density (the ratio of number of modes to the frequency bandwidth) becomes large. The modal overlap factor is effectively the ratio of the width of a resonant peak (the damping ratio times the resonant frequency) to the average frequency interval between resonant peaks (or rather, the inverse of the modal density). It is shown that this parameter largely determines whether substantial modal cross-coupling occurs in a given system's response. Here, two prototypical systems are considered. The first is a simple rectangular plate whose significant modal cross-coupling is the exception rather than the norm. The second is a pair of rectangular plates attached at a point where significant modal cross-coupling is more likely to occur. We show that, for certain cases of modal density and damping, non-negligible cross coupling occurs in both systems. Under similar circumstances, the constraint force between the two plates in the latter system becomes broadband. The implications of this for using Asymptotic Modal Analysis (AMA) in multi-component systems are discussed.

  19. Mental Health Disorder Therapeutic Modalities Modified for the GMS.

    PubMed

    Sumneangsanor, Tipsuda; Vuthiarpa, Sararud; Somprasert, Chomchueun

    2017-12-01

    Mental health disorders can affect physical and psychological behaviors. The people of the Greater Mekong Subregion (GMS) have a high risk of mental health disorders, such as depression, stress, and substance abuse be-cause the people in this region are trafficked for forced sex work and various forms of forced labor. In these situations, vic-tims often endure violence and abuse from trafficking recruiters, employers, and other individuals. The purposes of this study were to identify the elements characterizing mental health disorders, especially in terms of depression, stress, and sub-stance abuse, and to identify the treatment modalities for mental health disorders in the GMS. The researcher undertook a comparative analysis of the literature, reviews of epidemiological studies and mental disorder therapies, and overviews of previous research studies, were used to generate a synthesis of the existing knowledge of the mental disorder therapeutic modalities. Regarding the search methods, the data from the electronic databases PubMed, PsycINFO, Dynamed and ScienceDirect were supplemented with a manual reference search covering relevant studies from 2005 to 2016. Thirty-one papers were included in the review of elements characterizing mental health disorders, especially in terms of depression, stress, and substance abuse, and to identify the treatment modalities for mental health disorders in the GMS. Nine papers defined characterizing mental health disorders, in terms of depression, stress, and substance abuse. Twenty-two papers showed the treatment modalities for mental health disorders that the treatment was effective, these in-cluded pharmacological treatments and psychological treatments, such as mindfulness-based cognitive therapy, biofeedback, and music therapy. Useful guidance can be provided for the prevention and treatment of mental health disorders, and for the care of people in the Greater Mekong Subregion. The finding of this review confirms the

  20. Experiential Education, Outdoor Adventure As a Modality in Residential Treatment. A Survey of Programs, Principles, Research and Practice.

    ERIC Educational Resources Information Center

    Duindam, Ton

    Orthopedagogisch Centrum (OC) Michiel is a multifunctional regional institution in the Netherlands that serves troubled families and youth at risk. Outdoor programs are used as a treatment modality for adolescents with behavior disorders, drug addictions, or criminal records. Outward Bound was the first experiential outdoor program in the…

  1. A reformed surgical treatment modality for children with giant cystic craniopharyngioma.

    PubMed

    Zhu, Wanchun; Li, Xiang; He, Jintao; Sun, Tao; Li, Chunde; Gong, Jian

    2017-09-01

    , aspiration of cystic fluid in 2-day interval for continuously 7-10 days, and the delayed tumor resection. This combined treatment modality maybe an effective method to treat children with giant cystic craniopharyngiomas.

  2. Multi-Modality Imaging in the Evaluation and Treatment of Mitral Regurgitation.

    PubMed

    Bouchard, Marc-André; Côté-Laroche, Claudia; Beaudoin, Jonathan

    2017-10-13

    Mitral regurgitation (MR) is frequent and associated with increased mortality and morbidity when severe. It may be caused by intrinsic valvular disease (primary MR) or ventricular deformation (secondary MR). Imaging has a critical role to document the severity, mechanism, and impact of MR on heart function as selected patients with MR may benefit from surgery whereas other will not. In patients planned for a surgical intervention, imaging is also important to select candidates for mitral valve (MV) repair over replacement and to predict surgical success. Although standard transthoracic echocardiography is the first-line modality to evaluate MR, newer imaging modalities like three-dimensional (3D) transesophageal echocardiography, stress echocardiography, cardiac magnetic resonance (CMR), and computed tomography (CT) are emerging and complementary tools for MR assessment. While some of these modalities can provide insight into MR severity, others will help to determine its mechanism. Understanding the advantages and limitations of each imaging modality is important to appreciate their respective role for MR assessment and help to resolve eventual discrepancies between different diagnostic methods. With the increasing use of transcatheter mitral procedures (repair or replacement) for high-surgical-risk patients, multimodality imaging has now become even more important to determine eligibility, preinterventional planning, and periprocedural guidance.

  3. Quality of Life in 807 Patients with Vestibular Schwannoma: Comparing Treatment Modalities.

    PubMed

    Soulier, Géke; van Leeuwen, Bibian M; Putter, Hein; Jansen, Jeroen C; Malessy, Martijn J A; van Benthem, Peter Paul G; van der Mey, Andel G L; Stiggelbout, Anne M

    2017-07-01

    Objective In vestibular schwannoma treatment, the choice among treatment modalities is controversial. The first aim of this study was to examine the quality of life of patients with vestibular schwannoma having undergone observation, radiation therapy, or microsurgical resection. The second aim was to examine the relationship between perceived symptoms and quality of life. Last, the association between quality of life and time since treatment was studied. Study Design Cross-sectional study. Setting Tertiary referral center. Subjects and Methods A total of 1208 patients treated for sporadic vestibular schwannoma between 2004 and 2014 were mailed the disease-specific Penn Acoustic Neuroma Quality of Life (PANQOL) questionnaire and additional questions on symptoms associated with vestibular schwannoma. Total and domain scores were calculated and compared among treatment groups. Propensity scores were used, and results were stratified according to tumor size to control for potential confounders. Correlations were calculated to examine the relationship between self-reported symptoms and quality of life, as well as between quality of life and time since treatment. Results Patients with small tumors (≤10 mm) under observation showed a higher PANQOL score when compared with the radiation therapy and microsurgical resection groups. A strong negative correlation was found between self-reported symptoms and quality of life, with balance problems and vertigo having the largest impact. No correlation was found between PANQOL score and time since treatment. Conclusion This study suggests that patients with small vestibular schwannomas experience better quality of life when managed with observation than do patients who have undergone active treatment.

  4. Modal Logics with Counting

    NASA Astrophysics Data System (ADS)

    Areces, Carlos; Hoffmann, Guillaume; Denis, Alexandre

    We present a modal language that includes explicit operators to count the number of elements that a model might include in the extension of a formula, and we discuss how this logic has been previously investigated under different guises. We show that the language is related to graded modalities and to hybrid logics. We illustrate a possible application of the language to the treatment of plural objects and queries in natural language. We investigate the expressive power of this logic via bisimulations, discuss the complexity of its satisfiability problem, define a new reasoning task that retrieves the cardinality bound of the extension of a given input formula, and provide an algorithm to solve it.

  5. SU-F-T-27: A Comparative Case Study Among Four Modalities for the Superficial Treatment of Squamous Cell Carcinoma

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

    Ashenafi, M; Koch, N; Peng, J

    Purpose: We performed a comparative planning study among High Dose Rate (HDR) brachytherapy, superficial electrons, Volume Modulated Arc Therapy (VMAT), and Helical IMRT (Tomotherapy) for squamous cell carcinoma of the abdominal wall with consideration for the underlining bowel. Methods: A 69-year old female presented with squamous cell carcinoma protruding 8mm beyond the anterior skin surface of the midabdomen was considered for treatment. The patient had a ventral hernia which resulted in the reduction of the abdominal wall thickness and the adjacent small bowel being the dose limiting structure. Four plans were generated using different treatment modalities: a) an enface electronmore » field (eMC, Eclipse v. 11), b) Tomotherapy (HI-Art II v.5.0.5), c) VMAT (Acuros, Eclipse v. 11), and d) HDR using a Freiburg applicator (Oncentra v. 4.3). The following plan objectives were used for all four plans: for the CTV target, V90% ≥90% (61.8Gy2/2).For the small bowel, D0.1cc < 56.2 Gy2/2 was a hard constraint and expressed as a percentage of the prescription for comparison to demonstrate the dose fall-off achieved among the modalities.For HDR, V200% <0.1cc was an additional constraint. Multiple dosimetric parameters, including those listed above, were compared among the four modalities. Results: The HDR plan showed comparable target coverage compared to the Tomotherapy plan and better coverage compared to the electron plan. Small bowel doses (D0.1cc) were lower in HDR plan compared to Tomotherapy, electron, & VMAT plans (88.8%, 89.6%, 90.9%, & 96.6%). Integral dose to the whole body (V5%) was much higher for HDR, VMAT, and Tomotherapy when compared to electron plan by factors of seven, eight, and ten, respectively. After reviewing all treatment modalities, the physician selected HDR owing to better control of the small bowel dose while maintaining adequate target coverage. Conclusion: This case study demonstrated HDR can successfully treat superficial lesions with

  6. TU-FG-201-03: Automatic Pre-Delivery Verification Using Statistical Analysis of Consistencies in Treatment Plan Parameters by the Treatment Site and Modality

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

    Liu, S; Wu, Y; Chang, X

    Purpose: A novel computer software system, namely APDV (Automatic Pre-Delivery Verification), has been developed for verifying patient treatment plan parameters right prior to treatment deliveries in order to automatically detect and prevent catastrophic errors. Methods: APDV is designed to continuously monitor new DICOM plan files on the TMS computer at the treatment console. When new plans to be delivered are detected, APDV checks the consistencies of plan parameters and high-level plan statistics using underlying rules and statistical properties based on given treatment site, technique and modality. These rules were quantitatively derived by retrospectively analyzing all the EBRT treatment plans ofmore » the past 8 years at authors’ institution. Therapists and physicists will be notified with a warning message displayed on the TMS computer if any critical errors are detected, and check results, confirmation, together with dismissal actions will be saved into database for further review. Results: APDV was implemented as a stand-alone program using C# to ensure required real time performance. Mean values and standard deviations were quantitatively derived for various plan parameters including MLC usage, MU/cGy radio, beam SSD, beam weighting, and the beam gantry angles (only for lateral targets) per treatment site, technique and modality. 2D-based rules of combined MU/cGy ratio and averaged SSD values were also derived using joint probabilities of confidence error ellipses. The statistics of these major treatment plan parameters quantitatively evaluate the consistency of any treatment plans which facilitates automatic APDV checking procedures. Conclusion: APDV could be useful in detecting and preventing catastrophic errors immediately before treatment deliveries. Future plan including automatic patient identify and patient setup checks after patient daily images are acquired by the machine and become available on the TMS computer. This project is supported by

  7. Interoception: the forgotten modality in perceptual grounding of abstract and concrete concepts.

    PubMed

    Connell, Louise; Lynott, Dermot; Banks, Briony

    2018-08-05

    Conceptual representations are perceptually grounded, but when investigating which perceptual modalities are involved, researchers have typically restricted their consideration to vision, touch, hearing, taste and smell. However, there is another major modality of perceptual information that is distinct from these traditional five senses; that is, interoception, or sensations inside the body. In this paper, we use megastudy data (modality-specific ratings of perceptual strength for over 32 000 words) to explore how interoceptive information contributes to the perceptual grounding of abstract and concrete concepts. We report how interoceptive strength captures a distinct form of perceptual experience across the abstract-concrete spectrum, but is markedly more important to abstract concepts (e.g. hungry , serenity ) than to concrete concepts (e.g. capacity , rainy ). In particular, interoception dominates emotion concepts, especially negative emotions relating to fear and sadness , moreso than other concepts of equivalent abstractness and valence. Finally, we examine whether interoceptive strength represents valuable information in conceptual content by investigating its role in concreteness effects in word recognition, and find that it enhances semantic facilitation over and above the traditional five sensory modalities. Overall, these findings suggest that interoception has comparable status to other modalities in contributing to the perceptual grounding of abstract and concrete concepts.This article is part of the theme issue 'Varieties of abstract concepts: development, use and representation in the brain'. © 2018 The Author(s).

  8. Use of New Treatment Modalities for Non-small Cell Lung Cancer Care in the Medicare Population

    PubMed Central

    Vest, Michael T.; Herrin, Jeph; Soulos, Pamela R.; Decker, Roy H.; Tanoue, Lynn; Michaud, Gaetane; Kim, Anthony W.; Detterbeck, Frank; Morgensztern, Daniel

    2013-01-01

    Background: Many older patients with early stage non-small cell lung cancer (NSCLC) do not receive curative therapy. New surgical techniques and radiation therapy modalities, such as video-assisted thoracoscopic surgery (VATS), potentially allow more patients to receive treatment. The adoption of these techniques and their impact on access to cancer care among Medicare beneficiaries with stage I NSCLC are unknown. Methods: We used the Surveillance, Epidemiology and End Results-Medicare database to identify patients with stage I NSCLC diagnosed between 1998 and 2007. We assessed temporal trends and created hierarchical generalized linear models of the relationship between patient, clinical, and regional factors and type of treatment. Results: The sample comprised 13,458 patients with a mean age of 75.7 years. The proportion of patients not receiving any local treatment increased from 14.6% in 1998 to 18.3% in 2007. The overall use of surgical resection declined from 75.2% to 67.3% (P < .001), although the proportion of patients undergoing VATS increased from 11.3% to 32.0%. Similarly, although the use of new radiation modalities increased from 0% to 5.2%, the overall use of radiation remained stable. The oldest patients were less likely to receive surgical vs no treatment (OR, 0.12; 95% CI, 0.09-0.16) and more likely to receive radiation vs surgery (OR, 13.61; 95% CI, 9.75-19.0). Conclusion: From 1998 to 2007, the overall proportion of older patients with stage I NSCLC receiving curative local therapy decreased, despite the dissemination of newer, less-invasive forms of surgery and radiation. PMID:23187634

  9. Technological Advances in the Treatment of Cancer: Combining Modalities to Optimize Outcomes.

    PubMed

    Wong, Eric T; Toms, Steven A; Ahluwalia, Manmeet S

    2015-11-01

    The anticancer treatment modality tumor treating fields (TTFields; Optune, Novocure) use the lower frequency range of the electromagnetic spectrum to destroy tumor cells during mitosis. This treatment has been evaluated in several trials of patients with glioblastoma. In these patients, TTFields are delivered through 4 transducer arrays applied to the scalp. In a phase 3 clinical trial of patients with recurrent glioblastoma, TTFields were as effective as chemotherapy, and were associated with fewer and milder systemic toxicities. Data from a phase 3 trial in newly diagnosed glioblastoma suggested that the addition of TTFields to postoperative radiation therapy and chemotherapy represents an important advance in the management of newly diagnosed glioblastoma. Ongoing clinical trials are investigating the efficacy and safety of TTFields in other tumor types, including pancreatic cancer, mesothelioma, ovarian cancer, and non–small cell lung cancer. Other recent advances in the management of cancer have been seen with immunomodulatory therapy, including immune checkpoint inhibitors. Further study will be necessary to evaluate whether TTFields will enhance or impair other established and newly emerging therapies.

  10. A New Modality for Cancer Treatment--Nanoparticle Mediated Microwave Induced Photodynamic Therapy.

    PubMed

    Yao, Mengyu; Ma, Lun; Li, Lihua; Zhang, Junying; Lim, Rebecca; Chen, Wei; Zhang, Yu

    2016-10-01

    Photodynamic therapy (PDT) has attracted ever-growing attention as a promising modality for cancer treatment. However, due to poor tissue penetration by light, photodynamic therapy has rarely been used for deeply situated tumors. This problem can be solved if photosensitizers are activated by microwaves (MW) that are able to penetrate deeply into tissues. Here, for the first time, we report microwave-induced photodynamic therapy and exploit copper cysteamine nanoparticles as a new type of photosensitizer that can be activated by microwaves to produce singlet oxygen for cancer treatment. Both in vitro and in vivo studies on a rat osteosarcoma cell line (UMR 106-01) have shown significant cell destruction using copper cysteamine (Cu-Cy) under microwave activation. The heating effects and the release of copper ions from Cu-Cy upon MW stimulation are the main mechanisms for the generation of reactive oxygen species that are lethal bullets for cancer destruction. The copper cysteamine nanoparticle-based microwave-induced photodynamic therapy opens a new door for treating cancer and other diseases.

  11. Bacterial vaginosis: Etiology and modalities of treatment—A brief note

    PubMed Central

    Kumar, Nikhil; Behera, Beauty; Sagiri, Sai S.; Pal, Kunal; Ray, Sirsendu S.; Roy, Saroj

    2011-01-01

    A large women population of the world is suffering from a vaginal infection commonly known as bacterial vaginosis. The disease is associated with the decrease in the lactobacilli count in the vagina. Till date, there is a lack of full proof treatment modalities for the cure of the disease. The treatment includes the use of antimicrobials and/or acidifying agents and probiotics, either separately or in combination. This note discusses about the etiology and the various present-day modalities of treatment of bacterial vaginosis. PMID:22219582

  12. Mental Health Disorder Therapeutic Modalities Modified for the GMS

    PubMed Central

    Sumneangsanor, Tipsuda; Vuthiarpa, Sararud; Somprasert, Chomchueun

    2017-01-01

    Background: Mental health disorders can affect physical and psychological behaviors. The people of the Greater Mekong Subregion (GMS) have a high risk of mental health disorders, such as depression, stress, and substance abuse be-cause the people in this region are trafficked for forced sex work and various forms of forced labor. In these situations, vic-tims often endure violence and abuse from trafficking recruiters, employers, and other individuals. The purposes of this study were to identify the elements characterizing mental health disorders, especially in terms of depression, stress, and sub-stance abuse, and to identify the treatment modalities for mental health disorders in the GMS. Methods: The researcher undertook a comparative analysis of the literature, reviews of epidemiological studies and mental disorder therapies, and overviews of previous research studies, were used to generate a synthesis of the existing knowledge of the mental disorder therapeutic modalities. Regarding the search methods, the data from the electronic databases PubMed, PsycINFO, Dynamed and ScienceDirect were supplemented with a manual reference search covering relevant studies from 2005 to 2016. Results: Thirty-one papers were included in the review of elements characterizing mental health disorders, especially in terms of depression, stress, and substance abuse, and to identify the treatment modalities for mental health disorders in the GMS. Nine papers defined characterizing mental health disorders, in terms of depression, stress, and substance abuse. Twenty-two papers showed the treatment modalities for mental health disorders that the treatment was effective, these in-cluded pharmacological treatments and psychological treatments, such as mindfulness-based cognitive therapy, biofeedback, and music therapy. Useful guidance can be provided for the prevention and treatment of mental health disorders, and for the care of people in the Greater Mekong Subregion. Conclusion: The

  13. Surgery versus radiation therapy as single-modality treatment of tonsillar fossa carcinoma: the Roswell Park Cancer Institute experience (1971-1991).

    PubMed

    Hicks, W L; Kuriakose, M A; Loree, T R; Orner, J B; Schwartz, G; Mullins, A; Donaldson, C; Winston, J M; Bakamjian, V Y

    1998-07-01

    To compare the efficacy and treatment outcomes in patients with tonsillar fossa cancer using surgery or radiation as a single modality therapy. From 1971 to 1991 239 patients with oral pharyngeal cancer were treated at Roswell Park Cancer Institute. Of these patients 90 had tonsillar carcinoma. Seventy-six of these patients received either surgery (SA) (n = 56) or radiation therapy (RA) (n = 20) as single-modality therapy and are the subject of this review. All patients in the radiation arm of this review were surgical candidates who declined primary surgical therapy. Sixty-three percent of the SA and 80% of the RA treatment groups presented with either stage III or stage IV disease (P < or = .05). Forty-seven percent of the SA group and 52% of the RA patients had clinically positive regional disease at initial presentation. There was a predictable pattern of nodal presentation, with level II the most frequently involved region. The rate of occult metastasis was 27% and was evenly distributed between T1 and T4 disease. The overall local control rate in the SA group was 75%, compared with 60% in the RA group (P value was not significant). The disease-specific survival (all stages) was 61% in the SA group and 37% in the RA group (P < or = .05). The disease-free survival for stage III and stage IV disease in the SA group was 47% and in the RA group 27% (P < or = .05). Survival measured against clinical response to radiation therapy, in complete responders (all stages) was 83%; by contrast there were no survivors past 24 months in the partial response group (P < or = .001). The results from this study suggest that for early disease (stage I/II), surgery or radiation therapy as single-modality treatment is equally effective. For advanced disease radiation therapy is inferior to surgery as a single-modality treatment, as measured by ultimate survival and the local control of disease. There is, however, a subset of patients with advanced disease who respond to radiation

  14. Economic evaluation of bone stimulation modalities: A systematic review of the literature.

    PubMed

    Button, Melissa L; Sprague, Sheila; Gharsaa, Osama; Latouche, Sandra; Bhandari, Mohit

    2009-04-01

    Various bone stimulation modalities are commonly used in treatment of fresh fractures and nonunions; however, the effectiveness and efficiency of these modalities remain uncertain. A systematic review of trials evaluating the clinical and economical outcomes of ultrasounds, electrical stimulation, and extracorporeal sound waves on fracture healing was conducted. We searched four electronic databases for economic evaluations that assessed bone stimulation modalities using ultrasound therapy, electrical stimulation, or extracorporeal shock waves. In addition, we searched the references and related articles of eligible studies, and a content expert was contacted. Information on the clinical and economical outcomes of patients was independently extracted by reviewers. Fourteen studies met the inclusion criteria; therefore, very limited research was found on the cost associated with treatments and the corresponding outcomes. The data available focus primarily on the efficacy of newly introduced treatment methods for bone growth, but failed to incorporate the costs of implementing such treatments. One economic analysis was identified that assessed different treatment paths using ultrasound. A total cost savings of 24-40% per patient occurred when ultrasound was used for fresh fractures and nonunions (grade C recommendation). The results suggest that the ultrasound is a viable alternative for bone stimulation; however, the impacts of the other modalities are left unknown due to the lack of research available. Methodological limitations leave the overall economic and clinical impact of these modalities uncertain. Large, prospective, randomized controlled trials that include cost-effectiveness analyses are needed to further define the clinical effectiveness and financial burden associated with bone stimulation modalities.

  15. Axillary hyperhidrosis: A review of the extent of the problem and treatment modalities.

    PubMed

    Singh, Sanjay; Davis, Harriet; Wilson, Paul

    2015-10-01

    The purpose of this review is to summarize the extent of the problem of axillary hyperhidrosis and treatment modalities available. The benefits and disadvantages of various treatments are reflected on with the hope of providing a starting point to investigate new ways of treating hyperhidrosis. A literature search was conducted using various databases and search criteria. Current treatments include aluminium chloride antiperspirants, iontophoresis, botox injections and endoscopic thoracic sympathectomy. Botox therapy is usually the most effective treatment, without surgery or unpleasant side effects. However it has to be administered by a skilled clinician and involves around 20 injections to treat axillary hyperhidrosis. Other ways of giving Botox are being developed, the most promising one being the use of microneedles which are able to penetrate the skin and deliver drugs to the target area of the dermis without causing pain. In comparison to the temporary effects of microneedles, laser and microwave therapies are also assessed as they offer the hope of permanent relief from hyperhidrosis. There is a considerable dearth in the literature on the management of axillary hyperhidrosis. Further study in larger populations with longer follow up times is critical to access the long term effects of treatment. Microneedles could be the future treatment of choice with the potential to deliver drugs in a safe and pain free way. Copyright © 2015 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  16. Expertise and reasoning with possibility: An explanation of modal logic and expert systems

    NASA Technical Reports Server (NTRS)

    Rochowiak, Daniel

    1988-01-01

    Recently systems of modal reasoning have been brought to the foreground of artificial intelligence studies. The intuitive idea of research efforts in this area is that in addition to the actual world in which sentences have certain truth values there are other worlds in which those sentences have different truth values. Such alternative worlds can be considered as possible worlds, and an agent may or may not have access to some or all of them. This approach to reasoning can be valuable in extending the expert system paradigm. Using the scheme of reasoning proposed by Toulmin, Reike and Janick and the modal system T, a scheme is proposed for expert reasoning that mitigates some of the criticisms raised by Schank and Nickerson.

  17. RhD isoimmunization and current management modalities.

    PubMed

    Neal, J L

    2001-01-01

    To review the literature on current perspectives and treatment of RhD isoimmunization. A search was conducted on MEDLINE and CINAHL, and supplemental articles/ bulletins were obtained from cited references and the Web site of the American College of Obstetricians and Gynecologists. Recent texts also were reviewed. Key search words: isoimmunization, Rho (d) immune globulin, fetal erythroblastosis, intrauterine blood transfusions, alloimmunization. Articles and comprehensive works from indexed journals in the English language relevant to key words and published after 1995 were evaluated. Historically relevant periodicals and texts were also reviewed and selected. Data were extracted and organized under the following headings: testing of the antepartum patient, antepartum treatment of isoimmunization, testing of the postpartum patient, anti-D immune globulin, antepartum anti-D immune globulin prophylaxis, other antepartum and obstetric indications for anti-D immune globulin administration, postpartum anti-D immune globulin prophylaxis, nursing implications, and future possibilities. RhD isoimmunized pregnancies continue to contribute to worldwide perinatal and neonatal morbidity and mortality. This review describes the basic knowledge necessary to care for these pregnancies and the current management modalities. The management options for RhD compromised gestations continue to evolve almost as quickly as technological advances are made. Multiple areas of research in this field have surfaced, and nurses can become valuable members of these research teams. The literature also indicates that with the available knowledge and resources, the current rate of RhD isoimmunization can be further decreased with closer adherence to proposed management guidelines by all health care professionals.

  18. Treatment modalities in children with teeth affected by molar-incisor enamel hypomineralisation (MIH): A systematic review.

    PubMed

    Lygidakis, N A

    2010-04-01

    This was to review the literature concerning the treatment of permanent teeth with molar-incisor hypomineralised enamel (MIH), comment about possible shortcomings and propose areas of future research. A search of MedLine, Scopus, ResearchGate, Isis and Google Scholar databases was conducted using all terms relevant to the subject. Relevant papers published in English were identified after a review of their titles, abstracts or full reading of the papers. Of 189 references initially found, 66 papers were included; 34 directly relevant to the subject. From the latter, only 14 concerned laboratory or clinical studies dealing with treatment for MIH. Since 2000 11 reviews evaluated, to a certain extent, treatment options for affected teeth. Analysis of the proposed treatment modalities indicated options for prevention, restorations, and adhesion to hypomineralised enamel, full coronal coverage and extraction followed by orthodontics. Based on these findings, a treatment decision plan is proposed. Although treatment approaches for MIH have started to be clearer, long-term clinical trials, supported by laboratory studies, should be conducted to further facilitate the clinical management of this dental defect.

  19. Extraction of valuable compounds from mangosteen pericarps by hydrothermal assisted sonication

    NASA Astrophysics Data System (ADS)

    Machmudah, Siti; Lestari, Sarah Duta; Shiddiqi, Qifni Yasa'Ash; Widiyastuti, Winardi, Sugeng; Wahyudiono, Kanda, Hideki; Goto, Motonobu

    2015-12-01

    Valuable compounds, such as xanthone and phenolic compounds, from mangosteen pericarps was extracted by hydrothermal treatment at temperatures of 120-160 °C and pressures of 5 MPa using batch and semi-batch extractor. This method is a simple and environmentally friendly extraction method requiring no chemicals other than water. Under these conditions, there is possibility for the formation of phenolic compounds from mangosteen pericarps from decomposition of bounds between lignin, cellulose, and hemicellulose via autohydrolysis. In order to increase the amount of extracted valuable compounds, sonication pre-treament was performed prior to the hydrothermal extraction process. 30 min of sonication pre-treatment could increase significantly the amount of xanthone and phenolic compounds mangosteen pericarps extraction. In batch-system, the xanthone recovery approach to 100 % at 160 °C with 30 min sonication pre-treatment for 150 min extraction time. Under semi-batch process, the total phenolic compounds in the extract was 217 mg/g sample at 160 °C with 30 min sonication pre-treatment for 150 min total extraction time. The results revealed that hydrothermal extraction assisted sonication pre-treatment is applicable method for the isolation of polyphenolic compounds from other types of biomass and may lead to an advanced plant biomass components extraction technology.

  20. Hyperbaric oxygen modalities are differentially effective in distinct brain ischemia models

    PubMed Central

    Ostrowski, Robert P.; Stępień, Katarzyna; Pucko, Emanuela; Matyja, Ewa

    2016-01-01

    The effectiveness and efficacy of hyperbaric oxygen (HBO) preconditioning and post-treatment modalities have been demonstrated in experimental models of ischemic cerebrovascular diseases, including global brain ischemia, transient focal and permanent focal cerebral ischemia, and experimental neonatal hypoxia-ischemia encephalopathy. In general, early and repetitive post-treatment of HBO appears to create enhanced protection against brain ischemia whereas delayed HBO treatment after transient focal ischemia may even aggravate brain injury. This review advocates the level of injury reduction upon HBO as an important component for translational evaluation of HBO based treatment modalities. The combined preconditioning and HBO post-treatment that would provide synergistic effects is also worth considering. PMID:27826422

  1. Dutch modality exclusivity norms: Simulating perceptual modality in space.

    PubMed

    Speed, Laura J; Majid, Asifa

    2017-12-01

    Perceptual information is important for the meaning of nouns. We present modality exclusivity norms for 485 Dutch nouns rated on visual, auditory, haptic, gustatory, and olfactory associations. We found these nouns are highly multimodal. They were rated most dominant in vision, and least in olfaction. A factor analysis identified two main dimensions: one loaded strongly on olfaction and gustation (reflecting joint involvement in flavor), and a second loaded strongly on vision and touch (reflecting joint involvement in manipulable objects). In a second study, we validated the ratings with similarity judgments. As expected, words from the same dominant modality were rated more similar than words from different dominant modalities; but - more importantly - this effect was enhanced when word pairs had high modality strength ratings. We further demonstrated the utility of our ratings by investigating whether perceptual modalities are differentially experienced in space, in a third study. Nouns were categorized into their dominant modality and used in a lexical decision experiment where the spatial position of words was either in proximal or distal space. We found words dominant in olfaction were processed faster in proximal than distal space compared to the other modalities, suggesting olfactory information is mentally simulated as "close" to the body. Finally, we collected ratings of emotion (valence, dominance, and arousal) to assess its role in perceptual space simulation, but the valence did not explain the data. So, words are processed differently depending on their perceptual associations, and strength of association is captured by modality exclusivity ratings.

  2. Modality and Task Switching Interactions using Bi-Modal and Bivalent Stimuli

    ERIC Educational Resources Information Center

    Sandhu, Rajwant; Dyson, Benjamin J.

    2013-01-01

    Investigations of concurrent task and modality switching effects have to date been studied under conditions of uni-modal stimulus presentation. As such, it is difficult to directly compare resultant task and modality switching effects, as the stimuli afford both tasks on each trial, but only one modality. The current study investigated task and…

  3. Enhancing image classification models with multi-modal biomarkers

    NASA Astrophysics Data System (ADS)

    Caban, Jesus J.; Liao, David; Yao, Jianhua; Mollura, Daniel J.; Gochuico, Bernadette; Yoo, Terry

    2011-03-01

    Currently, most computer-aided diagnosis (CAD) systems rely on image analysis and statistical models to diagnose, quantify, and monitor the progression of a particular disease. In general, CAD systems have proven to be effective at providing quantitative measurements and assisting physicians during the decision-making process. As the need for more flexible and effective CADs continues to grow, questions about how to enhance their accuracy have surged. In this paper, we show how statistical image models can be augmented with multi-modal physiological values to create more robust, stable, and accurate CAD systems. In particular, this paper demonstrates how highly correlated blood and EKG features can be treated as biomarkers and used to enhance image classification models designed to automatically score subjects with pulmonary fibrosis. In our results, a 3-5% improvement was observed when comparing the accuracy of CADs that use multi-modal biomarkers with those that only used image features. Our results show that lab values such as Erythrocyte Sedimentation Rate and Fibrinogen, as well as EKG measurements such as QRS and I:40, are statistically significant and can provide valuable insights about the severity of the pulmonary fibrosis disease.

  4. Uncertainty quantification in operational modal analysis with stochastic subspace identification: Validation and applications

    NASA Astrophysics Data System (ADS)

    Reynders, Edwin; Maes, Kristof; Lombaert, Geert; De Roeck, Guido

    2016-01-01

    Identified modal characteristics are often used as a basis for the calibration and validation of dynamic structural models, for structural control, for structural health monitoring, etc. It is therefore important to know their accuracy. In this article, a method for estimating the (co)variance of modal characteristics that are identified with the stochastic subspace identification method is validated for two civil engineering structures. The first structure is a damaged prestressed concrete bridge for which acceleration and dynamic strain data were measured in 36 different setups. The second structure is a mid-rise building for which acceleration data were measured in 10 different setups. There is a good quantitative agreement between the predicted levels of uncertainty and the observed variability of the eigenfrequencies and damping ratios between the different setups. The method can therefore be used with confidence for quantifying the uncertainty of the identified modal characteristics, also when some or all of them are estimated from a single batch of vibration data. Furthermore, the method is seen to yield valuable insight in the variability of the estimation accuracy from mode to mode and from setup to setup: the more informative a setup is regarding an estimated modal characteristic, the smaller is the estimated variance.

  5. Tumor treating fields - an emerging cancer treatment modality.

    PubMed

    Davis, Mary Elizabeth

    2013-08-01

    Tumor treating fields (TTFs) are an evolving new anticancer modality. The U.S. Food and Drug Administration has approved the first device, the NovoTTF-100A™, that uses this technology and is indicated for use in progressive glioblastoma multiforme after standard therapies have failed. Promising clinical trial results will likely lead to expanded uses in primary brain tumors and other cancer types. This article will review the concept of TTFs and their mechanism of action, and overview the TTF device and its approved usage.

  6. Modal analysis using a Fourier analyzer, curve-fitting, and modal tuning

    NASA Technical Reports Server (NTRS)

    Craig, R. R., Jr.; Chung, Y. T.

    1981-01-01

    The proposed modal test program differs from single-input methods in that preliminary data may be acquired using multiple inputs, and modal tuning procedures may be employed to define closely spaced frquency modes more accurately or to make use of frequency response functions (FRF's) which are based on several input locations. In some respects the proposed modal test proram resembles earlier sine-sweep and sine-dwell testing in that broadband FRF's are acquired using several input locations, and tuning is employed to refine the modal parameter estimates. The major tasks performed in the proposed modal test program are outlined. Data acquisition and FFT processing, curve fitting, and modal tuning phases are described and examples are given to illustrate and evaluate them.

  7. Recommendations of the Spanish Societies of Radiation Oncology (SEOR), Nuclear Medicine & Molecular Imaging (SEMNiM), and Medical Physics (SEFM) on 18F-FDG PET-CT for radiotherapy treatment planning

    PubMed Central

    Caballero Perea, Begoña; Villegas, Antonio Cabrera; Rodríguez, José Miguel Delgado; Velloso, María José García; Vicente, Ana María García; Cabrerizo, Carlos Huerga; López, Rosa Morera; Romasanta, Luis Alberto Pérez; Beltrán, Moisés Sáez

    2012-01-01

    Positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) is a valuable tool for diagnosing and staging malignant lesions. The fusion of PET and computed tomography (CT) yields images that contain both metabolic and morphological information, which, taken together, have improved the diagnostic precision of PET in oncology. The main imaging modality for planning radiotherapy treatment is CT. However, PET-CT is an emerging modality for use in planning treatments because it allows for more accurate treatment volume definition. The use of PET-CT for treatment planning is highly complex, and protocols and standards for its use are still being developed. It seems probable that PET-CT will eventually replace current CT-based planning methods, but this will require a full understanding of the relevant technical aspects of PET-CT planning. The aim of the present document is to review these technical aspects and to provide recommendations for clinical use of this imaging modality in the radiotherapy planning process. PMID:24377032

  8. Recommendations of the Spanish Societies of Radiation Oncology (SEOR), Nuclear Medicine & Molecular Imaging (SEMNiM), and Medical Physics (SEFM) on (18)F-FDG PET-CT for radiotherapy treatment planning.

    PubMed

    Caballero Perea, Begoña; Villegas, Antonio Cabrera; Rodríguez, José Miguel Delgado; Velloso, María José García; Vicente, Ana María García; Cabrerizo, Carlos Huerga; López, Rosa Morera; Romasanta, Luis Alberto Pérez; Beltrán, Moisés Sáez

    2012-01-01

    Positron emission tomography (PET) with (18)F-fluorodeoxyglucose (FDG) is a valuable tool for diagnosing and staging malignant lesions. The fusion of PET and computed tomography (CT) yields images that contain both metabolic and morphological information, which, taken together, have improved the diagnostic precision of PET in oncology. The main imaging modality for planning radiotherapy treatment is CT. However, PET-CT is an emerging modality for use in planning treatments because it allows for more accurate treatment volume definition. The use of PET-CT for treatment planning is highly complex, and protocols and standards for its use are still being developed. It seems probable that PET-CT will eventually replace current CT-based planning methods, but this will require a full understanding of the relevant technical aspects of PET-CT planning. The aim of the present document is to review these technical aspects and to provide recommendations for clinical use of this imaging modality in the radiotherapy planning process.

  9. Combined Modality Treatment for PET-Positive Non-Hodgkin Lymphoma: Favorable Outcomes of Combined Modality Treatment for Patients With Non-Hodgkin Lymphoma and Positive Interim or Postchemotherapy FDG-PET

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

    Halasz, Lia M.; Jacene, Heather A.; Catalano, Paul J.

    2012-08-01

    Purpose: To evaluate outcomes of patients treated for aggressive non-Hodgkin lymphoma (NHL) with combined modality therapy based on [{sup 18}F]fluoro-2-deoxy-2-D-glucose positron emission tomography (FDG-PET) response. Methods and Materials: We studied 59 patients with aggressive NHL, who received chemotherapy and radiation therapy (RT) from 2001 to 2008. Among them, 83% of patients had stage I/II disease. Patients with B-cell lymphoma received R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone)-based chemotherapy, and 1 patient with anaplastic lymphoma kinase-negative anaplastic T-cell lymphoma received CHOP therapy. Interim and postchemotherapy FDG-PET or FDG-PET/computed tomography (CT) scans were performed for restaging. All patients received consolidated involved-field RT.more » Median RT dose was 36 Gy (range, 28.8-50 Gy). Progression-free survival (PFS) and local control (LC) rates were calculated with and without a negative interim or postchemotherapy FDG-PET scan. Results: Median follow-up was 46.5 months. Thirty-nine patients had negative FDG-PET results by the end of chemotherapy, including 12 patients who had a negative interim FDG-PET scan and no postchemotherapy PET. Twenty patients were FDG-PET-positive, including 7 patients with positive interim FDG-PET and no postchemotherapy FDG-PET scans. The 3-year actuarial PFS rates for patients with negative versus positive FDG-PET scans were 97% and 90%, respectively. The 3-year actuarial LC rates for patients with negative versus positive FDG-PET scans were 100% and 90%, respectively. Conclusions: Patients who had a positive interim or postchemotherapy FDG-PET had a PFS rate of 90% at 3 years after combined modality treatment, suggesting that a large proportion of these patients can be cured with consolidated RT.« less

  10. Perception about the importance and use of therapeutic massage as a treatment modality among physical therapists working in Saudi Arabia

    PubMed Central

    Zafar, Hamayun; Oluseye, Kamaldeen; Alghadir, Ahmad; Iqbal, Zaheen A.

    2015-01-01

    [Purpose] To report perceptions about the importance and use of therapeutic massage as a treatment modality among physical therapists working in Saudi Arabia. [Subjects and Methods] A 21-item structured questionnaire was used to assess various domains including the demographic and professional characteristics of physical therapists and their perceptions about the importance and use of therapeutic massage in their daily practice. The questionnaire was uploaded online and the web link was sent to 140 members of the Saudi Physical Therapy Association (SPTA). [Results] The overall response rate was 86%. Among the respondents, 31% reported occasional use of therapeutic massage in their clinical practice, and 55% reported to have received formal training for therapeutic massage. Use of therapeutic massage was more common among female physical therapists. [Conclusion] Many physical therapists working in Saudi Arabia consider therapeutic massage to be an important treatment modality, but its use is relatively limited, either due to the time and effort required to dispense it, or the lack of scientific evidence for its efficacy. PMID:26180330

  11. Choice of radiotherapy planning modality influences toxicity in the treatment of locally advanced esophageal cancer.

    PubMed

    Mackley, Heath B; Adelstein, Jonathan S; Reddy, Chandana A; Adelstein, David J; Rice, Thomas W; Saxton, Jerrold P; Videtic, Gregory M M

    2008-01-01

    Three-dimensional computed tomography-based radiotherapy planning (3DCTP) is increasingly employed in the treatment of esophageal cancer. It is unknown whether a 3DCTP approach influences outcomes compared to two-dimensional planning (2DP). This study compares clinical outcomes for homogeneously treated patient cohorts stratified by planning modality. A retrospective chart review was conducted on patients with T3/4 and/or node-positive esophageal carcinoma treated at the Cleveland Clinic between July 1, 2003 and May 31, 2006 who were managed with an institutional regimen consisting of preoperative radiotherapy, whether 3DCTP or 2DP [30 Gy/20 fractions/1.5 Gy twice daily over 2 weeks], with concurrent cisplatin and 5-fluorouracil the first week. Following definitive resection, an identical postoperative course of concurrent chemoradiotherapy (CRT) was delivered. One hundred and forty-one patients completed preoperative CRT and were available for review. The median follow-up of living patients is 21.7 months. Fifty-five percent underwent 3DCTP and 45% had 2DP. The treatment groups were similar, with the exception of clinical stage group, with 2DP having more stage II and fewer stage III patients than 3DCTP (p = 0.02). 3DCTP plans had significantly smaller field sizes by area (p < 0.0001). Pathologic response, locoregional control, distant control, and overall survival were equivalent between the two planning modalities. Esophagitis was significantly less common with a 3D approach compared to 2D planning (49% vs. 71%, p = 0.0096), with other toxicities equivalent between the groups. 3DCTP reduces acute esophagitis in patients receiving multimodality therapy for esophageal cancer without compromising clinical outcomes.

  12. Cross-modal versus within-modal recall: differences in behavioral and brain responses.

    PubMed

    Butler, Andrew J; James, Karin H

    2011-10-31

    Although human experience is multisensory in nature, previous research has focused predominantly on memory for unisensory as opposed to multisensory information. In this work, we sought to investigate behavioral and neural differences between the cued recall of cross-modal audiovisual associations versus within-modal visual or auditory associations. Participants were presented with cue-target associations comprised of pairs of nonsense objects, pairs of nonsense sounds, objects paired with sounds, and sounds paired with objects. Subsequently, they were required to recall the modality of the target given the cue while behavioral accuracy, reaction time, and blood oxygenation level dependent (BOLD) activation were measured. Successful within-modal recall was associated with modality-specific reactivation in primary perceptual regions, and was more accurate than cross-modal retrieval. When auditory targets were correctly or incorrectly recalled using a cross-modal visual cue, there was re-activation in auditory association cortex, and recall of information from cross-modal associations activated the hippocampus to a greater degree than within-modal associations. Findings support theories that propose an overlap between regions active during perception and memory, and show that behavioral and neural differences exist between within- and cross-modal associations. Overall the current study highlights the importance of the role of multisensory information in memory. Copyright © 2011 Elsevier B.V. All rights reserved.

  13. Platelet-rich plasma-an 'Elixir' for treatment of alopecia: personal experience on 117 patients with review of literature.

    PubMed

    Garg, Suruchi; Manchanda, Shweta

    2017-01-01

    Platelet-rich plasma (PRP) has emerged as a new treatment modality in regenerative plastic surgery and dermatology. PRP is a simple, cost-effective and feasible treatment option with high patient satisfaction for hair loss and can be regarded as a valuable adjuvant treatment modality for androgenic alopecia and other types of non-scarring alopecias. Authors have proposed a hair model termed "Golden anchorage with 'molecular locking' of ectodermal and mesenchymal components for survival and integrity of hair follicle (HF)" in this article. Golden anchorage comprises of bulge stem cells, ectodermal basement membrane and bulge portion of APM. PRP with its autologous supply of millions of growth factors works on 'Golden anchorage' along with keratinocytes (PDGF), dermal papilla (IGF and fibroblast growth factor), vasculature (VEGF and PDGF) and neural cells (Nerve Growth Factor) in a multipronged manner serving as an 'elixir' for hair growth and improving overall environment.

  14. A complications-based clinical staging of obesity to guide treatment modality and intensity

    PubMed Central

    Daniel, Sunil; Soleymani, Taraneh; Garvey, William T.

    2014-01-01

    Purpose of review The current medical model for obesity management is BMI-centric because BMI is the predominant measure used to gauge disease severity, as well as indications for various treatment modalities. Recent advancements in therapy and understanding of the relationship between BMI and obesity-related complications call for a re-examination of this approach. Recent findings Advancements in treatment, including the recent approval of two new weight loss medications in the USA, have enabled development of new medical models for management of obesity. On the basis of accumulating data demonstrating the benefits of weight loss regarding multiple obesity-related complications (e.g., diabetes prevention, type 2 diabetes mellitus, cardiovascular disease risk, nonalcoholic steatohepatitis, sleep apnea), a complications-centric model is proposed that employs weight loss as a tool to treat and prevent obesity comorbidities. This model assures that the aggressiveness of therapy is commensurate with disease severity, and that therapy is directed at those obese patients who will benefit most from weight loss therapy. The treatment algorithm is comprehensive in addressing complications and quantitative when possible in the staging of risk or disease severity. Summary A complications-centric approach to obesity management identifies patients who will benefit most from weight loss, and optimizes patient outcomes, benefit/risk ratio, and the cost–effectiveness of interventions. PMID:23974764

  15. Understanding the tissue interaction of new treatment modalities in laparoscopic surgery in view of safe and effective application (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Grimbergen, Matthijs C. M.; Klaessens, John H.; van der Veen, Albert J.; Verdaasdonk, Rudolf M.

    2016-03-01

    During laparoscopic surgery, devices are require to either cut, ablate or coagulate tissue and veins with high precision and controlled lateral damage preferably in an one-for-all modality. The tissue interactions of 3 new treatment modalities were studied using special imaging techniques to obtain a better understanding the working mechanism in view of effective and safe application. The Plasmajet produces a high temperature ionized gas 'flame' directed to the tissue surface at the tip of a 4 mm diameter rigid hand piece. The Lumenis DUO CO2 laser enables endoscopic laser energy delivery through a 1 mm outer diameter flexible hollow waveguide. The 2 µm 'Thulium' laser is delivered by (standard) 400 µm diameter optical fiber. Thermal imaging and Schlieren techniques were used to assess the superficial ablative and coagulation effects these surgical instruments scanning at preset velocities and distances from the surface of biological tissues and phantoms . The CO2 was very effective in tissue ablation even at a distance up to 10 mm due to a very small diverging beam from the hollow waveguide. In contrast, the Thulium laser showed less ablation and increasing coagulation at larger distance to the tissue. The gas 'flame' of the Plasmajet spread the thermal energy over the surface for effective superficial ablation and coagulation. However, the pressure of the gas flow is substantial on the tissue surface creating turbulence and even indirect cooling. The specific ablation and coagulation effects of the three treatment modalities have to be appreciate and the effective and safe application will depend on the preference and skills of the surgeon

  16. An alternative representation of the receptance: The 'elliptical plane' and its modal properties

    NASA Astrophysics Data System (ADS)

    Montalvão, Diogo; Amafabia, Daerefa-a. Mitsheal

    2018-03-01

    Modal Identification from Frequency Response Functions (FRFs) has been extensively investigated up to the point its research reached a stagnation state. Yet, a new approach to determine the modal damping factors from FRFs was recently proposed, showing that there still is scope for new findings in the field. Contrary to other modal identification methods which are based on the dynamic motion governing equations, the method used the dissipated energy per cycle of vibration as a starting point. For lightly damped systems with conveniently spaced modes, it produced quite accurate results, especially when compared to the well-known method of the inverse. The method used a plot of the sine of the phase of the receptance against its amplitude, whereby damping was determined from the slope of a linear fit to the resulting plot. In this paper, it is shown that this plot has other (perhaps more important) special properties that were not explored before. Near resonant frequencies, its shape is elliptical, whereby the real and imaginary parts of the modal constants can be determined from numerical curve-fitting. This finding allowed developing a new method which formulation is presented in this paper. The method is discussed through numerical and experimental examples. Although the intention is not to present a new modal identification method that is superior to other existing ones (like the method of the inverse or those based on the Nyquist plot), the authors believe that this new representation of the receptance and its properties may bring valuable insights for other researchers in the field.

  17. Dual-modality imaging with a ultrasound-gamma device for oncology

    NASA Astrophysics Data System (ADS)

    Polito, C.; Pellegrini, R.; Cinti, M. N.; De Vincentis, G.; Lo Meo, S.; Fabbri, A.; Bennati, P.; Cencelli, V. Orsolini; Pani, R.

    2018-06-01

    Recently, dual-modality systems have been developed, aimed to correlate anatomical and functional information, improving disease localization and helping oncological or surgical treatments. Moreover, due to the growing interest in handheld detectors for preclinical trials or small animal imaging, in this work a new dual modality integrated device, based on a Ultrasounds probe and a small Field of View Single Photon Emission gamma camera, is proposed.

  18. Development of a multi-modal Monte-Carlo radiation treatment planning system combined with PHITS

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

    Kumada, Hiroaki; Nakamura, Takemi; Komeda, Masao

    A new multi-modal Monte-Carlo radiation treatment planning system is under development at Japan Atomic Energy Agency. This system (developing code: JCDS-FX) builds on fundamental technologies of JCDS. JCDS was developed by JAEA to perform treatment planning of boron neutron capture therapy (BNCT) which is being conducted at JRR-4 in JAEA. JCDS has many advantages based on practical accomplishments for actual clinical trials of BNCT at JRR-4, the advantages have been taken over to JCDS-FX. One of the features of JCDS-FX is that PHITS has been applied to particle transport calculation. PHITS is a multipurpose particle Monte-Carlo transport code, thus applicationmore » of PHITS enables to evaluate doses for not only BNCT but also several radiotherapies like proton therapy. To verify calculation accuracy of JCDS-FX with PHITS for BNCT, treatment planning of an actual BNCT conducted at JRR-4 was performed retrospectively. The verification results demonstrated the new system was applicable to BNCT clinical trials in practical use. In framework of R and D for laser-driven proton therapy, we begin study for application of JCDS-FX combined with PHITS to proton therapy in addition to BNCT. Several features and performances of the new multimodal Monte-Carlo radiotherapy planning system are presented.« less

  19. Modal sound transmission loss of a single leaf panel: Effects of inter-modal coupling.

    PubMed

    Wang, Chong

    2015-06-01

    Sound transmission through a single leaf panel has mostly been discussed and explained by using the approaching wave concept, from which the well-known mass law can be derived. In this paper, the modal behavior in sound transmission coefficients is explored, and it is shown that the mutual modal radiation impedances in modal sound transmission coefficients may not be ignored even for a panel immersed in a light fluid. By introducing the equivalent modal impedance which incorporates the inter-modal coupling effect, an analytical expression for the modal sound transmission coefficient is derived, and the overall sound transmission coefficient is simply a modal superposition of modal sound transmission coefficients. A good correlation is obtained between analytical calculation and boundary element method. In addition, it is found that inter-modal coupling has noticeable effects in modal sound transmission coefficients in the subsonic region but may be ignored as modes become supersonic. It is also shown that the well-known mass law performance is attributed to all the supersonic modes.

  20. Using online modules is a multi-modality teaching system: a high-touch high-tech approach to geriatric education.

    PubMed

    Gainor, Sara Jane; Goins, R Turner; Miller, Lee Ann

    2004-01-01

    Making geriatric education available to rural faculty/preceptors, students, and practitioners presents many challenges. Often the only options considered for educating those in the health professions about geriatrics are either traditional face-to-face courses or distance education programs. The purpose of this paper was to examine the use of Web-based modules or courses and other distance learning technology in concert with traditional learning modalities. The Mountain State Geriatric Education Center explored the use of a multi-modal approach within a high-touch, high-tech framework. Our findings indicate the following: it is important to start where participants are ready to begin; flexibility and variety are needed; soliciting evaluative feedback from participants is valuable; there is a need to integrate distance learning with more traditional modalities; and a high-tech, high-touch approach provides a format which participants find acceptable, accessible, and attractive. This assertion does not rule out the use of technology for distance education but rather encourages educators to take advantage of a wide range of modalities, traditional and technological, to reach rural practitioners, faculty, and students.

  1. A framework for optimizing micro-CT in dual-modality micro-CT/XFCT small-animal imaging system

    NASA Astrophysics Data System (ADS)

    Vedantham, Srinivasan; Shrestha, Suman; Karellas, Andrew; Cho, Sang Hyun

    2017-09-01

    Dual-modality Computed Tomography (CT)/X-ray Fluorescence Computed Tomography (XFCT) can be a valuable tool for imaging and quantifying the organ and tissue distribution of small concentrations of high atomic number materials in small-animal system. In this work, the framework for optimizing the micro-CT imaging system component of the dual-modality system is described, either when the micro-CT images are concurrently acquired with XFCT and using the x-ray spectral conditions for XFCT, or when the micro-CT images are acquired sequentially and independently of XFCT. This framework utilizes the cascaded systems analysis for task-specific determination of the detectability index using numerical observer models at a given radiation dose, where the radiation dose is determined using Monte Carlo simulations.

  2. Investigation of a dual modal method for bone pathologies using quantitative ultrasound and photoacoustics

    NASA Astrophysics Data System (ADS)

    Steinberg, Idan; Gannot, Israel; Eyal, Avishay

    2015-03-01

    Osteoporosis is a widespread disease that has a catastrophic impact on patient's lives and overwhelming related healthcare costs. In recent works, we have developed a multi-spectral, frequency domain photoacoustic method for the evaluation of bone pathologies. This method has great advantages over pure ultrasonic or optical methods as it provides both molecular information from the bone absorption spectrum and bone mechanical status from the characteristics of the ultrasound propagation. These characteristics include both the Speed of Sound (SOS) and Broadband Ultrasonic Attenuation (BUA). To test the method's quantitative predictions, we have constructed a combined ultrasound and photoacoustic setup. Here, we experimentally present a dual modality system, and compares between the methods on bone samples in-vitro. The differences between the two modalities are shown to provide valuable insight into the bone structure and functional status.

  3. Comparison of the effects of intensive insulin treatment modalities on cardiovascular biomarkers in type 1 diabetes mellitus.

    PubMed

    Cetinkalp, Sevki; Felekoglu, Canan; Karadeniz, Muammer; Boyacıoglu, Hayal; Delen, Yasemin; Yildirim, Eser; Yilmaz, Candeger

    2015-01-01

    To evaluate effects of intensive insulin treatment modalities on cardiovascular biomarkers in patients with type 1 diabetes mellitus (T1DM). A total of 25 patients with T1DM receiving intensive insulin therapy either in the form of continuous insulin pump (IP group; n=13) or as multiple daily injections (MDI group; n=12) and 13 controls (control group, n=13) were included. Data on demographics, anthropometrics, diabetes history, and laboratory findings including glycemic and lipid parameters, and cardiovascular biomarkers [C-reactive protein (mg/dL), homocysteine (μmol/L), fibrinogen (mg/dL), oxidized LDL (ng/dL), PAI-1 (ng/mL), MCP-1 (pg/mL) and VEGF (pg/mL)] were recorded in each group. Correlation of cardiovascular biomarkers to other parameters was also evaluated in T1DM patients. Apart from significantly higher mean (SD) values for HbA1c [6.1 (0.3) vs. 5.6 (0.5)% (43 (3) vs. 38 (5) mmol/mol), p<0.05)] and HDL-cholesterol [71.5 (13.6) vs. 58.2 (10.8), p<0.01) in the IP than in the MDI group, no significance difference was noted between insulin treatment modalities as well as between patient and control groups in terms of demographic, anthropometric and laboratory parameters. Negative correlation of MCP-1 to treatment duration (r=-0.615, p=0.025), and HDL-c to CRP (r=-0.685, p=0.010) and VEGF (r=-0.678, p=0.011) was noted in IP group, whereas positive correlation of PAI-1 to diabetes age (r=0.805, p=0.002) and treatment duration was noted in MDI group. Our findings in a cohort of T1DM patients with optimal glycemic control revealed that intensive insulin therapy was not associated with an increase in atherosclerotic markers in T1DM, regardless of whether continuous IP infusion or MDIs was administered. Copyright © 2015 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  4. Automatic vibration mode selection and excitation; combining modal filtering with autoresonance

    NASA Astrophysics Data System (ADS)

    Davis, Solomon; Bucher, Izhak

    2018-02-01

    Autoresonance is a well-known nonlinear feedback method used for automatically exciting a system at its natural frequency. Though highly effective in exciting single degree of freedom systems, in its simplest form it lacks a mechanism for choosing the mode of excitation when more than one is present. In this case a single mode will be automatically excited, but this mode cannot be chosen or changed. In this paper a new method for automatically exciting a general second-order system at any desired natural frequency using Autoresonance is proposed. The article begins by deriving a concise expression for the frequency of the limit cycle induced by an Autoresonance feedback loop enclosed on the system. The expression is based on modal decomposition, and provides valuable insight into the behavior of a system controlled in this way. With this expression, a method for selecting and exciting a desired mode naturally follows by combining Autoresonance with Modal Filtering. By taking various linear combinations of the sensor signals, by orthogonality one can "filter out" all the unwanted modes effectively. The desired mode's natural frequency is then automatically reflected in the limit cycle. In experiment the technique has proven extremely robust, even if the amplitude of the desired mode is significantly smaller than the others and the modal filters are greatly inaccurate.

  5. Multiple sclerosis - New treatment modalities

    PubMed Central

    Totaro, Rocco; Di Carmine, Caterina; Marini, Carmine; Carolei, Antonio

    2015-01-01

    Ever since the introduction of the first disease modifying therapies, the concept of multiple sclerosis treatment algorithms developed ceaselessly. The increasing number of available drugs is paralleled by impelling issue of ensuring the most appropriate treatment to the right patient at the right time. The purpose of this review is to describe novel agents recently approved for multiple sclerosis treatment, namely teriflunomide, alemtuzumab and dimethylfumarate, focusing on mechanism of action, efficacy data in experimental setting, safety and tolerability. The place in therapy of newer treatment implies careful balancing of risk-benefit profile as well as accurate patient selection. Hence the widening of therapeutic arsenal provides greater opportunity for personalized therapy but also entails a complex trade-off between efficacy, tolerability, safety and eventually patient preference. PMID:26831413

  6. Impact of salvage treatment modalities in patients with positive FDG-PET/CT after R-CHOP chemotherapy for aggressive B-cell non-Hodgkin lymphoma.

    PubMed

    Chin, Vicky; Fulham, Michael; Hertzberg, Mark; Jackson, Michael; Lindeman, Robert; Brighton, Timothy; Kidson-Gerber, Giselle; Wegner, Eva A; Cheung, Carol; MacCallum, Susan; Williams, Janet; Thompson, Stephen R

    2018-06-01

    To compare outcomes of different salvage treatment modalities in patients with aggressive B-cell non-Hodgkin lymphoma (NHL) who remain FDG-PET positive after R-CHOP chemotherapy. Existing data on these patients with FDG-PET primary refractory disease are limited. Patients with diffuse large B-cell lymphoma or grade 3 follicular lymphoma were retrospectively reviewed from the Prince of Wales Hospital databases. Eligibility criteria were: age≥18 years, treated with R-CHOP, with positive post-chemotherapy FDG-PET. Salvage treatment modalities were: radical radiotherapy (RT, dose≥30 Gy), high dose chemotherapy and autologous stem cell transplant (ASCT), or non-radical management. Survival was calculated from date of post-chemotherapy FDG-PET to last follow-up. Twenty-six patients from 2003-2015 met the inclusion criteria. Median age was 60 (range 19-84). Most had adverse baseline features: 21 (81%) stage III-IV, 24 (92%) bulky disease and nine (35%) skeletal involvement. Characteristics of PET-positivity post-chemotherapy were single site in 16 (62%), sites of prior bulk in 24 of 24, skeletal sites in five of nine, and able to be encompassed by RT in 21 (81%). Salvage treatment was: radical RT in 17 (65%), ASCT in four (15%) and non-radical in five (20%). Median follow-up of surviving patients was 31 months. Kaplan-Meier estimates of 3-year PFS and OS were 41% and 52%, respectively. By salvage modality, 3-year PFS was 51% for RT, 25% for ASCT and 20% for non-radical treatment, (P = 0.453); 3-year OS was respectively 65%, 25% and 40% (P = 0.173). Patients with FDG-PET positive disease after R-CHOP for aggressive B-cell NHL are salvageable with radiotherapy. © 2018 The Royal Australian and New Zealand College of Radiologists.

  7. Determining the effectiveness of various treatment modalities in carpal tunnel syndrome by ultrasonography and comparing ultrasonographic findings with other outcomes.

    PubMed

    Soyupek, Feray; Yesildag, Ahmet; Kutluhan, Suleyman; Askin, Ayhan; Ozden, Ahmet; Uslusoy, Gokcen Ay; Demirci, Seden

    2012-10-01

    Firstly, we aimed to determine the effectiveness of various treatment modalities using ultrasonography (US), and secondly, we aimed to assess the correlations between the ultrasonographic findings and electrophysiological tests, symptom severity, functional status and physical findings. 74 hands of 47 patients with carpal tunnel syndrome (CTS) were randomly treated by applying wrist splinting alone in the neutral position (23 hands), phonophoresis with corticosteroid (PCS) (28 hands) and phonophoresis with non-steroid anti-inflamatory drug (PNSAI) (23 hands). The cross-sectional area (CSA) of the median nerve (MN) was determined by ultrasound on the initial and at the 3 months after treatment. MN conduction studies were performed on the initial visit and 3 months after treatment. The patients completed the Boston symptom severity questionnaire. For clinical evaluation, we used Phalen's and Tinel's signs. We could find reduction in CSA of MN in PCS group (P < 0.001). The CSA of MN was inversely correlated with motor sensory and median nerve conduction velocity (NCV) (r = 0.421, r = 0.213, respectively). Statistically significant correlations were not detected between ultrasonographic parameters and clinical evaluation parameters (P > 0.05) and also between ultrasonographic parameters and BQ scores (P > 0.05). Although there was some improvement in clinical parameters, ultrasonographic parameters did not change in P-NSAI group. The most effective treatment modality was P-CS according to ultrasonographic and other findings. Although there were inverse correlations between the CSA of MN and sensory and motor MN conduction velocity, no relationship was found between symptom severity, functional status and US findings or electrophysiological studies.

  8. Multishaker modal testing

    NASA Technical Reports Server (NTRS)

    Craig, R. R., Jr.

    1983-01-01

    Procedures for improving the modal modeling of structures using test data and to determine appropriate analytical models based on substructure experimental data were explored. Two related research topics were considered in modal modeling: using several independently acquired columns of frequency response data, and modal modeling using simultaneous multi-point excitation. In component mode synthesis modeling, the emphasis is on determining the best way to employ complex modes and residuals.

  9. Cerebral arteriovenous malformations and seizures: differential impact on the time to seizure-free state according to the treatment modalities.

    PubMed

    Hyun, Seung-Jae; Kong, Doo-Sik; Lee, Jung-Il; Kim, Jong-Soo; Hong, Seung-Chyul

    2012-06-01

    To determine the prognostic factors for the incidence and the outcome of seizure in patients with cerebral arteriovenous malformation (AVM) and to identify the time to seizure-free state according to the treatment modalities. Between 1995 and 2008, the multidisciplinary team at our institution treated 399 patients with cerebral AVMs. Treatment consisted of surgical resection, radiosurgery, and embolization, either alone or in combination. The median follow-up period was 6.0 years (range, 3.0-16.2 years). Eighty-six patients (21.5 %) experienced seizures before treatment. We investigated the variables associated with seizure incidence and seizure outcome and analyzed the outcomes of seizure among each treatment modality. After treatment, 60 (70 %) patients were seizure-free. Compared with 313 patients who did not experience seizures, we found that younger age (≤ 35 years), size ≥ 3 cm, and location of temporal lobe were associated with seizures (p < 0.05). Short seizure history, accompanying intracerebral hemorrhage, generalized tonic-clonic type seizure, deep-seated or infratentorial AVM, complete obliteration of AVM, and a favorable neurological outcome at 12 months were closely associated with Engel Class I outcomes (p < 0.05). Seizure-free outcomes after microsurgery, radiosurgery, or embolization were 78 %, 66 %, and 50 %, respectively. The overall annual bleeding rate was 1.0 % and 2.2 % in microsurgery-treated and radiosurgery-treated AVMs, respectively. In the surgery group, the median time to seizure-free status was 1.1 months (95 % CI, 0.7-1.2 months), whereas the radiosurgery group and embolization-alone group showed 20.5 months (95 % CI, 18.3-23.8 months), and 8.1 months (95 % CI, 6.0-13.5 months), respectively. A multidisciplinary team approach for cerebral AVMs achieved satisfactory seizure control results. Microsurgery led to the highest percentage of seizure-free outcomes and had the lowest annual bleeding rate, whereas radiosurgery had a higher

  10. MIND: modality independent neighbourhood descriptor for multi-modal deformable registration.

    PubMed

    Heinrich, Mattias P; Jenkinson, Mark; Bhushan, Manav; Matin, Tahreema; Gleeson, Fergus V; Brady, Sir Michael; Schnabel, Julia A

    2012-10-01

    Deformable registration of images obtained from different modalities remains a challenging task in medical image analysis. This paper addresses this important problem and proposes a modality independent neighbourhood descriptor (MIND) for both linear and deformable multi-modal registration. Based on the similarity of small image patches within one image, it aims to extract the distinctive structure in a local neighbourhood, which is preserved across modalities. The descriptor is based on the concept of image self-similarity, which has been introduced for non-local means filtering for image denoising. It is able to distinguish between different types of features such as corners, edges and homogeneously textured regions. MIND is robust to the most considerable differences between modalities: non-functional intensity relations, image noise and non-uniform bias fields. The multi-dimensional descriptor can be efficiently computed in a dense fashion across the whole image and provides point-wise local similarity across modalities based on the absolute or squared difference between descriptors, making it applicable for a wide range of transformation models and optimisation algorithms. We use the sum of squared differences of the MIND representations of the images as a similarity metric within a symmetric non-parametric Gauss-Newton registration framework. In principle, MIND would be applicable to the registration of arbitrary modalities. In this work, we apply and validate it for the registration of clinical 3D thoracic CT scans between inhale and exhale as well as the alignment of 3D CT and MRI scans. Experimental results show the advantages of MIND over state-of-the-art techniques such as conditional mutual information and entropy images, with respect to clinically annotated landmark locations. Copyright © 2012 Elsevier B.V. All rights reserved.

  11. Platelet-rich plasma—an ‘Elixir’ for treatment of alopecia: personal experience on 117 patients with review of literature

    PubMed Central

    Manchanda, Shweta

    2017-01-01

    Platelet-rich plasma (PRP) has emerged as a new treatment modality in regenerative plastic surgery and dermatology. PRP is a simple, cost-effective and feasible treatment option with high patient satisfaction for hair loss and can be regarded as a valuable adjuvant treatment modality for androgenic alopecia and other types of non-scarring alopecias. Authors have proposed a hair model termed “Golden anchorage with ‘molecular locking’ of ectodermal and mesenchymal components for survival and integrity of hair follicle (HF)” in this article. Golden anchorage comprises of bulge stem cells, ectodermal basement membrane and bulge portion of APM. PRP with its autologous supply of millions of growth factors works on ‘Golden anchorage’ along with keratinocytes (PDGF), dermal papilla (IGF and fibroblast growth factor), vasculature (VEGF and PDGF) and neural cells (Nerve Growth Factor) in a multipronged manner serving as an ‘elixir’ for hair growth and improving overall environment. PMID:28815175

  12. A novel treatment modality in patients with premature ejaculation resistant to conventional methods: the neuromodulation of dorsal penile nerves by pulsed radiofrequency.

    PubMed

    Basal, Seref; Goktas, Serdar; Ergin, Atilla; Yildirim, Ibrahim; Atim, Abdulkadir; Tahmaz, Lutfi; Dayanc, Murat

    2010-01-01

    Premature ejaculation (PE) is the most common sexual problem experienced by men, and it affects 20%-30% of them. Pulsed radiofrequency (PRF) neuromodulation has been shown to be an effective treatment for a wide range of pain conditions. We used PRF to treat PE by desensitizing dorsal penile nerves in patients resistant to conventional treatments. Fifteen patients with a lifelong history of PE, defined as an intravaginal ejaculatory latency time (IELT) of <1 minute that occurred in more than 90% of acts of intercourse and was resistant to conventional treatments, were enrolled in this study. Patients with erectile dysfunction were excluded. The mean age of the patients was 39 +/- 9 years. Before and 3 weeks after the treatment, IELT and sexual satisfaction score (SSS; for patients and their partners) were obtained. The mean IELTs before and 3 weeks after procedure were 18.5 +/- 17.9 and 139.9 +/- 55.1 seconds, respectively. Side effects did not occur. Mean SSSs of patients before and after treatment were 1.3 +/- 0.3 and 4.6 +/- 0.5, and mean SSSs of partners before and after treatment were 1.3 +/- 0.4 and 4.4 +/- 0.5, respectively. In all cases, IELT and SSS were significantly increased (P < .05). None of the patients or their wives reported any treatment failure during the follow-up period. The mean follow-up time was 8.3 +/- 1.9 months. It is early to conclude that this new treatment modality might be used widely for the treatment of PE; however, because it is an innovative modality, placebo-controlled studies (eg, sham procedure), with larger numbers of patients and including assessment of penile sensitivity (eg, biothesiometry), are needed.

  13. Computing the modal mass from the state space model in combined experimental-operational modal analysis

    NASA Astrophysics Data System (ADS)

    Cara, Javier

    2016-05-01

    Modal parameters comprise natural frequencies, damping ratios, modal vectors and modal masses. In a theoretic framework, these parameters are the basis for the solution of vibration problems using the theory of modal superposition. In practice, they can be computed from input-output vibration data: the usual procedure is to estimate a mathematical model from the data and then to compute the modal parameters from the estimated model. The most popular models for input-output data are based on the frequency response function, but in recent years the state space model in the time domain has become popular among researchers and practitioners of modal analysis with experimental data. In this work, the equations to compute the modal parameters from the state space model when input and output data are available (like in combined experimental-operational modal analysis) are derived in detail using invariants of the state space model: the equations needed to compute natural frequencies, damping ratios and modal vectors are well known in the operational modal analysis framework, but the equation needed to compute the modal masses has not generated much interest in technical literature. These equations are applied to both a numerical simulation and an experimental study in the last part of the work.

  14. Controlling modal interactions in lasers for frequency selection and power enhancement

    NASA Astrophysics Data System (ADS)

    Ge, Li

    2015-03-01

    The laser is an out-of-equilibrium non-linear wave system where the interplay of the cavity geometry and non-linear wave interactions determines the self-organized oscillation frequencies and the associated spatial field patterns. Using the correspondence between nonlinear and linear systems, we propose a simple and systematic method to achieve selective excitation of lasing modes that would have been dwarfed by more dominant ones. The key idea is incorporating the control of modal interaction into the spatial pump profile. Our proposal is most valuable in the regime of spatially and spectrally overlapping modes, which can lead to a significant enhancement of laser power as well.

  15. Risk of major depression in patients with chronic renal failure on different treatment modalities: A matched-cohort and population-based study in Taiwan.

    PubMed

    Chen, Shih-Feng; Wang, I-Jen; Lang, Hui-Chu

    2016-01-01

    The influence of different treatment modalities on the risk of developing major depression in patients with chronic renal failure (CRF) is not well understood. We aimed to explore the incidence of major depression among patients with CRF who were on different dialysis modalities, who had received renal transplantation (RT), and those who had not yet received any of the aforementioned renal replacement therapies. We conducted a population-based retrospective cohort study using a national health insurance research database. This study investigated 89,336 study controls, 17,889 patients with chronic kidney disease on conservative treatment, 3823 patients on hemodialysis (HD), 351 patients on peritoneal dialysis (PD), and 322 patients who had RT. We followed all individuals until the occurrence of major depression or the date of loss to follow-up. The PD group had the highest risk (hazard ratio [HR] 2.43; 95% confidence interval [CI] 1.26-4.69), whereas the RT group had the lowest risk (HR 0.18; 95% CI 0.03-1.29) of developing major depression compared with the control group. Patients initiated on PD had a higher risk of developing major depression than patients initiated on HD (pairwise comparison: HR 2.20; 95% CI 1.09-4.46). Different treatment modalities are associated with different risks of developing major depression in patients with CRF. Among renal replacement therapies, patients who have had RT have the lowest risk of developing major depression. Patients who initiate renal therapy on PD may have a higher risk of major depression compared with patients who initiate renal therapy on HD. © 2015 International Society for Hemodialysis.

  16. Implementation and applications of dual-modality imaging

    NASA Astrophysics Data System (ADS)

    Hasegawa, Bruce H.; Barber, William C.; Funk, Tobias; Hwang, Andrew B.; Taylor, Carmen; Sun, Mingshan; Seo, Youngho

    2004-06-01

    In medical diagnosis, functional or physiological data can be acquired using radionuclide imaging with positron emission tomography or with single-photon emission computed tomography. However, anatomical or structural data can be acquired using X-ray computed tomography. In dual-modality imaging, both radionuclide and X-ray detectors are incorporated in an imaging system to allow both functional and structural data to be acquired in a single procedure without removing the patient from the imaging system. In a clinical setting, dual-modality imaging systems commonly are used to localize radiopharmaceutical uptake with respect to the patient's anatomy. This helps the clinician to differentiate disease from regions of normal radiopharmaceutical accumulation, to improve diagnosis or cancer staging, or to facilitate planning for radiation therapy or surgery. While initial applications of dual-modality imaging were developed for clinical imaging on humans, it now is recognized that these systems have potentially important applications for imaging small animals involved in experimental studies including basic investigations of mammalian biology and development of new pharmaceuticals for diagnosis or treatment of disease.

  17. Dissociable identity- and modality-specific neural representations as revealed by cross-modal nonspatial inhibition of return.

    PubMed

    Chi, Yukai; Yue, Zhenzhu; Liu, Yupin; Mo, Lei; Chen, Qi

    2014-08-01

    There are ongoing debates on whether object concepts are coded as supramodal identity-based or modality-specific representations in the human brain. In this fMRI study, we adopted a cross-modal "prime-neutral cue-target" semantic priming paradigm, in which the prime-target relationship was manipulated along both the identity and the modality dimensions. The prime and the target could refer to either the same or different semantic identities, and could be delivered via either the same or different sensory modalities. By calculating the main effects and interactions of this 2 (identity cue validity: "Identity_Cued" vs. "Identity_Uncued") × 2 (modality cue validity: "Modality_Cued" vs. "Modality_Uncued") factorial design, we aimed at dissociating three neural networks involved in creating novel identity-specific representations independent of sensory modality, in creating modality-specific representations independent of semantic identity, and in evaluating changes of an object along both the identity and the modality dimensions, respectively. Our results suggested that bilateral lateral occipital cortex was involved in creating a new supramodal semantic representation irrespective of the input modality, left dorsal premotor cortex, and left intraparietal sulcus were involved in creating a new modality-specific representation irrespective of its semantic identity, and bilateral superior temporal sulcus was involved in creating a representation when the identity and modality properties were both cued or both uncued. In addition, right inferior frontal gyrus showed enhanced neural activity only when both the identity and the modality of the target were new, indicating its functional role in novelty detection. Copyright © 2014 Wiley Periodicals, Inc.

  18. Cortical GABAergic Interneurons in Cross-Modal Plasticity following Early Blindness

    PubMed Central

    Desgent, Sébastien; Ptito, Maurice

    2012-01-01

    Early loss of a given sensory input in mammals causes anatomical and functional modifications in the brain via a process called cross-modal plasticity. In the past four decades, several animal models have illuminated our understanding of the biological substrates involved in cross-modal plasticity. Progressively, studies are now starting to emphasise on cell-specific mechanisms that may be responsible for this intermodal sensory plasticity. Inhibitory interneurons expressing γ-aminobutyric acid (GABA) play an important role in maintaining the appropriate dynamic range of cortical excitation, in critical periods of developmental plasticity, in receptive field refinement, and in treatment of sensory information reaching the cerebral cortex. The diverse interneuron population is very sensitive to sensory experience during development. GABAergic neurons are therefore well suited to act as a gate for mediating cross-modal plasticity. This paper attempts to highlight the links between early sensory deprivation, cortical GABAergic interneuron alterations, and cross-modal plasticity, discuss its implications, and further provide insights for future research in the field. PMID:22720175

  19. A wide-angle high Mach number modal expansion for infrasound propagation.

    PubMed

    Assink, Jelle; Waxler, Roger; Velea, Doru

    2017-03-01

    The use of modal expansions to solve the problem of atmospheric infrasound propagation is revisited. A different form of the associated modal equation is introduced, valid for wide-angle propagation in atmospheres with high Mach number flow. The modal equation can be formulated as a quadratic eigenvalue problem for which there are simple and efficient numerical implementations. A perturbation expansion for the treatment of attenuation, valid for stratified media with background flow, is derived as well. Comparisons are carried out between the proposed algorithm and a modal algorithm assuming an effective sound speed, including a real data case study. The comparisons show that the effective sound speed approximation overestimates the effect of horizontal wind on sound propagation, leading to errors in traveltime, propagation path, trace velocity, and absorption. The error is found to be dependent on propagation angle and Mach number.

  20. Evaluation of the Spies™ modalities image quality

    PubMed Central

    Emiliani, Esteban; Talso, Michele; Baghdadi, Mohammed; Barreiro, Aarón; Orosa, Andrea; Serviàn, Pol; Gavrilov, Pavel; Proietti, Silvia; Traxer, Olivier

    2017-01-01

    Introduction The Spies™ system (Karl-Storz®) was introduced into digital ureteroscopy to improve endoscopic vision. To date, there is no data to either indicate which of the Spies modalities is better for improving diagnosis and treatment procedures, nor to compare the modalities in terms of image quality. The aim of this study was to evaluate and compare the image quality of five Spies™ modalities (SM) to the standard white light in an in-vitro model. Materials and Methods Two standardized grids and 3 stones of different composition were recorded in white light and the 5SM (Clara, Chroma, Clara+Chroma), Spectra A and B) using 4 standardized aqueous scenarios. Twelve templates were done in order to simultaneously compare the same objective in the different modalities. Six urologists, five medical students, five urology residents, and five persons not involved with urology evaluated each video on a scale of 1 (very bad) to 5 (very good). Results Comparing white light to SM, subjects scored better the quality of Clara and Clara+Chroma than white light (p=0.0139 and p<0.05) and scored worse Spectra A and B (p=0.0005 and p=0.0023)). When comparing Clara to the other SM, it was ranked equivalent to Clara+Chroma (p=0.67) and obtained a higher rank than Chroma, Spectra A and B (p<0.05, p=0.0001 and p=0.0001). In the multivariate analysis mean scores were higher among urologists. Conclusion In all analyzed scenarios, the subjects ranked Clara and Clara+Chroma as the modalities with better image quality compared to white light. PMID:28338307

  1. ADMultiImg: a novel missing modality transfer learning based CAD system for diagnosis of MCI due to AD using incomplete multi-modality imaging data

    NASA Astrophysics Data System (ADS)

    Liu, Xiaonan; Chen, Kewei; Wu, Teresa; Weidman, David; Lure, Fleming; Li, Jing

    2018-02-01

    Alzheimer's Disease (AD) is the most common cause of dementia and currently has no cure. Treatments targeting early stages of AD such as Mild Cognitive Impairment (MCI) may be most effective to deaccelerate AD, thus attracting increasing attention. However, MCI has substantial heterogeneity in that it can be caused by various underlying conditions, not only AD. To detect MCI due to AD, NIA-AA published updated consensus criteria in 2011, in which the use of multi-modality images was highlighted as one of the most promising methods. It is of great interest to develop a CAD system based on automatic, quantitative analysis of multi-modality images and machine learning algorithms to help physicians more adequately diagnose MCI due to AD. The challenge, however, is that multi-modality images are not universally available for many patients due to cost, access, safety, and lack of consent. We developed a novel Missing Modality Transfer Learning (MMTL) algorithm capable of utilizing whatever imaging modalities are available for an MCI patient to diagnose the patient's likelihood of MCI due to AD. Furthermore, we integrated MMTL with radiomics steps including image processing, feature extraction, and feature screening, and a post-processing for uncertainty quantification (UQ), and developed a CAD system called "ADMultiImg" to assist clinical diagnosis of MCI due to AD using multi-modality images together with patient demographic and genetic information. Tested on ADNI date, our system can generate a diagnosis with high accuracy even for patients with only partially available image modalities (AUC=0.94), and therefore may have broad clinical utility.

  2. Valuable water

    NASA Astrophysics Data System (ADS)

    Carlowicz, Michael

    In some places, money flows with water. Studying both the water quality and property values around 22 lakes in south-central Maine, Kevin Boyle and Holly James of the University of Maine and Roy Bouchard of the Maine Department of Environmental Protection have found that good water quality makes waterfront property even more valuable. To gauge water quality, the researchers used Secchi disks to measure the clarity of the water at depth. They also reviewed 543 lakefront property sales between 1990 and 1994 to determine how values correlated with changing water conditions. The group also considered such factors as lake frontage, sizes of the houses and lots, and size of the lake.

  3. Pain and disability determine treatment modality for older patients with adult scoliosis, while deformity guides treatment for younger patients.

    PubMed

    Bess, Shay; Boachie-Adjei, Oheneba; Burton, Doug; Cunningham, Matthew; Shaffrey, Chris; Shelokov, Alexis; Hostin, Richard; Schwab, Frank; Wood, Kirkham; Akbarnia, Behrooz

    2009-09-15

    Multi-center, retrospective review. Identify age associated clinical and radiographic features correlating with AS treatment. Little information exists about factors determining treatment for adult scoliosis (AS). Existing studies have not evaluated age stratified differences. Multicenter, retrospective review of 290 patients treated for AS. Patients divided into operative (OP) or nonoperative (NON), and age stratified into 3 groups (G1 = <50 years, G2 = 50-65 years, G3 = >65 years). Demographic and spinopelvic radiographic parameters evaluated. Health-related quality of life (HRQL) measures included SRS-22, Oswestry Disability Index (ODI), visual analog pain scale. Treatment groups (OP, n = 137; NON, n = 153) demonstrated similar age (OP = 52.7 years; NON = 55.5 years; P > 0.05) and comorbidities. OP had larger thoracic curves than NON (OP = 51 degrees, NON = 45 degrees; P < 0.05). OP had worse HRQL scores than NON (SRS = 2.95 vs. 3.12, P < 0.05; ODI = 33.4 vs. 28.7, P < 0.05; visual analog pain scale = 6.9 vs. 5.6, P < 0.05, respectively). Age stratification of OP demonstrated larger curves in G1 and G2 versus G3, progressively worsening sagittal imbalance in older age groups, and worse HRQL scores in G3 versus G1 and G2. Age stratification of NON demonstrated worsening sagittal imbalance with age, however, other radiographic values and HRQL scores were similar between all NON age groups. Treatment stratification of age groups demonstrated G1-OP had greater deformity than G1-NON (mean thoracic curve: G1-OP = 53 degrees, G1-NON = 43 degrees; P < 0.05) but similar HRQL values. Whereas G2 and G3-OP had similar radiographic coronal and sagittal values as G2 and G3-NON, but worse HRQL scores. Counter to previous reports, age, comorbidities, and sagittal balance did not influence treatment modality for AS. Operative treatment for younger patients was driven by increased coronal plane deformity. Conversely, pain and disability mandated treatment for older patients

  4. Transcutaneous laser treatment of leg veins.

    PubMed

    Meesters, Arne A; Pitassi, Luiza H U; Campos, Valeria; Wolkerstorfer, Albert; Dierickx, Christine C

    2014-03-01

    Leg telangiectasias and reticular veins are a common complaint affecting more than 80% of the population to some extent. To date, the gold standard remains sclerotherapy for most patients. However, there may be some specific situations, where sclerotherapy is contraindicated such as needle phobia, allergy to certain sclerosing agents, and the presence of vessels smaller than the diameter of a 30-gauge needle (including telangiectatic matting). In these cases, transcutaneous laser therapy is a valuable alternative. Currently, different laser modalities have been proposed for the management of leg veins. The aim of this article is to present an overview of the basic principles of transcutaneous laser therapy of leg veins and to review the existing literature on this subject, including the most recent developments. The 532-nm potassium titanyl phosphate (KTP) laser, the 585-600-nm pulsed dye laser, the 755-nm alexandrite laser, various 800-983-nm diode lasers, and the 1,064-nm neodymium yttrium-aluminum-garnet (Nd:YAG) laser and various intense pulsed light sources have been investigated for this indication. The KTP and pulsed dye laser are an effective treatment option for small vessels (<1 mm). The side effect profile is usually favorable to that of longer wavelength modalities. For larger veins, the use of a longer wavelength is required. According to the scarce evidence available, the Nd:YAG laser produces better clinical results than the alexandrite and diode laser. Penetration depth is high, whereas absorption by melanin is low, making the Nd:YAG laser suitable for the treatment of larger and deeply located veins and for the treatment of patients with dark skin types. Clinical outcome of Nd:YAG laser therapy approximates that of sclerotherapy, although the latter is associated with less pain. New developments include (1) the use of a nonuniform pulse sequence or a dual-wavelength modality, inducing methemoglobin formation and enhancing the optical absorption

  5. Cross-modal perceptual load: the impact of modality and individual differences.

    PubMed

    Sandhu, Rajwant; Dyson, Benjamin James

    2016-05-01

    Visual distractor processing tends to be more pronounced when the perceptual load (PL) of a task is low compared to when it is high [perpetual load theory (PLT); Lavie in J Exp Psychol Hum Percept Perform 21(3):451-468, 1995]. While PLT is well established in the visual domain, application to cross-modal processing has produced mixed results, and the current study was designed in an attempt to improve previous methodologies. First, we assessed PLT using response competition, a typical metric from the uni-modal domain. Second, we looked at the impact of auditory load on visual distractors, and of visual load on auditory distractors, within the same individual. Third, we compared individual uni- and cross-modal selective attention abilities, by correlating performance with the visual Attentional Network Test (ANT). Fourth, we obtained a measure of the relative processing efficiency between vision and audition, to investigate whether processing ease influences the extent of distractor processing. Although distractor processing was evident during both attend auditory and attend visual conditions, we found that PL did not modulate processing of either visual or auditory distractors. We also found support for a correlation between the uni-modal (visual) ANT and our cross-modal task but only when the distractors were visual. Finally, although auditory processing was more impacted by visual distractors, our measure of processing efficiency only accounted for this asymmetry in the auditory high-load condition. The results are discussed with respect to the continued debate regarding the shared or separate nature of processing resources across modalities.

  6. Electrotherapy modalities for adhesive capsulitis (frozen shoulder).

    PubMed

    Page, Matthew J; Green, Sally; Kramer, Sharon; Johnston, Renea V; McBain, Brodwen; Buchbinder, Rachelle

    2014-10-01

    Adhesive capsulitis (also termed frozen shoulder) is a common condition characterised by spontaneous onset of pain, progressive restriction of movement of the shoulder and disability that restricts activities of daily living, work and leisure. Electrotherapy modalities, which aim to reduce pain and improve function via an increase in energy (electrical, sound, light, thermal) into the body, are often delivered as components of a physical therapy intervention. This review is one in a series of reviews which form an update of the Cochrane review 'Physiotherapy interventions for shoulder pain'. To synthesise the available evidence regarding the benefits and harms of electrotherapy modalities, delivered alone or in combination with other interventions, for the treatment of adhesive capsulitis. We searched CENTRAL, MEDLINE, EMBASE, CINAHL Plus and the ClinicalTrials.gov and World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) clinical trials registries up to May 2014, unrestricted by language, and reviewed the reference lists of review articles and retrieved trials to identify any other potentially relevant trials. We included randomised controlled trials (RCTs) and controlled clinical trials using a quasi-randomised method of allocation that included adults with adhesive capsulitis and compared any electrotherapy modality to placebo, no treatment, a different electrotherapy modality, or any other intervention. The two main questions of the review focused on whether electrotherapy modalities are effective compared to placebo or no treatment, or if they are an effective adjunct to manual therapy or exercise (or both). The main outcomes of interest were participant-reported pain relief of 30% or greater, overall pain, function, global assessment of treatment success, active shoulder abduction, quality of life, and the number of participants experiencing any adverse event. Two review authors independently selected trials for inclusion

  7. Etiology, distribution, treatment modalities and complications of maxillofacial fractures

    PubMed Central

    Pham-Dang, Nathalie; Barthélémy, Isabelle; Orliaguet, Thierry; Artola, Alain; Mondié, Jean M.

    2014-01-01

    Purpose: This study evaluated the trends and factors associated with maxillofacial fractures treated from 1997 to 2007 in the Oral and Maxillofacial Surgery Department of the Clermont-Ferrand University Hospital. Material and Methods: This study included 364 patients of which 82% were men and 45%, 20-29-years old. The etiology, anatomical distribution, treatment modality and complications of maxillofacial fractures were examined. Results: Overall, interpersonal violence, traffic accidents and falls were the most common mechanisms of injury. There was a decreasing trend in traffic accidents and increasing one in falls as a cause of fracture over the 11-years period of this study. Young male patients were preferentially victim of interpersonal violence and traffic accidents, while middle-aged ones were of falls and work-related accidents. Middle-aged female patients were preferentially victim of traffic accidents and interpersonal violence, while older ones were of falls. And the number of fractures per patient varied according to the mechanism of injury: low after work-related accidents and high after traffic accidents. About two-third of fractures involved the mandible. Most of these mandibular fractures were treated by osteosynthesis with or without intermaxillary fixation, with the proportion of the latter increasing over time. There were very few postoperative infections and only in mandible. Conclusions: Maxillofacial fractures predominantly occur in young men, due to interpersonal violence. There is nevertheless an increasing trend in falls as a cause of fracture, especially in female patients, consistent with the increasing trend in presentation of older people. Most maxillofacial fractures involve the mandible and there is an increasing trend in treating these fractures by osteosynthesis without intermaxillary fixation. Antibiotic prophylaxis associated with dental hygiene care can be indicated to prevent postoperative infections. Key words

  8. Thermoradiation therapy in combined modality treatment for locally advanced laryngeal and hypopharyngeal cancer

    NASA Astrophysics Data System (ADS)

    Choynzonov, E. L.; Startseva, Zh. A.; Gribova, O. V.; Mukhamedov, M. R.; Spivakova, I. O.

    2017-09-01

    The article presents the results of combined modality treatment for stage III-IV (T3N0-2M0) laryngeal and hypopharyngeal cancers. All patients (55) were divided into 2 groups. Group I patients (n = 25) received pre-operative thermoradiation therapy and Group II patients (n = 30) received pre-operative radiation therapy alone. The follow-up period was 6-24 months. In Group I patients, partial tumor regression was achieved in 21 (84%) patients and stable disease was observed in 4 (16%) patients. In group II patients, partial tumor regression and stable disease were diagnosed in 18 (60%) and 12 (49%) patients, respectively. Local and regional recurrences occurred in 1 patient (4%) of Group I within the first year of follow-up and in 11 patients of Group II (7 within the first year and 4 within two years of follow-up). The 2-year overall survival rate was 100% in Group I patients and 76.7% ± 10.1% in Group II patients. Disease-free survival rates were 96.6 ± 3.5% and 63.3 ± 13.9%, respectively.

  9. Modality-specific effects on crosstalk in task switching: evidence from modality compatibility using bimodal stimulation.

    PubMed

    Stephan, Denise Nadine; Koch, Iring

    2016-11-01

    The present study was aimed at examining modality-specific influences in task switching. To this end, participants switched either between modality compatible tasks (auditory-vocal and visual-manual) or incompatible spatial discrimination tasks (auditory-manual and visual-vocal). In addition, auditory and visual stimuli were presented simultaneously (i.e., bimodally) in each trial, so that selective attention was required to process the task-relevant stimulus. The inclusion of bimodal stimuli enabled us to assess congruence effects as a converging measure of increased between-task interference. The tasks followed a pre-instructed sequence of double alternations (AABB), so that no explicit task cues were required. The results show that switching between two modality incompatible tasks increases both switch costs and congruence effects compared to switching between two modality compatible tasks. The finding of increased congruence effects in modality incompatible tasks supports our explanation in terms of ideomotor "backward" linkages between anticipated response effects and the stimuli that called for this response in the first place. According to this generalized ideomotor idea, the modality match between response effects and stimuli would prime selection of a response in the compatible modality. This priming would cause increased difficulties to ignore the competing stimulus and hence increases the congruence effect. Moreover, performance would be hindered when switching between modality incompatible tasks and facilitated when switching between modality compatible tasks.

  10. Educating Tomorrow's Valuable Citizen.

    ERIC Educational Resources Information Center

    Burstyn, Joan N., Ed.

    This collection of essays by various authors discusses the dilemmas that face those who would educate tomorrow's valuable citizens and describes the day-to-day commitment needed to maintain a community. The book gives guidelines for action through examples of current programs that provide a forum for civic discussion and public consensus on the…

  11. Why we should not routinely apply irreversible electroporation as an alternative curative treatment modality for localized prostate cancer at this stage.

    PubMed

    Wendler, J J; Ganzer, R; Hadaschik, B; Blana, A; Henkel, T; Köhrmann, K U; Machtens, S; Roosen, A; Salomon, G; Sentker, L; Witzsch, U; Schlemmer, H P; Baumunk, D; Köllermann, J; Schostak, M; Liehr, U B

    2017-01-01

    Irreversible electroporation (IRE), a new tissue ablation procedure available since 2007, could meet the requirements for ideal focal therapy of prostate cancer with its postulated features, especially the absence of a thermal ablation effect. Thus far, there is not enough evidence of its effectiveness or adverse effects to justify its use as a definitive treatment option for localized prostate cancer. Moreover, neither optimal nor individual treatment parameters nor uniform endpoints have been defined thus far. No advantages over established treatment procedures have as yet been demonstrated. Nevertheless, IRE is now being increasingly applied for primary prostate cancer therapy outside clinical trials, not least through active advertising in the lay press. This review reflects the previous relevant literature on IRE of the prostate or prostate cancer and shows why we should not adopt IRE as a routine treatment modality at this stage.

  12. Physiological Modalities for Relaxation Skill Transfer in Biofeedback Games.

    PubMed

    Parnandi, Avinash; Gutierrez-Osuna, Ricardo

    2017-03-01

    We present an adaptive biofeedback game for teaching self-regulation of stress. Our approach consists of monitoring the user's physiology during gameplay and adapting the game using a positive feedback loop that rewards relaxing behaviors and penalizes states of high arousal. We evaluate the approach using a casual game under three biofeedback modalities: electrodermal activity, heart rate variability, and breathing rate. The three biosignals can be measured noninvasively with wearable sensors, and represent different degrees of voluntary control and selectivity toward arousal. We conducted an experiment trial with 25 participants to compare the three modalities against a standard treatment (deep breathing) and a control condition (the game without biofeedback). Our results indicate that breathing-based game biofeedback is more effective in inducing relaxation during treatment than the other four groups. Participants in this group also showed greater retention of the relaxation skills (without biofeedback) during a subsequent stressor.

  13. Bi-modal radiofrequency treatment for coexisting neuralgia and neuropathy in adjacent divisions of the trigeminal nerve.

    PubMed

    Bhatjiwale, M; Bhatjiwale, M; Naik, L D; Chopade, P

    2018-05-29

    Trigeminal neuralgia and deafferentation neuropathic pain, or trigeminal neuropathy, are different symptomatologies, rarely reported to present together. The case of a 65-year-old gentleman suffering from trigeminal neuralgia of the maxillary and mandibular division is reported. He first underwent an infraorbital neurectomy that was complicated by deafferentation neuropathic pain, whilst his mandibular neuralgia continued. He was treated successfully for both the neuropathic and neuralgic symptoms in the same session using ultra-extended euthermic pulsed radiofrequency treatment for the maxillary division (V2) and radiofrequency thermocoagulation for the mandibular division (V3). This report is novel in describing the use of dual modalities in the same session for two distinct coexisting clinical entities in two different divisions of the same cranial nerve. The use of ultra-extended pulsed radiofrequency treatment for neuropathic pain in this case is also unique. Nearly 2years after the procedure, the patient continues to have complete pain relief. Copyright © 2018 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  14. Electrotherapy modalities for rotator cuff disease.

    PubMed

    Page, Matthew J; Green, Sally; Mrocki, Marshall A; Surace, Stephen J; Deitch, Jessica; McBain, Brodwen; Lyttle, Nicolette; Buchbinder, Rachelle

    2016-06-10

    Management of rotator cuff disease may include use of electrotherapy modalities (also known as electrophysical agents), which aim to reduce pain and improve function via an increase in energy (electrical, sound, light, or thermal) into the body. Examples include therapeutic ultrasound, low-level laser therapy (LLLT), transcutaneous electrical nerve stimulation (TENS), and pulsed electromagnetic field therapy (PEMF). These modalities are usually delivered as components of a physical therapy intervention. This review is one of a series of reviews that form an update of the Cochrane review, 'Physiotherapy interventions for shoulder pain'. To synthesise available evidence regarding the benefits and harms of electrotherapy modalities for the treatment of people with rotator cuff disease. We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 3), Ovid MEDLINE (January 1966 to March 2015), Ovid EMBASE (January 1980 to March 2015), CINAHL Plus (EBSCOhost, January 1937 to March 2015), ClinicalTrials.gov and the WHO ICTRP clinical trials registries up to March 2015, unrestricted by language, and reviewed the reference lists of review articles and retrieved trials, to identify potentially relevant trials. We included randomised controlled trials (RCTs) and quasi-randomised trials, including adults with rotator cuff disease (e.g. subacromial impingement syndrome, rotator cuff tendinitis, calcific tendinitis), and comparing any electrotherapy modality with placebo, no intervention, a different electrotherapy modality or any other intervention (e.g. glucocorticoid injection). Trials investigating whether electrotherapy modalities were more effective than placebo or no treatment, or were an effective addition to another physical therapy intervention (e.g. manual therapy or exercise) were the main comparisons of interest. Main outcomes of interest were overall pain, function, pain on motion, patient-reported global assessment of treatment success

  15. Memory Characteristics and Modality in Multimedia Learning: An Aptitude-Treatment-Interaction Study

    ERIC Educational Resources Information Center

    Seufert, Tina; Schutze, Maren; Brunken, Roland

    2009-01-01

    According to the modality effect in multimedia, a text accompanying a picture should be auditorily presented instead of visually in order to avoid split of attention. In two experimental studies (34 and 78 participants, respectively), the impact and possible compensatory effects of two aptitude variables, that is, memory strategy skills and…

  16. Treatment modalities in sinonasal undifferentiated carcinoma: an analysis from the national cancer database.

    PubMed

    Khan, Mohemmed N; Konuthula, Neeraja; Parasher, Arjun; Genden, Eric M; Miles, Brett A; Govindaraj, Satish; Iloreta, Alfred M

    2017-02-01

    Sinonasal undifferentiated carcinoma (SNUC) is a rare, aggressive malignancy of unknown etiology with a poor overall prognosis. Its relative rarity has made it difficult to determine the impact of different treatment modalities on survival. Retrospective study of cases in the National Cancer Data Base (NCDB). NCDB cases that were diagnosed as having SNUC between January 1, 2004, and December 31, 2013 were included in the analysis. Outcomes of patients treated with surgery followed adjuvant chemoradiotherapy were compared with definitive chemoradiotherapy. A 5-year survival rate of 42.2% was observed in the 460 patients in the analysis. American Joint Committee on Cancer (AJCC) clinical staging data were available for 304 patients. Of these patients, 60.2% had advanced tumors (AJCC stage 3 or 4). Surgery followed by adjuvant chemoradiotherapy was associated with better survival than definitive chemoradiotherapy (55.8% vs 42.6%, p = 0.007) in the study population. However, in late-stage tumors, there was no difference in survival between the 2 treatment groups (p = 0.22). For late-stage tumors, the time to initiation of adjuvant therapy was 49.2 ± 5.1 days for the surgery plus adjuvant therapy group as compared with 25.9 ± 2.6 days in the definitive chemoradiotherapy group (p < 0.0001), yet this did not appear to affect outcomes. No differences in age, gender, race, Charlson-Deyo score, facility type (academic vs nonacademic), or radiation dose were found between the 2 treatment groups (p > 0.05). Margin status played a critical role in the success of surgical resection, as no patients with positive margin status receiving adjuvant therapy survived to 5 years. Surgery may play a role in a multimodality approach to treatment of late-stage SNUC if the tumor is amenable to surgical resection and negative margins can be reliably obtained. However, in cases where there may be difficulty obtaining negative margins, or this is considered unlikely preoperatively, surgical

  17. Treatments for pregnancy-related lumbopelvic pain: a systematic review of physiotherapy modalities.

    PubMed

    Gutke, Annelie; Betten, Carola; Degerskär, Kristina; Pousette, Sara; Olsén, Monika Fagevik

    2015-11-01

    To explore the effect of physiotherapeutic interventions on pregnancy-related lumbopelvic pain. Data sources: MEDLINE, Cochrane Central Register of Controlled Trials, PEDro, CINAHL, AMED, and SCOPUS databases were searched up to December 2014 for studies written in English, French, German or Scandinavian languages that evaluated physiotherapeutic modalities for preventing and treating pregnancy-related lumbopelvic pain. For lumbopelvic pain during pregnancy, the evidence was strong for positive effects of acupuncture and pelvic belts. The evidence was low for exercise in general and for specific stabilizing exercises. The evidence was very limited for efficacy of water gymnastics, progressive muscle relaxation, a specific pelvic tilt exercise, osteopathic manual therapy, craniosacral therapy, electrotherapy and yoga. For postpartum lumbopelvic pain, the evidence was very limited for clinic-based treatment concepts, including specific stabilizing exercises, and for self-management interventions for women with severe disabilities. No specific adverse events were reported for any intervention. No meta-analysis could be performed because of study heterogeneity. The levels of evidence were strong for a positive effect of acupuncture and pelvic belts, but weak for an effect of specific exercises. Caution should prevail in choosing other interventions for pregnancy-related lumbopelvic pain. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

  18. Treatment of pneumothorax following acupuncture: is a closed thoracostomy necessary for a first choice of treatment modality?

    PubMed

    Kim, Eung-Soo; Kang, Jong-Yael; Pyo, Chang-Hae; Rhee, Gwang-Woo

    2009-02-01

    Acupuncture is currently the most popular of all forms of complementary and alternative medicine, and acupuncture is not dangerous in the hands of a trained practitioner. However, complications of acupuncture including pneumothorax have been reported. Despite the use of fine needles in acupuncture, the lung-collapsed degree of acupuncture pneumothorax is relatively high. In general, the treatment modality of acupuncture pneumothorax is closed thoracostomy with a chest tube of larger diameter. However, the treatment of acupuncture pneumothorax frequently faces controversy concerning the necessity of a standard chest drain insertion. This was a retrospective study from March 1994 to February 2004. Nine (9) patients were admitted due to pneumothorax following acupuncture from March 1994 to February 2004 in Hanil General Hospital, KEPCO Medical Foundation (Seoul, Republic of Korea). Five (5) patients had a moderate degree of pneumothoraces, while 4 patients had a severe degree of pneumothoraces. Four (4) patients were treated by closed thoracostomy with a standard chest drain and the other four patients were treated by the percutaneous chest drainage with a narrow-bore central venous catheter. One (1) patient with a mild degree of pneumothorax was treated only by nasal oxygen inhalation. One (1) patient was treated by video-assisted thoracic surgery after the closed thoracostomy due to continuous air leak. We treated the acupuncture pneumothorax by making a choice between the closed thoracostomy and the percutaneous chest drainage based on a smoking history and chest radiographic findings. In the absence of smoking history and pulmonary emphysema or bullae, we got favorable results, not by the closed thoracostomy but only by the percutaneous chest drainage with a narrow-bore central venous catheter.

  19. Multi-Modal Treatment of Nocturnal Enuresis.

    ERIC Educational Resources Information Center

    Mohr, Caroline; Sharpley, Christopher F.

    1988-01-01

    The article reports a multimodal treatment of nocturnal enuresis and anxious behavior in a mildly mentally retarded woman. Behavioral treatment and removal of caffeine from the subject's diet eliminated both nocturnal enuresis and anxious behavior. (Author/DB)

  20. Modal cost analysis for simple continua

    NASA Technical Reports Server (NTRS)

    Hu, A.; Skelton, R. E.; Yang, T. Y.

    1988-01-01

    The most popular finite element codes are based upon appealing theories of convergence of modal frequencies. For example, the popularity of cubic elements for beam-like structures is due to the rapid convergence of modal frequencies and stiffness properties. However, for those problems in which the primary consideration is the accuracy of response of the structure at specified locations, it is more important to obtain accuracy in the modal costs than in the modal frequencies. The modal cost represents the contribution of a mode in the norm of the response vector. This paper provides a complete modal cost analysis for simple continua such as beam-like structures. Upper bounds are developed for mode truncation errors in the model reduction process and modal cost analysis dictates which modes to retain in order to reduce the model for control design purposes.

  1. Evaluation of the Spies TM modalities image quality.

    PubMed

    Emiliani, Esteban; Talso, Michele; Baghdadi, Mohammed; Barreiro, Aaron; Orosa, Andrea; Serviàn, Pol; Gavrilov, Pavel; Proietti, Silvia; Traxer, Olivier

    2017-01-01

    The Spies™ system (Karl-Storz®) was introduced into digital ureteroscopy to improve endoscopic vision. To date, there is no data to either indicate which of the Spies modalities is better for improving diagnosis and treatment procedures, nor to compare the modalities in terms of image quality. The aim of this study was to evaluate and compare the image quality of five Spies™ modalities (SM) to the standard white light in an in-vitro model. Two standardized grids and 3 stones of different composition were recorded in white light and the 5SM (Clara, Chroma, Clara+Chroma), Spectra A and B) using 4 standardized aqueous scenarios. Twelve templates were done in order to simultaneously compare the same objective in the different modalities. Six urologists, five medical students, five urology residents, and five persons not involved with urology evaluated each video on a scale of 1 (very bad) to 5 (very good). Comparing white light to SM, subjects scored better the quality of Clara and Clara+Chroma than white light (p=0.0139 and p<0.05) and scored worse Spectra A and B (p=0.0005 and p=0.0023). When comparing Clara to the other SM, it was ranked equivalent to Clara+Chroma (p=0.67) and obtained a higher rank than Chroma, Spectra A and B (p<0.05, p=0.0001 and p=0.0001). In the multivariate analysis mean scores were higher among urologists. In all analyzed scenarios, the subjects ranked Clara and Clara+Chroma as the modalities with better image quality compared to white light. Copyright® by the International Brazilian Journal of Urology.

  2. HEAVY-DUTY DIESEL VEHICLE MODAL EMISSION MODEL (HDDV-MEM): VOLUME I: MODAL EMISSION MODELING FRAMEWORK; VOLUME II: MODAL COMPONENTS AND OUTPUTS

    EPA Science Inventory

    This research outlines a proposed Heavy-Duty Diesel Vehicle Modal Emission Modeling Framework (HDDV-MEMF) for heavy-duty diesel-powered trucks and buses. The heavy-duty vehicle modal modules being developed under this research effort, although different, should be compatible wi...

  3. Musicians are more consistent: Gestural cross-modal mappings of pitch, loudness and tempo in real-time

    PubMed Central

    Küssner, Mats B.; Tidhar, Dan; Prior, Helen M.; Leech-Wilkinson, Daniel

    2014-01-01

    Cross-modal mappings of auditory stimuli reveal valuable insights into how humans make sense of sound and music. Whereas researchers have investigated cross-modal mappings of sound features varied in isolation within paradigms such as speeded classification and forced-choice matching tasks, investigations of representations of concurrently varied sound features (e.g., pitch, loudness and tempo) with overt gestures—accounting for the intrinsic link between movement and sound—are scant. To explore the role of bodily gestures in cross-modal mappings of auditory stimuli we asked 64 musically trained and untrained participants to represent pure tones—continually sounding and concurrently varied in pitch, loudness and tempo—with gestures while the sound stimuli were played. We hypothesized musical training to lead to more consistent mappings between pitch and height, loudness and distance/height, and tempo and speed of hand movement and muscular energy. Our results corroborate previously reported pitch vs. height (higher pitch leading to higher elevation in space) and tempo vs. speed (increasing tempo leading to increasing speed of hand movement) associations, but also reveal novel findings pertaining to musical training which influenced consistency of pitch mappings, annulling a commonly observed bias for convex (i.e., rising–falling) pitch contours. Moreover, we reveal effects of interactions between musical parameters on cross-modal mappings (e.g., pitch and loudness on speed of hand movement), highlighting the importance of studying auditory stimuli concurrently varied in different musical parameters. Results are discussed in light of cross-modal cognition, with particular emphasis on studies within (embodied) music cognition. Implications for theoretical refinements and potential clinical applications are provided. PMID:25120506

  4. Modality independence of order coding in working memory: Evidence from cross-modal order interference at recall.

    PubMed

    Vandierendonck, André

    2016-01-01

    Working memory researchers do not agree on whether order in serial recall is encoded by dedicated modality-specific systems or by a more general modality-independent system. Although previous research supports the existence of autonomous modality-specific systems, it has been shown that serial recognition memory is prone to cross-modal order interference by concurrent tasks. The present study used a serial recall task, which was performed in a single-task condition and in a dual-task condition with an embedded memory task in the retention interval. The modality of the serial task was either verbal or visuospatial, and the embedded tasks were in the other modality and required either serial or item recall. Care was taken to avoid modality overlaps during presentation and recall. In Experiment 1, visuospatial but not verbal serial recall was more impaired when the embedded task was an order than when it was an item task. Using a more difficult verbal serial recall task, verbal serial recall was also more impaired by another order recall task in Experiment 2. These findings are consistent with the hypothesis of modality-independent order coding. The implications for views on short-term recall and the multicomponent view of working memory are discussed.

  5. Analysis of the costs of dialysis and the effects of an incentive mechanism for low-cost dialysis modalities.

    PubMed

    Cleemput, Irina; De Laet, Chris

    2013-05-01

    Treatment costs of end-stage renal disease with dialysis are high and vary between dialysis modalities. Public healthcare payers aim at stimulating the use of less expensive dialysis modalities, with maintenance of healthcare quality. This study examines the effects of Belgian financial incentive mechanisms for the use of low-cost dialysis treatments. First, the costs of different dialysis modalities were calculated from the hospital's perspective. Data were obtained through a hospital survey. The balance between costs and revenues was simulated for an average Belgian dialysis programme. Incremental profits were calculated in function of the proportion of patients on alternative dialysis modalities. Hospital haemodialysis is the most expensive modality per patient year, followed by peritoneal dialysis and finally satellite haemodialysis. Under current reimbursement rules mean profits of a dialysis programme are maximal if about 28% of patients are treated with a low-cost dialysis modality. This is only slightly lower than the observed percentage in Belgian dialysis centres in the same period. In Belgium, the financial incentives for the use of low-cost dialysis modalities only had a modest impact due to the continuing profits that could be generated by high-cost dialysis. Profit neutrality is crucial for the success of any financial incentive mechanism for low-cost dialysis modalities. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  6. Radiotherapy as valid modality for hepatocellular carcinoma with portal vein tumor thrombosis

    PubMed Central

    Yu, Jeong Il; Park, Hee Chul

    2016-01-01

    Although the current standard treatment for hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) is sorafenib, many previous studies have established the need for a reliable local modality for PVTT control, which is a major cause of liver function deterioration and metastasis. Additionally, there is growing evidence for the prognostic significance of PVTT classification according to the location of tumor thrombosis. Favorable outcomes can be obtained by applying local modalities, including surgery or transarterial chemoembolization, especially in second-order or distal branch PVTT. Rapid control of PVTT could maintain or improve liver function and reduce intrahepatic as well as distant metastasis. Radiotherapy (RT) is one of the main locoregional treatment modalities in oncologic fields, but has rarely been used in HCC because of concerns regarding hepatic toxicity. However, with the development of advanced techniques, RT has been increasingly applied in HCC management. Randomized studies have yet to definitively prove the benefit of RT, but several comparative studies have justified the application of RT in HCC. The value of RT is especially noticeable in HCC with PVTT; several prospective and retrospective studies have reported favorable outcomes, including a 40% to 60% objective response rate and median overall survival of 15 mo to 20 mo in responders. In this review, we evaluate the role of RT as an alternative local modality in HCC with PVTT. PMID:27570422

  7. The optimal hormonal replacement modality selection for multiple organ procurement from brain-dead organ donors

    PubMed Central

    Mi, Zhibao; Novitzky, Dimitri; Collins, Joseph F; Cooper, David KC

    2015-01-01

    The management of brain-dead organ donors is complex. The use of inotropic agents and replacement of depleted hormones (hormonal replacement therapy) is crucial for successful multiple organ procurement, yet the optimal hormonal replacement has not been identified, and the statistical adjustment to determine the best selection is not trivial. Traditional pair-wise comparisons between every pair of treatments, and multiple comparisons to all (MCA), are statistically conservative. Hsu’s multiple comparisons with the best (MCB) – adapted from the Dunnett’s multiple comparisons with control (MCC) – has been used for selecting the best treatment based on continuous variables. We selected the best hormonal replacement modality for successful multiple organ procurement using a two-step approach. First, we estimated the predicted margins by constructing generalized linear models (GLM) or generalized linear mixed models (GLMM), and then we applied the multiple comparison methods to identify the best hormonal replacement modality given that the testing of hormonal replacement modalities is independent. Based on 10-year data from the United Network for Organ Sharing (UNOS), among 16 hormonal replacement modalities, and using the 95% simultaneous confidence intervals, we found that the combination of thyroid hormone, a corticosteroid, antidiuretic hormone, and insulin was the best modality for multiple organ procurement for transplantation. PMID:25565890

  8. Dielectric studies on struvite urinary crystals, a gateway to the new treatment modality for urolithiasis

    NASA Astrophysics Data System (ADS)

    Rajan, Reshma; Raj, N. Arunai Nambi; Madeswaran, S.; Babu, D. Rajan

    2015-09-01

    Struvite or magnesium ammonium phosphate hexahydrate (MAPH) are biological crystals, found in the kidney, which are formed due to the infection caused by urea splitting bacteria in the urinary tract. The struvite crystals observe different morphologies and were developed using single diffusion gel growth technique. The crystalline nature and its composition were studied from different characterization techniques like X-ray Diffraction (XRD) and FTIR. The dielectric behavior of the developed crystal was studied by varying temperature and at different frequencies. The parameters like dielectric constant, dielectric loss, ac conductivity, ac resistivity, impedance and admittance of the struvite crystals were calculated. The studies proved that the dielectric loss or dissipation heat is high in lower frequencies at normal body temperature, which develops a plasma state in the stones and in turn leads to the disintegration of urinary stones. The dielectric nature of the stones leads to the dielectric therapy, which will be a gateway for future treatment modality for urolithiasis.

  9. One-pot DNA construction for synthetic biology: the Modular Overlap-Directed Assembly with Linkers (MODAL) strategy

    PubMed Central

    Casini, Arturo; MacDonald, James T.; Jonghe, Joachim De; Christodoulou, Georgia; Freemont, Paul S.; Baldwin, Geoff S.; Ellis, Tom

    2014-01-01

    Overlap-directed DNA assembly methods allow multiple DNA parts to be assembled together in one reaction. These methods, which rely on sequence homology between the ends of DNA parts, have become widely adopted in synthetic biology, despite being incompatible with a key principle of engineering: modularity. To answer this, we present MODAL: a Modular Overlap-Directed Assembly with Linkers strategy that brings modularity to overlap-directed methods, allowing assembly of an initial set of DNA parts into a variety of arrangements in one-pot reactions. MODAL is accompanied by a custom software tool that designs overlap linkers to guide assembly, allowing parts to be assembled in any specified order and orientation. The in silico design of synthetic orthogonal overlapping junctions allows for much greater efficiency in DNA assembly for a variety of different methods compared with using non-designed sequence. In tests with three different assembly technologies, the MODAL strategy gives assembly of both yeast and bacterial plasmids, composed of up to five DNA parts in the kilobase range with efficiencies of between 75 and 100%. It also seamlessly allows mutagenesis to be performed on any specified DNA parts during the process, allowing the one-step creation of construct libraries valuable for synthetic biology applications. PMID:24153110

  10. SU-E-T-560: Inter- and Intra-Fraction Variations in Esophageal Dose for Lung Cancer Patients, and the Impact of Setup Technique and Treatment Modality.

    PubMed

    Carroll, M; Cheung, J; Zhang, L; Court, L

    2012-06-01

    To understand the dose-response of the esophagus in photon and proton therapy, it is important to appreciate the variations in delivered dose caused by inter- and intra-fraction motion. Four lung cancer patients were identified who had experienced grade 3 esophagitis during their treatment, and for whom their esophagus was close, but not encompassed by, the treatment volume. Each patient had been treated with proton therapy using 35-37 2Gy fractions, and had received weekly 4DCT imaging. IMRT plans were also created using the same treatment planning constraints. In-house image registration software was used to deform the esophagus contour from the treatment plan to each phase of the 4DCT for each weekly image set. Daily setup using both bony and soft tissue (GTV) registration was simulated, and the treatment dose calculated for each CT image. Changes to the esophagus DVH relative to the treatment plan were quantified in terms of the relative volume of the esophagus receiving 45, 55, and 65Gy (V45, V55 and V65). For all combinations of treatment modality (photon, proton) and setup method (bony, GTV), intra-fraction motion resulted in a range of V45, V55 and V65 from 3.6 to 5.5%. Inter-fraction motion comparing daily exhale or inhale phases showed the range of V45, V55 and V65 from 8.5 to 18.6% (exhale) and 9.8 to 16.3% (inhale). Inter-fractional motion resulted in larger variations in dose delivered to the esophagus than intra-fractional motion. The inter-fraction range for V45, V55 and V65 varied by around 10% between patients. The treatment modality (photon, proton) and setup technique (bony, GTV) had minimal impact on the results. © 2012 American Association of Physicists in Medicine.

  11. Perception of Scenes in Different Sensory Modalities: A Result of Modal Completion.

    PubMed

    Gruber, Ronald R; Block, Richard A

    2017-01-01

    Dynamic perception includes amodal and modal completion, along with apparent movement. It fills temporal gaps for single objects. In 2 experiments, using 6 stimulus presentation conditions involving 3 sensory modalities, participants experienced 8-10 sequential stimuli (200 ms each) with interstimulus intervals (ISIs) of 0.25-7.0 s. Experiments focused on spatiotemporal completion (walking), featural completion (object changing), auditory, completion (falling bomb), and haptic changes (insect crawling). After each trial, participants judged whether they experienced the process of "happening " or whether they simply knew that the process must have occurred. The phenomenon was frequency independent, being reported at short ISIs but not at long ISIs. The phenomenon involves dynamic modal completion and possibly also conceptual processes.

  12. The small molecule survivin inhibitor YM155 may be an effective treatment modality for colon cancer through increasing apoptosis

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

    Li, Wan Lu, E-mail: lvvlchina@msn.cn; Lee, Mi-Ra, E-mail: mira1125@yonsei.ac.kr; Cho, Mee-Yon, E-mail: meeyon@yonsei.ac.kr

    Survivin has a known beneficial role in the survival of both cancer cells and normal cells. Therapies targeting survivin have been proposed as an alternative treatment modality for various tumors; however, finding the proper indication for this toxic therapy is critical for reducing unavoidable side effects. We recently observed that high survivin expression in CD133{sup +} cells is related to chemoresistance in Caco-2 colon cancer cells. However, the effect of survivin-targeted therapy on CD133{sup +} colon cancer is unknown. In this study, we investigated the roles of CD133 and survivin expression in colon cancer biology in vitro and comparatively analyzed themore » anticancer effects of survivin inhibitor on CD133{sup +} cells (ctrl-siRNA group) and small interfering RNA (siRNA)-induced CD133{sup −} cells (CD133-siRNA group) obtained from a single colon cancer cell line. CD133 knockdown via siRNA transfection did not change the tumorigenicity of cells, although in vitro survivin expression levels in CD133{sup +} cells were higher than those in siRNA-induced CD133{sup −} cells. The transfection procedure seemed to induce survivin expression. Notably, a significant number of CD133{sup −} cells (33.8%) was found in the cell colonies of the CD133-siRNA group. In the cell proliferation assay after treatment, YM155 and a combination of YM155 and 5-fluorouracil (5-FU) proved to be far more effective than 5-FU alone. A significantly increased level of apoptosis was observed with increasing doses of YM155 in all groups. However, significant differences in therapeutic effect and apoptosis among the mock, ctrl-siRNA, and CD133-siRNA groups were not detected. Survivin inhibitor is an effective treatment modality for colon cancer; however, the role of CD133 and the use of survivin expression as a biomarker for this targeted therapy must be verified.« less

  13. Cross-modal and modality-specific expectancy effects between pain and disgust

    PubMed Central

    Sharvit, Gil; Vuilleumier, Patrik; Delplanque, Sylvain; Corradi-Dell’ Acqua, Corrado

    2015-01-01

    Pain sensitivity increases when a noxious stimulus is preceded by cues predicting higher intensity. However, it is unclear whether the modulation of nociception by expectancy is sensory-specific (“modality based”) or reflects the aversive-affective consequence of the upcoming event (“unpleasantness”), potentially common with other negative events. Here we compared expectancy effects for pain and disgust by using different, but equally unpleasant, nociceptive (thermal) and olfactory stimulations. Indeed both pain and disgust are aversive, associated with threat to the organism, and processed in partly overlapping brain networks. Participants saw cues predicting the unpleasantness (high/low) and the modality (pain/disgust) of upcoming thermal or olfactory stimulations, and rated the associated unpleasantness after stimuli delivery. Results showed that identical thermal stimuli were perceived as more unpleasant when preceded by cues threatening about high (as opposed to low) pain. A similar expectancy effect was found for olfactory disgust. Critically, cross-modal expectancy effects were observed on inconsistent trials when thermal stimuli were preceded by high-disgust cues or olfactory stimuli preceded by high-pain cues. However, these effects were stronger in consistent than inconsistent conditions. Taken together, our results suggest that expectation of an unpleasant event elicits representations of both its modality-specific properties and its aversive consequences. PMID:26631975

  14. Assisted reproduction and risk of preterm birth in singletons by infertility diagnoses and treatment modalities: a population-based study.

    PubMed

    Dunietz, Galit Levi; Holzman, Claudia; Zhang, Yujia; Li, Chenxi; Todem, David; Boulet, Sheree L; McKane, Patricia; Kissin, Dmitry M; Copeland, Glenn; Bernson, Dana; Diamond, Michael P

    2017-11-01

    The purpose of this study is to examine the spectrum of infertility diagnoses and assisted reproductive technology (ART) treatments in relation to risk of preterm birth (PTB) in singletons. Population-based assisted reproductive technology surveillance data for 2000-2010 were linked with birth certificates from three states: Florida, Massachusetts, and Michigan, resulting in a sample of 4,370,361 non-ART and 28,430 ART-related singletons. Logistic regression models with robust variance estimators were used to compare PTB risk among singletons conceived with and without ART, the former grouped by parental infertility diagnoses and treatment modalities. Demographic and pregnancy factors were included in adjusted analyses. ART was associated with increased PTB risk across all infertility diagnosis groups and treatment types: for conventional ART, adjusted relative risks ranged from 1.4 (95% CI 1.0, 1.9) for male infertility to 2.4 (95% CI 1.8, 3.3) for tubal ligation. Adding intra-cytoplasmic sperm injection and/or assisted hatching to conventional ART treatment did not alter associated PTB risks. Singletons conceived by mothers without infertility diagnosis and with donor semen had an increased PTB risk relative to non-ART singletons. PTB risk among ART singletons is increased within each treatment type and all underlying infertility diagnosis, including male infertility. Preterm birth in ART singletons may be attributed to parental infertility, ART treatments, or their combination.

  15. Dual-modality imaging

    NASA Astrophysics Data System (ADS)

    Hasegawa, Bruce; Tang, H. Roger; Da Silva, Angela J.; Wong, Kenneth H.; Iwata, Koji; Wu, Max C.

    2001-09-01

    In comparison to conventional medical imaging techniques, dual-modality imaging offers the advantage of correlating anatomical information from X-ray computed tomography (CT) with functional measurements from single-photon emission computed tomography (SPECT) or with positron emission tomography (PET). The combined X-ray/radionuclide images from dual-modality imaging can help the clinician to differentiate disease from normal uptake of radiopharmaceuticals, and to improve diagnosis and staging of disease. In addition, phantom and animal studies have demonstrated that a priori structural information from CT can be used to improve quantification of tissue uptake and organ function by correcting the radionuclide data for errors due to photon attenuation, partial volume effects, scatter radiation, and other physical effects. Dual-modality imaging therefore is emerging as a method of improving the visual quality and the quantitative accuracy of radionuclide imaging for diagnosis of patients with cancer and heart disease.

  16. Noise elimination algorithm for modal analysis

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

    Bao, X. X., E-mail: baoxingxian@upc.edu.cn; Li, C. L.; Xiong, C. B.

    2015-07-27

    Modal analysis is an ongoing interdisciplinary physical issue. Modal parameters estimation is applied to determine the dynamic characteristics of structures under vibration excitation. Modal analysis is more challenging for the measured vibration response signals are contaminated with noise. This study develops a mathematical algorithm of structured low rank approximation combined with the complex exponential method to estimate the modal parameters. Physical experiments using a steel cantilever beam with ten accelerometers mounted, excited by an impulse load, demonstrate that this method can significantly eliminate noise from measured signals and accurately identify the modal frequencies and damping ratios. This study provides amore » fundamental mechanism of noise elimination using structured low rank approximation in physical fields.« less

  17. Cross-modal decoupling in temporal attention.

    PubMed

    Mühlberg, Stefanie; Oriolo, Giovanni; Soto-Faraco, Salvador

    2014-06-01

    Prior studies have repeatedly reported behavioural benefits to events occurring at attended, compared to unattended, points in time. It has been suggested that, as for spatial orienting, temporal orienting of attention spreads across sensory modalities in a synergistic fashion. However, the consequences of cross-modal temporal orienting of attention remain poorly understood. One challenge is that the passage of time leads to an increase in event predictability throughout a trial, thus making it difficult to interpret possible effects (or lack thereof). Here we used a design that avoids complete temporal predictability to investigate whether attending to a sensory modality (vision or touch) at a point in time confers beneficial access to events in the other, non-attended, sensory modality (touch or vision, respectively). In contrast to previous studies and to what happens with spatial attention, we found that events in one (unattended) modality do not automatically benefit from happening at the time point when another modality is expected. Instead, it seems that attention can be deployed in time with relative independence for different sensory modalities. Based on these findings, we argue that temporal orienting of attention can be cross-modally decoupled in order to flexibly react according to the environmental demands, and that the efficiency of this selective decoupling unfolds in time. © 2014 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

  18. Helium ions for radiotherapy? Physical and biological verifications of a novel treatment modality

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

    Krämer, Michael, E-mail: m.kraemer@gsi.de; Scifoni, Emanuele; Schuy, Christoph

    Purpose: Modern facilities for actively scanned ion beam radiotherapy allow in principle the use of helium beams, which could present specific advantages, especially for pediatric tumors. In order to assess the potential use of these beams for radiotherapy, i.e., to create realistic treatment plans, the authors set up a dedicated {sup 4}He beam model, providing base data for their treatment planning system TRiP98, and they have reported that in this work together with its physical and biological validations. Methods: A semiempirical beam model for the physical depth dose deposition and the production of nuclear fragments was developed and introduced inmore » TRiP98. For the biological effect calculations the last version of the local effect model was used. The model predictions were experimentally verified at the HIT facility. The primary beam attenuation and the characteristics of secondary charged particles at various depth in water were investigated using {sup 4}He ion beams of 200 MeV/u. The nuclear charge of secondary fragments was identified using a ΔE/E telescope. 3D absorbed dose distributions were measured with pin point ionization chambers and the biological dosimetry experiments were realized irradiating a Chinese hamster ovary cells stack arranged in an extended target. Results: The few experimental data available on basic physical processes are reproduced by their beam model. The experimental verification of absorbed dose distributions in extended target volumes yields an overall agreement, with a slight underestimation of the lateral spread. Cell survival along a 4 cm extended target is reproduced with remarkable accuracy. Conclusions: The authors presented a simple simulation model for therapeutical {sup 4}He beams which they introduced in TRiP98, and which is validated experimentally by means of physical and biological dosimetries. Thus, it is now possible to perform detailed treatment planning studies with {sup 4}He beams, either exclusively or

  19. Dermatological Feasibility of Multimodal Facial Color Imaging Modality for Cross-Evaluation of Facial Actinic Keratosis

    PubMed Central

    Bae, Youngwoo; Son, Taeyoon; Nelson, J. Stuart; Kim, Jae-Hong; Choi, Eung Ho; Jung, Byungjo

    2010-01-01

    Background/Purpose Digital color image analysis is currently considered as a routine procedure in dermatology. In our previous study, a multimodal facial color imaging modality (MFCIM), which provides a conventional, parallel- and cross-polarization, and fluorescent color image, was introduced for objective evaluation of various facial skin lesions. This study introduces a commercial version of MFCIM, DermaVision-PRO, for routine clinical use in dermatology and demonstrates its dermatological feasibility for cross-evaluation of skin lesions. Methods/Results Sample images of subjects with actinic keratosis or non-melanoma skin cancers were obtained at four different imaging modes. Various image analysis methods were applied to cross-evaluate the skin lesion and, finally, extract valuable diagnostic information. DermaVision-PRO is potentially a useful tool as an objective macroscopic imaging modality for quick prescreening and cross-evaluation of facial skin lesions. Conclusion DermaVision-PRO may be utilized as a useful tool for cross-evaluation of widely distributed facial skin lesions and an efficient database management of patient information. PMID:20923462

  20. Dual modality instrument for simultaneous optical coherence tomography imaging and fluorescence spectroscopy.

    PubMed

    Barton, Jennifer Kehlet; Guzman, Francisco; Tumlinson, Alexandre

    2004-01-01

    We develop a dual-modality device that combines the anatomical imaging capabilities of optical coherence tomography (OCT) with the functional capabilities of laser-induced fluorescence (LIF) spectroscopy. OCT provides cross-sectional images of tissue structure to a depth of up to 2 mm with approximately 10-microm resolution. LIF spectroscopy provides histochemical information in the form of emission spectra from a given tissue location. The OCT subsystem utilizes a superluminescent diode with a center wavelength of 1300 nm, whereas a helium cadmium laser provides the LIF excitation source at wavelengths of 325 and 442 nm. Preliminary data are obtained on eight postmortem aorta samples, each 10 mm in length. OCT images and LIF spectra give complementary information from normal and atherosclerotic portions of aorta wall. OCT images show structures such as intima, media, internal elastic lamina, and fibrotic regions. Emission spectra ratios of 520/490 (325-nm excitation) and 595/635 (442-nm excitation) could be used to identify normal and plaque regions with 97 and 91% correct classification rates, respectively. With miniaturization of the delivery probe and improvements in system speed, this dual-modality device could provide a valuable tool for identification and characterization of atherosclerotic plaques. (c) 2004 Society of Photo-Optical Instrumentation Engineers.

  1. Ares I-X In-Flight Modal Identification

    NASA Technical Reports Server (NTRS)

    Bartkowicz, Theodore J.; James, George H., III

    2011-01-01

    Operational modal analysis is a procedure that allows the extraction of modal parameters of a structure in its operating environment. It is based on the idealized premise that input to the structure is white noise. In some cases, when free decay responses are corrupted by unmeasured random disturbances, the response data can be processed into cross-correlation functions that approximate free decay responses. Modal parameters can be computed from these functions by time domain identification methods such as the Eigenvalue Realization Algorithm (ERA). The extracted modal parameters have the same characteristics as impulse response functions of the original system. Operational modal analysis is performed on Ares I-X in-flight data. Since the dynamic system is not stationary due to propellant mass loss, modal identification is only possible by analyzing the system as a series of linearized models over short periods of time via a sliding time-window of short time intervals. A time-domain zooming technique was also employed to enhance the modal parameter extraction. Results of this study demonstrate that free-decay time domain modal identification methods can be successfully employed for in-flight launch vehicle modal extraction.

  2. Treatment of Pediculosis Capitis

    PubMed Central

    Verma, Prashant; Namdeo, Chaitanya

    2015-01-01

    An endeavour to delineate the salient details of the treatment of head lice infestation has been made in the present article. Treatment modalities including over the counter permethrin and pyrethrin, and prescription medicines, including malathion, lindane, benzyl alcohol, spinosad are discussed. Salient features of alternative medicine and physical treatment modalities are outlined. The problem of resistance to treatment has also been taken cognizance of. PMID:26120148

  3. Does the modality effect exist? And if so, which modality effect?

    PubMed

    Reinwein, Joachim

    2012-02-01

    The modality effect is a central issue in multimedia learning [see Mayer (Cambridge University Press, 2005a), for a review]. Sweller's Cognitive Load Theory (CLT), for example, presumes that an illustrated text is better understood when presented visually rather than orally. The predictive power of CLT lies in how it links in to Baddeley's (1986) model of working memory and Penney's (Mem Cognit 17:398-442, 1989) Separate-Streams Hypothesis. Ginns's (Learn Instr 4:313-331, 2005) recent meta-analysis also supports the modality effect (d = 0.72, based on 43 independent effects). This article replicates the meta-analysis of the modality effect based on 86 independent effects (with within-study subgroups as the unit of analysis and with mean of the outcomes as the dependent measure), with results showing a reduction of the overall effect size by almost half (d = 0.38), and even more when Duval and Tweedie's Trim and Fill method is used to correct publication bias (d = 0.20). This article also widens the scope of the analysis of moderator variables (e.g. Pace of presentation, Type of visualization, Research group) as well as their potentially confounded effects. Finally, it is argued that, for theoretical reasons, the so-called modality effect cannot be based on Penney's or Baddeley's theories and must be explained in a different way.

  4. Dominant modal decomposition method

    NASA Astrophysics Data System (ADS)

    Dombovari, Zoltan

    2017-03-01

    The paper deals with the automatic decomposition of experimental frequency response functions (FRF's) of mechanical structures. The decomposition of FRF's is based on the Green function representation of free vibratory systems. After the determination of the impulse dynamic subspace, the system matrix is formulated and the poles are calculated directly. By means of the corresponding eigenvectors, the contribution of each element of the impulse dynamic subspace is determined and the sufficient decomposition of the corresponding FRF is carried out. With the presented dominant modal decomposition (DMD) method, the mode shapes, the modal participation vectors and the modal scaling factors are identified using the decomposed FRF's. Analytical example is presented along with experimental case studies taken from machine tool industry.

  5. Treatment of lateral epicondilitis using three different local injection modalities: a randomized prospective clinical trial.

    PubMed

    Dogramaci, Yunus; Kalaci, Aydiner; Savaş, Nazan; Duman, I Gokhan; Yanat, A Nedim

    2009-10-01

    To determine the effectiveness of three different local injection modalities in the treatment of lateral epicondilitis. In a prospective randomized study on lateral epicondilitis, 75 patients were divided into three equal groups A, B and C (n = 25) and were treated using three different method of local injection. The patients in group A were treated with local injection of a steroid (1 mL triamcinolone) combined with local anaesthetic (1 mL lidocaine), those in group B were treated with injection of local anaesthetic (1 mL lidocaine) combined with peppering technique and those in group C with local injection of a steroid (1 mL triamcinolone) combined with local anaesthetic (1 mL lidocaine) and peppering technique. The outcome was defined by measuring the elbow pain during the activity using a 10-cm visual analogue scale (VAS) and satisfaction with the treatment using a scoring system based on the criteria of the Verhaar et al. at 3 weeks and 6 months after the injection and compared with the pre-treatment condition. There were significant (P = 0.006) differences in the successful outcomes between the three groups at 6 months. In group C in which local steroid + peppering injection technique were used; excellent results were obtained in 84% of patients comparing to 36% and 48% for patients in groups A and B, respectively. The successful outcomes were statistically higher in group C comparing to group A (P = 0.002) and group B (P = 0.011). In all groups, there was a significantly lower pain (VAS) at the 3-week and 6-month follow-ups comparing to the pre-treatment condition. VAS measured at 6-month follow-up were significantly lower in group C comparing to other groups (P = 0.002). In the treatment of lateral epicondilitis, combination of corticosteroid injections with peppering is more effective than corticosteroid injections or peppering injections alone and produces better clinical results.

  6. On the Multi-Modal Object Tracking and Image Fusion Using Unsupervised Deep Learning Methodologies

    NASA Astrophysics Data System (ADS)

    LaHaye, N.; Ott, J.; Garay, M. J.; El-Askary, H. M.; Linstead, E.

    2017-12-01

    The number of different modalities of remote-sensors has been on the rise, resulting in large datasets with different complexity levels. Such complex datasets can provide valuable information separately, yet there is a bigger value in having a comprehensive view of them combined. As such, hidden information can be deduced through applying data mining techniques on the fused data. The curse of dimensionality of such fused data, due to the potentially vast dimension space, hinders our ability to have deep understanding of them. This is because each dataset requires a user to have instrument-specific and dataset-specific knowledge for optimum and meaningful usage. Once a user decides to use multiple datasets together, deeper understanding of translating and combining these datasets in a correct and effective manner is needed. Although there exists data centric techniques, generic automated methodologies that can potentially solve this problem completely don't exist. Here we are developing a system that aims to gain a detailed understanding of different data modalities. Such system will provide an analysis environment that gives the user useful feedback and can aid in research tasks. In our current work, we show the initial outputs our system implementation that leverages unsupervised deep learning techniques so not to burden the user with the task of labeling input data, while still allowing for a detailed machine understanding of the data. Our goal is to be able to track objects, like cloud systems or aerosols, across different image-like data-modalities. The proposed system is flexible, scalable and robust to understand complex likenesses within multi-modal data in a similar spatio-temporal range, and also to be able to co-register and fuse these images when needed.

  7. Diabetic foot disease: From the evaluation of the “foot at risk” to the novel diabetic ulcer treatment modalities

    PubMed Central

    Amin, Noha; Doupis, John

    2016-01-01

    The burden of diabetic foot disease (DFD) is expected to increase in the future. The incidence of DFD is still rising due to the high prevalence of DFD predisposing factors. DFD is multifactorial in nature; however most of the diabetic foot amputations are preceded by foot ulceration. Diabetic peripheral neuropathy (DPN) is a major risk factor for foot ulceration. DPN leads to loss of protective sensation resulting in continuous unconscious traumas. Patient education and detection of high risk foot are essential for the prevention of foot ulceration and amputation. Proper assessment of the diabetic foot ulceration and appropriate management ensure better prognosis. Management is based on revascularization procedures, wound debridement, treatment of infection and ulcer offloading. Management and type of dressing applied are tailored according to the type of wound and the foot condition. The scope of this review paper is to describe the diabetic foot syndrome starting from the evaluation of the foot at risk for ulceration, up to the new treatment modalities. PMID:27076876

  8. Results of a systematic literature review of treatment modalities for jugulotympanic paraganglioma, stratified per Fisch class.

    PubMed

    Jansen, T T G; Timmers, H J L M; Marres, H A M; Kaanders, J H A M; Kunst, H P M

    2018-04-01

    Key for successful jugulotympanic paraganglioma management is a personalised approach aiming for the best practice for each individual patient. To this end, a systematic review is performed, evaluating the local control and complication rates for the different treatment modalities stratified by the broadly accepted Fisch classification. A systematic literature review according to the PRISMA statement was performed. A detailed overview of individual treatment outcomes per Fisch class is provided. Local control, cranial nerve damage, complications, function recovery. Eighteen studies were selected, resembling 83 patients treated with radiotherapy and 299 with surgery. Excellent local control was found post-surgery for class A and B tumours, and risk of cranial nerve damage was <1%. For class C1-4 tumours, local control was 80%-95% post-surgery (84% post-radiotherapy), and cranial nerve damage was found in 71%-76% (none post-radiotherapy; P < .05). There was no difference in treatment outcomes between tumours of different C class. For class C1-4De/Di tumours, local control was 38%-86% (98% post-radiotherapy; P < .05) and cranial nerve damage/complication rates were 67%-100% (3% post-radiotherapy; P < .05). C1-4DeDi tumours showed lesser local control and cranial nerve damage rates when compared to C1-4De tumours. An individual risk is constituted for surgery and radiotherapy, stratified per Fisch class. For class A and B tumours, surgery is a suitable treatment option. For class C and D tumours, radiotherapy results in lower complication rates and similar or better local control rates when compared to the surgical group. © 2017 John Wiley & Sons Ltd.

  9. Modality-specific selective attention attenuates multisensory integration.

    PubMed

    Mozolic, Jennifer L; Hugenschmidt, Christina E; Peiffer, Ann M; Laurienti, Paul J

    2008-01-01

    Stimuli occurring in multiple sensory modalities that are temporally synchronous or spatially coincident can be integrated together to enhance perception. Additionally, the semantic content or meaning of a stimulus can influence cross-modal interactions, improving task performance when these stimuli convey semantically congruent or matching information, but impairing performance when they contain non-matching or distracting information. Attention is one mechanism that is known to alter processing of sensory stimuli by enhancing perception of task-relevant information and suppressing perception of task-irrelevant stimuli. It is not known, however, to what extent attention to a single sensory modality can minimize the impact of stimuli in the unattended sensory modality and reduce the integration of stimuli across multiple sensory modalities. Our hypothesis was that modality-specific selective attention would limit processing of stimuli in the unattended sensory modality, resulting in a reduction of performance enhancements produced by semantically matching multisensory stimuli, and a reduction in performance decrements produced by semantically non-matching multisensory stimuli. The results from two experiments utilizing a cued discrimination task demonstrate that selective attention to a single sensory modality prevents the integration of matching multisensory stimuli that is normally observed when attention is divided between sensory modalities. Attention did not reliably alter the amount of distraction caused by non-matching multisensory stimuli on this task; however, these findings highlight a critical role for modality-specific selective attention in modulating multisensory integration.

  10. Modal strain energies in COSMIC NASTRAN

    NASA Technical Reports Server (NTRS)

    Snyder, B. D.; Venkayya, V. B.

    1989-01-01

    A computer program was developed to take a NASTRAN output file from a normal modes analysis and calculate the modal strain energies of selected elements. The FORTRAN program can determine the modal strain energies for CROD, CBAR, CELAS, CTRMEM, CQDMEM2, and CSHEAR elements. Modal strain energies are useful in estimating damping in structures.

  11. The modality effect of ego depletion: Auditory task modality reduces ego depletion.

    PubMed

    Li, Qiong; Wang, Zhenhong

    2016-08-01

    An initial act of self-control that impairs subsequent acts of self-control is called ego depletion. The ego depletion phenomenon has been observed consistently. The modality effect refers to the effect of the presentation modality on the processing of stimuli. The modality effect was also robustly found in a large body of research. However, no study to date has examined the modality effects of ego depletion. This issue was addressed in the current study. In Experiment 1, after all participants completed a handgrip task, one group's participants completed a visual attention regulation task and the other group's participants completed an auditory attention regulation task, and then all participants again completed a handgrip task. The ego depletion phenomenon was observed in both the visual and the auditory attention regulation task. Moreover, participants who completed the visual task performed worse on the handgrip task than participants who completed the auditory task, which indicated that there was high ego depletion in the visual task condition. In Experiment 2, participants completed an initial task that either did or did not deplete self-control resources, and then they completed a second visual or auditory attention control task. The results indicated that depleted participants performed better on the auditory attention control task than the visual attention control task. These findings suggest that altering task modality may reduce ego depletion. © 2016 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

  12. An Investigation of Feasibility and Safety of Bi-Modal Stimulation for the Treatment of Tinnitus: An Open-Label Pilot Study.

    PubMed

    Hamilton, Caroline; D'Arcy, Shona; Pearlmutter, Barak A; Crispino, Gloria; Lalor, Edmund C; Conlon, Brendan J

    2016-12-01

    Tinnitus is the perception of sound in the absence of an external auditory stimulus. It is widely believed that tinnitus, in patients with associated hearing loss, is a neurological phenomenon primarily affecting the central auditory structures. However, there is growing evidence for the involvement of the somatosensory system in this form of tinnitus. For this reason it has been suggested that the condition may be amenable to bi-modal stimulation of the auditory and somatosensory systems. We conducted a pilot study to investigate the feasibility and safety of a device that delivers simultaneous auditory and somatosensory stimulation to treat the symptoms of chronic tinnitus. A cohort of 54 patients used the stimulation device for 10 weeks. Auditory stimulation was delivered via headphones and somatosensory stimulation was delivered via electrical stimulation of the tongue. Patient usage, logged by the device, was used to classify patients as compliant or noncompliant. Safety was assessed by reported adverse events and changes in tinnitus outcome measures. Response to treatment was assessed using tinnitus outcome measures: Minimum Masking Level (MML), Tinnitus Loudness Matching (TLM), and Tinnitus Handicap Inventory (THI). The device was well tolerated by patients and no adverse events or serious difficulties using the device were reported. Overall, 68% of patients met the defined compliance threshold. Compliant patients (N = 30) demonstrated statistically significant improvements in mean outcome measures after 10 weeks of treatment: THI (-11.7 pts, p < 0.001), TLM (-7.5dB, p < 0.001), and MML (-9.7dB, p < 0.001). The noncompliant group (N = 14) demonstrated no statistical improvements. This study demonstrates the feasibility and safety of a new bi-modal stimulation device and supports the potential efficacy of this new treatment for tinnitus. © 2016 Neuromod Devices Ltd. Neuromodulation: Technology at the Neural Interface published by Wiley

  13. Polyarteritis nodosa: MDCT as a 'One-Stop Shop' Modality for Whole-Body Arterial Evaluation

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

    Tsai, W.-L.; Tsai, I-C.; Lee Tain, E-mail: s841082@ym.edu.t

    Polyarteritis nodosa is a rare disease, which is characterized by aneurysm formation and occlusion in the arteries of multiple systems. Due to its extensive involvement, whole-body evaluation is necessary for diagnosis and treatment monitoring. We report a case of polyarteritis nodosa using multidetector-row computed tomography (MDCT) as a 'one-stop shop' modality for whole-body arterial evaluation. With precise protocol design, MDCT can be used as a reliable noninvasive modality providing comprehensive whole-body arterial evaluation.

  14. Methotrexate in psoriasis: a systematic review of treatment modalities, incidence, risk factors and monitoring of liver toxicity.

    PubMed

    Montaudié, H; Sbidian, E; Paul, C; Maza, A; Gallini, A; Aractingi, S; Aubin, F; Bachelez, H; Cribier, B; Joly, P; Jullien, D; Le Maître, M; Misery, L; Richard, M-A; Ortonne, J-P

    2011-05-01

    To define practical use and to specify the ideal method for monitoring the liver toxicity of MTX in the management of psoriasis. To systematically review the literature regarding treatment modalities with methotrexate (MTX) in psoriasis, risk of MTX-mediated liver fibrosis and monitoring of hepatic toxicity. A systematic literature search was carried out in Medline, Embase and Cochrane Library databases from 1980 to 2010 searching for randomized controlled trials and observational studies on methods of administering MTX in psoriasis and risk factors and assessment of liver toxicity. We limited the literature search to articles on human subjects over 19 years of age, articles in English or French on psoriasis and articles including psoriatic arthritis and original data. Among 949 references identified, 23 published studies were included. There were no studies focusing directly on the question of MTX treatment modalities. Treatment outcome appears to be dose dependent. A single study in rheumatoid arthritis showed the slightly superior efficacy of subcutaneous administration vs. oral dosing with a similar safety profile. Combination with folic acid may decrease the efficacy of MTX while improving tolerability. The extreme variability of the incidence of hepatic fibrosis in the literature does not allow the risk of hepatic fibrosis to be quantified. Type 2 diabetes and obesity, were associated with a significant increased risk of liver fibrosis. Hepatitis B and C and alcohol consumption were associated with a modest and non-significant increased risk of liver fibrosis. Procollagen III for detection of hepatic fibrosis dosing was the most extensively validated method to monitor liver fibrosis showing a sensitivity of 77.3% and a specificity of 91.5%. The Positive Predictive Value and Negative Predictive Value fluctuated depending on the prevalence of hepatic fibrosis. The sensitivities of the FibroTest and the fibroscan were of 83 and 50%, respectively, with specific

  15. Communication modality sampling for a toddler with Angelman syndrome.

    PubMed

    Hyppa Martin, Jolene; Reichle, Joe; Dimian, Adele; Chen, Mo

    2013-10-01

    Vocal, gestural, and graphic communication modes were implemented concurrently with a toddler with Angelman syndrome to identify the most efficiently learned communication mode to emphasize in an initial augmentative communication system. Symbols representing preferred objects were introduced in vocal, gestural, and graphic communication modes using an alternating treatment single-subject experimental design. Conventionally accepted prompting strategies were used to teach symbols in each communication mode. Because the learner did not vocally imitate, vocal mode intervention focused on increasing vocal frequency as an initial step. When graphic and gestural mode performances were compared, the learner most accurately produced requests in graphic mode (percentage of nonoverlapping data = 96). Given the lack of success in prompting vocal productions, a comparison between vocal and the other two communication modes was not made. A growing body of evidence suggests that concurrent modality sampling is a promising low-inference, data-driven procedure that can be used to inform selection of a communication mode(s) for initial emphasis with young children. Concurrent modality sampling can guide clinical decisions regarding the allocation of treatment resources to promote success in building an initial communicative repertoire.

  16. Conceptual Structure within and between Modalities

    PubMed Central

    Dilkina, Katia; Lambon Ralph, Matthew A.

    2012-01-01

    Current views of semantic memory share the assumption that conceptual representations are based on multimodal experience, which activates distinct modality-specific brain regions. This proposition is widely accepted, yet little is known about how each modality contributes to conceptual knowledge and how the structure of this contribution varies across these multiple information sources. We used verbal feature lists, features from drawings, and verbal co-occurrence statistics from latent semantic analysis to examine the informational structure in four domains of knowledge: perceptual, functional, encyclopedic, and verbal. The goals of the analysis were three-fold: (1) to assess the structure within individual modalities; (2) to compare structures between modalities; and (3) to assess the degree to which concepts organize categorically or randomly. Our results indicated significant and unique structure in all four modalities: perceptually, concepts organize based on prominent features such as shape, size, color, and parts; functionally, they group based on use and interaction; encyclopedically, they arrange based on commonality in location or behavior; and verbally, they group associatively or relationally. Visual/perceptual knowledge gives rise to the strongest hierarchical organization and is closest to classic taxonomic structure. Information is organized somewhat similarly in the perceptual and encyclopedic domains, which differs significantly from the structure in the functional and verbal domains. Notably, the verbal modality has the most unique organization, which is not at all categorical but also not random. The idiosyncrasy and complexity of conceptual structure across modalities raise the question of how all of these modality-specific experiences are fused together into coherent, multifaceted yet unified concepts. Accordingly, both methodological and theoretical implications of the present findings are discussed. PMID:23293593

  17. A single institution experience of combined modality management of extra skeletal Ewings sarcoma.

    PubMed

    Venkitaraman, Ramachandran; George, Mathew K; Ramanan, S Ganapathy; Sagar, T G

    2007-01-11

    Extraskeletal Ewings sarcoma are rare tumors for which there is no consensus on optimal management. A retrospective review of the clinical features, treatment and outcome of patients with extraskeletal Ewings sarcoma who reported to a single institution between January 1992-December 2003 is reported. A total of 19 patients with extraskeletal Ewings sarcoma were identified. Of these, 4 patients had metastatic disease at presentation and 15 patients with non-metastatic disease received combined modality treatment with primary combination chemotherapy followed by local treatment with radiotherapy or surgery. Disease free survival and overall survival for patients with non metastatic disease after combined modality treatment were 60% and 30% respectively. The significant predictors for prolonged disease free survival and overall survival were high haemoglobin (p = 0.002), low lactate dehydrogenase (p = 0.028), chemotherapy with Vincristine, Adriamycin, Cyclophosphamide, Ifosfamide and Etoposide regime (p = 0.008) and complete response to chemotherapy (p = 0.001). Aggressive combination chemotherapy followed by complete surgery or radiotherapy to a dose of more than 50 Gy is essential to confer optimal outcome for patients with extraskeletal Ewings sarcoma.

  18. Experimental modal analysis of the fuselage panels of an Aero Commander aircraft

    NASA Technical Reports Server (NTRS)

    Geisler, D.

    1981-01-01

    The reduction of interior noise in light aircraft was investigated with emphasis the thin fuselage sidewall. The approach used is theoretical and involves modeling of the sidewall panels and stiffeners. Experimental data obtained from tests investigating the effects of mass and stiffness treatments to the sidewalls are presented. The dynamic characteristics of treated panels are contrasted with the untreated sidewall panels using experimental modal analysis techniques. The results include the natural frequencies, modal dampling, and mode shapes of selected panels. Frequency response functions, data relating to the global fuselage response, and acoustic response are also presented.

  19. Palateless custom bar supported overdenture: a treatment modality to treat patient with severe gag reflex.

    PubMed

    Singh, Kunwarjeet; Gupta, Nidhi

    2012-01-01

    To suggest a custom bar supported overdenture treatment modality for prosthodontic management of patients with severe gag reflex. Some patients have a severe gag reflex and cannot tolerate conventional maxillary complete dentures with maximum palatal coverage and extensions of all borders. The condition further gets complicated in patients suffering from respiratory problems along with severe gag reflex. Severe gagging acts as a barrier to treat such patients with accepted clinical procedures and prevent patients from wearing the prosthesis. By saving some of the remaining natural teeth and fabricating, a horse shoe shape palateless simple tooth or bar supported overdenture can be successfully used for treating such patients. The remaining maxillary right and left canines were prepared with the tapered round end diamond bur to receive copings of custom bar after intentional root canal treatment of same teeth. Impression was made with light body and putty of the polyvinyl siloxane elastomer with double step putty wash technique. Impression was poured with die stone. Wax pattern of copings with bar was fabricated with inlay wax which was invested and casted. After retrieving the bar, it was finished and its fit was evaluated. The coping-bar assembly was finally cemented with the glass ionomer cement. Palateless overdenture was fabricated by conventional technique used for the fabrication of complete denture. Palateless custom bar supported overdenture procedure can be successfully used for the management of patients with severe gag reflex with improved denture retention, stability, chewing efficiency and comfort of the patient.

  20. Modal noise in multimode optical fibers

    NASA Astrophysics Data System (ADS)

    Rawson, E. G.; Goodman, J. W.

    1983-03-01

    A changing speckle pattern exists at the output of a multimode optical fiber if the optical source is sufficiently coherent. When spatial filtration (for example, at a misaligned connector) or polarization filtration (for example, in certain access couplers) occurs in the presence of such speckle, the optical signal power fluctuates; such fluctuations are called 'modal noise'. This paper reviews modal noise theory and experiment, including the prediction and measurement of the modal noise signal-to-noise ratio in the presence of spatial filtration and constrained total guided power. It also presents new results relating to modal noise effects in fiber branching devices such as star couplers, access couplers, and power dividers.

  1. Restricted Acoustic Modal Analysis Applied to Internal Combustor Spectra and Cross-Spectra Measurements

    NASA Technical Reports Server (NTRS)

    Miles, Jeffrey Hilton

    2006-01-01

    A treatment of the modal decomposition of the pressure field in a combustor as determined by two Kulite pressure measurements is developed herein. It is applied to a Pratt & Whitney PW4098 engine combustor over a range of operating conditions. For modes other than the plane wave the new part of the treatment is the assumption that there are distinct frequency bands in which the individual modes, including the plane wave mode, overlap such that if circumferential mode m and circumferential mode m-1 are present than circumferential mode m 2 is not. Consequently, in the analysis used herein at frequencies above the first cut-off mode frequency, only pairs of circumferential modes are individually present at each frequency. Consequently, this is a restricted modal analysis. A new result is that the successful use of the same modal span frequencies over a range of operating conditions for this particular engine suggests that the temperature, T, and the velocity, v, of the flow at each operating condition are related by c(sup 2)-v(sup 2) = a constant where c is the speed of sound.

  2. Combined multi-modal photoacoustic tomography, optical coherence tomography (OCT) and OCT angiography system with an articulated probe for in vivo human skin structure and vasculature imaging

    PubMed Central

    Liu, Mengyang; Chen, Zhe; Zabihian, Behrooz; Sinz, Christoph; Zhang, Edward; Beard, Paul C.; Ginner, Laurin; Hoover, Erich; Minneman, Micheal P.; Leitgeb, Rainer A.; Kittler, Harald; Drexler, Wolfgang

    2016-01-01

    Cutaneous blood flow accounts for approximately 5% of cardiac output in human and plays a key role in a number of a physiological and pathological processes. We show for the first time a multi-modal photoacoustic tomography (PAT), optical coherence tomography (OCT) and OCT angiography system with an articulated probe to extract human cutaneous vasculature in vivo in various skin regions. OCT angiography supplements the microvasculature which PAT alone is unable to provide. Co-registered volumes for vessel network is further embedded in the morphologic image provided by OCT. This multi-modal system is therefore demonstrated as a valuable tool for comprehensive non-invasive human skin vasculature and morphology imaging in vivo. PMID:27699106

  3. Picosecond 532-nm neodymium-doped yttrium aluminium garnet laser-a novel and promising modality for the treatment of café-au-lait macules.

    PubMed

    Artzi, Ofir; Mehrabi, Joseph N; Koren, Amir; Niv, Roni; Lapidoth, Moshe; Levi, Assi

    2018-05-01

    Café-au-lait macules (CALMs) present as benign hyperpigmented, well-circumscribed spots on the skin for which many patients seek treatment for aesthetic reasons. The objective of this study is to report our experience in treating CALMs using a picosecond 532-nm neodymium-doped yttrium aluminium garnet (PS 532 nm) laser. This is a retrospective case series of 16 patients with CALMs who were treated by a PS 532-nm laser (1-4 treatments, 4-8 weeks apart). Response as seen on clinical photographs was assessed by two independent dermatologists and graded on a scale of 0 (exacerbation) to 5 (95-100% improvement). Patient satisfaction and tolerance were documented at final visit. The results of 15 patients demonstrated significant improvement (average 3.43), and their satisfaction and tolerance levels were high. One patient had no response whatsoever to treatment. The PS 532-nm laser is a promising novel modality for the treatment of CALMs.

  4. Short-Term Memory in Mathematics-Proficient and Mathematics-Disabled Students as a Function of Input-Modality/Output-Modality Pairings.

    ERIC Educational Resources Information Center

    Webster, Raymond E.

    1980-01-01

    A significant two-way input modality by output modality interaction suggested that short term memory capacity among the groups differed as a function of the modality used to present the items in combination with the output response required. (Author/CL)

  5. Ravens reconcile after aggressive conflicts with valuable partners.

    PubMed

    Fraser, Orlaith N; Bugnyar, Thomas

    2011-03-25

    Reconciliation, a post-conflict affiliative interaction between former opponents, is an important mechanism for reducing the costs of aggressive conflict in primates and some other mammals as it may repair the opponents' relationship and reduce post-conflict distress. Opponents who share a valuable relationship are expected to be more likely to reconcile as for such partners the benefits of relationship repair should outweigh the risk of renewed aggression. In birds, however, post-conflict behavior has thus far been marked by an apparent absence of reconciliation, suggested to result either from differing avian and mammalian strategies or because birds may not share valuable relationships with partners with whom they engage in aggressive conflict. Here, we demonstrate the occurrence of reconciliation in a group of captive subadult ravens (Corvus corax) and show that it is more likely to occur after conflicts between partners who share a valuable relationship. Furthermore, former opponents were less likely to engage in renewed aggression following reconciliation, suggesting that reconciliation repairs damage caused to their relationship by the preceding conflict. Our findings suggest not only that primate-like valuable relationships exist outside the pair bond in birds, but that such partners may employ the same mechanisms in birds as in primates to ensure that the benefits afforded by their relationships are maintained even when conflicts of interest escalate into aggression. These results provide further support for a convergent evolution of social strategies in avian and mammalian species.

  6. New Therapeutic Modalities of Retinal Laser Injury.

    DTIC Science & Technology

    1992-03-31

    Clawticarroni New Therapeutic Modalities for Retinal Laser Injury 1 2 . PERSONAL AUTHOR(S) Tim T.Lar. Ph.D., .and Mark Q.M. Tso. M.D. 13a. TYPE OF...Experimental treatment of retinal laser Injury 4 1.3: Clinical therapy 4 1.4: Our hypothesis and approaches 4 Chapter 2 : Accidental laser Injury to the...human retina 7 2.1: Introduction 7 2.2: Case 1 7 2.3: Case 2 8 2.4: General comments 9 2.5: Clinical course 10 2.6: Implications 10 Chapter 3: Sub

  7. Hybrid Surgical Guidance: Does Hardware Integration of γ- and Fluorescence Imaging Modalities Make Sense?

    PubMed

    KleinJan, Gijs H; Hellingman, Daan; van den Berg, Nynke S; van Oosterom, Matthias N; Hendricksen, Kees; Horenblas, Simon; Valdes Olmos, Renato A; van Leeuwen, Fijs Wb

    2017-04-01

    The clinically applied hybrid tracer indocyanine green- 99m Tc-nanocolloid enables combined radio- and fluorescence image guidance during sentinel node (SN) biopsy procedures. To provide optimal surgical guidance, this tracer requires the presence of both γ- and fluorescence modalities in the operating room. We reasoned that the combination or integration of these modalities could further evolve the hybrid surgical guidance concept. To study this potential, we clinically applied 2 setups that included the combination of γ-detection modalities and an open surgery fluorescence camera. Methods: To attach the fluorescence camera (VITOM) to either a γ-ray detection probe (GP; VITOM-GP) or a portable γ-camera (GC; Vitom GC), clip-on brackets were designed and printed in 3-dimensional sterilizable RC31. Both combined modalities were evaluated in, respectively, 5 and 6 patients with penile cancer during an SN biopsy procedure using indocyanine green- 99m Tc-nanocolloid. Intraoperatively, radio- and fluorescence-guided SN detection rates were scored at working distances of 0, 10, 20, and 30 cm for both combinations. Results: Using the VITOM-GP combination, we evaluated 9 SNs. γ-tracing rates were shown to be 100%, 88.9%, 55.6%, and 55.6% at a respective working distance of 0, 10, 20, and 30 cm. Detection rates for the fluorescence imaging-based detection were found to be 100%, 77.8%, and 77.8%, at respective working distances of 10, 20, and 30 cm. When the VITOM-GC setup was used, all 10 intraoperatively evaluated SNs could be visualized with the γ-camera independent of the working distance. Fluorescence detection rates were 90%, 80%, and 80% at 10-, 20-, and 30-cm working distances. The integrated detection modalities were shown to work synergistically; overall the, GC was most valuable for rough localization (10- to 30-cm range) of the SNs, the GP for providing convenient real-time acoustic feedback, whereas fluorescence guidance allowed detailed real-time SN

  8. Reimbursement and economic factors influencing dialysis modality choice around the world

    PubMed Central

    Just, Paul M.; de Charro, Frank Th.; Tschosik, Elizabeth A.; Noe, Les L.; Bhattacharyya, Samir K.; Riella, Miguel C.

    2008-01-01

    The worldwide incidence of kidney failure is on the rise and treatment is costly; thus, the global burden of illness is growing. Kidney failure patients require either a kidney transplant or dialysis to maintain life. This review focuses on the economics of dialysis. Alternative dialysis modalities are haemodialysis (HD) and peritoneal dialysis (PD). Important economic factors influencing dialysis modality selection include financing, reimbursement and resource availability. In general, where there is little or no facility or physician reimbursement or payment for PD, the share of PD is very low. Regarding resource availability, when centre HD capacity is high, there is an incentive to use that capacity rather than place patients on home dialysis. In certain countries, there is interest in revising the reimbursement structure to favour home-based therapies, including PD and home HD. Modality selection is influenced by employment status, with an association between being employed and PD as the modality choice. Cost drivers differ for PD and HD. PD is driven mainly by variable costs such as solutions and tubing, while HD is driven mainly by fixed costs of facility space and staff. Many cost comparisons of dialysis modalities have been conducted. A key factor to consider in reviewing cost comparisons is the perspective of the analysis because different costs are relevant for different perspectives. In developed countries, HD is generally more expensive than PD to the payer. Additional research is needed in the developing world before conclusive statements may be made regarding the relative costs of HD and PD. PMID:18234844

  9. Integrating Conceptual Knowledge Within and Across Representational Modalities

    PubMed Central

    McNorgan, Chris; Reid, Jackie; McRae, Ken

    2011-01-01

    Research suggests that concepts are distributed across brain regions specialized for processing information from different sensorimotor modalities. Multimodal semantic models fall into one of two broad classes differentiated by the assumed hierarchy of convergence zones over which information is integrated. In shallow models, communication within- and between-modality is accomplished using either direct connectivity, or a central semantic hub. In deep models, modalities are connected via cascading integration sites with successively wider receptive fields. Four experiments provide the first direct behavioral tests of these models using speeded tasks involving feature inference and concept activation. Shallow models predict no within-modal versus cross-modal difference in either task, whereas deep models predict a within-modal advantage for feature inference, but a cross-modal advantage for concept activation. Experiments 1 and 2 used relatedness judgments to tap participants’ knowledge of relations for within- and cross-modal feature pairs. Experiments 3 and 4 used a dual feature verification task. The pattern of decision latencies across Experiments 1 to 4 is consistent with a deep integration hierarchy. PMID:21093853

  10. Integrating conceptual knowledge within and across representational modalities.

    PubMed

    McNorgan, Chris; Reid, Jackie; McRae, Ken

    2011-02-01

    Research suggests that concepts are distributed across brain regions specialized for processing information from different sensorimotor modalities. Multimodal semantic models fall into one of two broad classes differentiated by the assumed hierarchy of convergence zones over which information is integrated. In shallow models, communication within- and between-modality is accomplished using either direct connectivity, or a central semantic hub. In deep models, modalities are connected via cascading integration sites with successively wider receptive fields. Four experiments provide the first direct behavioral tests of these models using speeded tasks involving feature inference and concept activation. Shallow models predict no within-modal versus cross-modal difference in either task, whereas deep models predict a within-modal advantage for feature inference, but a cross-modal advantage for concept activation. Experiments 1 and 2 used relatedness judgments to tap participants' knowledge of relations for within- and cross-modal feature pairs. Experiments 3 and 4 used a dual-feature verification task. The pattern of decision latencies across Experiments 1-4 is consistent with a deep integration hierarchy. Copyright © 2010 Elsevier B.V. All rights reserved.

  11. Systematic Review of the Effectiveness of Physical Therapy Modalities in Women With Provoked Vestibulodynia.

    PubMed

    Morin, Mélanie; Carroll, Marie-Soleil; Bergeron, Sophie

    2017-07-01

    Pelvic floor muscle physical therapy is recommended in clinical guidelines for women with provoked vestibulodynia (PVD). Including isolated or combined treatment modalities, physical therapy is viewed as an effective first-line intervention, yet no systematic review concerning the effectiveness of physical therapy has been conducted. To systematically appraise the current literature on the effectiveness of physical therapy modalities for decreasing pain during intercourse and improving sexual function in women with PVD. A systematic literature search using PubMed, Scopus, CINHAL, and PEDro was conducted until October 2016. Moreover, a manual search from reference lists of included articles was performed. Ongoing trials also were reviewed using clinicaltrial.gov and ISRCTNregistry. Randomized controlled trials, prospective and retrospective cohorts, and case reports evaluating the effect of isolated or combined physical therapy modalities in women with PVD were included in the review. Main outcome measures were pain during intercourse, sexual function, and patient's perceived improvement. The literature search resulted in 43 eligible studies including 7 randomized controlled trials, 20 prospective studies, 5 retrospective studies, 6 case reports, and 6 study protocols. Most studies had a high risk of bias mainly associated with the lack of a comparison group. Another common bias was related to insufficient sample size, non-validated outcomes, non-standardized intervention, and use of other ongoing treatment. The vast majority of studies showed that physical therapy modalities such as biofeedback, dilators, electrical stimulation, education, multimodal physical therapy, and multidisciplinary approaches were effective for decreasing pain during intercourse and improving sexual function. The positive findings for the effectiveness of physical therapy modalities in women with PVD should be investigated further in robust and well-designed randomized controlled trials

  12. Photoacoustic/ultrasound dual-modality contrast agent and its application to thermotherapy.

    PubMed

    Wang, Yu-Hsin; Liao, Ai-Ho; Chen, Jui-Hao; Wang, Churng-Ren Chris; Li, Pai-Chi

    2012-04-01

    This study investigates a photoacoustic/ultrasound dual-modality contrast agent, including extending its applications from image-contrast enhancement to combined diagnosis and therapy with site-specific targeting. The contrast agent comprises albumin-shelled microbubbles with encapsulated gold nanorods (AuMBs). The gas-filled microbubbles, whose diameters range from submicrometer to several micrometers, are not only echogenic but also can serve as drug-delivery vehicles. The gold nanorods are used to enhance the generation of both photoacoustic and photothermal signals. The optical absorption peak of the gold nanorods is tuned to 760 nm and is invariant after microbubble encapsulation. Dual-modality contrast enhancement is first described here, and the applications to cellular targeting and laser-induced thermotherapy in a phantom are demonstrated. Photoacoustic imaging can be used to monitor temperature increases during the treatment. The targeting capability of AuMBs was verified, and the temperature increased by 26°C for a laser power of 980 mW, demonstrating the potential of combined diagnosis and therapy with the dual-modality agent. Targeted photo- or acoustic-mediated delivery is also possible.

  13. Arithmetic Memory Is Modality Specific.

    PubMed

    Myers, Timothy; Szücs, Dénes

    2015-01-01

    In regards to numerical cognition and working memory, it is an open question as to whether numbers are stored into and retrieved from a central abstract representation or from separate notation-specific representations. This study seeks to help answer this by utilizing the numeral modality effect (NME) in three experiments to explore how numbers are processed by the human brain. The participants were presented with numbers (1-9) as either Arabic digits or written number words (Arabic digits and dot matrices in Experiment 2) at the first (S1) and second (S2) stimuli. The participant's task was to add the first two stimuli together and verify whether the answer (S3), presented simultaneously with S2, was correct. We hypothesized that if reaction time (RT) at S2/S3 depends on the modality of S1 then numbers are retrieved from modality specific memory stores. Indeed, RT depended on the modality of S1 whenever S2 was an Arabic digit which argues against the concept of numbers being stored and retrieved from a central, abstract representation.

  14. Arithmetic Memory Is Modality Specific

    PubMed Central

    Myers, Timothy; Szücs, Dénes

    2015-01-01

    In regards to numerical cognition and working memory, it is an open question as to whether numbers are stored into and retrieved from a central abstract representation or from separate notation-specific representations. This study seeks to help answer this by utilizing the numeral modality effect (NME) in three experiments to explore how numbers are processed by the human brain. The participants were presented with numbers (1–9) as either Arabic digits or written number words (Arabic digits and dot matrices in Experiment 2) at the first (S1) and second (S2) stimuli. The participant’s task was to add the first two stimuli together and verify whether the answer (S3), presented simultaneously with S2, was correct. We hypothesized that if reaction time (RT) at S2/S3 depends on the modality of S1 then numbers are retrieved from modality specific memory stores. Indeed, RT depended on the modality of S1 whenever S2 was an Arabic digit which argues against the concept of numbers being stored and retrieved from a central, abstract representation. PMID:26716692

  15. Comparative study of different osteotomy modalities in maxillary distraction osteogenesis for cleft lip and palate.

    PubMed

    Yu, Hongbo; Wang, Xudong; Fang, Bing; Shen, Steve Guofang

    2012-11-01

    Conventional maxillary distraction osteogenesis and anterior maxillary segmental distraction were applied in the treatment of severe maxillary hypoplasia secondary to cleft clip and palate. The aim of the present study was to compare the difference between these 2 osteotomy modalities used for rigid external distraction. Ten patients with severe maxillary hypoplasia secondary to CLP were enrolled in our study. They were randomly divided into 2 groups. Conventional maxillary distraction osteogenesis was performed in 5 patients and anterior maxillary segmental distraction in 5 patients. The preoperative and postoperative lateral cephalograms were compared, and cephalometric analysis was performed. The independent sample t test was used to evaluate the differences between the 2 groups. All patients healed uneventfully, and the maxillae moved forward satisfactorily. The sella-nasion-point A angles, nasion-point A-Frankfort horizontal plane angles, overjets, and 0-meridian to subnasale distances had increased significantly after distraction osteogenesis. Significant differences were found in the changes in palatal length between the 2 groups (P < .05). A mean increase of 7.50 mm in palatal length was found in the anterior maxillary segmental distraction group. No significant difference in the changes in palatopharyngeal depth or soft palatal length was found. With the ability of increasing the palatal and arch length, avoiding changes in palatopharyngeal depth, and preserving palatopharyngeal closure function, anterior maxillary segmental distraction has great value in the treatment of maxillary hypoplasia secondary to CLP. It is a promising and valuable technique in this potentially complicated procedure. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  16. Roles of frequency, attitudes, and multiple intelligence modality surrounding Electricity Content-Based Reader's Theatre

    NASA Astrophysics Data System (ADS)

    Hosier, Julie Winchester

    Integration of subjects is something elementary teachers must do to insure required objectives are covered. Science-based Reader's Theatre is one way to weave reading into science. This study examined the roles of frequency, attitudes, and Multiple Intelligence modalities surrounding Electricity Content-Based Reader's Theatre. This study used quasi-experimental, repeated measures ANOVA with time as a factor design. A convenience sample of two fifth-grade classrooms participated in the study for eighteen weeks. Five Electricity Achievement Tests were given throughout the study to assess students' growth. A Student Reader's Theatre Attitudinal Survey revealed students' attitudes before and after Electricity Content-Based Reader's Theatre treatment. The Multiple Intelligence Inventory for Kids (Faris, 2007) examined whether Multiple Intelligence modality played a role in achievement on Electricity Test 4, the post-treatment test. Analysis using repeated measures ANOVA and an independent t-test found that students in the experimental group, which practiced its student-created Electricity Content-Based Reader's Theatre skits ten times versus two times for the for control group, did significantly better on Electricity Achievement Test 4, t(76) = 3.018, p = 0.003. Dependent t-tests did not find statistically significant differences between students' attitudes about Electricity Content-Based Reader's Theatre before and after treatment. A Kruskal-Wallis test found no statistically significant difference between the various Multiple Intelligence modalities score mean ranks (x2 = 5.57, df = 2, alpha = .062). Qualitative data do, however, indicate students had strong positive feelings about Electricity Content-Based Reader's Theatre after treatment. Students indicated it to be motivating, confidence-building, and a fun way to learn about science; however, they disliked writing their own scripts. Examining the frequency, attitudes, and Multiple Intelligence modalities lead to

  17. Treatment of nonconvergence of Fourier modal method arising from irregular field singularities at lossless metal-dielectric right-angle edges.

    PubMed

    Mei, Yanpeng; Liu, Haitao; Zhong, Ying

    2014-04-01

    In a recent work [J. Opt. Soc. Am. A28, 738 (2011)], Lifeng Li and Gerard Granet investigate nonconvergence cases of the Fourier modal method (FMM). They demonstrate that the nonconvergence is due to the irregular field singularities at lossless metal-dielectric right-angle edges. Here we make further investigations on the problem and find that the FMM surprisingly converges for deep sub-wavelength gratings (grating period being much smaller than the illumination wavelength). To overcome the nonconvergence for gratings that are not deep sub-wavelength, we approximately replace the lossless metal-dielectric right-angle edges by a medium with a gradually varied refraction index, so as to remove the irregular field singularities. With such treatment, convergence is observed as the region of the approximate medium approaches vanishing.

  18. Dual-modal photoacoustic and ultrasound imaging of dental implants

    NASA Astrophysics Data System (ADS)

    Lee, Donghyun; Park, Sungjo; Kim, Chulhong

    2018-02-01

    Dental implants are common method to replace decayed or broken tooth. As the implant treatment procedures varies according to the patients' jawbone, bone ridge, and sinus structure, appropriate examinations are necessary for successful treatment. Currently, radiographic examinations including periapical radiology, panoramic X-ray, and computed tomography are commonly used for diagnosing and monitoring. However, these radiographic examinations have limitations in that patients and operators are exposed to radioactivity and multiple examinations are performed during the treatment. In this study, we demonstrated photoacoustic (PA) and ultrasound (US) combined imaging of dental implant that can lower the total amount of absorbed radiation dose in dental implant treatment. An acoustic resolution PA macroscopy and a clinical PA/US system was used for dental implant imaging. The acquired dual modal PA/US imaging results support that the proposed photoacoustic imaging strategy can reduce the radiation dose rate during dental implant treatment.

  19. Protocol for a systematic review with network meta-analysis of the modalities used to deliver eHealth interventions for chronic pain.

    PubMed

    Slattery, Brian W; Haugh, Stephanie; Francis, Kady; O'Connor, Laura; Barrett, Katie; Dwyer, Christopher P; O'Higgins, Siobhan; Egan, Jonathan; McGuire, Brian E

    2017-03-03

    As eHealth interventions prove both efficacious and practical, and as they arguably overcome certain barriers encountered by traditional face-to-face treatment for chronic pain, their number has increased dramatically in recent times. However, there is a dearth of research that focuses on evaluating and comparing the different types of technology-assisted interventions. This is a protocol for a systematic review that aims to evaluate the eHealth modalities in the context of psychological and non-psychological (other than non-drug) interventions for chronic pain. We will search the Cochrane Central Register of Controlled Trials (CENTRAL: The Cochrane Library), MEDLINE, Embase and PsycINFO. Randomised controlled trials (RCTs) with more than 20 participants per trial arm that have evaluated non-drug psychological or non-psychological interventions delivered via an eHealth modality and have pain as an outcome measure will be included. Two review authors will independently extract data and assess the study suitability in accordance with the Cochrane Collaboration Risk of Bias Tool. Studies will be included if they measure at least one outcome variable in accordance with the IMMPACT guidelines (i.e. pain severity, pain interference, physical functioning, symptoms, emotional functioning, global improvement and disposition). Secondary outcomes will be measures of depression and health-related quality of life (HRQoL). A network meta-analysis will be conducted based on direct comparisons to generate indirect comparisons of modalities across treatment trials, which will return rankings for the eHealth modalities in terms of their effectiveness. Most trials that use an eHealth intervention to manage chronic pain typically use one modality. As a result, little evidence exists to support which modality type is the most effective. The current review will address this gap in the literature and compare the different eHealth modalities used for technology-assisted interventions for

  20. Modal vector estimation for closely spaced frequency modes

    NASA Technical Reports Server (NTRS)

    Craig, R. R., Jr.; Chung, Y. T.; Blair, M.

    1982-01-01

    Techniques for obtaining improved modal vector estimates for systems with closely spaced frequency modes are discussed. In describing the dynamical behavior of a complex structure modal parameters are often analyzed: undamped natural frequency, mode shape, modal mass, modal stiffness and modal damping. From both an analytical standpoint and an experimental standpoint, identification of modal parameters is more difficult if the system has repeated frequencies or even closely spaced frequencies. The more complex the structure, the more likely it is to have closely spaced frequencies. This makes it difficult to determine valid mode shapes using single shaker test methods. By employing band selectable analysis (zoom) techniques and by employing Kennedy-Pancu circle fitting or some multiple degree of freedom (MDOF) curve fit procedure, the usefulness of the single shaker approach can be extended.

  1. Missing Modality Transfer Learning via Latent Low-Rank Constraint.

    PubMed

    Ding, Zhengming; Shao, Ming; Fu, Yun

    2015-11-01

    Transfer learning is usually exploited to leverage previously well-learned source domain for evaluating the unknown target domain; however, it may fail if no target data are available in the training stage. This problem arises when the data are multi-modal. For example, the target domain is in one modality, while the source domain is in another. To overcome this, we first borrow an auxiliary database with complete modalities, then consider knowledge transfer across databases and across modalities within databases simultaneously in a unified framework. The contributions are threefold: 1) a latent factor is introduced to uncover the underlying structure of the missing modality from the known data; 2) transfer learning in two directions allows the data alignment between both modalities and databases, giving rise to a very promising recovery; and 3) an efficient solution with theoretical guarantees to the proposed latent low-rank transfer learning algorithm. Comprehensive experiments on multi-modal knowledge transfer with missing target modality verify that our method can successfully inherit knowledge from both auxiliary database and source modality, and therefore significantly improve the recognition performance even when test modality is inaccessible in the training stage.

  2. Fecal microbiota transplantation is a rescue treatment modality for refractory ulcerative colitis

    PubMed Central

    Uygun, Ahmet; Ozturk, Kadir; Demirci, Hakan; Oger, Cem; Avci, Ismail Yasar; Turker, Turker; Gulsen, Mustafa

    2017-01-01

    Abstract Background: Fecal microbial transplantation (FMT) provides to replace beneficial bacteria with more favorable microbiomes in recipient with dysbiosis. The aim of the present study was to prospectively investigate the efficacy of FMT by assessing the clinical and endoscopic response in patients with ulcerative colitis (UC) who had failed anti-inflammatory and immunosuppressive therapy. Methods: In this prospective and uncontrolled study, 30 patients with UC were included. All medications except mesalazine were stopped 4 weeks before FMT. Colonoscopy was performed both before and after FMT. To assess the efficacy of FMT, Mayo scores were calculated at week 0 and week 12. A total of 500 mL extracted fresh fecal suspension was administered into the 30 to 40 cm proximal of terminal ileum of recipients. Results: After FMT, 21 of the (70%) 30 patients showed clinical response, and 13 of the 30 (43.3%) patients achieved clinical and endoscopic remission at the week 12. Nine patients (30%) were accepted as a nonresponder at the end of the week 12. There was no significant difference among donors concerning both the rate of clinical remission and clinical response. No adverse events were observed in the majority of patients during FMT and 12 weeks follow-up. Seven patients (23.3%) experienced mild adverse events such as nausea, vomiting, abdominal pain, diarrhea, and fewer after FMT. Conclusion: FMT could be considered as a promising rescue treatment modality before surgery in patients with refractory UC. Besides, FMT also appears to be definitely safer and more tolerable than the immunosuppressive therapy in patients with UC (NCT02575040). PMID:28422836

  3. Combined modality treatment of gastric cancer

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

    Gunderson, L.L.; Hoskins, R.B.; Cohen, A.C.

    1983-07-01

    In a series of 46 patients with localized gastric cancer treated at Massachusetts General Hospital, problems with excessive acute or chronic toxicity due to combination treatment with irradiation (XRT) and chemotherapy (CT) were not seen. Forty of the 46 received combined treatment with 2 regimens: (1) irradiation plus concomitant 3 days of 5-FU followed by maintenance 5-FU or combined drugs-26 patients; (2) in the other 14 patients, the sequence of irradiation and chemotherapy was altered. A single course of combined drug chemotherapy was given prior to irradiation and 5 to 6 additional courses were administered after completion of XRT (CT-XRT-CT).more » The drug combination was initially 5-FU-BGNU but this was changed to FAM (5-FU, Adriamycin, Mitomycin C). In this series, there were no cases of septicemia or any deaths related to treatment. A 3 year survival rate of about 20% was achieved for the total group of patients and 43% in the group with resection but at high risk for later failure. Our inability to improve these numbers is undoubtedly a result of dose limitations with external beam irradiation combined with a systemic failure problem. When irradiation is combined with surgical resection of all or a majority of tumor, both survival and local control appear to be better than in the unresected patient group. Only 4 of 29 patients (14%) with curative resection, or resection but residual disease, had later evidence of failure within the irradiation field as opposed to 6 of 9 or 66% in the group with unresectable disease.« less

  4. An introduction to physical therapy modalities.

    PubMed

    Chapman, Brenda L; Liebert, Rainer B; Lininger, Monica R; Groth, Jessica J

    2007-05-01

    Timely and appropriate rehabilitation of musculoskeletal injuries is the most effective way of restoring full function and decreasing the likelihood of recurrence of the same injury. Application of specific physical therapy modalities and therapeutic exercises is based on the stages of healing. A typical physical therapy protocol progresses sequentially through the following phases: pain control, restoring range of motion, restoring strength, neuromuscular retraining, and return to full activity. The commonly used modalities reviewed here include heat, cold, ultrasound, phonophoresis, iontophoresis, and electrical stimulation. In this article we provide a basic review of physical therapy modalities.

  5. Features and treatment modality of iliopsoas abscess and its outcome: a 6-year hospital-based study

    PubMed Central

    2013-01-01

    Background Percutaneous drainage (PCD) and surgical intervention are two primary treatment options for iliopsoas abscess (IPA). However, there is currently no consensus on when to use PCD or surgical intervention, especially in patients with gas-forming IPA. This study compared the characteristics of patients with gas-forming and non-gas forming IPA and their mortality rates under different treatment modalities. An algorithm for selecting appropriate treatment for IPA patients is proposed based on our findings. Methods Eighty-eight IPA patients between July 2007 and February 2013 were enrolled in this retrospective study. Patients < 18 years of age or with an incomplete course of treatment were excluded. Demographic information, clinical characteristics, and outcomes of different treatment approaches were compared between gas-forming IPA and non-gas forming IPA patients. Results Among the 88 enrolled patients, 27 (31%) had gas-forming IPA and 61 (69%) had non-gas forming IPA. The overall intra-hospital mortality rate was 25%. The gas-forming IPA group had a higher intra-hospital mortality rate (12/27, 44.0%) than the non-gas forming IPA group (10/61, 16.4%) (P < 0.001). Only 2 of the 13 patients in the gas-forming IPA group initially accepting PCD had a good outcome (success rate = 15.4%). Three of the 11 IPA patients with failed initial PCD expired, and 8 of the 11 patients with failed initial PCD accepted salvage operation, of whom 5 survived. Seven of the 8 gas-forming IPA patients accepting primary surgical intervention survived (success rate = 87.5%). Only 1 of the 6 gas-forming IPA patients who accepted antibiotics alone, without PCD or surgical intervention, survived (success rate = 16.7%). In the non-gas forming IPA group, 23 of 61 patients initially accepted PCD, which was successful in 17 patients (73.9%). The success rate of PCD was much higher in the non-gas forming group than in the gas-forming group (P <0.01). Conclusions Based on

  6. Eigenvectors phase correction in inverse modal problem

    NASA Astrophysics Data System (ADS)

    Qiao, Guandong; Rahmatalla, Salam

    2017-12-01

    The solution of the inverse modal problem for the spatial parameters of mechanical and structural systems is heavily dependent on the quality of the modal parameters obtained from the experiments. While experimental and environmental noises will always exist during modal testing, the resulting modal parameters are expected to be corrupted with different levels of noise. A novel methodology is presented in this work to mitigate the errors in the eigenvectors when solving the inverse modal problem for the spatial parameters. The phases of the eigenvector component were utilized as design variables within an optimization problem that minimizes the difference between the calculated and experimental transfer functions. The equation of motion in terms of the modal and spatial parameters was used as a constraint in the optimization problem. Constraints that reserve the positive and semi-positive definiteness and the inter-connectivity of the spatial matrices were implemented using semi-definite programming. Numerical examples utilizing noisy eigenvectors with augmented Gaussian white noise of 1%, 5%, and 10% were used to demonstrate the efficacy of the proposed method. The results showed that the proposed method is superior when compared with a known method in the literature.

  7. Blood glutamate grabbing does not reduce the hematoma in an intracerebral hemorrhage model but it is a safe excitotoxic treatment modality.

    PubMed

    da Silva-Candal, Andrés; Vieites-Prado, Alba; Gutiérrez-Fernández, María; Rey, Ramón I; Argibay, Bárbara; Mirelman, David; Sobrino, Tomás; Rodríguez-Frutos, Berta; Castillo, José; Campos, Francisco

    2015-07-01

    Recent studies have shown that blood glutamate grabbing is an effective strategy to reduce the excitotoxic effect of extracellular glutamate released during ischemic brain injury. The purpose of the study was to investigate the effect of two of the most efficient blood glutamate grabbers (oxaloacetate and recombinant glutamate oxaloacetate transaminase 1: rGOT1) in a rat model of intracerebral hemorrhage (ICH). Intracerebral hemorrhage was produced by injecting collagenase into the basal ganglia. Three treatment groups were developed: a control group treated with saline, a group treated with oxaloacetate, and a final group treated with human rGOT1. Treatments were given 1 hour after hemorrhage. Hematoma volume (analyzed by magnetic resonance imaging (MRI)), neurologic deficit, and blood glutamate and GOT levels were quantified over a period of 14 days after surgery. The results observed showed that the treatments used induced a significant reduction of blood glutamate levels; however, they did not reduce the hematoma, nor did they improve the neurologic deficit. In the present experimental study, we have shown that this novel therapeutic strategy is not effective in case of ICH pathology. More importantly, these findings suggest that blood glutamate grabbers are a safe treatment modality that can be given in cases of suspected ischemic stroke without previous neuroimaging.

  8. New diagnostic modalities in the diagnosis of heart failure.

    PubMed Central

    Mitchell, Judith E.; Palta, Sanjeev

    2004-01-01

    Heart failure (HF) is the one cardiovascular disease that is increasing in prevalence in the United States. As the population continues to age, the incidence will certainly be amplified. However, some studies have shown that HF is correctly diagnosed initially in only 50% of affected patients. Despite the use of history, physical examination, echocardiogram, and chest x-ray, the percentage of correct initial diagnosis of HF is low. Recognizing the symptoms of HF decompensations is often problematic because other diagnoses can mimic them. There are two new diagnostic modalities that offer promise in improving HF diagnostic accuracy and identifying early HF decompensations. These diagnostic modalities include tests utilizing impedance cardiography and the B-type natriuretic peptide assay. They have the potential of increasing the accuracy of HF diagnosis and guide pharmacological treatment in the inpatient and outpatient settings. They may also assist in the recognition (or prediction) of acute HF decompensations. Images Figure 2 PMID:15586645

  9. [Alternative treatments for interstitial cystitis].

    PubMed

    Gamé, X; Bart, S; Castel-Lacanal, E; De Sèze, M; Karsenty, G; Labat, J-J; Rigaud, J; Scheiber-Nogueira, M C; Ruffion, A

    2009-06-01

    Interstitial cystitis is the first cause of bladder pain. In case of failure of the usual treatments, several other modalities have been proposed. These therapeutic modalities are posterior sacral root neuromodulation, posterior tibial nerve stimulation, vanilloid agent intravesical instillation, intradetrusor botulinum toxin injections and surgery. A certain efficiency of each of these treatments in the interstitial cystitis has been reported. However, the evaluation of these treatments is limited and the level of evidence is too low to propose these treatments in routine.

  10. Comparison of HELIX TWT Simulation Using 2-D PIC (Magic), 2-D Modal (Gator), and 1-D Modal (Christine) Methods

    DTIC Science & Technology

    1998-05-01

    Mission Research Corporation MRC/WDC-R-424 COMPARISON OF HELIX TWT SIMULATION USING 2-D PIC ( MAGIC ), 2-D MODAL (GATOR), AND 1-D MODAL (CHRISTINE...BRILLOUIN RUN 9 3.4 OUTLIER ELECTRON EFFECT IN GATOR 12 3.5 EMISSION CONDITION AND NONLAMINAR FLOW IN MAGIC 12 3.6 RADIAL SHEAR 13 SECTION 4. PPM B...Simulation using 2-D PIC ( MAGIC ), 2-D Modal (GATOR) and 1-D Modal (CHRISTINE) methods * D.N. Smithe(a), H. Freund(b), T. M. Antonsen Jr.,(b)’(c), E

  11. [Spatial-temporal analysis and clinical findings of gait: comparison of two modalities of treatment in children with cerebral palsy-spastic hemiplegia. Preliminary report].

    PubMed

    Arellano-Martínez, Irma Tamara; Rodríguez-Reyes, Gerardo; Quiñones-Uriostegui, Ivet; Arellano-Saldaña, María Elena

    2013-01-01

    Cerebral palsy is the most common cause of disability among children. Parent's main concerns are the acquisition and improvement of gait. The aim of this study was to compare long term results of the effect of two modalities of gait training. Quantitative measurement of gait and clinical assessment of the gross motor function classification system and Modified Ashworth Scale were perfomed in 14 patients with Cerebral palsy -spastic hemiplegia and randomizedly assigned into two groups of treatment: the first one using a driven gait orthosis (Lokomat(®)) and the second a gait training a long a rail inside a hydrotherapy tank. Measurements and assessments, above described, were performed immediately and one year after the treatment concluded. Significant change was observed in the gross motor function classification system from II to I among children (p=0.042) and a positive correlation between the shape functional of the march and the gross motor function classification system (r = 0.54, p = 0.042). Patients on the Lokomat(®) training improved on gait symmetry over patients on the conventional therapy (p = 0.05). A year after, this intervention showed tendency to kept the gait patterns only on patients treated with the Lokomat(®) Benefit obtained with either modality was evident for both groups. However, residual effects observed on the Lokomat group, either in clinical assessment or gait parameters, were more promising than in the conventional therapy. Due to the size of the sample used in this study the results are not conclusive and more research must be done on this subject in long term time horizon.

  12. Modal-Power-Based Haptic Motion Recognition

    NASA Astrophysics Data System (ADS)

    Kasahara, Yusuke; Shimono, Tomoyuki; Kuwahara, Hiroaki; Sato, Masataka; Ohnishi, Kouhei

    Motion recognition based on sensory information is important for providing assistance to human using robots. Several studies have been carried out on motion recognition based on image information. However, in the motion of humans contact with an object can not be evaluated precisely by image-based recognition. This is because the considering force information is very important for describing contact motion. In this paper, a modal-power-based haptic motion recognition is proposed; modal power is considered to reveal information on both position and force. Modal power is considered to be one of the defining features of human motion. A motion recognition algorithm based on linear discriminant analysis is proposed to distinguish between similar motions. Haptic information is extracted using a bilateral master-slave system. Then, the observed motion is decomposed in terms of primitive functions in a modal space. The experimental results show the effectiveness of the proposed method.

  13. Thermal treatment and ammoniacal leaching for the recovery of valuable metals from spent lithium-ion batteries.

    PubMed

    Chen, Yongming; Liu, Nannan; Hu, Fang; Ye, Longgang; Xi, Yan; Yang, Shenghai

    2018-05-01

    The recycling of spent commercial lithium-ion batteries (LIBs) generates numerous environmental and economic benefits. In this research, a thermal treatment-ammoniacal leaching process is proposed to recover valuable metals from cathode active powder. Based on the thermal behavior by TG-DSC analysis, the cathode active powder is calcined at 300 °C and 550 °C in air atmosphere, and the crystalline phase characterization indicates that a new phase of Co 3 O 4 appears in the cathode active powder calcined at 550 °C, which signifies that the layer structure of LiCoO 2 collapses. The valence of manganese increases to form Li 4 Mn 5 O 12 in spinel structure of LiMn 2 O 4 . Using calcined cathode powder as feed material, ammoniacal leaching is carried out in (NH 4 ) 2 SO 4 -(NH 4 ) 2 SO 3 solution. Under the optimum conditions, Ni, Co, Mn and Li can be completely leached out with efficiencies of 98%, 81%, 92% and 98%, respectively. However, with the increase of ammonia concentration, the leaching efficiency of Mn decreases dramatically to 4% due to the formation of double salts. It is found that Co and Mn can be precipitated into residues in the form of (NH 4 ) 2 Co(SO 4 ) 2 ·H 2 O, (NH 4 ) 2 Mn(SO 3 ) 2 ·H 2 O and (NH 4 ) 2 Mn(SO 4 ) 2 ·6H 2 O under different leaching parameters. Based on the corresponding relationship between the leaching efficiency and phase evolution of object element, selective leaching can be achieved by controlling the formation of double salts. Copyright © 2018 Elsevier Ltd. All rights reserved.

  14. Response Modality Variations Affect Determinations of Children's Learning Styles.

    ERIC Educational Resources Information Center

    Janowitz, Jeffrey M.

    The Swassing-Barbe Modality Index (SBMI) uses visual, auditory, and tactile inputs, but only reconstructed output, to measure children's modality strengths. In this experiment, the SBMI's three input modalities were crossed with two output modalities (spoken and drawn) in addition to the reconstructed standard to result in nine treatment…

  15. Different patterns of modality dominance across development.

    PubMed

    Barnhart, Wesley R; Rivera, Samuel; Robinson, Christopher W

    2018-01-01

    The present study sought to better understand how children, young adults, and older adults attend and respond to multisensory information. In Experiment 1, young adults were presented with two spoken words, two pictures, or two word-picture pairings and they had to determine if the two stimuli/pairings were exactly the same or different. Pairing the words and pictures together slowed down visual but not auditory response times and delayed the latency of first fixations, both of which are consistent with a proposed mechanism underlying auditory dominance. Experiment 2 examined the development of modality dominance in children, young adults, and older adults. Cross-modal presentation attenuated visual accuracy and slowed down visual response times in children, whereas older adults showed the opposite pattern, with cross-modal presentation attenuating auditory accuracy and slowing down auditory response times. Cross-modal presentation also delayed first fixations in children and young adults. Mechanisms underlying modality dominance and multisensory processing are discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Multilayer modal actuator-based piezoelectric transformers.

    PubMed

    Huang, Yao-Tien; Wu, Wen-Jong; Wang, Yen-Chieh; Lee, Chih-Kung

    2007-02-01

    An innovative, multilayer piezoelectric transformer equipped with a full modal filtering input electrode is reported herein. This modal-shaped electrode, based on the orthogonal property of structural vibration modes, is characterized by full modal filtering to ensure that only the desired vibration mode is excited during operation. The newly developed piezoelectric transformer is comprised of three layers: a multilayered input layer, an insulation layer, and a single output layer. The electrode shape of the input layer is derived from its structural vibration modal shape, which takes advantage of the orthogonal property of the vibration modes to achieve a full modal filtering effect. The insulation layer possesses two functions: first, to couple the mechanical vibration energy between the input and output, and second, to provide electrical insulation between the two layers. To meet the two functions, a low temperature, co-fired ceramic (LTCC) was used to provide the high mechanical rigidity and high electrical insulation. It can be shown that this newly developed piezoelectric transformer has the advantage of possessing a more efficient energy transfer and a wider optimal working frequency range when compared to traditional piezoelectric transformers. A multilayer piezoelectric, transformer-based inverter applicable for use in LCD monitors or portable displays is presented as well.

  17. Assessment of normal tissue complications following prostate cancer irradiation: Comparison of radiation treatment modalities using NTCP models

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

    Takam, Rungdham; Bezak, Eva; Yeoh, Eric E.

    2010-09-15

    Purpose: Normal tissue complication probability (NTCP) of the rectum, bladder, urethra, and femoral heads following several techniques for radiation treatment of prostate cancer were evaluated applying the relative seriality and Lyman models. Methods: Model parameters from literature were used in this evaluation. The treatment techniques included external (standard fractionated, hypofractionated, and dose-escalated) three-dimensional conformal radiotherapy (3D-CRT), low-dose-rate (LDR) brachytherapy (I-125 seeds), and high-dose-rate (HDR) brachytherapy (Ir-192 source). Dose-volume histograms (DVHs) of the rectum, bladder, and urethra retrieved from corresponding treatment planning systems were converted to biological effective dose-based and equivalent dose-based DVHs, respectively, in order to account for differences inmore » radiation treatment modality and fractionation schedule. Results: Results indicated that with hypofractionated 3D-CRT (20 fractions of 2.75 Gy/fraction delivered five times/week to total dose of 55 Gy), NTCP of the rectum, bladder, and urethra were less than those for standard fractionated 3D-CRT using a four-field technique (32 fractions of 2 Gy/fraction delivered five times/week to total dose of 64 Gy) and dose-escalated 3D-CRT. Rectal and bladder NTCPs (5.2% and 6.6%, respectively) following the dose-escalated four-field 3D-CRT (2 Gy/fraction to total dose of 74 Gy) were the highest among analyzed treatment techniques. The average NTCP for the rectum and urethra were 0.6% and 24.7% for LDR-BT and 0.5% and 11.2% for HDR-BT. Conclusions: Although brachytherapy techniques resulted in delivering larger equivalent doses to normal tissues, the corresponding NTCPs were lower than those of external beam techniques other than the urethra because of much smaller volumes irradiated to higher doses. Among analyzed normal tissues, the femoral heads were found to have the lowest probability of complications as most of their volume was irradiated to

  18. Awareness of Prostate Cancer and Screening Modalities Among Long Island Men.

    PubMed

    Leonard, James A; Wells, Jenna B; Brandler, Ethan S

    2017-03-01

    Despite advances in prostate cancer (PC) treatment and outcomes, it remains one of the most commonly diagnosed cancers and the second leading cause of cancer mortality in men. Furthermore, there exist little data about patient awareness of PC and the frequency of screening. Adult men (470) presenting to the emergency department at a tertiary care center (Stony Brook University) between 2014 and 2015 were surveyed orally for their perceived risk of PC, awareness of PC and screening modalities, and screening history. In a population that mirrors the racial demographics of the United States, it was observed that significant disparities in awareness of PC exist among several populations including those at greatest risk. This study revealed an important opportunity for education on PC and screening modalities among the population of men at risk.

  19. Cortical reorganization in postlingually deaf cochlear implant users: Intra-modal and cross-modal considerations.

    PubMed

    Stropahl, Maren; Chen, Ling-Chia; Debener, Stefan

    2017-01-01

    With the advances of cochlear implant (CI) technology, many deaf individuals can partially regain their hearing ability. However, there is a large variation in the level of recovery. Cortical changes induced by hearing deprivation and restoration with CIs have been thought to contribute to this variation. The current review aims to identify these cortical changes in postlingually deaf CI users and discusses their maladaptive or adaptive relationship to the CI outcome. Overall, intra-modal and cross-modal reorganization patterns have been identified in postlingually deaf CI users in visual and in auditory cortex. Even though cross-modal activation in auditory cortex is considered as maladaptive for speech recovery in CI users, a similar activation relates positively to lip reading skills. Furthermore, cross-modal activation of the visual cortex seems to be adaptive for speech recognition. Currently available evidence points to an involvement of further brain areas and suggests that a focus on the reversal of visual take-over of the auditory cortex may be too limited. Future investigations should consider expanded cortical as well as multi-sensory processing and capture different hierarchical processing steps. Furthermore, prospective longitudinal designs are needed to track the dynamics of cortical plasticity that takes place before and after implantation. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  20. Current status of the use of modalities in wound care: electrical stimulation and ultrasound therapy.

    PubMed

    Ennis, William J; Lee, Claudia; Plummer, Malgorzata; Meneses, Patricio

    2011-01-01

    Wound healing is a complex pathway that requires cells, an appropriate biochemical environment (i.e., cytokines, chemokines), an extracellular matrix, perfusion, and the application of both macrostrain and microstrain. The process is both biochemically complex and energy dependent. Healing can be assisted in difficult cases through the use of physical modalities. In the current literature, there is much debate over which treatment modality, dosage level, and timing is optimal. The mechanism of action for both electrical stimulation and ultrasound are reviewed along with possible clinical applications for the plastic surgeon.

  1. 40 CFR 1033.520 - Alternative ramped modal cycles.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) Following the completion of the third test phase of the applicable ramped modal cycle, conduct the post... POLLUTION CONTROLS CONTROL OF EMISSIONS FROM LOCOMOTIVES Test Procedures § 1033.520 Alternative ramped modal... locomotive notch settings. Ramped modal cycles combine multiple test modes of a discrete-mode steady-state...

  2. Aging and response interference across sensory modalities.

    PubMed

    Guerreiro, Maria J S; Adam, Jos J; Van Gerven, Pascal W M

    2014-06-01

    Advancing age is associated with decrements in selective attention. It was recently hypothesized that age-related differences in selective attention depend on sensory modality. The goal of the present study was to investigate the role of sensory modality in age-related vulnerability to distraction, using a response interference task. To this end, 16 younger (mean age = 23.1 years) and 24 older (mean age = 65.3 years) adults performed four response interference tasks, involving all combinations of visual and auditory targets and distractors. The results showed that response interference effects differ across sensory modalities, but not across age groups. These results indicate that sensory modality plays an important role in vulnerability to distraction, but not in age-related distractibility by irrelevant spatial information.

  3. Modality and risk management for orthodontic extrusion procedures in interdisciplinary treatment for generating proper bone and tissue contours for the planned implant: a case report.

    PubMed

    Maeda, Sachiko; Sasaki, Takeshi

    2015-12-01

    In adult interdisciplinary treatments with using dental implants, limited orthodontic treatment, especially orthodontic extrusion (OE), offers many benefits by both correcting teeth alignment and by contributing to the regeneration of periodontal tissues. However, orthodontic procedures carry some risks and unpredictabilities that might compromise tooth and/or periodontal tissue health. Especially in complex cases, it is difficult to decide which orthodontic treatment modalities should be combined, in what sequences they should be applied, and what their force systems and treatment times are.To achieve optimum results, some cases require two or more OEs to the same site being carried out at different times while taking the treatment effects into consideration. Such staged OE offers minimum intervention and maximum efficiency. In this case report, OE was first applied for orthodontic extraction. After bone regeneration followed by an implant placement and another surgical operation, a second OE was applied to align the inclination of an adjacent tooth. As a result, a predictable prognosis of implants as well as greatly improved esthetics and periodontal tissue health were achieved.

  4. Veterans in substance abuse treatment program self-initiate box gardening as a stress reducing therapeutic modality.

    PubMed

    Lehmann, Lauren P; Detweiler, Jonna G; Detweiler, Mark B

    2018-02-01

    To assess the experiences of a veteran initiated horticultural therapy garden during their 28-day inpatient Substance Abuse Residential Rehabilitation Treatment Program (SARRTP). Retrospective study. Veterans Affairs Medical Center (VAMC), Salem, Virginia, USA INTERVENTIONS: Group interviews with veterans from the last SARRTP classes and individual interviews with VAMC greenhouse staff in summer of 2016. Time spent in garden, frequency of garden visits, types of passive and active garden activities, words describing the veterans' emotional reactions to utilizing the garden. In 3 summer months of 2016, 50 percent of the 56 veterans interviewed visited and interacted with the gardens during their free time. Frequency of visits generally varied from 3 times weekly to 1-2 times a day. Amount of time in the garden varied from 10min to 2h. The veterans engaged in active and/or passive gardening activities during their garden visits. The veterans reported feeling "calm", "serene", and "refreshed" during garden visitation and after leaving the garden. Although data was secured only at the end of the 2016 growing season, interviews of the inpatient veterans revealed that they used their own initiative and resources to continue the horticulture therapy program for 2 successive growing years after the original pilot project ended in 2014. These non-interventionist, therapeutic garden projects suggest the role of autonomy and patient initiative in recovery programs for veterans attending VAMC treatment programs and they also suggest the value of horticulture therapy as a meaningful evidence- based therapeutic modality for veterans. Published by Elsevier Ltd.

  5. Modulation of Myostatin/Hepatocyte Growth Factor Balance by Different Hemodialysis Modalities.

    PubMed

    Esposito, Pasquale; La Porta, Edoardo; Calatroni, Marta; Grignano, Maria Antonietta; Milanesi, Samantha; Verzola, Daniela; Battaglia, Yuri; Gregorini, Marilena; Libetta, Carmelo; Garibotto, Giacomo; Rampino, Teresa

    2017-01-01

    Background. In this study we investigated the relevance of myostatin and Hepatocyte Growth Factor (HGF) in patients undergoing hemodialysis HD and the influence of different HD modalities on their levels. Methods. We performed a prospective crossover study in which HD patients were randomized to undergo 3-month treatment periods with bicarbonate hemodialysis (BHD) followed by online hemodiafiltration (HDF). Clinical data, laboratory parameters, and myostatin and HGF serum levels were collected and compared. Results. Ten patients and six controls (C) were evaluated. In any experimental condition myostatin and HGF levels were higher in HD than in C. At enrollment and after BHD there were not significant correlations, whereas at the end of the HDF treatment period myostatin and HGF were inversely correlated ( r   -0.65, p < 0.05), myostatin serum levels inversely correlated with transferrin ( r   -0.73, p < 0.05), and HGF levels that resulted positively correlated with BMI ( r 0.67, p < 0.05). Moving from BHD to HDF, clinical and laboratory parameters were unchanged, as well as serum HGF, whereas myostatin levels significantly decreased (6.3 ± 4.1 versus 4.3 ± 3.1 ng/ml, p < 0.05). Conclusions. Modulation of myostatin levels and myostatin/HGF balance by the use of different HD modalities might represent a novel approach to the prevention and treatment of HD-related muscle wasting syndrome.

  6. The metaphysics of quantum mechanics: Modal interpretations

    NASA Astrophysics Data System (ADS)

    Gluck, Stuart Murray

    2004-11-01

    This dissertation begins with the argument that a preferred way of doing metaphysics is through philosophy of physics. An understanding of quantum physics is vital to answering questions such as: What counts as an individual object in physical ontology? Is the universe fundamentally indeterministic? Are indiscernibles identical? This study explores how the various modal interpretations of quantum mechanics answer these sorts of questions; modal accounts are one of the two classes of interpretations along with so-called collapse accounts. This study suggests a new alternative within the class of modal views that yields a more plausible ontology, one in which the Principle of the Identity of Indisceribles is necessarily true. Next, it shows that modal interpretations can consistently deny that the universe must be fundamentally indeterministic so long as they accept certain other metaphysical commitments: either a perfect initial distribution of states in the universe or some form of primitive dispositional properties. Finally, the study sketches out a future research project for modal interpretations based on developing quantified quantum logic.

  7. The therapeutic effectiveness of using visual art modalities with the bereaved: a systematic review

    PubMed Central

    Gramling, Sandra E

    2018-01-01

    Bereaved individuals are increasingly considered at risk for negative psychological and physiological outcomes. Visual art modalities are often incorporated into grief therapy interventions, and clinical application of art therapy techniques with the bereaved has been widely documented. Although clinicians and recipients of these interventions advocate for their helpfulness in adapting to bereavement, research investigating the efficacy of visual art modalities has produced equivocal results and has not yet been synthesized to establish empirical support across settings. Accordingly, this review critically evaluates the existent literature on the effectiveness of visual art modalities with the bereaved and offers suggestions for future avenues of research. A total of 27 studies were included in the current review. Meta-analysis was not possible because of clinical heterogeneity and insufficient comparable data on outcome measures across studies. A narrative synthesis reports that therapeutic application of visual art modalities was associated with positive changes such as continuing bonds with the deceased and meaning making. Modest and conflicting preliminary evidence was found to support treatment effectiveness in alleviating negative grief symptoms such as general distress, functional impairment, and symptoms of depression and anxiety. PMID:29440940

  8. The therapeutic effectiveness of using visual art modalities with the bereaved: a systematic review.

    PubMed

    Weiskittle, Rachel E; Gramling, Sandra E

    2018-01-01

    Bereaved individuals are increasingly considered at risk for negative psychological and physiological outcomes. Visual art modalities are often incorporated into grief therapy interventions, and clinical application of art therapy techniques with the bereaved has been widely documented. Although clinicians and recipients of these interventions advocate for their helpfulness in adapting to bereavement, research investigating the efficacy of visual art modalities has produced equivocal results and has not yet been synthesized to establish empirical support across settings. Accordingly, this review critically evaluates the existent literature on the effectiveness of visual art modalities with the bereaved and offers suggestions for future avenues of research. A total of 27 studies were included in the current review. Meta-analysis was not possible because of clinical heterogeneity and insufficient comparable data on outcome measures across studies. A narrative synthesis reports that therapeutic application of visual art modalities was associated with positive changes such as continuing bonds with the deceased and meaning making. Modest and conflicting preliminary evidence was found to support treatment effectiveness in alleviating negative grief symptoms such as general distress, functional impairment, and symptoms of depression and anxiety.

  9. Verifying different-modality properties for concepts produces switching costs.

    PubMed

    Pecher, Diane; Zeelenberg, René; Barsalou, Lawrence W

    2003-03-01

    According to perceptual symbol systems, sensorimotor simulations underlie the representation of concepts. It follows that sensorimotor phenomena should arise in conceptual processing. Previous studies have shown that switching from one modality to another during perceptual processing incurs a processing cost. If perceptual simulation underlies conceptual processing, then verifying the properties of concepts should exhibit a switching cost as well. For example, verifying a property in the auditory modality (e.g., BLENDER-loud) should be slower after verifying a property in a different modality (e.g., CRANBERRIES-tart) than after verifying a property in the same modality (e.g., LEAVES-rustling). Only words were presented to subjects, and there were no instructions to use imagery. Nevertheless, switching modalities incurred a cost, analogous to the cost of switching modalities in perception. A second experiment showed that this effect was not due to associative priming between properties in the same modality. These results support the hypothesis that perceptual simulation underlies conceptual processing.

  10. The genetic basis of new treatment modalities in melanoma.

    PubMed

    Kunz, Manfred

    2015-01-01

    In recent years, intracellular signal transduction via RAS-RAF-MEK-ERK has been successfully targeted in new treatment approaches for melanoma using small molecule inhibitors against activated BRAF (V600E mutation) and activated MEK1/2. Also mutated c-KIT has been identified as a promising target. Meanwhile, evidence has been provided that combinations between BRAF inhibitors and MEK1/2 inhibitors are more promising than single-agent treatments. Moreover, new treatment algorithms favor sequential treatment using BRAF inhibitors and newly developed immunotherapies targeting common T lymphocyte antigen 4 (CTLA-4) or programmed cell death 1 (PD-1). In depth molecular analyses have uncovered new mechanisms of treatment resistance and recurrence, which may impact on future treatment decisions. Moreover, next-generation sequencing data have shown that recurrent lesions harbor specific genetic aberrations. At the same time, high throughput sequencing studies of melanoma unraveled a series of new treatment candidates for future treatment approaches such as ERBB4, GRIN2A, GRM3, and RAC1. More recent bioinformatic technologies provided genetic evidence for extensive tumor heterogeneity and tumor clonality of solid tumors, which might also be of relevance for melanoma. However, these technologies have not yet been applied to this tumor. In this review, an overview on the genetic basis of current treatment of melanoma, treatment resistance and recurrences including new treatment perspectives based on recent high-throughput sequencing data is provided. Moreover, future aspects of individualized treatment based on each patient's individual mutational landscape are discussed.

  11. Semantic control and modality: an input processing deficit in aphasia leading to deregulated semantic cognition in a single modality.

    PubMed

    Thompson, Hannah E; Jefferies, Elizabeth

    2013-08-01

    Research suggests that semantic memory deficits can occur in at least three ways. Patients can (1) show amodal degradation of concepts within the semantic store itself, such as in semantic dementia (SD), (2) have difficulty in controlling activation within the semantic system and accessing appropriate knowledge in line with current goals or context, as in semantic aphasia (SA) and (3) experience a semantic deficit in only one modality following degraded input from sensory cortex. Patients with SA show deficits of semantic control and access across word and picture tasks, consistent with the view that their problems arise from impaired modality-general control processes. However, there are a few reports in the literature of patients with semantic access problems restricted to auditory-verbal materials, who show decreasing ability to retrieve concepts from words when they are presented repeatedly with closely related distractors. These patients challenge the notion that semantic control processes are modality-general and suggest instead a separation of 'access' to auditory-verbal and non-verbal semantic systems. We had the rare opportunity to study such a case in detail. Our aims were to examine the effect of manipulations of control demands in auditory-verbal semantic, non-verbal semantic and non-semantic tasks, allowing us to assess whether such cases always show semantic control/access impairments that follow a modality-specific pattern, or whether there are alternative explanations. Our findings revealed: (1) deficits on executive tasks, unrelated to semantic demands, which were more evident in the auditory modality than the visual modality; (2) deficits in executively-demanding semantic tasks which were accentuated in the auditory-verbal domain compared with the visual modality, but still present on non-verbal tasks, and (3) a coupling between comprehension and executive control requirements, in that mild impairment on single word comprehension was greatly

  12. Valuable human capital: the aging health care worker.

    PubMed

    Collins, Sandra K; Collins, Kevin S

    2006-01-01

    With the workforce growing older and the supply of younger workers diminishing, it is critical for health care managers to understand the factors necessary to capitalize on their vintage employees. Retaining this segment of the workforce has a multitude of benefits including the preservation of valuable intellectual capital, which is necessary to ensure that health care organizations maintain their competitive advantage in the consumer-driven market. Retaining the aging employee is possible if health care managers learn the motivators and training differences associated with this category of the workforce. These employees should be considered a valuable resource of human capital because without their extensive expertise, intense loyalty and work ethic, and superior customer service skills, health care organizations could suffer severe economic repercussions in the near future.

  13. Modal Analysis of Space-rocket Equipment Components

    NASA Astrophysics Data System (ADS)

    Igolkin, A. A.; Safin, A. I.; Prokofiev, A. B.

    2018-01-01

    In order to prevent vibration damage an analysis of natural frequencies and mode shapes of elements of rocket and space technology should be developed. This paper discusses technique of modal analysis on the example of the carrier platform. Modal analysis was performed by using mathematical modeling and laser vibrometer. Experimental data was clarified by using Test.Lab software. As a result of modal analysis amplitude-frequency response of carrier platform was obtained and the parameters of the elasticity was clarified.

  14. Pre-Motor Response Time Benefits in Multi-Modal Displays

    DTIC Science & Technology

    2013-11-12

    when animals are presented with stimuli from two sensory modalities as compared with stimulation from only one modality. The combinations of two...modality attention and orientation behaviors (see also Wallace, Meredith, & Stein, 609 !998). Multi-modal stimulation in the world is not always...perceptually when the stimuli are congruent. In another study, Craig (2006) had participants judge the direction of apparent motion by stimulating

  15. 3D multi-scale FCN with random modality voxel dropout learning for Intervertebral Disc Localization and Segmentation from Multi-modality MR Images.

    PubMed

    Li, Xiaomeng; Dou, Qi; Chen, Hao; Fu, Chi-Wing; Qi, Xiaojuan; Belavý, Daniel L; Armbrecht, Gabriele; Felsenberg, Dieter; Zheng, Guoyan; Heng, Pheng-Ann

    2018-04-01

    Intervertebral discs (IVDs) are small joints that lie between adjacent vertebrae. The localization and segmentation of IVDs are important for spine disease diagnosis and measurement quantification. However, manual annotation is time-consuming and error-prone with limited reproducibility, particularly for volumetric data. In this work, our goal is to develop an automatic and accurate method based on fully convolutional networks (FCN) for the localization and segmentation of IVDs from multi-modality 3D MR data. Compared with single modality data, multi-modality MR images provide complementary contextual information, which contributes to better recognition performance. However, how to effectively integrate such multi-modality information to generate accurate segmentation results remains to be further explored. In this paper, we present a novel multi-scale and modality dropout learning framework to locate and segment IVDs from four-modality MR images. First, we design a 3D multi-scale context fully convolutional network, which processes the input data in multiple scales of context and then merges the high-level features to enhance the representation capability of the network for handling the scale variation of anatomical structures. Second, to harness the complementary information from different modalities, we present a random modality voxel dropout strategy which alleviates the co-adaption issue and increases the discriminative capability of the network. Our method achieved the 1st place in the MICCAI challenge on automatic localization and segmentation of IVDs from multi-modality MR images, with a mean segmentation Dice coefficient of 91.2% and a mean localization error of 0.62 mm. We further conduct extensive experiments on the extended dataset to validate our method. We demonstrate that the proposed modality dropout strategy with multi-modality images as contextual information improved the segmentation accuracy significantly. Furthermore, experiments conducted on

  16. Comparison of Sexual Function and Hormonal Parameters Between Mood Stabilizer Treatment Modalities in Bipolar Disorder

    PubMed Central

    KESEBİR, Sermin; TOPRAK, Burak; BAYKARAN, Burak; HARİRİ, Aytül; BİLİCİ, Mustafa

    2014-01-01

    Introduction The aim of this study was to determine the differences between lithium and atypical antipsychotics (quetiapine and olanzapine) with regard to their effects on sexual functions and hormonal variables and to assess the findings in term of gender differences, in patients with bipolar disorder. Method 28 female and 29 male patients diagnosed as having bipolar disorder type I according to the DSM-IV, using lithium or quetiapine and quetiapine+lithium or olanzapine and olanzapine+lithium were evaluated consecutively. Being in remission period and given informed consent were set as inclusion criteria in these cases. Interviews with the patients were carried out using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and SKIP-TURK. Sexual functions and satisfaction were evaluated with the Arizona Sexual Experiences Scale (ASEX) and the Golombok Rust Inventory of Sexual Satisfaction (GRISS). Blood samples of the patients were taken in order to determine prolactin (PRL), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), and free testosterone (T) levels. Results GRISS scores in male patients were higher than in female patients (p=.001). The number of manic, depressive and total episodes, and functionality levels were similar between the treatment groups, both in female and male patients. No differences were found between treatment modalities in terms of hormone levels both in female and male patients. Among females, ASEX scores of the patients treated with lithium monotherapy were less than the ones treated with quetiapine and olanzapine. Among patients with quetiapine monotherapy, GRISS scores in male patients were higher than in female patients. Conclusion There are some evidences showing gender-based differences in the side effects of atypical antipsychotic drugs. Future studies with a specific focus on this topic are needed in order to have a better understanding of the basic mechanisms of gender differences

  17. Cost-effectiveness of secondary screening modalities for hypertension.

    PubMed

    Wang, Y Claire; Koval, Alisa M; Nakamura, Miyabi; Newman, Jonathan D; Schwartz, Joseph E; Stone, Patricia W

    2013-02-01

    Clinic-based blood pressure (CBP) has been the default approach for the diagnosis of hypertension, but patients may be misclassified because of masked hypertension (false negative) or 'white coat' hypertension (false positive). The incorporation of other diagnostic modalities, such as home blood pressure monitoring (HBPM) and ambulatory blood pressure monitoring (ABPM), holds promise to improve diagnostic accuracy and subsequent treatment decisions. We reviewed the literature on the costs and cost-effectiveness of adding HBPM and ABPM to routine blood pressure screening in adults. We excluded letters, editorials, and studies of pregnant and/or pre-eclamptic patients, children, and patients with specific conditions (e.g. diabetes). We identified 14 original, English language studies that included cost outcomes and compared two or more modalities. ABPM was found to be cost saving for diagnostic confirmation following an elevated CBP in six studies. Three of four studies found that adding HBPM to an elevated CBP was also cost-effective. Existing evidence supports the cost-effectiveness of incorporating HBPM or ABPM after an initial CBP-based diagnosis of hypertension. Future research should focus on their implementation in clinical practice, long-term economic values, and potential roles in identifying masked hypertension.

  18. [Use of hypnosis in the treatment of combat post traumatic stress disorder (PTSD)].

    PubMed

    Abramowitz, Eitan G; Bonne, Omer

    2013-08-01

    Clinical reports and observations going back almost two centuries consistently indicate that hypnotherapy is an effective modality for the treatment of post traumatic stress disorder (PTSD). Pierre Janet was the first clinician to describe the successful initiation of stepwise hypnotic techniques in PTSD symptom reduction. Hypnotherapy may accelerate the formation of a therapeutic alliance and contribute to a positive treatment outcome. Hypnotic techniques may be valuable for patients with PTSD who exhibit symptoms such as anxiety, dissociation, widespread somatoform pain complaints and sleep disturbances. Hypnotic techniques may also facilitate the arduous tasks of working through traumatic memories, increasing coping skills, and promoting a sense of competency. In this review we will present guidelines for the stepwise implementation of hypnotherapy in PTSD. Since most data regarding the use of hypnotherapy in PTSD has been gathered from uncontrolled clinical observations, methodologically sound research demonstrating the efficacy of hypnotic techniques in PTSD is required for hypnotherapy to be officially added to the therapeutic armamentarium for this disorder.

  19. Radical Cystectomy Compared to Combined Modality Treatment for Muscle-Invasive Bladder Cancer: A Systematic Review and Meta-Analysis

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

    Vashistha, Vishal; Wang, Hanzhang; Mazzone, Andrew

    Purpose: To perform a comprehensive comparison of overall survival (OS), disease-specific survival (DSS), progression-free survival (PFS), and treatment-related complications between radical cystectomy (RC) and combined modality treatment (CMT—radiation therapy, concurrent chemotherapy, and maximal transurethral resection of bladder tumor) in the setting of muscle-invasive bladder cancer. Methods and Materials: We searched 7 databases (PubMed, Scopus, EMBASE, Proquest, CINAHL, and (ClinicalTrials.gov)) for randomized, controlled trials and prospective and retrospective studies directly comparing RC with CMT from database inception to March 2016. We conducted meta-analyses evaluating OS, DSS, and PFS with hazard ratios (HRs) and 95% confidence intervals (CIs). Results: Nineteen studies evaluating 12,380 subjects weremore » selected. For the 8 studies encompassing 9554 subjects eligible for meta-analyses, we found no difference in OS at 5 years (HR 0.96, favoring CMT, 95% CI 0.72-1.29; P=.778) or 10 years (HR 1.02, favoring cystectomy, 95% CI 0.73-1.42; P=.905). No difference was observed in DSS at 5 years (HR 0.83, favoring radiation, 95% CI 0.54-1.28; P=.390) or 10 years (HR 1.17, favoring cystectomy, 95% CI 0.89-1.55; P=.264), or PFS at 10 years (HR 0.85, favoring CMT, 95% CI 0.43-1.67; P=.639). The cystectomy arms had higher rates of early major complications, whereas rates of minor complications were similar between the 2 treatments. Conclusion: Current meta-analysis reveals no differences in OS, DSS, or PFS between RC and CMT. Further randomized, controlled trials are necessary to identify the optimal treatment for specific patients.« less

  20. Dynamic modal estimation using instrumental variables

    NASA Technical Reports Server (NTRS)

    Salzwedel, H.

    1980-01-01

    A method to determine the modes of dynamical systems is described. The inputs and outputs of a system are Fourier transformed and averaged to reduce the error level. An instrumental variable method that estimates modal parameters from multiple correlations between responses of single input, multiple output systems is applied to estimate aircraft, spacecraft, and off-shore platform modal parameters.

  1. Modality comparison for small animal radiotherapy: A simulation study

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

    Bazalova, Magdalena, E-mail: bazalova@stanford.edu; Nelson, Geoff; Noll, John M.

    Purpose: Small animal radiation therapy has advanced significantly in recent years. Whereas in the past dose was delivered using a single beam and a lead shield for sparing of healthy tissue, conformal doses can be now delivered using more complex dedicated small animal radiotherapy systems with image guidance. The goal of this paper is to investigate dose distributions for three small animal radiation treatment modalities. Methods: This paper presents a comparison of dose distributions generated by the three approaches—a single-field irradiator with a 200 kV beam and no image guidance, a small animal image-guided conformal system based on a modified microCTmore » scanner with a 120 kV beam developed at Stanford University, and a dedicated conformal system, SARRP, using a 220 kV beam developed at Johns Hopkins University. The authors present a comparison of treatment plans for the three modalities using two cases: a mouse with a subcutaneous tumor and a mouse with a spontaneous lung tumor. A 5 Gy target dose was calculated using the EGSnrc Monte Carlo codes. Results: All treatment modalities generated similar dose distributions for the subcutaneous tumor case, with the highest mean dose to the ipsilateral lung and bones in the single-field plan (0.4 and 0.4 Gy) compared to the microCT (0.1 and 0.2 Gy) and SARRP (0.1 and 0.3 Gy) plans. The lung case demonstrated that due to the nine-beam arrangements in the conformal plans, the mean doses to the ipsilateral lung, spinal cord, and bones were significantly lower in the microCT plan (2.0, 0.4, and 1.9 Gy) and the SARRP plan (1.5, 0.5, and 1.8 Gy) than in single-field irradiator plan (4.5, 3.8, and 3.3 Gy). Similarly, the mean doses to the contralateral lung and the heart were lowest in the microCT plan (1.5 and 2.0 Gy), followed by the SARRP plan (1.7 and 2.2 Gy), and they were highest in the single-field plan (2.5 and 2.4 Gy). For both cases, dose uniformity was greatest in the single-field irradiator plan

  2. A comparison of three different physiotherapy modalities used in the physiotherapy of burns.

    PubMed

    Sar, Zübeyir; Polat, Mine Gülden; Özgül, Bahar; Aydoğdu, Onur; Camcoğlu, Burcu; Acar, Ahmet Hakan; Yurdalan, Saadet Ufuk

    2013-01-01

    The present study compared the effectiveness of matrix rhythm therapy, ultrasound treatment (UT), laser treatment (LT) used in the physiotherapy of burns. The study was conducted at the Wound and Burn Healing Center, Dr. Lütfi Kırdar Kartal Education and Research Hospital (Turkey) from June 2009 to January 2012. The case series comprised 39 individuals with second- and third-degree upper-limb burns, whose burn traumas ended approximately 1 to 3 months previously. Participants were separated into three groups: matrix rhythm treatment (MRT), UT and LT; each group was also applied a treatment protocol including whirlpool and exercise. Pain, range of motion (ROM), muscular strength, skin elasticity, and sensory functions were evaluated before and after the treatment. Pressure sense and passive ROM were higher in the MRT group than in the LT group (P < .05). Pain was lower in the LT group than in the UT group, and passive ROM was higher in the UT group than the in LT group (P < .05). Active ROM was found to increase in all treatment groups, whereas passive ROM increased only in the MRT and UT groups; pressure sense increased only in the MRT group, and pain decreased only in the LT group (P < .05). MRT was found to be more effective in the restoration of sensory functions than LT, whereas LT was more effective in reducing pain than UT. No significant difference was observed in terms of skin elasticity according to the results of three treatment modalities. It is suggested that further research with more cases should be conducted to examine the long-term effect of treatment modalities.

  3. Dual-modality imaging of function and physiology

    NASA Astrophysics Data System (ADS)

    Hasegawa, Bruce H.; Iwata, Koji; Wong, Kenneth H.; Wu, Max C.; Da Silva, Angela; Tang, Hamilton R.; Barber, William C.; Hwang, Andrew B.; Sakdinawat, Anne E.

    2002-04-01

    Dual-modality imaging is a technique where computed tomography or magnetic resonance imaging is combined with positron emission tomography or single-photon computed tomography to acquire structural and functional images with an integrated system. The data are acquired during a single procedure with the patient on a table viewed by both detectors to facilitate correlation between the structural and function images. The resulting data can be useful for localization for more specific diagnosis of disease. In addition, the anatomical information can be used to compensate the correlated radionuclide data for physical perturbations such as photon attenuation, scatter radiation, and partial volume errors. Thus, dual-modality imaging provides a priori information that can be used to improve both the visual quality and the quantitative accuracy of the radionuclide images. Dual-modality imaging systems also are being developed for biological research that involves small animals. The small-animal dual-modality systems offer advantages for measurements that currently are performed invasively using autoradiography and tissue sampling. By acquiring the required data noninvasively, dual-modality imaging has the potential to allow serial studies in a single animal, to perform measurements with fewer animals, and to improve the statistical quality of the data.

  4. Experience with free fibula transfer with screw fixation as a primary modality of treatment for congenital pseudarthosis of tibia in children - Series of 26 cases

    PubMed Central

    Kalra, Guru Dayal Singh; Agarwal, Amit

    2012-01-01

    Background: Congenital pseudarthrosis is one of the greatest challenges of paediatric orthopaedic practice. Treatment options and literature addressing this condition are numerous, reflecting the difficulty in management. We aimed to study the effectiveness of free fibula transfer as a primary modality of treatment in children with this condition in terms of achieving length, union, and normal axis of the involved leg. Materials and Methods: During the period of 2001 to 2010, 26 children with congenital pseudarthrosis of tibia between age group of 2-8 years were evaluated and were reconstructed using contra-lateral free fibula graft, and then patients were followed up for 5 years subsequently. Patients were examined and time of bony union, weight bearing ability and walking without support were noted. Any complication directly or indirectly related to surgery with any complication seen in the due course of follow up of 5 years was also taken care of. Results: In our experience with treatment of congenital pseudarthrosis over a span of 10 years with free fibula transfer, the results have been gratifying with no flap loss. All our patients had UNEVENTFUL post-op recovery. Only 2 patients out of 26 had non-union, for which cancellous bone grafting was done (7.6%). Most of the patients were ambulatory with support by 3-6 months and continued to walk without support after a span of 18-24 months. The incidence of stress fracture in our study over the follow-up period was 4 out of 26 pts (15.3%). None of them had any deformity in the donor leg. Conclusion: When compared to other surgical modalities of treatment of the problem in question, vascularised free fibula transfer has emerged as a real saviour with good patient compliance and less complication rate in our study. It achieves the desired target with no residual deformities and near normal to normal gait with no stigma of bone removal from other leg. PMID:23450675

  5. Modal Filtering for Control of Flexible Aircraft

    NASA Technical Reports Server (NTRS)

    Suh, Peter M.; Mavris, Dimitri N.

    2013-01-01

    Modal regulators and deformation trackers are designed for an open-loop fluttering wing model. The regulators are designed with modal coordinate and accelerometer inputs respectively. The modal coordinates are estimated with simulated fiber optics. The robust stability of the closed-loop systems is compared in a structured singular-value vector analysis. Performance is evaluated and compared in a gust alleviation and flutter suppression simulation. For the same wing and flight condition two wing-shape-tracking control architectures are presented, which achieve deformation control at any point on the wing.

  6. Learning Across Senses: Cross-Modal Effects in Multisensory Statistical Learning

    PubMed Central

    Mitchel, Aaron D.; Weiss, Daniel J.

    2014-01-01

    It is currently unknown whether statistical learning is supported by modality-general or modality-specific mechanisms. One issue within this debate concerns the independence of learning in one modality from learning in other modalities. In the present study, the authors examined the extent to which statistical learning across modalities is independent by simultaneously presenting learners with auditory and visual streams. After establishing baseline rates of learning for each stream independently, they systematically varied the amount of audiovisual correspondence across 3 experiments. They found that learners were able to segment both streams successfully only when the boundaries of the audio and visual triplets were in alignment. This pattern of results suggests that learners are able to extract multiple statistical regularities across modalities provided that there is some degree of cross-modal coherence. They discuss the implications of their results in light of recent claims that multisensory statistical learning is guided by modality-independent mechanisms. PMID:21574745

  7. Recovery of valuable materials from waste liquid crystal display panel.

    PubMed

    Li, Jinhui; Gao, Song; Duan, Huabo; Liu, Lili

    2009-07-01

    Associated with the rapid development of the information and electronic industry, liquid crystal displays (LCDs) have been increasingly sold as displays. However, during the discarding at their end-of-life stage, significant environmental hazards, impacts on health and a loss of resources may occur, if the scraps are not managed in an appropriate way. In order to improve the efficiency of the recovery of valuable materials from waste LCDs panel in an environmentally sound manner, this study presents a combined recycling technology process on the basis of manual dismantling and chemical treatment of LCDs. Three key processes of this technology have been studied, including the separation of LCD polarizing film by thermal shock method the removal of liquid crystals between the glass substrates by the ultrasonic cleaning, and the recovery of indium metal from glass by dissolution. The results show that valuable materials (e.g. indium) and harmful substances (e.g. liquid crystals) could be efficiently recovered or separated through above-mentioned combined technology. The optimal conditions are: (1) the peak temperature of thermal shock to separate polarizing film, ranges from 230 to 240 degrees C, where pyrolysis could be avoided; (2) the ultrasonic-assisted cleaning was most efficient at a frequency of 40 KHz (P = 40 W) and the exposure of the substrate to industrial detergents for 10 min; and (3) indium separation from glass in a mix of concentrated hydrochloric acid at 38% and nitric acid at 69% (HCl:HNO(3):H(2)O = 45:5:50, volume ratio). The indium separation process was conducted with an exposure time of 30 min at a constant temperature of 60 degrees C.

  8. Investigative modalities in infectious keratitis.

    PubMed

    Gupta, Noopur; Tandon, Radhika

    2008-01-01

    Standard recommended guidelines for diagnosis of infectious keratitis do exist. Based on an extensive Medline literature search, the various investigative modalities available for aiding the diagnosis of microbial keratitis have been reviewed and described briefly. Preferred practice patterns have been outlined and the importance of routine pre-treatment cultures in the primary management of infectious keratitis has been highlighted. Corneal scraping, tear samples and corneal biopsy are few of the specimens needed to carry out the investigative procedures for diagnosis and for initiating therapy in cases of microbial keratitis. In bacterial, fungal and amoebic keratitis, microscopic examination of smears is essential for rapid diagnosis. Potassium hydroxide (KOH) wet mount, Gram's stain and Giemsa stain are widely used and are important for clinicians to start empirical therapy before microbial culture results are available. The usefulness of performing corneal cultures in all cases of suspected infectious keratitis has been well established. In cases of suspected viral keratitis, therapy can be initiated on clinical judgment alone. If a viral culture is needed, scrapings should directly be inoculated into the viral transport media. In vivo confocal microscopy is a useful adjunct to slit lamp bio-microscopy for supplementing diagnosis in most cases and establishing early diagnosis in many cases of non-responding fungal and amoebic keratitis. This is a non-invasive, high resolution technique which allows rapid detection of Acanthamoeba cysts and trophozoites and fungal hyphae in the cornea long before laboratory cultures give conclusive results. Other new modalities for detection of microbial keratitis include molecular diagnostic techniques like polymerase chain reaction, and genetic finger printing by pulsed field gel electrophoresis.

  9. Dialysis modality preference of patients with CKD and family caregivers: a discrete-choice study.

    PubMed

    Morton, Rachael L; Snelling, Paul; Webster, Angela C; Rose, John; Masterson, Rosemary; Johnson, David W; Howard, Kirsten

    2012-07-01

    Dialysis modality preferences of patients with chronic kidney disease (CKD) and family caregivers are important, yet rarely quantified. Prospective, unlabeled, discrete-choice experiment with random-parameter logit analysis. Adults with stages 3-5 CKD and caregivers educated about dialysis treatment options from 8 Australian renal clinics. Preferences for and trade-offs between the dialysis treatment attributes of life expectancy, number of hospital visits per week, ability to travel, hours per treatment, treatment time of day, subsidized transport service, and flexibility of treatment schedule. Results presented as ORs for preferring home-based or in-center dialysis to conservative care. 105 predialysis patients and 73 family caregivers completed the study. Median patient age was 63 years, and mean estimated glomerular filtration rate was 18.1 (range, 6-34) mL/min/1.73 m(2). Median caregiver age was 61 years. Home-based dialysis (either peritoneal or home hemodialysis) was chosen by patients in 65% of choice sets; in-center dialysis, in 35%; and conservative care, in 10%. For caregivers, this was 72%, 25%, and 3%, respectively. Both patients and caregivers preferred longer rather than shorter hours of dialysis (ORs of 2.02 [95% CI, 1.51-2.70] and 2.67 [95% CI, 1.85-3.85] for patients and caregivers, respectively), but were less likely to choose nocturnal than daytime dialysis (ORs of 0.07 [95% CI, 0.01-0.75] and 0.03 [95% CI, 0.01-0.20]). Patients were willing to forgo 23 (95% CI, 19-27) months of life expectancy with home-based dialysis to decrease their travel restrictions. For caregivers, this was 17 (95% CI, 16-18) patient-months. Data were limited to stated preferences rather than actual choice of dialysis modality. Our study suggests that it is rare for caregivers to prefer conservative nondialytic care for family members with CKD. Home-based dialysis modalities that enable patients and their family members to travel with minimal restriction would be

  10. [Effect of sound amplification on parent's communicative modalities].

    PubMed

    Couto, Maria Inês Vieira; Lichtig, Ida

    2007-01-01

    auditory rehabilitation in deaf children users of sign language. to verify the effects of sound amplification on parent's communicative modalities when interacting with their deaf children. participants were twelve deaf children, aged 50 to 80 months and their hearing parents. Children had severe or profound hearing loss in their better ear and were fitted with hearing aids in both ears. Children communicated preferably through sign language. The cause-effect relation between the children's auditory skills profile (insertion gain, functional gain and The Meaningful Auditory Integration Scale--MAIS) and the communicative modalities (auditive-oral, visuo-spacial, bimodal) used by parents was analyzed. Communicative modalities were compared in two different experimental situations during a structured interaction between parents and children, i.e. when children were not fitted with their hearing aids (Situation 1) and when children were fitted with them (Situation 2). Data was analyzed using descriptive statistics. the profile of the deaf children's auditory skills demonstrated to be lower than 53% (unsatisfactory). Parents used predominately the bimodal modality to gain children's attention, to transmit and to end tasks. A slight positive effect of sound amplification on the communicative modalities was observed, once parents presented more turn-takings during communication when using the auditory-oral modality in Situation 2. hearing parents tend to use more turn-takings during communication in the auditory-oral modality to gain children's attention, to transmit and to end tasks, since they observe an improvement in the auditory skills of their children.

  11. Is Attentional Resource Allocation Across Sensory Modalities Task-Dependent?

    PubMed

    Wahn, Basil; König, Peter

    2017-01-01

    Human information processing is limited by attentional resources. That is, via attentional mechanisms, humans select a limited amount of sensory input to process while other sensory input is neglected. In multisensory research, a matter of ongoing debate is whether there are distinct pools of attentional resources for each sensory modality or whether attentional resources are shared across sensory modalities. Recent studies have suggested that attentional resource allocation across sensory modalities is in part task-dependent. That is, the recruitment of attentional resources across the sensory modalities depends on whether processing involves object-based attention (e.g., the discrimination of stimulus attributes) or spatial attention (e.g., the localization of stimuli). In the present paper, we review findings in multisensory research related to this view. For the visual and auditory sensory modalities, findings suggest that distinct resources are recruited when humans perform object-based attention tasks, whereas for the visual and tactile sensory modalities, partially shared resources are recruited. If object-based attention tasks are time-critical, shared resources are recruited across the sensory modalities. When humans perform an object-based attention task in combination with a spatial attention task, partly shared resources are recruited across the sensory modalities as well. Conversely, for spatial attention tasks, attentional processing does consistently involve shared attentional resources for the sensory modalities. Generally, findings suggest that the attentional system flexibly allocates attentional resources depending on task demands. We propose that such flexibility reflects a large-scale optimization strategy that minimizes the brain's costly resource expenditures and simultaneously maximizes capability to process currently relevant information.

  12. Rigorous modal analysis of plasmonic nanoresonators

    NASA Astrophysics Data System (ADS)

    Yan, Wei; Faggiani, Rémi; Lalanne, Philippe

    2018-05-01

    The specificity of modal-expansion formalisms is their capabilities to model the physical properties in the natural resonance-state basis of the system in question, leading to a transparent interpretation of the numerical results. In electromagnetism, modal-expansion formalisms are routinely used for optical waveguides. In contrast, they are much less mature for analyzing open non-Hermitian systems, such as micro- and nanoresonators. Here, by accounting for material dispersion with auxiliary fields, we considerably extend the capabilities of these formalisms, in terms of computational effectiveness, number of states handled, and range of validity. We implement an efficient finite-element solver to compute the resonance states, and derive closed-form expressions of the modal excitation coefficients for reconstructing the scattered fields. Together, these two achievements allow us to perform rigorous modal analysis of complicated plasmonic resonators, being not limited to a few resonance states, with straightforward physical interpretations and remarkable computation speeds. We particularly show that, when the number of states retained in the expansion increases, convergence toward accurate predictions is achieved, offering a solid theoretical foundation for analyzing important issues, e.g., Fano interference, quenching, and coupling with the continuum, which are critical in nanophotonic research.

  13. Modal Filters for Infrared Interferometry

    NASA Technical Reports Server (NTRS)

    Ksendzov, Alexander; MacDonald, Daniel R.; Soibel, Alexander

    2009-01-01

    Modal filters in the approximately equal to 10-micrometer spectral range have been implemented as planar dielectric waveguides in infrared interferometric applications such as searching for Earth-like planets. When looking for a small, dim object ("Earth") in close proximity to a large, bright object ("Sun"), the interferometric technique uses beams from two telescopes combined with a 180 phase shift in order to cancel the light from a brighter object. The interferometer baseline can be adjusted so that, at the same time, the light from the dimmer object arrives at the combiner in phase. This light can be detected and its infrared (IR) optical spectra can be studied. The cancellation of light from the "Sun" to approximately equal to 10(exp 6) is required; this is not possible without special devices-modal filters- that equalize the wavefronts arriving from the two telescopes. Currently, modal filters in the approximately equal to 10-micrometer spectral range are implemented as single- mode fibers. Using semiconductor technology, single-mode waveguides for use as modal filters were fabricated. Two designs were implemented: one using an InGaAs waveguide layer matched to an InP substrate, and one using InAlAs matched to an InP substrate. Photon Design software was used to design the waveguides, with the main feature all designs being single-mode operation in the 10.5- to 17-micrometer spectral range. Preliminary results show that the filter's rejection ratio is 26 dB.

  14. Study modality and false recall.

    PubMed

    Smith, Rebekah E; Engle, Randall W

    2011-01-01

    False memories occur when individuals mistakenly report an event as having taken place when that event did not in fact occur. The DRM (Deese, 1959; Roediger & McDermott, 1995) paradigm provides an effective technique for creating and investigating false memories. In this paradigm participants study a list of words (e.g., SOUR, CANDY,…) that are highly associated to a non-presented critical item (e.g., SWEET). The study phase is followed by a test of memory for the study list words. Researchers typically find very high levels of false recall of the critical non-presented item. However, the likelihood of falsely remembering the non-presented critical items can be reduced by presenting studied associates visually rather than auditorally (e.g., Smith & Hunt, 1998). This is referred to as the modality effect in false memory. The current study investigated the role of resource availability in the expression of this modality effect in false recall. In Experiment 1 false recall was reduced in the visual study presentation condition relative to the auditory condition for participants with higher working memory capacity, but not for participants with lower working memory capacity. In Experiment 2 the effect of study modality on false recall was eliminated by the addition of a divided attention task at encoding. Both studies support the proposal that resource availability plays a role in the expression of the modality effect in the DRM paradigm (Smith, Lozito, & Bayen, 2005).

  15. Estimation of the risk of secondary malignancy arising from whole-breast irradiation: comparison of five radiotherapy modalities, including TomoHDA.

    PubMed

    Han, Eun Young; Paudel, Nava; Sung, Jiwon; Yoon, Myonggeun; Chung, Weon Kuu; Kim, Dong Wook

    2016-04-19

    The risk of secondary cancer from radiation treatment remains a concern for long-term breast cancer survivors, especially those treated with radiation at the age younger than 45 years. Treatment modalities optimally maximize the dose delivery to the tumor while minimizing radiation doses to neighboring organs, which can lead to secondary cancers. A new TomoTherapy treatment machine, TomoHDATM, can treat an entire breast with two static but intensity-modulated beams in a slice-by-slice fashion. This feature could reduce scattered and leakage radiation doses. We compared the plan quality and lifetime attributable risk (LAR) of a second malignancy among five treatment modalities: three-dimensional conformal radiation therapy, field-in-field forward-planned intensity-modulated radiation therapy, inverse-planned intensity-modulated radiation therapy (IMRT), volumetric modulated arc therapy, and TomoDirect mode on the TomoHDA system. Ten breast cancer patients were selected for retrospective analysis. Organ equivalent doses, plan characteristics, and LARs were compared. Out-of-field organ doses were measured with radio-photoluminescence glass dosimeters. Although the IMRT plan provided overall better plan quality, including the lowest probability of pneumonitis, it caused the second highest LAR. The TomoTherapy plan provided plan quality comparable to the IMRT plan and posed the lowest total LAR to neighboring organs. Therefore, it can be a better treatment modality for younger patients who have a longer life expectancy.

  16. The evolution of gadolinium based contrast agents: from single-modality to multi-modality

    NASA Astrophysics Data System (ADS)

    Zhang, Li; Liu, Ruiqing; Peng, Hui; Li, Penghui; Xu, Zushun; Whittaker, Andrew K.

    2016-05-01

    Gadolinium-based contrast agents are extensively used as magnetic resonance imaging (MRI) contrast agents due to their outstanding signal enhancement and ease of chemical modification. However, it is increasingly recognized that information obtained from single modal molecular imaging cannot satisfy the higher requirements on the efficiency and accuracy for clinical diagnosis and medical research, due to its limitation and default rooted in single molecular imaging technique itself. To compensate for the deficiencies of single function magnetic resonance imaging contrast agents, the combination of multi-modality imaging has turned to be the research hotpot in recent years. This review presents an overview on the recent developments of the functionalization of gadolinium-based contrast agents, and their application in biomedicine applications.

  17. On sine dwell or broadband methods for modal testing

    NASA Technical Reports Server (NTRS)

    Chen, Jay-Chung; Wada, Ben K.

    1987-01-01

    For large, complex spacecraft structural systems, the objectives of the modal test are outlined. Based on these objectives, the comparison criteria for the modal test methods, namely, the broadband excitation and the sine dwell methods are established. Using the Galileo spacecraft modal test and the Centaur G Prime upper stage vehicle modal test as examples, the relative advantages or disadvantages of each method are examined. The usefulness or shortcoming of the methods are given from a practicing engineer's view point.

  18. Converging modalities ground abstract categories: the case of politics.

    PubMed

    Farias, Ana Rita; Garrido, Margarida V; Semin, Gün R

    2013-01-01

    Three studies are reported examining the grounding of abstract concepts across two modalities (visual and auditory) and their symbolic representation. A comparison of the outcomes across these studies reveals that the symbolic representation of political concepts and their visual and auditory modalities is convergent. In other words, the spatial relationships between specific instances of the political categories are highly overlapping across the symbolic, visual and auditory modalities. These findings suggest that abstract categories display redundancy across modal and amodal representations, and are multimodal.

  19. Development of the "Treatment beliefs in knee and hip OsteoArthritis (TOA)" questionnaire.

    PubMed

    Selten, Ellen M H; Vriezekolk, Johanna E; Schers, Henk J; Nijhof, Marc W; van der Laan, Willemijn H; van der Meulen-Dilling, Roelien G; Geenen, Rinie; van den Ende, Cornelia H M

    2017-09-19

    Use of conservative treatment modalities in osteoarthritis (OA) is suboptimal, which appears to be partly due to patients' beliefs about treatments. The aim of this study was to develop a research instrument assessing patients' beliefs about various treatment modalities of hip and knee OA: the 'Treatment beliefs in OA (TOA) questionnaire'. The item pool that was retrieved from interviews with patients and healthcare providers comprised beliefs regarding five treatment modalities: physical activity, pain medication, physiotherapy, injections and arthroplasty. After an extensive selection procedure, a draft questionnaire with 200 items was constructed. Descriptive analyses and exploratory factor analyses with oblique rotation were conducted for each treatment modality separately to decide upon the final questionnaire. Internal consistency and test-retest reliability were determined. The final questionnaire comprised 60 items. It was completed by 351 patients with knee or hip OA. Each of the five treatment modalities yielded a two factor solution with 37% to 51% explained variance and high face validity. Factor I included 'positive treatment beliefs' and factor II 'negative treatment beliefs'. Internal consistency (Cronbach α's from 0.72 to 0.87) and test-retest reliability (i.e. intraclass correlation coefficient from 0.66-0.88; standard error of measurement from 0.06-0.11) were satisfactory to good. The TOA questionnaire is the first questionnaire assessing positive and negative treatment beliefs regarding five treatment modalities for knee and hip OA. The instrument will help to understand whether and to what extent treatment beliefs influence treatment choices.

  20. International Space Station Modal Correction Analysis

    NASA Technical Reports Server (NTRS)

    Fotz[atrocl. Lrostom; Grugoer. < ocjae; Laible, Michael; Sugavanam, Sujatha

    2012-01-01

    This paper summarizes the on-orbit modal test and the related modal analysis, model validation and correlation performed for the ISS Stage ULF4, DTF S4-1A, October 11,2010, GMT 284/06:13:00.00. The objective of this analysis is to validate and correlate analytical models with the intent to verify the ISS critical interface dynamic loads and improve fatigue life prediction. For the ISS configurations under consideration, on-orbit dynamic responses were collected with Russian vehicles attached and without the Orbiter attached to the ISS. ISS instrumentation systems that were used to collect the dynamic responses during the DTF S4-1A included the Internal Wireless Instrumentation System (IWIS), External Wireless Instrumentation System (EWIS), Structural Dynamic Measurement System (SDMS), Space Acceleration Measurement System (SAMS), Inertial Measurement Unit (IMU) and ISS External Cameras. Experimental modal analyses were performed on the measured data to extract modal parameters including frequency, damping and mode shape information. Correlation and comparisons between test and analytical modal parameters were performed to assess the accuracy of models for the ISS configuration under consideration. Based on the frequency comparisons, the accuracy of the mathematical models is assessed and model refinement recommendations are given. Section 2.0 of this report presents the math model used in the analysis. This section also describes the ISS configuration under consideration and summarizes the associated primary modes of interest along with the fundamental appendage modes. Section 3.0 discusses the details of the ISS Stage ULF4 DTF S4-1A test. Section 4.0 discusses the on-orbit instrumentation systems that were used in the collection of the data analyzed in this paper. The modal analysis approach and results used in the analysis of the collected data are summarized in Section 5.0. The model correlation and validation effort is reported in Section 6.0. Conclusions and

  1. A Modal Model to Simulate Typical Structural Dynamic Nonlinearity

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

    Pacini, Benjamin Robert; Mayes, Randall L.; Roettgen, Daniel R

    2015-10-01

    Some initial investigations have been published which simulate nonlinear response with almost traditional modal models: instead of connecting the modal mass to ground through the traditional spring and damper, a nonlinear Iwan element was added. This assumes that the mode shapes do not change with amplitude and there are no interactions between modal degrees of freedom. This work expands on these previous studies. An impact experiment is performed on a structure which exhibits typical structural dynamic nonlinear response, i.e. weak frequency dependence and strong damping dependence on the amplitude of vibration. Use of low level modal test results in combinationmore » with high level impacts are processed using various combinations of modal filtering, the Hilbert Transform and band-pass filtering to develop response data that are then fit with various nonlinear elements to create a nonlinear pseudo-modal model. Simulations of forced response are compared with high level experimental data for various nonlinear element assumptions.« less

  2. Dialysis modality and survival: Done to death.

    PubMed

    Trinh, Emilie; Chan, Christopher T; Perl, Jeffrey

    2018-03-14

    The debate surrounding whether peritoneal dialysis or hemodialysis is associated with differential survival continues as the numerous comparative studies over the past 3 decades have yielded conflicting results. Findings have also evolved over time in the setting of changing patient characteristics, advances in dialytic technologies, and the use of more robust statistical and epidemiologic approaches. Here, we will critically review the body of evidence, both historical and contemporary, comparing survival across dialysis modalities. Significant limitations of the observational nature of the current literature will be highlighted given that no adequately powered randomized controlled trials exist. Given the lack of consistency and limitations of current studies, coupled with the poor survival across both modalities, we can likely conclude that survival comparisons between both modalities do not appreciably differ. Hence, the choice of dialysis modality should not be dictated by survival comparisons, but rather be based on an individualized and informed decision making that places patient preference and lifestyle considerations at the forefront, while integrating medical factors and availability of resources and support. The emphasis of future research should move beyond survival outcomes when comparing dialysis modalities, and instead be redirected to patient-endorsed and patient-reported outcomes. © 2018 Wiley Periodicals, Inc.

  3. [Which complementary and alternative medicine modalities are integrated within Israeli healthcare organizations and do they match the public's preferences?].

    PubMed

    Keshet, Yael; Ben-Arye, Eran

    2011-08-01

    Complementary and alternative medicine (CAM) is a broad term that encompasses diverse healthcare modalities that emanate from a variety of healing cultures. One of the basic principles of CAM is the promotion of cultural pluralism and openness to diverse cultural aspects of health and illness. Some CAM modalities have been integrated into Israeli healthcare organizations over the past two decades. The objective of this research was to examine whether the integrated CAM modalities match the preferences of Israel's diverse ethnic groups. The research was conducted in northern Israel, an area marked by ethnic and religious diversity. We gathered information about the types of CAM modalities included in the clinics of all four public health funds health maintenance organizations (HMOs)--by means of a telephone survey. This data was assessed in relation to previous data regarding patients' preferences on integrating CAM in community care. The 4 HMOs offer 24 CAM modalities within 58 clinics in northern Israel. The most common CAM modalities are: reflexology, Chinese Medicine and acupuncture, massage, shiatsu, twina, homeopathy and naturopathy. These modalities partly match the Jewish and Arab populations' preferences concerning Chinese medicine and touch/movement modalities. The Arab population, however, which reports greater use of folk-traditional medicine, such as consultation with healers and use of herbal medicine, do not have these treatment options available within healthcare organizations. Western-oriented CAM modalities are integrated within the IsraeLi HMOs, while local folk-traditional medicine is not. The integrated modalities accord with the Jewish populations' preferences more than with those of the Arab population. Some of the factors that influence integration are discussed. Certain homegrown traditional healthcare modalities, such as use of local medicinal herbs, should be considered for addition to current CAM practices. Developing integrative medicine

  4. A Biofilm Pocket Model to Evaluate Different Non-Surgical Periodontal Treatment Modalities in Terms of Biofilm Removal and Reformation, Surface Alterations and Attachment of Periodontal Ligament Fibroblasts

    PubMed Central

    Hägi, Tobias T.; Klemensberger, Sabrina; Bereiter, Riccarda; Nietzsche, Sandor; Cosgarea, Raluca; Flury, Simon; Lussi, Adrian; Sculean, Anton; Eick, Sigrun

    2015-01-01

    Background and Aim There is a lack of suitable in vitro models to evaluate various treatment modalities intending to remove subgingival bacterial biofilm. Consequently, the aims of this in vitro-study were: a) to establish a pocket model enabling mechanical removal of biofilm and b) to evaluate repeated non-surgical periodontal treatment with respect to biofilm removal and reformation, surface alterations, tooth hard-substance-loss, and attachment of periodontal ligament (PDL) fibroblasts. Material and Methods Standardized human dentin specimens were colonized by multi-species biofilms for 3.5 days and subsequently placed into artificially created pockets. Non-surgical periodontal treatment was performed as follows: a) hand-instrumentation with curettes (CUR), b) ultrasonication (US), c) subgingival air-polishing using erythritol (EAP) and d) subgingival air-polishing using erythritol combined with chlorhexidine digluconate (EAP-CHX). The reduction and recolonization of bacterial counts, surface roughness (Ra and Rz), the caused tooth substance-loss (thickness) as well as the attachment of PDL fibroblasts were evaluated and statistically analyzed by means of ANOVA with Post-Hoc LSD. Results After 5 treatments, bacterial reduction in biofilms was highest when applying EAP-CHX (4 log10). The lowest reduction was found after CUR (2 log10). Additionally, substance-loss was the highest when using CUR (128±40 µm) in comparison with US (14±12 µm), EAP (6±7 µm) and EAP-CHX (11±10) µm). Surface was roughened when using CUR and US. Surfaces exposed to US and to EAP attracted the highest numbers of PDL fibroblasts. Conclusion The established biofilm model simulating a periodontal pocket combined with interchangeable placements of test specimens with multi-species biofilms enables the evaluation of different non-surgical treatment modalities on biofilm removal and surface alterations. Compared to hand instrumentation the application of ultrasonication and of air

  5. A Biofilm Pocket Model to Evaluate Different Non-Surgical Periodontal Treatment Modalities in Terms of Biofilm Removal and Reformation, Surface Alterations and Attachment of Periodontal Ligament Fibroblasts.

    PubMed

    Hägi, Tobias T; Klemensberger, Sabrina; Bereiter, Riccarda; Nietzsche, Sandor; Cosgarea, Raluca; Flury, Simon; Lussi, Adrian; Sculean, Anton; Eick, Sigrun

    2015-01-01

    There is a lack of suitable in vitro models to evaluate various treatment modalities intending to remove subgingival bacterial biofilm. Consequently, the aims of this in vitro-study were: a) to establish a pocket model enabling mechanical removal of biofilm and b) to evaluate repeated non-surgical periodontal treatment with respect to biofilm removal and reformation, surface alterations, tooth hard-substance-loss, and attachment of periodontal ligament (PDL) fibroblasts. Standardized human dentin specimens were colonized by multi-species biofilms for 3.5 days and subsequently placed into artificially created pockets. Non-surgical periodontal treatment was performed as follows: a) hand-instrumentation with curettes (CUR), b) ultrasonication (US), c) subgingival air-polishing using erythritol (EAP) and d) subgingival air-polishing using erythritol combined with chlorhexidine digluconate (EAP-CHX). The reduction and recolonization of bacterial counts, surface roughness (Ra and Rz), the caused tooth substance-loss (thickness) as well as the attachment of PDL fibroblasts were evaluated and statistically analyzed by means of ANOVA with Post-Hoc LSD. After 5 treatments, bacterial reduction in biofilms was highest when applying EAP-CHX (4 log10). The lowest reduction was found after CUR (2 log10). Additionally, substance-loss was the highest when using CUR (128±40 µm) in comparison with US (14±12 µm), EAP (6±7 µm) and EAP-CHX (11±10) µm). Surface was roughened when using CUR and US. Surfaces exposed to US and to EAP attracted the highest numbers of PDL fibroblasts. The established biofilm model simulating a periodontal pocket combined with interchangeable placements of test specimens with multi-species biofilms enables the evaluation of different non-surgical treatment modalities on biofilm removal and surface alterations. Compared to hand instrumentation the application of ultrasonication and of air-polishing with erythritol prevents from substance-loss and

  6. Converging Modalities Ground Abstract Categories: The Case of Politics

    PubMed Central

    Farias, Ana Rita; Garrido, Margarida V.; Semin, Gün R.

    2013-01-01

    Three studies are reported examining the grounding of abstract concepts across two modalities (visual and auditory) and their symbolic representation. A comparison of the outcomes across these studies reveals that the symbolic representation of political concepts and their visual and auditory modalities is convergent. In other words, the spatial relationships between specific instances of the political categories are highly overlapping across the symbolic, visual and auditory modalities. These findings suggest that abstract categories display redundancy across modal and amodal representations, and are multimodal. PMID:23593360

  7. Improvements of ModalMax High-Fidelity Piezoelectric Audio Device

    NASA Technical Reports Server (NTRS)

    Woodard, Stanley E.

    2005-01-01

    ModalMax audio speakers have been enhanced by innovative means of tailoring the vibration response of thin piezoelectric plates to produce a high-fidelity audio response. The ModalMax audio speakers are 1 mm in thickness. The device completely supplants the need to have a separate driver and speaker cone. ModalMax speakers can perform the same applications of cone speakers, but unlike cone speakers, ModalMax speakers can function in harsh environments such as high humidity or extreme wetness. New design features allow the speakers to be completely submersed in salt water, making them well suited for maritime applications. The sound produced from the ModalMax audio speakers has sound spatial resolution that is readily discernable for headset users.

  8. Linear Subspace Ranking Hashing for Cross-Modal Retrieval.

    PubMed

    Li, Kai; Qi, Guo-Jun; Ye, Jun; Hua, Kien A

    2017-09-01

    Hashing has attracted a great deal of research in recent years due to its effectiveness for the retrieval and indexing of large-scale high-dimensional multimedia data. In this paper, we propose a novel ranking-based hashing framework that maps data from different modalities into a common Hamming space where the cross-modal similarity can be measured using Hamming distance. Unlike existing cross-modal hashing algorithms where the learned hash functions are binary space partitioning functions, such as the sign and threshold function, the proposed hashing scheme takes advantage of a new class of hash functions closely related to rank correlation measures which are known to be scale-invariant, numerically stable, and highly nonlinear. Specifically, we jointly learn two groups of linear subspaces, one for each modality, so that features' ranking orders in different linear subspaces maximally preserve the cross-modal similarities. We show that the ranking-based hash function has a natural probabilistic approximation which transforms the original highly discontinuous optimization problem into one that can be efficiently solved using simple gradient descent algorithms. The proposed hashing framework is also flexible in the sense that the optimization procedures are not tied up to any specific form of loss function, which is typical for existing cross-modal hashing methods, but rather we can flexibly accommodate different loss functions with minimal changes to the learning steps. We demonstrate through extensive experiments on four widely-used real-world multimodal datasets that the proposed cross-modal hashing method can achieve competitive performance against several state-of-the-arts with only moderate training and testing time.

  9. Iatrogenic possibilities of orthodontic treatment and modalities of prevention

    PubMed Central

    Meeran, Nazeer Ahmed

    2013-01-01

    The benefits of orthodontic treatment are numerous and in most cases, the benefits outweigh the possible disadvantages. Orthodontic treatment can play an important role in enhancing esthetics, function, and self-esteem in patients. However, it carries with it the risks of enamel demineralization, tissue damage, root resorption, open gingival embrasures in the form of triangular spaces, allergic reactions to nickel, and treatment failure in the form of relapse. These potential complications are easily avoidable by undertaking certain precautions and timely interventions by both the orthodontist and the patient. The orthodontist must ensure that the patient is aware of the associated risks and stress the importance of the patient's role in preventing these untoward outcomes. The decision whether to proceed with the orthodontic treatment is essentially a risk-benefit analysis, where the perceived benefits of commencing treatment outweigh the potential risks. This article provides an overview of the iatrogenic possibilities of orthodontic treatment and the role of the patient as well as the orthodontist in preventing the associated risks. PMID:24987646

  10. Retrospective Evaluation of Hairy Cell Leukemia Patients Treated with Three Different First-Line Treatment Modalities in the Last Two Decades: A Single-Center Experience.

    PubMed

    Öngören, Şeniz; Eşkazan, Ahmet Emre; Berk, Selin; Elverdi, Tuğrul; Salihoğlu, Ayşe; Ar, Muhlis Cem; Başlar, Zafer; Aydın, Yıldız; Tüzüner, Nükhet; Soysal, Teoman

    2017-12-01

    In this study, we retrospectively analyzed the clinical outcome, treatment responses, infectious complications, and survival rates of 71 hairy cell leukemia (HCL) cases. Sixty-seven patients received a first-line treatment and 2-chlorodeoxyadenosine (cladribine-2-CdA) was administered in 31 cases, 19 patients received interferon-alpha (INF-α), splenectomy was performed in 16 cases, and rituximab was used in one. Although the highest overall response rate (ORR) was observed in patients receiving 2-CdA upfront, ORRs were comparable in the 2-CdA, INF-α, and splenectomy subgroups. Relapse rates were significantly lower in patients who received first-line 2-CdA. The progression-free survival (PFS) rate with 2-CdA was significantly higher than in patients with INF-α and splenectomy, but we found similar overall survival rates with all three upfront treatment modalities. Infections including tuberculosis were a major problem. Although purine analogues have improved the ORRs and PFS, there is still much progress to make with regard to overall survival and relapsed/refractory disease in patients with HCL.

  11. Carpal Tunnel Syndrome: Effectiveness of Physical Therapy and Electrophysical Modalities. An Updated Systematic Review of Randomized Controlled Trials.

    PubMed

    Huisstede, Bionka M; Hoogvliet, Peter; Franke, Thierry P; Randsdorp, Manon S; Koes, Bart W

    2017-09-20

    To review scientific literature studying the effectiveness of physical therapy and electrophysical modalities for carpal tunnel syndrome (CTS). The Cochrane Library, PubMed, Embase, CINAHL, and Physiotherapy Evidence Database. Two reviewers independently applied the inclusion criteria to select potential eligible studies. Two reviewers independently extracted the data and assessed the methodologic quality using the Cochrane Risk of Bias Tool. A best-evidence synthesis was performed to summarize the results of the included studies (2 reviews and 22 randomized controlled trials [RCTs]). For physical therapy, moderate evidence was found for myofascial massage therapy versus ischemic compression on latent, or active, trigger points or low-level laser therapy in the short term. For several electrophysical modalities, moderate evidence was found in the short term (ultrasound vs placebo, ultrasound as single intervention vs other nonsurgical interventions, ultrasound vs corticosteroid injection plus a neutral wrist splint, local microwave hyperthermia vs placebo, iontophoresis vs phonophoresis, pulsed radiofrequency added to wrist splint, continuous vs pulsed vs placebo shortwave diathermy, and interferential current vs transcutaneous electrical nerve stimulation vs a night-only wrist splint). In the midterm, moderate evidence was found in favor of radial extracorporeal shockwave therapy (ESWT) added to a neutral wrist splint, in favor of ESWT versus ultrasound, or cryo-ultrasound, and in favor of ultrasound versus placebo. For all other interventions studied, only limited, conflicting, or no evidence was found. No RCTs investigating the long-term effects of physical therapy and electrophysical modalities were found. Because of heterogeneity in the treatment parameters used in the included RCTs, optimal treatment parameters could not be identified. Moderate evidence was found for several physical therapy and electrophysical modalities for CTS in the short term and midterm

  12. Cross-modal illusory conjunctions between vision and touch.

    PubMed

    Cinel, Caterina; Humphreys, Glyn W; Poli, Riccardo

    2002-10-01

    Cross-modal illusory conjunctions (ICs) happen when, under conditions of divided attention, felt textures are reported as being seen or vice versa. Experiments provided evidence for these errors, demonstrated that ICs are more frequent if tactile and visual stimuli are in the same hemispace, and showed that ICs still occur under forced-choice conditions but do not occur when attention to the felt texture is increased. Cross-modal ICs were also found in a patient with parietal damage even with relatively long presentations of visual stimuli. The data are consistent with there being cross-modal integration of sensory information, with the modality of origin sometimes being misattributed when attention is constrained. The empirical conclusions from the experiments are supported by formal models.

  13. Search for biological correlates of depression and mechanisms of action of antidepressant treatment modalities. Do neuropeptides play a role?

    PubMed

    Mathé, Aleksander A; Husum, Henriette; El Khoury, Aram; Jiménez-Vasquez, Patricia; Gruber, Susanne H M; Wörtwein, Gitta; Nikisch, Georg; Baumann, Pierre; Agren, Hans; Andersson, Weronica; Södergren, Asa; Angelucci, Francesco

    2007-09-10

    Dysregulation of the monoaminergic systems is likely a sufficient but not a necessary cause of depression. A wealth of data indicates that neuropeptides, e.g., NPY, CRH, somatostatin, tachykinins and CGRP play a role in affective disorders and alcohol use/abuse. This paper focuses on NPY in etiology and pathophysiology of depression. Decreased peptide and mRNA NPY were found in hippocampus of both the genetic, e.g., the FSL strain, and environmental rat models of depression, e.g., chronic mild stress and early life maternal separation paradigms. Rat models of alcoholism also show altered NPY. Furthermore, NPY is also reduced in CSF of depressed patients. Antidepressive treatments tested so far (lithium, topiramate, SSRIs, ECT and ECS, wheel running) increase NPY selectively in rat hippocampus and in human CSF. Moreover, NPY given icv to rat has antidepressive effects which are antagonized by NPY-Y1 blockers. The data support our hypothesis that the NPY system dysregulation constitutes one of the biological underpinnings of depression and that one common mechanism of action of antidepressive treatment modalities may be effects on NPY and its receptors. In a novel paradigm, early life maternal separation was superimposed on "depressed" FSL and control rats and behavioral and brain neurochemistry changes observed in adulthood. The consequences were more deleterious in genetically vulnerable FSL. Early antidepressive treatment modulated the adult sequelae. Consequently, if these data are confirmed, the ethical and medical question that will be asked is whether it is permissible and advisable to consider prophylactically treating persons at risk.

  14. Operational modal analysis applied to the concert harp

    NASA Astrophysics Data System (ADS)

    Chomette, B.; Le Carrou, J.-L.

    2015-05-01

    Operational modal analysis (OMA) methods are useful to extract modal parameters of operating systems. These methods seem to be particularly interesting to investigate the modal basis of string instruments during operation to avoid certain disadvantages due to conventional methods. However, the excitation in the case of string instruments is not optimal for OMA due to the presence of damped harmonic components and low noise in the disturbance signal. Therefore, the present study investigates the least-square complex exponential (LSCE) and the modified least-square complex exponential methods in the case of a string instrument to identify modal parameters of the instrument when it is played. The efficiency of the approach is experimentally demonstrated on a concert harp excited by some of its strings and the two methods are compared to a conventional modal analysis. The results show that OMA allows us to identify modes particularly present in the instrument's response with a good estimation especially if they are close to the excitation frequency with the modified LSCE method.

  15. Enhancing resource coordination for multi-modal evacuation planning.

    DOT National Transportation Integrated Search

    2013-01-01

    This research project seeks to increase knowledge about coordinating effective multi-modal evacuation for disasters. It does so by identifying, evaluating, and assessing : current transportation management approaches for multi-modal evacuation planni...

  16. Modal Interpretation of Quantum Mechanics and Classical Physical Theories

    NASA Astrophysics Data System (ADS)

    Ingarden, R. S.

    In 1990, Bas C. van Fraassen defined the modal interpretation of quantum mechanics as the consideration of it as ``a pure theory of the possible, with testable, empirical implications for what actually happens". This is a narrow, traditional understanding of modality, only in the sense of the concept of possibility (usually denoted in logic by the C. I. Lewis's symbol 3) and the concept of necessity 2 defined by means of 3. In modern logic, however, modality is understood in a much wider sense as any intensional functor (i.e. non-extensional or determined not only by the truth value of a sentence). In the recent (independent of van Fraassen) publications of the author (1997), an attempt was made to apply this wider understanding of modality to interpretation of classical and quantum physics. In the present lecture, these problems are discussed on the background of a brief review of the logical approch to quantum mechanics in the recent 7 decades. In this discussion, the new concepts of sub-modality and super-modality of many orders are used.

  17. Effects of auditory and visual modalities in recall of words.

    PubMed

    Gadzella, B M; Whitehead, D A

    1975-02-01

    Ten experimental conditions were used to study the effects of auditory and visual (printed words, uncolored and colored pictures) modalities and their various combinations with college students. A recall paradigm was employed in which subjects responded in a written test. Analysis of data showed the auditory modality was superior to visual (pictures) ones but was not significantly different from visual (printed words) modality. In visual modalities, printed words were superior to colored pictures. Generally, conditions with multiple modes of representation of stimuli were significantly higher than for conditions with single modes. Multiple modalities, consisting of two or three modes, did not differ significantly from each other. It was concluded that any two modalities of the stimuli presented simultaneously were just as effective as three in recall of stimulus words.

  18. Modal Non-Assertions

    ERIC Educational Resources Information Center

    Rubio Vallejo, David

    2017-01-01

    The interaction between root (i.e. non-epistemic) modal verbs and functional heads like tense and aspect has been investigated in a wealth of recent literature, particularly in the context of counterfactual conditionals (Iatridou, 2000; Arregui, 2009; a.o.) and actuality entailments (Bhatt, 1999; Hacquard, 2006). In this work, I continue this…

  19. Interaction, Modality, and Word Engagement as Factors in Lexical Learning in a Chinese Context

    ERIC Educational Resources Information Center

    Niu, Ruiying; Helms-Park, Rena

    2014-01-01

    This study investigates the roles of collaborative output, the modality of output, and word engagement in vocabulary learning and retention by Chinese-speaking undergraduate EFL learners. The two treatment groups reconstructed a passage that they had read in one of two ways: (1) dyadic oral interaction while producing a written report (Written…

  20. Track/train dynamics test report modal survey

    NASA Technical Reports Server (NTRS)

    Vigil, R. A.

    1975-01-01

    The modal survey vibration test conducted on an 80 ton open hopper freight car is described. The test data, the post-test update of the modal survey test requirements and procedure, and an index to the test data are presented. Photographs of actual measurement locations and the test historical log are included.

  1. Development of a new multi-modal Monte-Carlo radiotherapy planning system.

    PubMed

    Kumada, H; Nakamura, T; Komeda, M; Matsumura, A

    2009-07-01

    A new multi-modal Monte-Carlo radiotherapy planning system (developing code: JCDS-FX) is under development at Japan Atomic Energy Agency. This system builds on fundamental technologies of JCDS applied to actual boron neutron capture therapy (BNCT) trials in JRR-4. One of features of the JCDS-FX is that PHITS has been applied to particle transport calculation. PHITS is a multi-purpose particle Monte-Carlo transport code. Hence application of PHITS enables to evaluate total doses given to a patient by a combined modality therapy. Moreover, JCDS-FX with PHITS can be used for the study of accelerator based BNCT. To verify calculation accuracy of the JCDS-FX, dose evaluations for neutron irradiation of a cylindrical water phantom and for an actual clinical trial were performed, then the results were compared with calculations by JCDS with MCNP. The verification results demonstrated that JCDS-FX is applicable to BNCT treatment planning in practical use.

  2. Optical and photoacoustic dual-modality imaging guided synergistic photodynamic/photothermal therapies

    NASA Astrophysics Data System (ADS)

    Yan, Xuefeng; Hu, Hao; Lin, Jing; Jin, Albert J.; Niu, Gang; Zhang, Shaoliang; Huang, Peng; Shen, Baozhong; Chen, Xiaoyuan

    2015-01-01

    Phototherapies such as photodynamic therapy (PDT) and photothermal therapy (PTT), due to their specific spatiotemporal selectivity and minimal invasiveness, have been widely investigated as alternative treatments of malignant diseases. Graphene and its derivatives not only have been used as carriers to deliver photosensitizers for PDT, but also as photothermal conversion agents (PTCAs) for PTT. Herein, we strategically designed and produced a novel photo-theranostic platform based on sinoporphyrin sodium (DVDMS) photosensitizer-loaded PEGylated graphene oxide (GO-PEG-DVDMS) for enhanced fluorescence/photoacoustic (PA) dual-modal imaging and combined PDT and PTT. The GO-PEG carrier drastically improves the fluorescence of loaded DVDMS via intramolecular charge transfer. Concurrently, DVDMS significantly enhances the near-infrared (NIR) absorption of GO for improved PA imaging and PTT. The cancer theranostic capability of the as-prepared GO-PEG-DVDMS was carefully investigated both in vitro and in vivo. This novel theranostics is well suited for fluorescence/PA dual-modal imaging and synergistic PDT/PTT.

  3. Multimodal Image Alignment via Linear Mapping between Feature Modalities.

    PubMed

    Jiang, Yanyun; Zheng, Yuanjie; Hou, Sujuan; Chang, Yuchou; Gee, James

    2017-01-01

    We propose a novel landmark matching based method for aligning multimodal images, which is accomplished uniquely by resolving a linear mapping between different feature modalities. This linear mapping results in a new measurement on similarity of images captured from different modalities. In addition, our method simultaneously solves this linear mapping and the landmark correspondences by minimizing a convex quadratic function. Our method can estimate complex image relationship between different modalities and nonlinear nonrigid spatial transformations even in the presence of heavy noise, as shown in our experiments carried out by using a variety of image modalities.

  4. Neonatal brain resting-state functional connectivity imaging modalities.

    PubMed

    Mohammadi-Nejad, Ali-Reza; Mahmoudzadeh, Mahdi; Hassanpour, Mahlegha S; Wallois, Fabrice; Muzik, Otto; Papadelis, Christos; Hansen, Anne; Soltanian-Zadeh, Hamid; Gelovani, Juri; Nasiriavanaki, Mohammadreza

    2018-06-01

    Infancy is the most critical period in human brain development. Studies demonstrate that subtle brain abnormalities during this state of life may greatly affect the developmental processes of the newborn infants. One of the rapidly developing methods for early characterization of abnormal brain development is functional connectivity of the brain at rest. While the majority of resting-state studies have been conducted using magnetic resonance imaging (MRI), there is clear evidence that resting-state functional connectivity (rs-FC) can also be evaluated using other imaging modalities. The aim of this review is to compare the advantages and limitations of different modalities used for the mapping of infants' brain functional connectivity at rest. In addition, we introduce photoacoustic tomography, a novel functional neuroimaging modality, as a complementary modality for functional mapping of infants' brain.

  5. Simulating flight boundary conditions for orbiter payload modal survey

    NASA Technical Reports Server (NTRS)

    Chung, Y. T.; Sernaker, M. L.; Peebles, J. H.

    1993-01-01

    An approach to simulate the characteristics of the payload/orbiter interfaces for the payload modal survey was developed. The flexure designed for this approach is required to provide adequate stiffness separation in the free and constrained interface degrees of freedom to closely resemble the flight boundary condition. Payloads will behave linearly and demonstrate similar modal effective mass distribution and load path as the flight if the flexure fixture is used for the payload modal survey. The potential non-linearities caused by the trunnion slippage during the conventional fixed base modal survey may be eliminated. Consequently, the effort to correlate the test and analysis models can be significantly reduced. An example is given to illustrate the selection and the sensitivity of the flexure stiffness. The advantages of using flexure fixtures for the modal survey and for the analytical model verification are also demonstrated.

  6. Motion-invariant SRT treatment detection from direct M-scan OCT imaging.

    PubMed

    Fountoukidou, Tatiana; Raisin, Philippe; Kaufmann, Daniel; Justiz, Jörn; Sznitman, Raphael; Wolf, Sebastian

    2018-03-08

    Selective retina therapy (SRT) is a laser treatment targeting specific posterior retinal layers. It is focused on inducing damage to the retinal pigment epithelium (RPE), while sparing other retinal tissue compared to traditional photocoagulation. However, the targeted RPE layer is invisible with most imaging modalities and induced SRT lesions cannot be monitored. In this work, imaging scans acquired from an experimental setup that couples the SRT laser beam with an optical coherence tomography (OCT) beam are analyzed in order to evaluate the treatment as they occur. We isolated a small part of the time-resolved scan corresponding to the end of the treatment, for which we have microscopic evidence of the SRT outcome. We then use a convolutional neural network to correspond each scan to the treatment result. We explore which aspects of the scan convey more valuable information for a robust therapy evaluation. By only using this adequately small part, we can achieve an online estimation, while being resilient to eye movement. The available dataset consists of time- resolved OCT scans of 98 ex vivo porcine eyes, treated with different energy levels. The proposed method yields high performance in the task of predicting whether the applied energy was adequate for SRT treatment, by focusing on the immediate OCT signal acquired during treatment time. We propose a strategy toward online noninvasive SRT treatment assessment, able to provide a satisfying evaluation of a treatment status, that therefore could be used for the planning of the treatment continuation.

  7. Asymptotic modal analysis and statistical energy analysis

    NASA Technical Reports Server (NTRS)

    Dowell, Earl H.

    1992-01-01

    Asymptotic Modal Analysis (AMA) is a method which is used to model linear dynamical systems with many participating modes. The AMA method was originally developed to show the relationship between statistical energy analysis (SEA) and classical modal analysis (CMA). In the limit of a large number of modes of a vibrating system, the classical modal analysis result can be shown to be equivalent to the statistical energy analysis result. As the CMA result evolves into the SEA result, a number of systematic assumptions are made. Most of these assumptions are based upon the supposition that the number of modes approaches infinity. It is for this reason that the term 'asymptotic' is used. AMA is the asymptotic result of taking the limit of CMA as the number of modes approaches infinity. AMA refers to any of the intermediate results between CMA and SEA, as well as the SEA result which is derived from CMA. The main advantage of the AMA method is that individual modal characteristics are not required in the model or computations. By contrast, CMA requires that each modal parameter be evaluated at each frequency. In the latter, contributions from each mode are computed and the final answer is obtained by summing over all the modes in the particular band of interest. AMA evaluates modal parameters only at their center frequency and does not sum the individual contributions from each mode in order to obtain a final result. The method is similar to SEA in this respect. However, SEA is only capable of obtaining spatial averages or means, as it is a statistical method. Since AMA is systematically derived from CMA, it can obtain local spatial information as well.

  8. Associative learning changes cross-modal representations in the gustatory cortex

    PubMed Central

    Vincis, Roberto; Fontanini, Alfredo

    2016-01-01

    A growing body of literature has demonstrated that primary sensory cortices are not exclusively unimodal, but can respond to stimuli of different sensory modalities. However, several questions concerning the neural representation of cross-modal stimuli remain open. Indeed, it is poorly understood if cross-modal stimuli evoke unique or overlapping representations in a primary sensory cortex and whether learning can modulate these representations. Here we recorded single unit responses to auditory, visual, somatosensory, and olfactory stimuli in the gustatory cortex (GC) of alert rats before and after associative learning. We found that, in untrained rats, the majority of GC neurons were modulated by a single modality. Upon learning, both prevalence of cross-modal responsive neurons and their breadth of tuning increased, leading to a greater overlap of representations. Altogether, our results show that the gustatory cortex represents cross-modal stimuli according to their sensory identity, and that learning changes the overlap of cross-modal representations. DOI: http://dx.doi.org/10.7554/eLife.16420.001 PMID:27572258

  9. Production of Fatty Acid-Derived Valuable Chemicals in Synthetic Microbes

    PubMed Central

    Yu, Ai-Qun; Pratomo Juwono, Nina Kurniasih; Leong, Susanna Su Jan; Chang, Matthew Wook

    2014-01-01

    Fatty acid derivatives, such as hydroxy fatty acids, fatty alcohols, fatty acid methyl/ethyl esters, and fatty alka(e)nes, have a wide range of industrial applications including plastics, lubricants, and fuels. Currently, these chemicals are obtained mainly through chemical synthesis, which is complex and costly, and their availability from natural biological sources is extremely limited. Metabolic engineering of microorganisms has provided a platform for effective production of these valuable biochemicals. Notably, synthetic biology-based metabolic engineering strategies have been extensively applied to refactor microorganisms for improved biochemical production. Here, we reviewed: (i) the current status of metabolic engineering of microbes that produce fatty acid-derived valuable chemicals, and (ii) the recent progress of synthetic biology approaches that assist metabolic engineering, such as mRNA secondary structure engineering, sensor-regulator system, regulatable expression system, ultrasensitive input/output control system, and computer science-based design of complex gene circuits. Furthermore, key challenges and strategies were discussed. Finally, we concluded that synthetic biology provides useful metabolic engineering strategies for economically viable production of fatty acid-derived valuable chemicals in engineered microbes. PMID:25566540

  10. Modal sound transmission loss of a single leaf panel: Asymptotic solutions.

    PubMed

    Wang, Chong

    2015-12-01

    In a previously published paper [C. Wang, J. Acoust. Soc. Am. 137(6), 3514-3522 (2015)], the modal sound transmission coefficients of a single leaf panel were discussed with regard to the inter-modal coupling effects. By incorporating such effect into the equivalent modal radiation impedance, which is directly related to the modal sound transmission coefficient of each mode, the overall sound transmission loss for both normal and randomized sound incidences was computed through a simple modal superposition. Benefiting from the analytical expressions of the equivalent modal impedance and modal transmission coefficients, in this paper, behaviors of modal sound transmission coefficients in several typical frequency ranges are discussed in detail. Asymptotic solutions are also given for the panels with relatively low bending stiffnesses, for which the sound transmission loss has been assumed to follow the mass law of a limp panel. Results are also compared to numerical analysis and the renowned mass law theories.

  11. Restricted Modal Analysis Applied to Internal Annular Combustor Autospectra and Cross-Spectra Measurements

    NASA Technical Reports Server (NTRS)

    Miles, Jeffrey Hilton

    2007-01-01

    A treatment of the modal decomposition of the pressure field in a combustor as determined by two pressure time history measurements is developed herein. It is applied to a Pratt and Whitney PW4098 engine combustor over a range of operating conditions. For modes other than the plane wave the assumption is made that there are distinct frequency bands in which the individual modes, including the plane wave mode, overlap such that if circumferential mode m and circumferential mode m-1 are present then circumferential mode m-2 is not. In the analysis used herein at frequencies above the first cutoff mode frequency, only pairs of circumferential modes are individually present at each frequency. Consequently, this is a restricted modal analysis. As part of the analysis one specifies mode cut-on frequencies. This creates a set of frequencies that each mode spans. One finding was the successful use of the same modal span frequencies over a range of operating conditions for this particular engine. This suggests that for this case the cut-on frequencies are in proximity at each operating condition. Consequently, the combustion noise spectrum related to the circumferential modes might not change much with operating condition.

  12. Comparison of sine dwell and broadband methods for modal testing

    NASA Technical Reports Server (NTRS)

    Chen, Jay-Chung

    1989-01-01

    The objectives of modal tests for large complex spacecraft structural systems are outlined. The comparison criteria for the modal test methods, namely, the broadband excitation and the sine dwell methods, are established. Using the Galileo spacecraft modal test and the Centaur G Prime upper stage vehicle modal test as examples, the relative advantage or disadvantage of each method is examined. The usefulness or shortcomings of the methods are given from a practical engineering viewpoint.

  13. Quasi-modal vibration control by means of active control bearings

    NASA Technical Reports Server (NTRS)

    Nonami, K.; Fleming, D. P.

    1986-01-01

    This paper investigates a design method of an active control bearing system with only velocity feedback. The study provides a new quasi-modal control method for a control system design of an active control bearing system in which feedback coefficients are determined on the basis of a modal analysis. Although the number of sensors and actuators is small, this quasi-modal control method produces a control effect close to an ideal modal control.

  14. Coupling between Theta Oscillations and Cognitive Control Network during Cross-Modal Visual and Auditory Attention: Supramodal vs Modality-Specific Mechanisms.

    PubMed

    Wang, Wuyi; Viswanathan, Shivakumar; Lee, Taraz; Grafton, Scott T

    2016-01-01

    Cortical theta band oscillations (4-8 Hz) in EEG signals have been shown to be important for a variety of different cognitive control operations in visual attention paradigms. However the synchronization source of these signals as defined by fMRI BOLD activity and the extent to which theta oscillations play a role in multimodal attention remains unknown. Here we investigated the extent to which cross-modal visual and auditory attention impacts theta oscillations. Using a simultaneous EEG-fMRI paradigm, healthy human participants performed an attentional vigilance task with six cross-modal conditions using naturalistic stimuli. To assess supramodal mechanisms, modulation of theta oscillation amplitude for attention to either visual or auditory stimuli was correlated with BOLD activity by conjunction analysis. Negative correlation was localized to cortical regions associated with the default mode network and positively with ventral premotor areas. Modality-associated attention to visual stimuli was marked by a positive correlation of theta and BOLD activity in fronto-parietal area that was not observed in the auditory condition. A positive correlation of theta and BOLD activity was observed in auditory cortex, while a negative correlation of theta and BOLD activity was observed in visual cortex during auditory attention. The data support a supramodal interaction of theta activity with of DMN function, and modality-associated processes within fronto-parietal networks related to top-down theta related cognitive control in cross-modal visual attention. On the other hand, in sensory cortices there are opposing effects of theta activity during cross-modal auditory attention.

  15. Modal Analysis and Testing of Missile Systems

    DTIC Science & Technology

    1988-12-01

    TECHNICAL REPORT -Rb-ST-eS MODAL ANALY AND TESMG OF MISSU E SYSTEMS Lfl 0 N Larry C. Mixon John A4 Schaeffel , Jr. Peter L. Green ,I iLT Roque L...Include Stcurty Claz ficaDin) MODAL ANALYSIS AND TESTING OF MISSILE SYSTEMS 12. PERSONAL AUTHOR(S) Larry C. Mixon, John A. Schaeffel , Jr., Peter L. Green

  16. Do early sensory cortices integrate cross-modal information?

    PubMed

    Kayser, Christoph; Logothetis, Nikos K

    2007-09-01

    Our different senses provide complementary evidence about the environment and their interaction often aids behavioral performance or alters the quality of the sensory percept. A traditional view defers the merging of sensory information to higher association cortices, and posits that a large part of the brain can be reduced into a collection of unisensory systems that can be studied in isolation. Recent studies, however, challenge this view and suggest that cross-modal interactions can already occur in areas hitherto regarded as unisensory. We review results from functional imaging and electrophysiology exemplifying cross-modal interactions that occur early during the evoked response, and at the earliest stages of sensory cortical processing. Although anatomical studies revealed several potential origins of these cross-modal influences, there is yet no clear relation between particular functional observations and specific anatomical connections. In addition, our view on sensory integration at the neuronal level is coined by many studies on subcortical model systems of sensory integration; yet, the patterns of cross-modal interaction in cortex deviate from these model systems in several ways. Consequently, future studies on cortical sensory integration need to leave the descriptive level and need to incorporate cross-modal influences into models of the organization of sensory processing. Only then will we be able to determine whether early cross-modal interactions truly merit the label sensory integration, and how they increase a sensory system's ability to scrutinize its environment and finally aid behavior.

  17. Librarian instruction-delivery modality preferences for professional continuing education.

    PubMed

    Lynn, Valerie A; Bose, Arpita; Boehmer, Susan J

    2010-01-01

    Attending professional continuing education (CE) is an important component of librarianship. This research study identified librarians' preferences in delivery modalities of instruction for professional CE. The study also identified influential factors associated with attending CE classes. Five instruction-delivery modalities and six influential factors were identified for inclusion in an online survey. The survey completed by members of the American Library Association (ALA), Special Libraries Association (SLA), and Medical Library Association (MLA) provided the data for analysis of librarian preferences and influential factors. The majority of respondents were MLA members, followed by ALA and SLA members. Librarians from all three library associations preferred the face-to-face instructional modality. The most influential factor associated with the decision to attend a professional CE class was cost. All five instruction-delivery modalities present useful structures for imparting professional CE. As librarians' experience with different modalities increases and as technology improves, preferences in instruction delivery may shift. But at present, face-to-face remains the most preferred modality. Based on the results of this study, cost was the most influential factor associated with attending a CE class. This may change as additional influential factors are identified and analyzed in future studies.

  18. Thermal-based treatment options for localized prostate cancer.

    PubMed

    Koch, Michael O; Gardner, Thomas A

    2005-09-01

    It seems clear that thermal-based therapies of prostate cancer have the potential to completely eradicate the prostate gland. Technical modifications continue to improve our ability to use these modalities more effectively, which can be seen in the ever decreasing morbidity from damage to adjacent structures. These treatments offer potential major advantages over surgery and radiation-based treatment modalities.

  19. Teachers Talking about Writing Assessment: Valuable Professional Learning?

    ERIC Educational Resources Information Center

    Reid, Lesley

    2007-01-01

    This article argues that the engagement of teachers in collaborative discussions about assessment can provide a fruitful context for valuable professional learning. It is of interest to those who provide Continuous Professional Development (CPD) opportunities for teachers and teachers themselves. It looks particularly at the value of writing…

  20. Laguerre-Gaussian quasi-modal q-plates from nanostructured glasses

    NASA Astrophysics Data System (ADS)

    Rafayelyan, Mushegh; Gertus, Titas; Brasselet, Etienne

    2017-06-01

    A quasi-modal version of the recently introduced Laguerre-Gaussian modal q-plates [Rafayelyan and Brasselet, Opt. Lett. 42, 1966-1969 (2017)] is proposed and implemented using femtosecond direct laser writing of space-variant nanogratings in the bulk of silica glass. The corresponding design consists of linear azimuthal modulation of the optical axis orientation and polynomial radial modulation of the retardance profile. Experimental demonstration is made for Laguerre-Gaussian modes with azimuthal indices l =(1, 2, 3) and radial index p = 0. Such quasi-modal q-plates overcome previous limitations regarding the robustness of modality against the handedness of the incident circular polarization state.

  1. Cross-sectional study comparing different therapeutic modalities for cystic lymphangiomas in children.

    PubMed

    Olímpio, Hugo de Oliveira; Bustorff-Silva, Joaquim; Oliveira Filho, Antonio Gonçalves de; Araujo, Kleber Cursino de

    2014-08-01

    Here, we describe our experience with different therapeutic modalities used to treat cystic lymphangiomas in children in our hospital, including single therapy with OK-432, bleomycin and surgery, and a combination of the three modalities. We performed a retrospective, cross-sectional study including patients treated from 1998 to 2011. The effects on macrocystic lymphangiomas and adverse reactions were evaluated. Twenty-nine children with cystic lymphangiomas without any previous treatment were included. Under general anesthesia, patients given sclerosing agents underwent puncture of the lesion (guided by ultrasound when necessary) and complete aspiration of the intralesional liquid. The patients were evaluated with ultrasound and clinical examinations for a maximum follow-up time of 4 years. The proportions of patients considered cured after the first therapeutic approach were 44% in the surgery group, 29% in the bleomycin group and 31% in the OK-432 group. These proportions were not significantly different. Sequential treatment increased the rates of curative results to 71%, 74% and 44%, respectively, after the final treatment, which in our case was approximately 1.5 applications per patient. The results of this study indicate that most patients with cystic lymphangiomas do not show complete resolution after the initial therapy, regardless of whether the therapy is surgical or involves the use of sclerosing agents. To achieve complete resolution of the lesions, either multiple operations or a combination of surgery and sclerotherapy must be used and should be tailored to the characteristics of each patient.

  2. Age-equivalent top-down modulation during cross-modal selective attention.

    PubMed

    Guerreiro, Maria J S; Anguera, Joaquin A; Mishra, Jyoti; Van Gerven, Pascal W M; Gazzaley, Adam

    2014-12-01

    Selective attention involves top-down modulation of sensory cortical areas, such that responses to relevant information are enhanced whereas responses to irrelevant information are suppressed. Suppression of irrelevant information, unlike enhancement of relevant information, has been shown to be deficient in aging. Although these attentional mechanisms have been well characterized within the visual modality, little is known about these mechanisms when attention is selectively allocated across sensory modalities. The present EEG study addressed this issue by testing younger and older participants in three different tasks: Participants attended to the visual modality and ignored the auditory modality, attended to the auditory modality and ignored the visual modality, or passively perceived information presented through either modality. We found overall modulation of visual and auditory processing during cross-modal selective attention in both age groups. Top-down modulation of visual processing was observed as a trend toward enhancement of visual information in the setting of auditory distraction, but no significant suppression of visual distraction when auditory information was relevant. Top-down modulation of auditory processing, on the other hand, was observed as suppression of auditory distraction when visual stimuli were relevant, but no significant enhancement of auditory information in the setting of visual distraction. In addition, greater visual enhancement was associated with better recognition of relevant visual information, and greater auditory distractor suppression was associated with a better ability to ignore auditory distraction. There were no age differences in these effects, suggesting that when relevant and irrelevant information are presented through different sensory modalities, selective attention remains intact in older age.

  3. To increase controllability of a large flexible antenna by modal optimization

    NASA Astrophysics Data System (ADS)

    Wang, Feng; Wang, Pengpeng; Jiang, Wenjian

    2017-12-01

    Large deployable antennas are widely used in aerospace engineering to meet the envelop limit of rocket fairing. The high flexibility and low damping of antenna has proposed critical requirement not only for stability control of the antenna itself, but also for attitude control of the satellite. This paper aims to increase controllability of a large flexible antenna by modal optimization. Firstly, Sensitivity analysis of antenna modal frequencies to stiffness of support structure and stiffness of scanning mechanism are conducted respectively. Secondly, Modal simulation results of antenna frequencies are given, influences of scanning angles on moment of inertia and modal frequencies are evaluated, and modal test is carried out to validate the simulation results. All the simulation and test results show that, after modal optimization the modal characteristic of the large deployable antenna meets the controllability requirement well.

  4. Visual and Spoken Texts in MCALL Courseware: The Effects of Text Modalities on the Vocabulary Retention of EFL Learners

    ERIC Educational Resources Information Center

    Sabet, Masoud Khalili; Shalmani, Hamed Babaie

    2010-01-01

    The present study sought to explore the effects of Multimedia Computer-Assisted Language Learning (MCALL) programs drawing on two different text modalities on the vocabulary retention of Iranian EFL learners. The two groups under study received treatment on vocabulary items under two multimedia conditions: The first group received treatment on the…

  5. Consensus recommendations from the American acne & rosacea society on the management of rosacea, part 4: a status report on physical modalities and devices.

    PubMed

    Tanghetti, Emil; Del Rosso, James Q; Thiboutot, Diane; Gallo, Richard; Webster, Guy; Eichenfield, Lawrence F; Stein-Gold, Linda; Berson, Diane; Zaenglein, Andrea

    2014-02-01

    The fourth article in this 5-part series reviews physical modalities and devices used to treat cutaneous rosacea based on consensus recommendations from the American Acne & Rosacea Society (AARS) on the management of the common presentations of cutaneous rosacea. The major therapeutic uses of physical modalities and devices, especially laser and light-based systems, are for treatment of telangiectases and persistent facial erythema (background erythema). Phymas, especially rhinophyma, also are treated with physical modalities such as ablative lasers or surgical devices (eg, electrosurgical loop). Appropriately selected and properly used lasers and intense pulsed light (IPL) devices can successfully address specific clinical manifestations of rosacea that exhibit limited or no response to available medical therapies, such as telangiectases and background centrofacial erythema. Rosacea-associated symptoms also may improve. In most cases, treatment will need to be repeated intermittently to sustain improvement.

  6. Constrained maximum likelihood modal parameter identification applied to structural dynamics

    NASA Astrophysics Data System (ADS)

    El-Kafafy, Mahmoud; Peeters, Bart; Guillaume, Patrick; De Troyer, Tim

    2016-05-01

    A new modal parameter estimation method to directly establish modal models of structural dynamic systems satisfying two physically motivated constraints will be presented. The constraints imposed in the identified modal model are the reciprocity of the frequency response functions (FRFs) and the estimation of normal (real) modes. The motivation behind the first constraint (i.e. reciprocity) comes from the fact that modal analysis theory shows that the FRF matrix and therefore the residue matrices are symmetric for non-gyroscopic, non-circulatory, and passive mechanical systems. In other words, such types of systems are expected to obey Maxwell-Betti's reciprocity principle. The second constraint (i.e. real mode shapes) is motivated by the fact that analytical models of structures are assumed to either be undamped or proportional damped. Therefore, normal (real) modes are needed for comparison with these analytical models. The work done in this paper is a further development of a recently introduced modal parameter identification method called ML-MM that enables us to establish modal model that satisfies such motivated constraints. The proposed constrained ML-MM method is applied to two real experimental datasets measured on fully trimmed cars. This type of data is still considered as a significant challenge in modal analysis. The results clearly demonstrate the applicability of the method to real structures with significant non-proportional damping and high modal densities.

  7. Modal description—A better way of characterizing human vibration behavior

    NASA Astrophysics Data System (ADS)

    Rützel, Sebastian; Hinz, Barbara; Wölfel, Horst Peter

    2006-12-01

    Biodynamic responses to whole body vibrations are usually characterized in terms of transfer functions, such as impedance or apparent mass. Data measurements from subjects are averaged and analyzed with respect to certain attributes (anthropometrics, posture, excitation intensity, etc.). Averaging involves the risk of identifying unnatural vibration characteristics. The use of a modal description as an alternative method is presented and its contribution to biodynamic modelling is discussed. Modal description is not limited to just one biodynamic function: The method holds for all transfer functions. This is shown in terms of the apparent mass and the seat-to-head transfer function. The advantages of modal description are illustrated using apparent mass data of six male individuals of the same mass percentile. From experimental data, modal parameters such as natural frequencies, damping ratios and modal masses are identified which can easily be used to set up a mathematical model. Following the phenomenological approach, this model will provide the global vibration behavior relating to the input data. The modal description could be used for the development of hardware vibration dummies. With respect to software models such as finite element models, the validation process for these models can be supported by the modal approach. Modal parameters of computational models and of the experimental data can establish a basis for comparison.

  8. Learning Discriminative Binary Codes for Large-scale Cross-modal Retrieval.

    PubMed

    Xu, Xing; Shen, Fumin; Yang, Yang; Shen, Heng Tao; Li, Xuelong

    2017-05-01

    Hashing based methods have attracted considerable attention for efficient cross-modal retrieval on large-scale multimedia data. The core problem of cross-modal hashing is how to learn compact binary codes that construct the underlying correlations between heterogeneous features from different modalities. A majority of recent approaches aim at learning hash functions to preserve the pairwise similarities defined by given class labels. However, these methods fail to explicitly explore the discriminative property of class labels during hash function learning. In addition, they usually discard the discrete constraints imposed on the to-be-learned binary codes, and compromise to solve a relaxed problem with quantization to obtain the approximate binary solution. Therefore, the binary codes generated by these methods are suboptimal and less discriminative to different classes. To overcome these drawbacks, we propose a novel cross-modal hashing method, termed discrete cross-modal hashing (DCH), which directly learns discriminative binary codes while retaining the discrete constraints. Specifically, DCH learns modality-specific hash functions for generating unified binary codes, and these binary codes are viewed as representative features for discriminative classification with class labels. An effective discrete optimization algorithm is developed for DCH to jointly learn the modality-specific hash function and the unified binary codes. Extensive experiments on three benchmark data sets highlight the superiority of DCH under various cross-modal scenarios and show its state-of-the-art performance.

  9. Analysis of structural response data using discrete modal filters. M.S. Thesis

    NASA Technical Reports Server (NTRS)

    Freudinger, Lawrence C.

    1991-01-01

    The application of reciprocal modal vectors to the analysis of structural response data is described. Reciprocal modal vectors are constructed using an existing experimental modal model and an existing frequency response matrix of a structure, and can be assembled into a matrix that effectively transforms the data from the physical space to a modal space within a particular frequency range. In other words, the weighting matrix necessary for modal vector orthogonality (typically the mass matrix) is contained within the reciprocal model matrix. The underlying goal of this work is mostly directed toward observing the modal state responses in the presence of unknown, possibly closed loop forcing functions, thus having an impact on both operating data analysis techniques and independent modal space control techniques. This study investigates the behavior of reciprocol modal vectors as modal filters with respect to certain calculation parameters and their performance with perturbed system frequency response data.

  10. Radiofrequency ablation, an effective modality of treatment in tumor-induced osteomalacia: a case series of three patients.

    PubMed

    Jadhav, Swati; Kasaliwal, Rajeev; Shetty, Nitin S; Kulkarni, Suyash; Rathod, Krantikumar; Popat, Bhavesh; Kakade, Harshal; Bukan, Amol; Khare, Shruti; Budyal, Sweta; Jagtap, Varsha S; Lila, Anurag R; Bandgar, Tushar; Shah, Nalini S

    2014-09-01

    Tumor-induced osteomalacia is curable if the tumors can be totally excised. However, when the tumors are present in locations that make surgery disproportionately risky, the need for less invasive strategies like radiofrequency ablation (RFA) is realized. We describe three patients with suspected tumor-induced osteomalacia who were treated in our department between 2006 and 2013 with tumors in surgically difficult locations and were subjected to single or multiple sessions of RFA. The response was documented in terms of symptomatic improvement, phosphorus normalization, and follow-up (99m)Technitium-labelled hydrazinonicotinyl-Tyr3-octreotide ((99m)Tc HYNIC TOC) scan. Two of the three individuals, patient A (with a 1.5 × 1.2-cm lesion in the head of the right femur) and patient B (with a 1.3 × 1.2-cm lesion on the endosteal surface of the shaft of the left femur), achieved complete remission with single sessions of RFA. Three months after the procedure, (99m)Tc HYNIC TOC scans revealed the absence of uptake at the previous sites, corroborating with the clinical improvement and phosphorus normalization. Patient C had a large 5.6 × 6.5-cm complex lesion in the lower end of the left femur with irregular margins, loculations, and bone grafts placed in previous surgery. He failed to achieve remission after multiple sessions of RFA due to the complex nature of the lesion, although the tumor burden was reduced significantly as documented on serial (99m)Tc HYNIC TOC scans. Although surgery remains the treatment of choice, RFA could be an effective, less invasive, and safe modality of treatment in judiciously selected patients.

  11. Modal identification experiment

    NASA Technical Reports Server (NTRS)

    Kvaternik, Raymond G.

    1992-01-01

    The Modal Identification Experiment (MIE) is a proposed on-orbit experiment being developed by NASA's Office of Aeronautics and Space Technology wherein a series of vibration measurements would be made on various configurations of Space Station Freedom (SSF) during its on-orbit assembly phase. The experiment is to be conducted in conjunction with station reboost operations and consists of measuring the dynamic responses of the spacecraft produced by station-based attitude control system and reboost thrusters, recording and transmitting the data, and processing the data on the ground to identify the natural frequencies, damping factors, and shapes of significant vibratory modes. The experiment would likely be a part of the Space Station on-orbit verification. Basic research objectives of MIE are to evaluate and improve methods for analytically modeling large space structures, to develop techniques for performing in-space modal testing, and to validate candidate techniques for in-space modal identification. From an engineering point of view, MIE will provide the first opportunity to obtain vibration data for the fully-assembled structure because SSF is too large and too flexible to be tested as a single unit on the ground. Such full-system data is essential for validating the analytical model of SSF which would be used in any engineering efforts associated with structural or control system changes that might be made to the station as missions evolve over time. Extensive analytical simulations of on-orbit tests, as well exploratory laboratory simulations using small-scale models, have been conducted in-house and under contract to develop a measurement plan and evaluate its potential performance. In particular, performance trade and parametric studies conducted as part of these simulations were used to resolve issues related to the number and location of the measurements, the type of excitation, data acquisition and data processing, effects of noise and nonlinearities

  12. New Therapies Offer Valuable Options for Patients with Melanoma

    Cancer.gov

    Two phase III clinical trials of new therapies for patients with metastatic melanoma presented in June at the 2011 ASCO conference confirmed that vemurafenib and ipilimumab (Yervoy™) offer valuable new options for the disease.

  13. AIDS: The Role of Imaging Modalities and Infection Control Policies

    PubMed Central

    Moore-Stovall, Joyce

    1988-01-01

    The availability of imaging modalities, such as the chest radiograph, gallium scan, double-contrast barium enema, computed tomography, and nuclear magnetic resonance, are very helpful in the diagnosis, treatment, and follow-up evaluation of patients with acquired immunodeficiency syndrome (AIDS). Because this syndrome causes irreversible destruction of the immune system, patients are susceptible to a multitude of opportunistic infections and malignancies. Health care professionals and the general public would be less fearful and apprehensive of AIDS victims if properly informed about the communicability of this syndrome. PMID:3047412

  14. Learning to Learn: From Within-Modality to Cross-Modality Transfer in Infancy

    PubMed Central

    Hupp, Julie M.; Sloutsky, Vladimir M.

    2011-01-01

    One critical aspect of learning is the ability to apply learned knowledge to new situations. This ability to transfer is often limited, and its development is not well understood. The current research investigated the development of transfer between 8- and 16-months of age. In Experiment 1, 8- and 16-month-olds (who were established to have a preference to the beginning of a visual sequence) were trained to attend to the end of a sequence. They were then tested on novel visual sequences. Results indicated transfer of learning, as both groups changed baseline preferences as a result of training. In Experiment 2, participants were trained to attend to the end of a visual sequence and then tested on an auditory sequence. Unlike Experiment 1, only older participants exhibited transfer of learning by changing baseline preferences. These findings suggest that the generalization of learning becomes broader with development, with transfer across modalities developing later than transfer within a modality. PMID:21663920

  15. Does the Modality Effect Exist? And if so, Which Modality Effect?

    ERIC Educational Resources Information Center

    Reinwein, Joachim

    2012-01-01

    The modality effect is a central issue in multimedia learning [see Mayer (Cambridge University Press, 2005a), for a review]. Sweller's Cognitive Load Theory (CLT), for example, presumes that an illustrated text is better understood when presented visually rather than orally. The predictive power of CLT lies in how it links in to Baddeley's (1986)…

  16. Identification of modal parameters including unmeasured forces and transient effects

    NASA Astrophysics Data System (ADS)

    Cauberghe, B.; Guillaume, P.; Verboven, P.; Parloo, E.

    2003-08-01

    In this paper, a frequency-domain method to estimate modal parameters from short data records with known input (measured) forces and unknown input forces is presented. The method can be used for an experimental modal analysis, an operational modal analysis (output-only data) and the combination of both. A traditional experimental and operational modal analysis in the frequency domain starts respectively, from frequency response functions and spectral density functions. To estimate these functions accurately sufficient data have to be available. The technique developed in this paper estimates the modal parameters directly from the Fourier spectra of the outputs and the known input. Instead of using Hanning windows on these short data records the transient effects are estimated simultaneously with the modal parameters. The method is illustrated, tested and validated by Monte Carlo simulations and experiments. The presented method to process short data sequences leads to unbiased estimates with a small variance in comparison to the more traditional approaches.

  17. Computer Based Behavioral Biometric Authentication via Multi-Modal Fusion

    DTIC Science & Technology

    2013-03-01

    the decisions made by each individual modality. Fusion of features is the simple concatenation of feature vectors from multiple modalities to be...of Features BayesNet MDL 330 LibSVM PCA 80 J48 Wrapper Evaluator 11 3.5.3 Ensemble Based Decision Level Fusion. In ensemble learning multiple ...The high fusion percentages validate our hypothesis that by combining features from multiple modalities, classification accuracy can be improved. As

  18. Multi-Modality Cascaded Convolutional Neural Networks for Alzheimer's Disease Diagnosis.

    PubMed

    Liu, Manhua; Cheng, Danni; Wang, Kundong; Wang, Yaping

    2018-03-23

    Accurate and early diagnosis of Alzheimer's disease (AD) plays important role for patient care and development of future treatment. Structural and functional neuroimages, such as magnetic resonance images (MRI) and positron emission tomography (PET), are providing powerful imaging modalities to help understand the anatomical and functional neural changes related to AD. In recent years, machine learning methods have been widely studied on analysis of multi-modality neuroimages for quantitative evaluation and computer-aided-diagnosis (CAD) of AD. Most existing methods extract the hand-craft imaging features after image preprocessing such as registration and segmentation, and then train a classifier to distinguish AD subjects from other groups. This paper proposes to construct cascaded convolutional neural networks (CNNs) to learn the multi-level and multimodal features of MRI and PET brain images for AD classification. First, multiple deep 3D-CNNs are constructed on different local image patches to transform the local brain image into more compact high-level features. Then, an upper high-level 2D-CNN followed by softmax layer is cascaded to ensemble the high-level features learned from the multi-modality and generate the latent multimodal correlation features of the corresponding image patches for classification task. Finally, these learned features are combined by a fully connected layer followed by softmax layer for AD classification. The proposed method can automatically learn the generic multi-level and multimodal features from multiple imaging modalities for classification, which are robust to the scale and rotation variations to some extent. No image segmentation and rigid registration are required in pre-processing the brain images. Our method is evaluated on the baseline MRI and PET images of 397 subjects including 93 AD patients, 204 mild cognitive impairment (MCI, 76 pMCI +128 sMCI) and 100 normal controls (NC) from Alzheimer's Disease Neuroimaging

  19. Multi-Modal Hallucinations and Cognitive Function in Parkinson's Disease

    PubMed Central

    Katzen, Heather; Myerson, Connie; Papapetropoulos, Spiridon; Nahab, Fatta; Gallo, Bruno; Levin, Bonnie

    2010-01-01

    Background/Aims Hallucinations have been linked to a constellation of cognitive deficits in Parkinson's disease (PD), but it is not known whether multi-modal hallucinations are associated with greater neuropsychological dysfunction. Methods 152 idiopathic PD patients were categorized based on the presence or absence of hallucinations and then were further subdivided into visual-only (VHonly; n = 35) or multi-modal (VHplus; n = 12) hallucination groups. All participants underwent detailed neuropsychological assessment. Results Participants with hallucinations performed more poorly on select neuropsychological measures and exhibited more mood symptoms. There were no differences between VHonly and VHplus groups. Conclusions PD patients with multi-modal hallucinations are not at greater risk for neuropsychological impairment than those with single-modal hallucinations. PMID:20689283

  20. The Perceptual Basis of the Modality Effect in Multimedia Learning

    ERIC Educational Resources Information Center

    Rummer, Ralf; Schweppe, Judith; Furstenberg, Anne; Scheiter, Katharina; Zindler, Antje

    2011-01-01

    Various studies have demonstrated an advantage of auditory over visual text modality when learning with texts and pictures. To explain this modality effect, two complementary assumptions are proposed by cognitive theories of multimedia learning: first, the visuospatial load hypothesis, which explains the modality effect in terms of visuospatial…

  1. Intraoperative utilization of advanced imaging modalities in a complex kidney stone case: a pilot case study.

    PubMed

    Christiansen, Andrew R; Shorti, Rami M; Smith, Cory D; Prows, William C; Bishoff, Jay T

    2018-05-01

    Despite the increasing use of advanced 3D imaging techniques and 3D printing, these techniques have not yet been comprehensively compared in a surgical setting. The purpose of this study is to explore the effectiveness of five different advanced imaging modalities during a complex renal surgical procedure. A patient with a horseshoe kidney and multiple large, symptomatic stones that had failed Extracorporeal Shock Wave Lithotripsy (ESWL) and ureteroscopy treatment was used for this evaluation. CT data were used to generate five different imaging modalities, including a 3D printed model, three different volume rendered models, and a geometric CAD model. A survey was used to evaluate the quality and breadth of the imaging modalities during four different phases of the laparoscopic procedure. In the case of a complex kidney procedure, the CAD model, 3D print, volume render on an autostereoscopic 3D display, interactive and basic volume render models demonstrated added insight and complemented the surgical procedure. CAD manual segmentation allowed tissue layers and/or kidney stones to be made colorful and semi-transparent, allowing easier navigation through abnormal vasculature. The 3D print allowed for simultaneous visualization of renal pelvis and surrounding vasculature. Our preliminary exploration indicates that various advanced imaging modalities, when properly utilized and supported during surgery, can be useful in complementing the CT data and laparoscopic display. This study suggests that various imaging modalities, such as ones utilized in this case, can be beneficial intraoperatively depending on the surgical step involved and may be more helpful than 3D printed models. We also present factors to consider when evaluating advanced imaging modalities during complex surgery.

  2. Parallel pathways for cross-modal memory retrieval in Drosophila.

    PubMed

    Zhang, Xiaonan; Ren, Qingzhong; Guo, Aike

    2013-05-15

    Memory-retrieval processing of cross-modal sensory preconditioning is vital for understanding the plasticity underlying the interactions between modalities. As part of the sensory preconditioning paradigm, it has been hypothesized that the conditioned response to an unreinforced cue depends on the memory of the reinforced cue via a sensory link between the two cues. To test this hypothesis, we studied cross-modal memory-retrieval processing in a genetically tractable model organism, Drosophila melanogaster. By expressing the dominant temperature-sensitive shibire(ts1) (shi(ts1)) transgene, which blocks synaptic vesicle recycling of specific neural subsets with the Gal4/UAS system at the restrictive temperature, we specifically blocked visual and olfactory memory retrieval, either alone or in combination; memory acquisition remained intact for these modalities. Blocking the memory retrieval of the reinforced olfactory cues did not impair the conditioned response to the unreinforced visual cues or vice versa, in contrast to the canonical memory-retrieval processing of sensory preconditioning. In addition, these conditioned responses can be abolished by blocking the memory retrieval of the two modalities simultaneously. In sum, our results indicated that a conditioned response to an unreinforced cue in cross-modal sensory preconditioning can be recalled through parallel pathways.

  3. Librarian instruction-delivery modality preferences for professional continuing education

    PubMed Central

    Lynn, Valerie A.; Bose, Arpita; Boehmer, Susan J.

    2010-01-01

    Objectives: Attending professional continuing education (CE) is an important component of librarianship. This research study identified librarians' preferences in delivery modalities of instruction for professional CE. The study also identified influential factors associated with attending CE classes. Methods: Five instruction-delivery modalities and six influential factors were identified for inclusion in an online survey. The survey completed by members of the American Library Association (ALA), Special Libraries Association (SLA), and Medical Library Association (MLA) provided the data for analysis of librarian preferences and influential factors. Results: The majority of respondents were MLA members, followed by ALA and SLA members. Librarians from all three library associations preferred the face-to-face instructional modality. The most influential factor associated with the decision to attend a professional CE class was cost. Conclusions: All five instruction-delivery modalities present useful structures for imparting professional CE. As librarians' experience with different modalities increases and as technology improves, preferences in instruction delivery may shift. But at present, face-to-face remains the most preferred modality. Based on the results of this study, cost was the most influential factor associated with attending a CE class. This may change as additional influential factors are identified and analyzed in future studies. PMID:20098656

  4. Combined modality treatment improves tumor control and overall survival in patients with early stage Hodgkin’s lymphoma: a systematic review

    PubMed Central

    Herbst, Christine; Rehan, Fareed A.; Brillant, Corinne; Bohlius, Julia; Skoetz, Nicole; Schulz, Holger; Monsef, Ina; Specht, Lena; Engert, Andreas

    2010-01-01

    Combined modality treatment (CMT) of chemotherapy followed by localized radiotherapy is standard treatment for patients with early stage Hodgkin’s lymphoma. However, the role of radiotherapy has been questioned recently and some clinical study groups advocate chemotherapy only for this indication. We thus performed a systematic review with meta-analysis of randomized controlled trials comparing chemotherapy alone with CMT in patients with early stage Hodgkin’s lymphoma with respect to response rate, tumor control and overall survival (OS). We searched Medline, EMBASE and the Cochrane Library as well as conference proceedings from January 1980 to February 2009 for randomized controlled trials comparing chemotherapy alone versus the same chemotherapy regimen plus radiotherapy. Progression free survival and similar outcomes were analyzed together as tumor control. Effect measures used were hazard ratios for OS and tumor control as well as relative risks for complete response (CR). Meta-analyses were performed using RevMan5. Five randomized controlled trials involving 1,245 patients were included. The hazard ratio (HR) was 0.41 (95% confidence interval (CI) 0.25 to 0.66) for tumor control and 0.40 (95% CI 0.27 to 0.59) for OS for patients receiving CMT compared to chemotherapy alone. CR rates were similar between treatment groups. In sensitivity analyses another 6 trials were included that did not fulfill the inclusion criteria of our protocol but were considered relevant to the topic. These trials underlined the results of the main analysis. In conclusion, adding radiotherapy to chemotherapy improves tumor control and OS in patients with early stage Hodgkin’s lymphoma. PMID:19951972

  5. Exploring Modality Switching Effects in Negated Sentences: Further Evidence for Grounded Representations

    PubMed Central

    Hald, Lea A.; Hocking, Ian; Vernon, David; Marshall, Julie-Ann; Garnham, Alan

    2013-01-01

    Theories of embodied cognition (e.g., Perceptual Symbol Systems Theory; Barsalou, 1999, 2009) suggest that modality specific simulations underlie the representation of concepts. Supporting evidence comes from modality switch costs: participants are slower to verify a property in one modality (e.g., auditory, BLENDER-loud) after verifying a property in a different modality (e.g., gustatory, CRANBERRIES-tart) compared to the same modality (e.g., LEAVES-rustling, Pecher et al., 2003). Similarly, modality switching costs lead to a modulation of the N400 effect in event-related potentials (ERPs; Collins et al., 2011; Hald et al., 2011). This effect of modality switching has also been shown to interact with the veracity of the sentence (Hald et al., 2011). The current ERP study further explores the role of modality match/mismatch on the processing of veracity as well as negation (sentences containing “not”). Our results indicate a modulation in the ERP based on modality and veracity, plus an interaction. The evidence supports the idea that modality specific simulations occur during language processing, and furthermore suggest that these simulations alter the processing of negation. PMID:23450002

  6. Therapeutic Modalities in Diabetic Nephropathy: Future Approaches*

    PubMed Central

    Reeves, William Brian; Rawal, Bishal B.; Abdel-Rahman, Emaad M.; Awad, Alaa S.

    2012-01-01

    Diabetes mellitus is the leading cause of end stage renal disease and is responsible for more than 40% of all cases in the United States. Several therapeutic interventions for the treatment of diabetic nephropathy have been developed and implemented over the past few decades with some degree of success. However, the renal protection provided by these therapeutic modalities is incomplete. More effective approaches are therefore urgently needed. Recently, several novel therapeutic strategies have been explored in treating DN patients including Islet cell transplant, Aldose reductase inhibitors, Sulodexide (GAC), Protein Kinase C (PKC) inhibitors, Connective tissue growth factor (CTGF) inhibitors, Transforming growth factor-beta (TGF-β) inhibitors and bardoxolone. The benefits and risks of these agents are still under investigation. This review aims to summarize the utility of these novel therapeutic approaches. PMID:23293752

  7. Modal Testing of Seven Shuttle Cargo Elements for Space Station

    NASA Technical Reports Server (NTRS)

    Kappus, Kathy O.; Driskill, Timothy C.; Parks, Russel A.; Patterson, Alan (Technical Monitor)

    2001-01-01

    From December 1996 to May 2001, the Modal and Control Dynamics Team at NASA's Marshall Space Flight Center (MSFC) conducted modal tests on seven large elements of the International Space Station. Each of these elements has been or will be launched as a Space Shuttle payload for transport to the International Space Station (ISS). Like other Shuttle payloads, modal testing of these elements was required for verification of the finite element models used in coupled loads analyses for launch and landing. The seven modal tests included three modules - Node, Laboratory, and Airlock, and four truss segments - P6, P3/P4, S1/P1, and P5. Each element was installed and tested in the Shuttle Payload Modal Test Bed at MSFC. This unique facility can accommodate any Shuttle cargo element for modal test qualification. Flexure assemblies were utilized at each Shuttle-to-payload interface to simulate a constrained boundary in the load carrying degrees of freedom. For each element, multiple-input, multiple-output burst random modal testing was the primary approach with controlled input sine sweeps for linearity assessments. The accelerometer channel counts ranged from 252 channels to 1251 channels. An overview of these tests, as well as some lessons learned, will be provided in this paper.

  8. Modality dependency of familiarity ratings of Japanese words.

    PubMed

    Amano, S; Kondo, T; Kakehi, K

    1995-07-01

    Familiarity ratings for a large number of aurally and visually presented Japanese words wer measured for 11 subjects, in order to investigate the modality dependency of familiarity. The correlation coefficient between auditory and visual ratings was .808, which is lower than that observed for English words, suggesting that a substantial portion of the mental lexicon is modality dependent. It was shown that the modality dependency is greater for low-familiarity words than it is for medium- or high-familiarity words. This difference between the low- and the medium- or high-familiarity words has a relationship to orthography. That is, the dependency is larger in words consisting only of kanji, which may have multiple pronunciations and usually represent meaning, than it is in words consisting only of hiragana or katakana, which have a single pronunciation and usually do not represent meaning. These results indicate that the idiosyncratic characteristics of Japanese orthography contribute to the modality dependency.

  9. Adaptive Modal Identification for Flutter Suppression Control

    NASA Technical Reports Server (NTRS)

    Nguyen, Nhan T.; Drew, Michael; Swei, Sean S.

    2016-01-01

    In this paper, we will develop an adaptive modal identification method for identifying the frequencies and damping of a flutter mode based on model-reference adaptive control (MRAC) and least-squares methods. The least-squares parameter estimation will achieve parameter convergence in the presence of persistent excitation whereas the MRAC parameter estimation does not guarantee parameter convergence. Two adaptive flutter suppression control approaches are developed: one based on MRAC and the other based on the least-squares method. The MRAC flutter suppression control is designed as an integral part of the parameter estimation where the feedback signal is used to estimate the modal information. On the other hand, the separation principle of control and estimation is applied to the least-squares method. The least-squares modal identification is used to perform parameter estimation.

  10. Unified-planning, graded-administration, and centralized-controlling: a management modality for treating acquired immune deficiency syndrome with Chinese medicine in Henan Province of China.

    PubMed

    Xu, Li-Ran; Guo, Hui-jun; Liu, Zhi-bin; Li, Qiang; Yang, Ji-ping; He, Ying

    2015-04-01

    Henan Province in China has a major epidemic of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). Chinese medicine (CM) has been used throughout the last decade, and a management modality was developed, which can be described by unified-planning, graded-administration, and centralized-controlling (UGC). The UGC modality has one primary concept (patient-centered medicine from CM theory), four basic foundations (classifying administrative region, characteristics of CM on disease treatment, health resource conditions, and distribution of patients living with HIV), six important relationships (the "three uniformities and three combinations," and the six relationships therein guide the treatment of AIDS with CM), and four key sections (management, operation, records, and evaluation). In this article, the authors introduce the UGC modality, which could be beneficial to developing countries or resource-limited areas for the management of chronic infectious disease.

  11. SU-E-T-509: Inter-Observer and Inter-Modality Contouring Analysis for Organs at Risk for HDR Gynecological Brachytherapy

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

    Sadeghi, P; Smith, W; Tom Baker Cancer Centre, Calgary, AB

    2015-06-15

    Purpose This study quantifies errors associated with MR-guided High Dose Rate (HDR) gynecological brachytherapy. Uncertainties in this treatment results from contouring, organ motion between imaging and treatment delivery, dose calculation, and dose delivery. We focus on interobserver and inter-modality variability in contouring and the motion of organs at risk (OARs) in the time span between the MR and CT scans (∼1 hour). We report the change in organ volume and position of center of mass (CM) between the two imaging modalities. Methods A total of 8 patients treated with MR-guided HDR brachytherapy were included in this study. Two observers contouredmore » the bladder and rectum on both MR and CT scans. The change in OAR volume and CM position between the MR and CT imaging sessions on both image sets were calculated. Results The absolute mean bladder volume change between the two imaging modalities is 67.1cc. The absolute mean inter-observer difference in bladder volume is much lower at 15.5cc (MR) and 11.0cc (CT). This higher inter-modality volume difference suggests a real change in the bladder filling between the two imaging sessions. Change in Rectum volume inter-observer standard error of means (SEM) is 3.18cc (MR) and 3.09cc (CT), while the inter-modality SEM is 3.65cc (observer 1), and 2.75cc (observer 2). The SEM for rectum CM position in the superior-inferior direction was approximately three times higher than in other directions for both the inter—observer (0.77 cm, 0.92 cm for observers 1 and 2, respectively) and inter-modality (0.91 cm, 0.95 cm for MR and CT, respectively) variability. Conclusion Bladder contours display good consistency between different observers on both CT and MR images. For rectum contouring the highest inconsistency stems from the observers’ choice of the superior-inferior borders. A complete analysis of a larger patient cohort will enable us to separate the true organ motion from the inter-observer variability.« less

  12. Hypnosis--A Neglected Tool for Client Empowerment.

    ERIC Educational Resources Information Center

    Winsor, Roswitha M.

    1993-01-01

    Calls clinical hypnosis valuable treatment modality that deserves to be more widely used by social workers. Presents overview of hypnosis, distinguishing between directive, Ericksonian, and permissive hypnosis. Presents characteristics of hypnotic trance and differing capacities of individuals in trance. Describes how permissive hypnosis is used…

  13. Multishaker modal testing

    NASA Technical Reports Server (NTRS)

    Craig, Roy R., Jr.

    1987-01-01

    The major accomplishments of this research are: (1) the refinement and documentation of a multi-input, multi-output modal parameter estimation algorithm which is applicable to general linear, time-invariant dynamic systems; (2) the development and testing of an unsymmetric block-Lanzcos algorithm for reduced-order modeling of linear systems with arbitrary damping; and (3) the development of a control-structure-interaction (CSI) test facility.

  14. Evidence for modality-independent order coding in working memory.

    PubMed

    Depoorter, Ann; Vandierendonck, André

    2009-03-01

    The aim of the present study was to investigate the representation of serial order in working memory, more specifically whether serial order is coded by means of a modality-dependent or a modality-independent order code. This was investigated by means of a series of four experiments based on a dual-task methodology in which one short-term memory task was embedded between the presentation and recall of another short-term memory task. Two aspects were varied in these memory tasks--namely, the modality of the stimulus materials (verbal or visuo-spatial) and the presence of an order component in the task (an order or an item memory task). The results of this study showed impaired primary-task recognition performance when both the primary and the embedded task included an order component, irrespective of the modality of the stimulus materials. If one or both of the tasks did not contain an order component, less interference was found. The results of this study support the existence of a modality-independent order code.

  15. Retrospective analysis of treatment modalities in diabetic muscle infarction

    PubMed Central

    Onyenemezu, Ikenna; Capitle, Eugenio

    2014-01-01

    Background Diabetic muscle infarction (DMI) is a spontaneous necrosis of skeletal muscle of unknown etiology. The major risk factor is longstanding uncontrolled diabetes mellitus (DM). Optimal treatment for DMI is not known. The purpose of this study was to analyze the outcome of surgical treatment, physiotherapy, and bed rest in DMI. Methods We searched Medline from its inception to April 2013. We selected cases that provided sufficient data on recovery duration, recurrences, and non-recurrences. Baseline characteristics, including age, sex, microvascular complications, lesion size estimated on magnetic resonance imaging, type of diabetes, and duration of diabetes were assessed. The primary outcome was mean time to recovery from initial treatment and secondary outcomes were mean time to recurrence and recurrence rate. Results Mean time to recovery was 149 (95% confidence interval [CI] 113–186), 71 (95% CI 47–96), and 43 (95% CI 30–57) days for surgery, physiotherapy and bed rest, respectively. These figures were statistically significant only for surgery versus physiotherapy and surgery versus bed rest (P<0.01). Mean time to recurrence was 30, 107, and 297 days for surgery, physiotherapy, and bed rest, respectively. The recurrence rate was 57%, 44%, and 24% for surgery, physiotherapy, and bed rest, respectively. Conclusion Our results show a similar outcome for physiotherapy as compared with bed rest. It also confirms nonsurgical treatment as a better therapeutic option compared with surgical treatment. PMID:27790029

  16. [Influence of lithotripsy modalities on complication rate].

    PubMed

    Radulović, Slobodan; Milenković-Petronić, Dragica; Vuksanović, Aleksandar; Vavić, Bozo

    2009-01-01

    Localization of ureteric stones and difference in disintegration success are the most important factors in determining the first treatment approach for ureteric stones. The aim of our study was to evaluate the difference in complication rate between different ureteric stone litho-tripsy modalities. Two hundred sixty patients with ureteric stones were analyzed in a prospective bicentric study that lasted 1 year.The patients were divided into two groups: 1-120 patients who underwent ESWL (extracorporeal shockwave lithotripsy) treatment and II-140 patients who were treated endoscopically with ballistic lithotripsy. RESULTS Ureteroscopic lithotripsy of all pelvic and iliac stones was significantly more successful comparing to ESWL, while lumbar ureteric stone treatment with ureteroscopic lithotripsy was not significantly more successful than ESWL, except for lumbar stones larger than 100mm2 that were significantly better treated endoscopically. In the I group complications after lithotripsy were recorded in 64 (59.3%) and in the II group in 58 (42.0%) patients, meaning that complications were statistically significantly more frequent in the I than in the II group. In the II group complications were significantly more often recorded after treatment of proximal comparing to ureteric stones of other localizations, while in the I group complica-tions were significantly more often detected after treatment of impacted stones than in the II group. Being significantly successful comparing to ESWL, ureteric stone treatment with ureteroscopic lithotripsy should be considered as the first therapeutic option for all, especially impacted stones located in the iliac and pelvic ureteric portion. In spite of absent statistical difference in the success rate, ESWL should be chosen as the first treatment option in all cases of lumbar ureteric stones due to lower complication rate except for stones larger than 100mm2that should be primarily treated endoscopically.

  17. Cross-modal Savings in the Contralateral Eyelid Conditioned Response

    PubMed Central

    Campolattaro, Matthew M.; Buss, Eric W.; Freeman, John H.

    2015-01-01

    The present experiment monitored bilateral eyelid responses during eyeblink conditioning in rats trained with a unilateral unconditioned stimulus (US). Three groups of rats were used to determine if cross-modal savings occurs when the location of the US is switched from one eye to the other. Rats in each group first received paired or unpaired eyeblink conditioning with a conditioned stimulus (tone or light; CS) and a unilateral periorbital electrical stimulation US. All rats were subsequently given paired training, but with the US location (Group 1), CS modality (Group 2), or US location and CS modality (Group 3) changed. Changing the location of the US alone resulted in an immediate transfer of responding in both eyelids (Group 1) in rats that received paired training prior to the transfer session. Rats in groups 2 and 3 that initially received paired training showed facilitated learning to the new CS modality during the transfer sessions, indicating that cross-modal savings occurs whether or not the location of the US is changed. All rats that were initially given unpaired training acquired conditioned eyeblink responses similar to de novo acquisition rate during the transfer sessions. Savings of CR incidence was more robust than savings of CR amplitude when the US switched sides, a finding that has implications for elucidating the neural mechanisms of cross-modal savings. PMID:26501170

  18. Information-Processing Modules and Their Relative Modality Specificity

    ERIC Educational Resources Information Center

    Anderson, John R.; Qin, Yulin; Jung, Kwan-Jin; Carter, Cameron S.

    2007-01-01

    This research uses fMRI to understand the role of eight cortical regions in a relatively complex information-processing task. Modality of input (visual versus auditory) and modality of output (manual versus vocal) are manipulated. Two perceptual regions (auditory cortex and fusiform gyrus) only reflected perceptual encoding. Two motor regions were…

  19. Cross-sectional study comparing different therapeutic modalities for cystic lymphangiomas in children

    PubMed Central

    de Oliveira Olímpio, Hugo; Bustorff-Silva, Joaquim; de Oliveira Filho, Antonio Gonçalves; de Araujo, Kleber Cursino

    2014-01-01

    OBJECTIVE: Here, we describe our experience with different therapeutic modalities used to treat cystic lymphangiomas in children in our hospital, including single therapy with OK-432, bleomycin and surgery, and a combination of the three modalities. METHODS: We performed a retrospective, cross-sectional study including patients treated from 1998 to 2011. The effects on macrocystic lymphangiomas and adverse reactions were evaluated. Twenty-nine children with cystic lymphangiomas without any previous treatment were included. Under general anesthesia, patients given sclerosing agents underwent puncture of the lesion (guided by ultrasound when necessary) and complete aspiration of the intralesional liquid. The patients were evaluated with ultrasound and clinical examinations for a maximum follow-up time of 4 years. RESULTS: The proportions of patients considered cured after the first therapeutic approach were 44% in the surgery group, 29% in the bleomycin group and 31% in the OK-432 group. These proportions were not significantly different. Sequential treatment increased the rates of curative results to 71%, 74% and 44%, respectively, after the final treatment, which in our case was approximately 1.5 applications per patient. CONCLUSION: The results of this study indicate that most patients with cystic lymphangiomas do not show complete resolution after the initial therapy, regardless of whether the therapy is surgical or involves the use of sclerosing agents. To achieve complete resolution of the lesions, either multiple operations or a combination of surgery and sclerotherapy must be used and should be tailored to the characteristics of each patient. PMID:25141107

  20. Sportsman hernia; the review of current diagnosis and treatment modalities.

    PubMed

    Paksoy, Melih; Sekmen, Ümit

    2016-01-01

    Groin pain is an important clinical entity that may affect a sportsman's active sports life. Sportsman's hernia is a chronic low abdominal and groin pain syndrome. Open and laparoscopic surgical treatment may be chosen in case of conservative treatment failure. Studies on sportsman's hernia, which is a challenging situation in both diagnosis and treatment, are ongoing in many centers. We reviewed the treatment results of 37 patients diagnosed and treated as sportsman's hernia at our hospital between 2011-2014, in light of current literature.

  1. Deep cleaning of a metallurgical zinc leaching residue and recovery of valuable metals

    NASA Astrophysics Data System (ADS)

    Xing, Peng; Ma, Bao-zhong; Zeng, Peng; Wang, Cheng-yan; Wang, Ling; Zhang, Yong-lu; Chen, Yong-qiang; Wang, Shuo; Wang, Qiu-yin

    2017-11-01

    Huge quantities of zinc leaching residues (ZLRs) generated from zinc production are dumped continuously around the world and pose a potential environmental threat because of their considerable amounts of entrained heavy metals (mainly lead). Most ZLRs have not been properly treated and the valuable metals in them have not yet been effectively recovered. Herein, the deep cleaning of a ZLR and recovery of valuable metals via a hydrometallurgical route were investigated. The cleaning process consists of two essential stages: acid leaching followed by calcium chloride leaching. The optimum conditions for extracting zinc, copper, and indium by acid leaching were a sulfuric acid concentration of 200 g·L-1, a liquid/solid ratio of 4:1 (mL/g), a leaching time of 2 h, and a temperature of 90°C. For lead and silver extractions, the optimum conditions were a calcium chloride concentration of 400 g·L-1, a pH value of 1.0, a leaching time of 1 h, and a temperature of 30°C. After calcium chloride leaching, silver and lead were extracted out and the lead was finally recovered as electrolytic lead by electrowinning. The anglesite phase, which poses the greatest potential environmental hazard, was removed from the ZLR after deep cleaning, thus reducing the cost of environmental management of ZLRs. The treatment of chlorine and spent electrolyte generated in the process was discussed.

  2. Sportsman hernia; the review of current diagnosis and treatment modalities

    PubMed Central

    Paksoy, Melih; Sekmen, Ümit

    2016-01-01

    Groin pain is an important clinical entity that may affect a sportsman’s active sports life. Sportsman’s hernia is a chronic low abdominal and groin pain syndrome. Open and laparoscopic surgical treatment may be chosen in case of conservative treatment failure. Studies on sportsman’s hernia, which is a challenging situation in both diagnosis and treatment, are ongoing in many centers. We reviewed the treatment results of 37 patients diagnosed and treated as sportsman’s hernia at our hospital between 2011–2014, in light of current literature. PMID:27436937

  3. [Treatment of chronic shoulder tendinitis].

    PubMed

    Brox, J I; Bøhmer, A S; Ljunggren, A E; Staff, P H

    1994-02-20

    The authors review current treatment modalities and present a study comparing supervised exercises and arthroscopic surgery in patients with rotator cuff disease. Exercises supervised by a physiotherapist emphasize relearning of normal patterns of movement and local endurance training to improve tendon and muscle tissue, and are supplemented by ergonomic advice. The clinician should try to elucidate whether the patient is supposed to benefit solely from information and self-treatment. For several of the currently used treatment modalities, such as ultrasound, soft laser, heat and massage, no effect has been documented. Surgery should be reserved for persons who do not benefit from supervised exercises. Careful rehabilitation is necessary for patients who report having a physically demanding job.

  4. Learning to learn: From within-modality to cross-modality transfer during infancy.

    PubMed

    Hupp, Julie M; Sloutsky, Vladimir M

    2011-11-01

    One critical aspect of learning is the ability to apply learned knowledge to new situations. This ability to transfer is often limited, and its development is not well understood. The current research investigated the development of transfer between 8 and 16 months of age. In Experiment 1, 8- and 16-month-olds (who were established to have a preference to the beginning of a visual sequence) were trained to attend to the end of a sequence. They were then tested on novel visual sequences. Results indicated transfer of learning, with both groups changing baseline preferences as a result of training. In Experiment 2, participants were trained to attend to the end of a visual sequence and were then tested on an auditory sequence. Unlike Experiment 1, only older participants exhibited transfer of learning by changing baseline preferences. These findings suggest that the generalization of learning becomes broader with development, with transfer across modalities developing later than transfer within a modality. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. A retrospective analysis of preoperative staging modalities for oral squamous cell carcinoma.

    PubMed

    Kähling, Ch; Langguth, T; Roller, F; Kroll, T; Krombach, G; Knitschke, M; Streckbein, Ph; Howaldt, H P; Wilbrand, J-F

    2016-12-01

    An accurate preoperative assessment of cervical lymph node status is a prerequisite for individually tailored cancer therapies in patients with oral squamous cell carcinoma. The detection of malignant spread and its treatment crucially influence the prognosis. The aim of the present study was to analyze the different staging modalities used among patients with a diagnosis of primary oral squamous cell carcinoma between 2008 and 2015. An analysis of preoperative staging findings, collected by clinical palpation, ultrasound, and computed tomography (CT), was performed. The results obtained were compared with the results of the final histopathological findings of the neck dissection specimens. A statistical analysis using McNemar's test was performed. The sensitivity of CT for the detection of malignant cervical tumor spread was 74.5%. The ultrasound obtained a sensitivity of 60.8%. Both CT and ultrasound demonstrated significantly enhanced sensitivity compared to the clinical palpation with a sensitivity of 37.1%. No significant difference was observed between CT and ultrasound. A combination of different staging modalities increased the sensitivity significantly compared with ultrasound staging alone. No significant difference in sensitivity was found between the combined use of different staging modalities and CT staging alone. The highest sensitivity, of 80.0%, was obtained by a combination of all three staging modalities: clinical palpation, ultrasound and CT. The present study indicates that CT has an essential role in the preoperative staging of patients with oral squamous cell carcinoma. Its use not only significantly increases the sensitivity of cervical lymph node metastasis detection but also offers a preoperative assessment of local tumor spread and resection borders. An additional non-invasive cervical lymph node examination increases the sensitivity of the tumor staging process and reduces the risk of occult metastasis. Copyright © 2016 European

  6. Traditional Chinese medicine valuably augments therapeutic options in the treatment of climacteric syndrome.

    PubMed

    Eisenhardt, Sarah; Fleckenstein, Johannes

    2016-07-01

    Climacteric syndrome refers to recurring symptoms such as hot flashes, chills, headache, irritability and depression. This is usually experienced by menopausal women and can be related to a hormonal reorganization in the hypothalamic-pituitary-gonadal axis. In Traditional Chinese Medicine, originating 1000s of years ago, above-mentioned symptoms can be interpreted on the basis of the philosophic diagnostic concepts, such as the imbalance of Yin and Yang, the Zang-Fu and Basic substances (e.g. Qi, Blood and Essence). These concepts postulate balance and harmonization as the principle aim of a treatment. In this context, it is not astounding that one of the most prominent ancient textbooks dating back to 500-200 BC, Huang di Neijing: The Yellow Emperor's Classic of Internal Medicine gives already first instructions for diagnosis and therapy of climacteric symptoms. For therapy, traditional Chinese medicine comprises five treatment principles: Chinese herbal medicine, TuiNa (a Chinese form of manual therapy), nutrition, activity (e.g. QiGong) and acupuncture (being the most widespread form of treatment used in Europe). This review provides an easy access to the concepts of traditional Chinese medicine particularly regarding to climacteric syndrome and also focuses on current scientific evidence.

  7. Alcoholism treatment and medical care costs from Project MATCH.

    PubMed

    Holder, H D; Cisler, R A; Longabaugh, R; Stout, R L; Treno, A J; Zweben, A

    2000-07-01

    This paper examines the costs of medical care prior to and following initiation of alcoholism treatment as part of a study of patient matching to treatment modality. Longitudinal study with pre- and post-treatment initiation. The total medical care costs for inpatient and outpatient treatment for patients participating over a span of 3 years post-treatment. Three treatment sites at two of the nine Project MATCH locations (Milwaukee, WI and Providence, RI). Two hundred and seventy-nine patients. Patients were randomly assigned to one of three treatment modalities: a 12-session cognitive behavioral therapy (CBT), a four-session motivational enhancement therapy (MET) or a 12-session Twelve-Step facilitation (TSF) treatment over 12 weeks. Total medical care costs declined from pre- to post-treatment overall and for each modality. Matching effects independent of clinical prognosis showed that MET has potential for medical-care cost-savings. However, patients with poor prognostic characteristics (alcohol dependence, psychiatric severity and/or social network support for drinking) have better cost-savings potential with CBT and/or TSF. Matching variables have significant importance in increasing the potential for medical-care cost-reductions following alcoholism treatment.

  8. Fuzzy Modal Control Applied to Smart Composite Structure

    NASA Astrophysics Data System (ADS)

    Koroishi, E. H.; Faria, A. W.; Lara-Molina, F. A.; Steffen, V., Jr.

    2015-07-01

    This paper proposes an active vibration control technique, which is based on Fuzzy Modal Control, as applied to a piezoelectric actuator bonded to a composite structure forming a so-called smart composite structure. Fuzzy Modal Controllers were found to be well adapted for controlling structures with nonlinear behavior, whose characteristics change considerably with respect to time. The smart composite structure was modelled by using a so called mixed theory. This theory uses a single equivalent layer for the discretization of the mechanical displacement field and a layerwise representation of the electrical field. Temperature effects are neglected. Due to numerical reasons it was necessary to reduce the size of the model of the smart composite structure so that the design of the controllers and the estimator could be performed. The role of the Kalman Estimator in the present contribution is to estimate the modal states of the system, which are used by the Fuzzy Modal controllers. Simulation results illustrate the effectiveness of the proposed vibration control methodology for composite structures.

  9. Feature-based Alignment of Volumetric Multi-modal Images

    PubMed Central

    Toews, Matthew; Zöllei, Lilla; Wells, William M.

    2014-01-01

    This paper proposes a method for aligning image volumes acquired from different imaging modalities (e.g. MR, CT) based on 3D scale-invariant image features. A novel method for encoding invariant feature geometry and appearance is developed, based on the assumption of locally linear intensity relationships, providing a solution to poor repeatability of feature detection in different image modalities. The encoding method is incorporated into a probabilistic feature-based model for multi-modal image alignment. The model parameters are estimated via a group-wise alignment algorithm, that iteratively alternates between estimating a feature-based model from feature data, then realigning feature data to the model, converging to a stable alignment solution with few pre-processing or pre-alignment requirements. The resulting model can be used to align multi-modal image data with the benefits of invariant feature correspondence: globally optimal solutions, high efficiency and low memory usage. The method is tested on the difficult RIRE data set of CT, T1, T2, PD and MP-RAGE brain images of subjects exhibiting significant inter-subject variability due to pathology. PMID:24683955

  10. Cross-modal individual recognition in wild African lions.

    PubMed

    Gilfillan, Geoffrey; Vitale, Jessica; McNutt, John Weldon; McComb, Karen

    2016-08-01

    Individual recognition is considered to have been fundamental in the evolution of complex social systems and is thought to be a widespread ability throughout the animal kingdom. Although robust evidence for individual recognition remains limited, recent experimental paradigms that examine cross-modal processing have demonstrated individual recognition in a range of captive non-human animals. It is now highly relevant to test whether cross-modal individual recognition exists within wild populations and thus examine how it is employed during natural social interactions. We address this question by testing audio-visual cross-modal individual recognition in wild African lions (Panthera leo) using an expectancy-violation paradigm. When presented with a scenario where the playback of a loud-call (roaring) broadcast from behind a visual block is incongruent with the conspecific previously seen there, subjects responded more strongly than during the congruent scenario where the call and individual matched. These findings suggest that lions are capable of audio-visual cross-modal individual recognition and provide a useful method for studying this ability in wild populations. © 2016 The Author(s).

  11. Effect of residual stress on modal patterns of MEMS vibratory gyroscope

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

    Dutta, Shankar, E-mail: shankardutta77@gmail.com; Panchal, Abha; Kumar, Manoj

    Deep boron diffusion often induces residual stress in bulk micromachined MEMS structures, which may affect the MEMS devices operation. In this study, we studied the modal patterns of MEMS vibratory gyroscope under the residual stress (100 – 1000 MPa). Modal patterns and modal frequencies of the gyro are found to be dependent on the residual stress values. Without any residual stress, the modal frequencies drive and sense modeswere found to be 20.06 kHz and 20.36 kHz respectively. In presence of 450 MPa residual stress, the modal frequencies of the drive and sense modes were changed to 42.75 kHz and 43.07 kHz respectively.

  12. Multipass haemodialysis: a novel dialysis modality

    PubMed Central

    Heaf, James Goya; Axelsen, Mette; Pedersen, Robert Smith

    2013-01-01

    Introduction Most home haemodialysis (HD) modalities are limited to home use since they are based on a single-pass (SP) technique, which requires preparation of large amounts of dialysate. We present a new dialysis method, which requires minimal dialysate volumes, continuously recycled during treatment [multipass HD (MPHD)]. Theoretical calculations suggest that MPHD performed six times weekly for 8 h/night, using a dialysate bath containing 50% of the calculated body water, will achieve urea clearances equivalent to conventional HD 4 h thrice weekly, and a substantial clearance of higher middle molecules. Methods Ten stable HD patients were dialyzed for 4 h using standard SPHD (dialysate flow 500 mL/min). Used dialysate was collected. One week later, an 8-h MPHD was performed. The dialysate volume was 50% of the calculated water volume, the dialysate inflow 500 mL/min−0.5 × ultrafiltration/min and the outflow 500 mL/min + 0.5 × ultrafiltration/min. Elimination rates of urea, creatinine, uric acid, phosphate and β2-microglobulin (B2M) and dialysate saturation were determined hourly. Results Three hours of MPHD removed 49, 54, 50, 51 and 57%, respectively, of the amounts of urea, creatinine, uric acid, phosphate and B2M that were removed by 4 h conventional HD. The corresponding figures after 8 h MPHD were 63, 78, 74, 78 and 111%. Conclusions Clearance of small molecules using MPHD 6 × 8 h/week will exceed traditional HD 3 × 4 h/week. Similarly, clearance of large molecules will significantly exceed traditional HD and HD 5 × 2.5 h/week. This modality will increase patients' freedom of movement compared with traditional home HD. The new method can also be used in the intensive care unit and for automated peritoneal dialysis. PMID:23136214

  13. Multi-modal Registration for Correlative Microscopy using Image Analogies

    PubMed Central

    Cao, Tian; Zach, Christopher; Modla, Shannon; Powell, Debbie; Czymmek, Kirk; Niethammer, Marc

    2014-01-01

    Correlative microscopy is a methodology combining the functionality of light microscopy with the high resolution of electron microscopy and other microscopy technologies for the same biological specimen. In this paper, we propose an image registration method for correlative microscopy, which is challenging due to the distinct appearance of biological structures when imaged with different modalities. Our method is based on image analogies and allows to transform images of a given modality into the appearance-space of another modality. Hence, the registration between two different types of microscopy images can be transformed to a mono-modality image registration. We use a sparse representation model to obtain image analogies. The method makes use of corresponding image training patches of two different imaging modalities to learn a dictionary capturing appearance relations. We test our approach on backscattered electron (BSE) scanning electron microscopy (SEM)/confocal and transmission electron microscopy (TEM)/confocal images. We perform rigid, affine, and deformable registration via B-splines and show improvements over direct registration using both mutual information and sum of squared differences similarity measures to account for differences in image appearance. PMID:24387943

  14. Dual ant colony operational modal analysis parameter estimation method

    NASA Astrophysics Data System (ADS)

    Sitarz, Piotr; Powałka, Bartosz

    2018-01-01

    Operational Modal Analysis (OMA) is a common technique used to examine the dynamic properties of a system. Contrary to experimental modal analysis, the input signal is generated in object ambient environment. Operational modal analysis mainly aims at determining the number of pole pairs and at estimating modal parameters. Many methods are used for parameter identification. Some methods operate in time while others in frequency domain. The former use correlation functions, the latter - spectral density functions. However, while some methods require the user to select poles from a stabilisation diagram, others try to automate the selection process. Dual ant colony operational modal analysis parameter estimation method (DAC-OMA) presents a new approach to the problem, avoiding issues involved in the stabilisation diagram. The presented algorithm is fully automated. It uses deterministic methods to define the interval of estimated parameters, thus reducing the problem to optimisation task which is conducted with dedicated software based on ant colony optimisation algorithm. The combination of deterministic methods restricting parameter intervals and artificial intelligence yields very good results, also for closely spaced modes and significantly varied mode shapes within one measurement point.

  15. Modalities of memory: is reading lips like hearing voices?

    PubMed

    Maidment, David W; Macken, Bill; Jones, Dylan M

    2013-12-01

    Functional similarities in verbal memory performance across presentation modalities (written, heard, lipread) are often taken to point to a common underlying representational form upon which the modalities converge. We show here instead that the pattern of performance depends critically on presentation modality and different mechanisms give rise to superficially similar effects across modalities. Lipread recency is underpinned by different mechanisms to auditory recency, and while the effect of an auditory suffix on an auditory list is due to the perceptual grouping of the suffix with the list, the corresponding effect with lipread speech is due to misidentification of the lexical content of the lipread suffix. Further, while a lipread suffix does not disrupt auditory recency, an auditory suffix does disrupt recency for lipread lists. However, this effect is due to attentional capture ensuing from the presentation of an unexpected auditory event, and is evident both with verbal and nonverbal auditory suffixes. These findings add to a growing body of evidence that short-term verbal memory performance is determined by modality-specific perceptual and motor processes, rather than by the storage and manipulation of phonological representations. Copyright © 2013 Elsevier B.V. All rights reserved.

  16. Monte Carlo simulations of medical imaging modalities

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

    Estes, G.P.

    Because continuous-energy Monte Carlo radiation transport calculations can be nearly exact simulations of physical reality (within data limitations, geometric approximations, transport algorithms, etc.), it follows that one should be able to closely approximate the results of many experiments from first-principles computations. This line of reasoning has led to various MCNP studies that involve simulations of medical imaging modalities and other visualization methods such as radiography, Anger camera, computerized tomography (CT) scans, and SABRINA particle track visualization. It is the intent of this paper to summarize some of these imaging simulations in the hope of stimulating further work, especially as computermore » power increases. Improved interpretation and prediction of medical images should ultimately lead to enhanced medical treatments. It is also reasonable to assume that such computations could be used to design new or more effective imaging instruments.« less

  17. Modal Ring Method for the Scattering of Electromagnetic Waves

    NASA Technical Reports Server (NTRS)

    Baumeister, Kenneth J.; Kreider, Kevin L.

    1993-01-01

    The modal ring method for electromagnetic scattering from perfectly electric conducting (PEC) symmetrical bodies is presented. The scattering body is represented by a line of finite elements (triangular) on its outer surface. The infinite computational region surrounding the body is represented analytically by an eigenfunction expansion. The modal ring method effectively reduces the two dimensional scattering problem to a one-dimensional problem similar to the method of moments. The modal element method is capable of handling very high frequency scattering because it has a highly banded solution matrix.

  18. On the dependence of response inhibition processes on sensory modality.

    PubMed

    Bodmer, Benjamin; Beste, Christian

    2017-04-01

    The ability to inhibit responses is a central sensorimotor function but only recently the importance of sensory processes for motor inhibition mechanisms went more into the research focus. In this regard it is elusive, whether there are differences between sensory modalities to trigger response inhibition processes. Due to functional neuroanatomical considerations strong differences may exist, for example, between the visual and the tactile modality. In the current study we examine what neurophysiological mechanisms as well as functional neuroanatomical networks are modulated during response inhibition. Therefore, a Go/NoGo-paradigm employing a novel combination of visual, tactile, and visuotactile stimuli was used. The data show that the tactile modality is more powerful than the visual modality to trigger response inhibition processes. However, the tactile modality loses its efficacy to trigger response inhibition processes when being combined with the visual modality. This may be due to competitive mechanisms leading to a suppression of certain sensory stimuli and the response selection level. Variations in sensory modalities specifically affected conflict monitoring processes during response inhibition by modulating activity in a frontal parietal network including the right inferior frontal gyrus, anterior cingulate cortex and the temporoparietal junction. Attentional selection processes are not modulated. The results suggest that the functional neuroanatomical networks involved in response inhibition critically depends on the nature of the sensory input. Hum Brain Mapp 38:1941-1951, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  19. Conflict when making decisions about dialysis modality.

    PubMed

    Chen, Nien-Hsin; Lin, Yu-Ping; Liang, Shu-Yuan; Tung, Heng-Hsin; Tsay, Shiow-Luan; Wang, Tsae-Jyy

    2018-01-01

    To explore decisional conflict and its influencing factors on choosing dialysis modality in patients with end-stage renal diseases. The influencing factors investigated include demographics, predialysis education, dialysis knowledge, decision self-efficacy and social support. Making dialysis modality decisions can be challenging for patients with end-stage renal diseases; there are pros and cons to both haemodialysis and peritoneal dialysis. Patients are often uncertain as to which one will be the best alternative for them. This decisional conflict increases the likelihood of making a decision that is not based on the patient's values or preferences and may result in undesirable postdecisional consequences. Addressing factors predisposing patients to decisional conflict helps to facilitate informed decision-making and then to improve healthcare quality. A predictive correlational cross-sectional study design was used. Seventy patients were recruited from the outpatient dialysis clinics of two general hospitals in Taiwan. Data were collected with study questionnaires, including questions on demographics, dialysis modality and predialysis education, the Dialysis Knowledge Scale, the Decision Self-Efficacy scale, the Social Support Scale, and the Decisional Conflict Scale. The mean score on the Decisional Conflict Scale was 29.26 (SD = 22.18). Decision self-efficacy, dialysis modality, predialysis education, professional support and dialysis knowledge together explained 76.4% of the variance in decisional conflict. Individuals who had lower decision self-efficacy, did not receive predialysis education on both haemodialysis and peritoneal dialysis, had lower dialysis knowledge and perceived lower professional support reported higher decisional conflict on choosing dialysis modality. When providing decisional support to predialysis stage patients, practitioners need to increase patients' decision self-efficacy, provide both haemodialysis and peritoneal dialysis

  20. Effects of medical and mental status on treatment modalities in patients treated under general anaesthesia at the KTU Faculty of Dentistry in Trabzon, Turkey: A comparative retrospective study.

    PubMed

    Baygin, Ozgul; Tuzuner, Tamer; Kusgoz, Adem; Yahyaoglu, Gorkem; Yilmaz, Nagehan; Aksoy, Simge

    2017-02-01

    This study evaluated the differences in dental conditions and treatment modalities between disabled and non-cooperative healthy children under general anaesthesia. The data were collected from paediatric patients between 3 and 15 years of age who received dental treatment under general anaesthesia. Patients with at least one mental/physical disturbance (group 1) and other healthy non-cooperative patients (group 2) were compared with regard to gender, age, weight, and treatment time-type. The statistical analyses were performed using Fisher's exact and Mann-Whitney U tests. No significant differences were observed between the groups with regard to gender, weight and treatment-time (p>0.05). The numbers of treated teeth (p<0.01) and extractions (p<0.001) were higher in group 1 than in group 2, whereas the frequency of advanced restorative procedures for group 1 was lower than that for group 2, including preventive-resin-restoration (p<0.001), glass-ionomer-cement (p<0.05), root-canal (p<0.001) and stainless-steel-crowns (p<0.001). This study supports the hypothesis that the general condition of the patients may alter the type of treatment provided and confirms the necessity of performing preventive procedures.

  1. The sweet spot: FDG and other 2-carbon glucose analogs for multi-modal metabolic imaging of tumor metabolism

    PubMed Central

    Cox, Benjamin L; Mackie, Thomas R; Eliceiri, Kevin W

    2015-01-01

    Multi-modal imaging approaches of tumor metabolism that provide improved specificity, physiological relevance and spatial resolution would improve diagnosing of tumors and evaluation of tumor progression. Currently, the molecular probe FDG, glucose fluorinated with 18F at the 2-carbon, is the primary metabolic approach for clinical diagnostics with PET imaging. However, PET lacks the resolution necessary to yield intratumoral distributions of deoxyglucose, on the cellular level. Multi-modal imaging could elucidate this problem, but requires the development of new glucose analogs that are better suited for other imaging modalities. Several such analogs have been created and are reviewed here. Also reviewed are several multi-modal imaging studies that have been performed that attempt to shed light on the cellular distribution of glucose analogs within tumors. Some of these studies are performed in vitro, while others are performed in vivo, in an animal model. The results from these studies introduce a visualization gap between the in vitro and in vivo studies that, if solved, could enable the early detection of tumors, the high resolution monitoring of tumors during treatment, and the greater accuracy in assessment of different imaging agents. PMID:25625022

  2. A Modal Model to Simulate Typical Structural Dynamic Nonlinearity [PowerPoint

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

    Mayes, Randall L.; Pacini, Benjamin Robert; Roettgen, Dan

    2016-01-01

    Some initial investigations have been published which simulate nonlinear response with almost traditional modal models: instead of connecting the modal mass to ground through the traditional spring and damper, a nonlinear Iwan element was added. This assumes that the mode shapes do not change with amplitude and there are no interactions between modal degrees of freedom. This work expands on these previous studies. An impact experiment is performed on a structure which exhibits typical structural dynamic nonlinear response, i.e. weak frequency dependence and strong damping dependence on the amplitude of vibration. Use of low level modal test results in combinationmore » with high level impacts are processed using various combinations of modal filtering, the Hilbert Transform and band-pass filtering to develop response data that are then fit with various nonlinear elements to create a nonlinear pseudo-modal model. Simulations of forced response are compared with high level experimental data for various nonlinear element assumptions.« less

  3. Modal Substructuring of Geometrically Nonlinear Finite-Element Models

    DOE PAGES

    Kuether, Robert J.; Allen, Matthew S.; Hollkamp, Joseph J.

    2015-12-21

    The efficiency of a modal substructuring method depends on the component modes used to reduce each subcomponent model. Methods such as Craig–Bampton have been used extensively to reduce linear finite-element models with thousands or even millions of degrees of freedom down orders of magnitude while maintaining acceptable accuracy. A novel reduction method is proposed here for geometrically nonlinear finite-element models using the fixed-interface and constraint modes of the linearized system to reduce each subcomponent model. The geometric nonlinearity requires an additional cubic and quadratic polynomial function in the modal equations, and the nonlinear stiffness coefficients are determined by applying amore » series of static loads and using the finite-element code to compute the response. The geometrically nonlinear, reduced modal equations for each subcomponent are then coupled by satisfying compatibility and force equilibrium. This modal substructuring approach is an extension of the Craig–Bampton method and is readily applied to geometrically nonlinear models built directly within commercial finite-element packages. The efficiency of this new approach is demonstrated on two example problems: one that couples two geometrically nonlinear beams at a shared rotational degree of freedom, and another that couples an axial spring element to the axial degree of freedom of a geometrically nonlinear beam. The nonlinear normal modes of the assembled models are compared with those of a truth model to assess the accuracy of the novel modal substructuring approach.« less

  4. Modal Substructuring of Geometrically Nonlinear Finite-Element Models

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

    Kuether, Robert J.; Allen, Matthew S.; Hollkamp, Joseph J.

    The efficiency of a modal substructuring method depends on the component modes used to reduce each subcomponent model. Methods such as Craig–Bampton have been used extensively to reduce linear finite-element models with thousands or even millions of degrees of freedom down orders of magnitude while maintaining acceptable accuracy. A novel reduction method is proposed here for geometrically nonlinear finite-element models using the fixed-interface and constraint modes of the linearized system to reduce each subcomponent model. The geometric nonlinearity requires an additional cubic and quadratic polynomial function in the modal equations, and the nonlinear stiffness coefficients are determined by applying amore » series of static loads and using the finite-element code to compute the response. The geometrically nonlinear, reduced modal equations for each subcomponent are then coupled by satisfying compatibility and force equilibrium. This modal substructuring approach is an extension of the Craig–Bampton method and is readily applied to geometrically nonlinear models built directly within commercial finite-element packages. The efficiency of this new approach is demonstrated on two example problems: one that couples two geometrically nonlinear beams at a shared rotational degree of freedom, and another that couples an axial spring element to the axial degree of freedom of a geometrically nonlinear beam. The nonlinear normal modes of the assembled models are compared with those of a truth model to assess the accuracy of the novel modal substructuring approach.« less

  5. Levulinic acid: a valuable platform chemical for fermentative syntheses

    USDA-ARS?s Scientific Manuscript database

    In 2004 the DOE included levulinic acid (LA) as a top platform molecule because of its production from renewable resources in large yields and its broad application potential as a precursor for many valuable chemical derivatives. While LA and its chemical derivatives have high application potential,...

  6. Modal Mineralogy of Lunar Soils

    NASA Astrophysics Data System (ADS)

    Taylor, J.; Martel, L.; Lucey, P. G.; Crites, S. T.; Blake, D. F.

    2012-12-01

    Modal mineralogy of the lunar regolith is fundamentally important. It varies with the composition of underlying bedrock, extent of addition of materials excavated by impact both local and distant, and small-scale reworking by micrometeorite bombardment, so it contains information about local geological history. Determining modal mineralogy of soils provides vital ground truth to remote sensing studies. Mineralogy can be determined by a variety of techniques that provide complementary information: X-Ray Diffraction (XRD), optical point counting, element mapping by scanning electron microscopy (SEM) or electron microprobe (EMP), and normative calculation from a bulk chemical analysis. SEM and EMP element mapping can be converted into mineral modal abundances in a variety of ways, including defining compositional windows for specific minerals and using image processing techniques. XRD provides direct determination of the phases present, but gives little information about the chemical composition of those phases. We have launched a project to determine the modal mineralogy of over 100 lunar soils from all Apollo sites. The goal is to use this quantitative mineralogy and laboratory and remote reflectance spectra of the same soils to improve our ability to extract quantitative mineralogy from remote sensing data. Samples (< 1mm bulk soils) were dry-sieved and the <150 micron fractions analyzed in a Terra XRD instrument (InXitu, Inc.) using sample sizes of ~35 mg. We reduced the data using Reitveld refinement as implemented by the Jade program (Materials Data, Inc.). Glass abundances were determined by choosing a linear background and fitting a broad Gaussian to the scattering hump above background. Quantitative XRD is well established, but usually requires some calibration, in spite of the sophisticated Reitveld refinement and whole-pattern fitting. We calibrated the instrument by using mixtures of terrestrial minerals and results from the Lunar Sample Characterization

  7. Free-decay time-domain modal identification for large space structures

    NASA Technical Reports Server (NTRS)

    Kim, Hyoung M.; Vanhorn, David A.; Doiron, Harold H.

    1992-01-01

    Concept definition studies for the Modal Identification Experiment (MIE), a proposed space flight experiment for the Space Station Freedom (SSF), have demonstrated advantages and compatibility of free-decay time-domain modal identification techniques with the on-orbit operational constraints of large space structures. Since practical experience with modal identification using actual free-decay responses of large space structures is very limited, several numerical and test data reduction studies were conducted. Major issues and solutions were addressed, including closely-spaced modes, wide frequency range of interest, data acquisition errors, sampling delay, excitation limitations, nonlinearities, and unknown disturbances during free-decay data acquisition. The data processing strategies developed in these studies were applied to numerical simulations of the MIE, test data from a deployable truss, and launch vehicle flight data. Results of these studies indicate free-decay time-domain modal identification methods can provide accurate modal parameters necessary to characterize the structural dynamics of large space structures.

  8. Modal density of rectangular structures in a wide frequency range

    NASA Astrophysics Data System (ADS)

    Parrinello, A.; Ghiringhelli, G. L.

    2018-04-01

    A novel approach to investigate the modal density of a rectangular structure in a wide frequency range is presented. First, the modal density is derived, in the whole frequency range of interest, on the basis of sound transmission through the infinite counterpart of the structure; then, it is corrected by means of the low-frequency modal behavior of the structure, taking into account actual size and boundary conditions. A statistical analysis reveals the connection between the modal density of the structure and the transmission of sound through its thickness. A transfer matrix approach is used to compute the required acoustic parameters, making it possible to deal with structures having arbitrary stratifications of different layers. A finite element method is applied on coarse grids to derive the first few eigenfrequencies required to correct the modal density. Both the transfer matrix approach and the coarse grids involved in the finite element analysis grant high efficiency. Comparison with alternative formulations demonstrates the effectiveness of the proposed methodology.

  9. Cross-modal links among vision, audition, and touch in complex environments.

    PubMed

    Ferris, Thomas K; Sarter, Nadine B

    2008-02-01

    This study sought to determine whether performance effects of cross-modal spatial links that were observed in earlier laboratory studies scale to more complex environments and need to be considered in multimodal interface design. It also revisits the unresolved issue of cross-modal cuing asymmetries. Previous laboratory studies employing simple cues, tasks, and/or targets have demonstrated that the efficiency of processing visual, auditory, and tactile stimuli is affected by the modality, lateralization, and timing of surrounding cues. Very few studies have investigated these cross-modal constraints in the context of more complex environments to determine whether they scale and how complexity affects the nature of cross-modal cuing asymmetries. Amicroworld simulation of battlefield operations with a complex task set and meaningful visual, auditory, and tactile stimuli was used to investigate cuing effects for all cross-modal pairings. Significant asymmetric performance effects of cross-modal spatial links were observed. Auditory cues shortened response latencies for collocated visual targets but visual cues did not do the same for collocated auditory targets. Responses to contralateral (rather than ipsilateral) targets were faster for tactually cued auditory targets and each visual-tactile cue-target combination, suggesting an inhibition-of-return effect. The spatial relationships between multimodal cues and targets significantly affect target response times in complex environments. The performance effects of cross-modal links and the observed cross-modal cuing asymmetries need to be examined in more detail and considered in future interface design. The findings from this study have implications for the design of multimodal and adaptive interfaces and for supporting attention management in complex, data-rich domains.

  10. A Benchmark Problem for Development of Autonomous Structural Modal Identification

    NASA Technical Reports Server (NTRS)

    Pappa, Richard S.; Woodard, Stanley E.; Juang, Jer-Nan

    1996-01-01

    This paper summarizes modal identification results obtained using an autonomous version of the Eigensystem Realization Algorithm on a dynamically complex, laboratory structure. The benchmark problem uses 48 of 768 free-decay responses measured in a complete modal survey test. The true modal parameters of the structure are well known from two previous, independent investigations. Without user involvement, the autonomous data analysis identified 24 to 33 structural modes with good to excellent accuracy in 62 seconds of CPU time (on a DEC Alpha 4000 computer). The modal identification technique described in the paper is the baseline algorithm for NASA's Autonomous Dynamics Determination (ADD) experiment scheduled to fly on International Space Station assembly flights in 1997-1999.

  11. Modality matters for the expression of inducible defenses: introducing a concept of predator modality.

    PubMed

    Herzog, Quirin; Laforsch, Christian

    2013-11-18

    Inducible defenses are a common and widespread form of phenotypic plasticity. A fundamental factor driving their evolution is an unpredictable and heterogeneous predation pressure. This heterogeneity is often used synonymously to quantitative changes in predation risk, depending on the abundance and impact of predators. However, differences in 'modality', that is, the qualitative aspect of natural selection caused by predators, can also cause heterogeneity. For instance, predators of the small planktonic crustacean Daphnia have been divided into two functional groups of predators: vertebrates and invertebrates. Predators of both groups are known to cause different defenses, yet predators of the same group are considered to cause similar responses. In our study we question that thought and address the issue of how multiple predators affect the expression and evolution of inducible defenses. We exposed D. barbata to chemical cues released by Triops cancriformis and Notonecta glauca, respectively. We found for the first time that two invertebrate predators induce different shapes of the same morphological defensive traits in Daphnia, rather than showing gradual or opposing reaction norms. Additionally, we investigated the adaptive value of those defenses in direct predation trials, pairing each morphotype (non-induced, Triops-induced, Notonecta-induced) against the other two and exposed them to one of the two predators. Interestingly, against Triops, both induced morphotypes offered equal protection. To explain this paradox we introduce a 'concept of modality' in multipredator regimes. Our concept categorizes two-predator-prey systems into three major groups (functionally equivalent, functionally inverse and functionally diverse). Furthermore, the concept includes optimal responses and costs of maladaptions of prey phenotypes in environments where both predators co-occur or where they alternate. With D. barbata, we introduce a new multipredator-prey system with a wide

  12. Modal control of an oblique wing aircraft

    NASA Technical Reports Server (NTRS)

    Phillips, James D.

    1989-01-01

    A linear modal control algorithm is applied to the NASA Oblique Wing Research Aircraft (OWRA). The control law is evaluated using a detailed nonlinear flight simulation. It is shown that the modal control law attenuates the coupling and nonlinear aerodynamics of the oblique wing and remains stable during control saturation caused by large command inputs or large external disturbances. The technique controls each natural mode independently allowing single-input/single-output techniques to be applied to multiple-input/multiple-output systems.

  13. Neural substrate of initiation of cross-modal working memory retrieval.

    PubMed

    Zhang, Yangyang; Hu, Yang; Guan, Shuchen; Hong, Xiaolong; Wang, Zhaoxin; Li, Xianchun

    2014-01-01

    Cross-modal working memory requires integrating stimuli from different modalities and it is associated with co-activation of distributed networks in the brain. However, how brain initiates cross-modal working memory retrieval remains not clear yet. In the present study, we developed a cued matching task, in which the necessity for cross-modal/unimodal memory retrieval and its initiation time were controlled by a task cue appeared in the delay period. Using functional magnetic resonance imaging (fMRI), significantly larger brain activations were observed in the left lateral prefrontal cortex (l-LPFC), left superior parietal lobe (l-SPL), and thalamus in the cued cross-modal matching trials (CCMT) compared to those in the cued unimodal matching trials (CUMT). However, no significant differences in the brain activations prior to task cue were observed for sensory stimulation in the l-LPFC and l-SPL areas. Although thalamus displayed differential responses to the sensory stimulation between two conditions, the differential responses were not the same with responses to the task cues. These results revealed that the frontoparietal-thalamus network participated in the initiation of cross-modal working memory retrieval. Secondly, the l-SPL and thalamus showed differential activations between maintenance and working memory retrieval, which might be associated with the enhanced demand for cognitive resources.

  14. A passive acoustic device for real-time monitoring of the efficacy of shockwave lithotripsy treatment.

    PubMed

    Leighton, T G; Fedele, F; Coleman, A J; McCarthy, C; Ryves, S; Hurrell, A M; De Stefano, A; White, P R

    2008-10-01

    Extracorporeal shockwave lithotripsy (ESWL) is the preferred modality for the treatment of renal and ureteric stone disease. Currently X-ray or ultrasound B-scan imaging are used to locate the stone and to check that it remains targeted at the focus of the lithotripter during treatment. Neither imaging modality is particularly effective in allowing the efficacy of treatment to be judged during the treatment session. A new device is described that, when placed on the patient's skin, can passively monitor the acoustic signals that propagate through the body after each lithotripter shock, and which can provide useful information on the effectiveness of targeting. These acoustic time histories are analyzed in real time to extract the two main characteristic peak amplitudes (m(1) and m(2)) and the time between these peaks (t(c)). A set of rules based on the acoustic parameters was developed during a clinical study in which a complete set of acoustic and clinical data was obtained for 30 of the 118 subjects recruited. The rules, which complied with earlier computational fluid dynamics (CFD) modeling and in vitro tests, allow each shock to be classified as "effective" or "ineffective." These clinically-derived rules were then applied in a second clinical study in which complete datasets were obtained for 49 of the 85 subjects recruited. This second clinical study demonstrated almost perfect agreement (kappa = 0.94) between the number of successful treatments, defined as >50% fragmentation as determined by X-ray at the follow-up appointment, and a device-derived global treatment score, TS(0), a figure derived from the total number of effective shocks in any treatment. The acoustic system is shown to provide a test of the success of the treatment that has a sensitivity of 91.7% and a specificity of 100%. In addition to the predictive capability, the device provides valuable real-time feedback to the lithotripter operator by indicating the effectiveness of each shock, plus

  15. A FBG pulse wave demodulation method based on PCF modal interference filter

    NASA Astrophysics Data System (ADS)

    Zhang, Cheng; Xu, Shan; Shen, Ziqi; Zhao, Junfa; Miao, Changyun; Bai, Hua

    2016-10-01

    Fiber optic sensor embedded in textiles has been a new direction of researching smart wearable technology. Pulse signal which is generated by heart beat contains vast amounts of physio-pathological information about the cardiovascular system. Therefore, the research for textile-based fiber optic sensor which can detect pulse wave has far-reaching effects on early discovery and timely treatment of cardiovascular diseases. A novel wavelength demodulation method based on photonic crystal fiber (PCF) modal interference filter is proposed for the purpose of developing FBG pulse wave sensing system embedded in smart clothing. The mechanism of the PCF modal interference and the principle of wavelength demodulation based on In-line Mach-Zehnder interferometer (In-line MZI) are analyzed in theory. The fabricated PCF modal interferometer has the advantages of good repeatability and low temperature sensitivity of 3.5pm/°C from 25°C to 60°C. The designed demodulation system can achieve linear demodulation in the range of 2nm, with the wavelength resolution of 2.2pm and the wavelength sensitivity of 0.055nm-1. The actual experiments' result indicates that the pulse wave can be well detected by this demodulation method, which is in accordance with the commercial demodulation instrument (SM130) and more sensitive than the traditional piezoelectric pulse sensor. This demodulation method provides important references for the research of smart clothing based on fiber grating sensor embedded in textiles and accelerates the developments of wearable fiber optic sensors technology.

  16. LongoVital- An Imminent Therapeutic Modality: An Unseen Drug Review with Advanced Features and Hypothesis.

    PubMed

    Khanna, Ruchika; Dua, Nisha; Kumar, Anand; Khanna, Ruchit; Khanna, Pyare Mohan Lal

    2016-04-01

    Herbal medication still happens to be the backbone of the major world's population essentially because of the assumption that these drugs are free of any side effects and easily available. LongoVital (LV) is a herbal preparation with documented immune-modulatory and immune-stimulatory effects in man. Various studies conducted to date, have shown LV to have prolonged and beneficial impact in the treatment of orofacial diseases, when administered in recommended daily doses. With its combined antimicrobial and immunostimulatory effects, LV can be regarded as an emerging therapeutic modality in the treatment of orofacial diseases.

  17. Modal noise investigation in multimode polymer waveguides

    NASA Astrophysics Data System (ADS)

    Beals, Joseph, IV; Bamiedakis, Nikos; Penty, Richard V.; White, Ian H.; DeGroot, Jon V., Jr.; Clapp, Terry V.

    2007-11-01

    In this work the recent interest in waveguides for use in short optical links has motivated a study of the modal noise dependence on launch conditions in short-reach step-index multimode polymer waveguides. Short optical links, especially those with several connection interfaces and utilising a restricted launch are likely to be subject to a modal noise power penalty. We therefore experimentally study the modal noise impact of restricted launches for a short-reach optical link employing a 50 x 50 μm polymer multimode waveguide. Lens launches resulting in small diameter input spots are investigated as are restricted launches from an 8 μm core optical fibre. For a launch spot of 10 μm diameter no impairment is observed for up to 9 dBo of mode selective loss, and for a fibre launch with a dynamic input movement of 6 μm no impairment is seen for up to 8 dBo of mode selective loss.

  18. Large Margin Multi-Modal Multi-Task Feature Extraction for Image Classification.

    PubMed

    Yong Luo; Yonggang Wen; Dacheng Tao; Jie Gui; Chao Xu

    2016-01-01

    The features used in many image analysis-based applications are frequently of very high dimension. Feature extraction offers several advantages in high-dimensional cases, and many recent studies have used multi-task feature extraction approaches, which often outperform single-task feature extraction approaches. However, most of these methods are limited in that they only consider data represented by a single type of feature, even though features usually represent images from multiple modalities. We, therefore, propose a novel large margin multi-modal multi-task feature extraction (LM3FE) framework for handling multi-modal features for image classification. In particular, LM3FE simultaneously learns the feature extraction matrix for each modality and the modality combination coefficients. In this way, LM3FE not only handles correlated and noisy features, but also utilizes the complementarity of different modalities to further help reduce feature redundancy in each modality. The large margin principle employed also helps to extract strongly predictive features, so that they are more suitable for prediction (e.g., classification). An alternating algorithm is developed for problem optimization, and each subproblem can be efficiently solved. Experiments on two challenging real-world image data sets demonstrate the effectiveness and superiority of the proposed method.

  19. Fast modal decomposition for optical fibers using digital holography.

    PubMed

    Lyu, Meng; Lin, Zhiquan; Li, Guowei; Situ, Guohai

    2017-07-26

    Eigenmode decomposition of the light field at the output end of optical fibers can provide fundamental insights into the nature of electromagnetic-wave propagation through the fibers. Here we present a fast and complete modal decomposition technique for step-index optical fibers. The proposed technique employs digital holography to measure the light field at the output end of the multimode optical fiber, and utilizes the modal orthonormal property of the basis modes to calculate the modal coefficients of each mode. Optical experiments were carried out to demonstrate the proposed decomposition technique, showing that this approach is fast, accurate and cost-effective.

  20. Dual-modality NIRF-MRI cubosomes and hexosomes: High throughput formulation and in vivo biodistribution.

    PubMed

    Tran, Nhiem; Bye, Nicole; Moffat, Bradford A; Wright, David K; Cuddihy, Andrew; Hinton, Tracey M; Hawley, Adrian M; Reynolds, Nicholas P; Waddington, Lynne J; Mulet, Xavier; Turnley, Ann M; Morganti-Kossmann, M Cristina; Muir, Benjamin W

    2017-02-01

    Engineered nanoparticles with multiple complementary imaging modalities are of great benefit to the rapid treatment and diagnosis of disease in various organs. Herein, we report the formulation of cubosomes and hexosomes that carry multiple amphiphilic imaging contrast agents in their self-assembled lipid bilayers. This is the first report of the use of both near infrared fluorescent (NIRF) imaging and gadolinium lipid based magnetic resonance (MR) imaging modalities in cubosomes and hexosomes. High-throughput screening was used to rapidly optimize formulations with desirable nano-architectures and low in vitro cytotoxicity. The dual-modal imaging nanoparticles in vivo biodistribution and organ specific contrast enhancement were then studied. The NIRF in vivo imaging results indicated accumulation of both cubosomes and hexosomes in the liver and spleen of mice up to 20h post-injection. Remarkably, the biodistribution of the nanoparticle formulations was affected by the mesophase (i.e. cubic or hexagonal), a finding of significant importance for the future use of these compounds, with hexosomes showing higher accumulation in the spleen than the liver compared to cubosomes. Furthermore, in vivo MRI data of animals injected with either type of lyotropic liquid crystal nanoparticle displayed enhanced contrast in the liver and spleen. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. Bayesian operational modal analysis of Jiangyin Yangtze River Bridge

    NASA Astrophysics Data System (ADS)

    Brownjohn, James Mark William; Au, Siu-Kui; Zhu, Yichen; Sun, Zhen; Li, Binbin; Bassitt, James; Hudson, Emma; Sun, Hongbin

    2018-09-01

    Vibration testing of long span bridges is becoming a commissioning requirement, yet such exercises represent the extreme of experimental capability, with challenges for instrumentation (due to frequency range, resolution and km-order separation of sensor) and system identification (because of the extreme low frequencies). The challenge with instrumentation for modal analysis is managing synchronous data acquisition from sensors distributed widely apart inside and outside the structure. The ideal solution is precisely synchronised autonomous recorders that do not need cables, GPS or wireless communication. The challenge with system identification is to maximise the reliability of modal parameters through experimental design and subsequently to identify the parameters in terms of mean values and standard errors. The challenge is particularly severe for modes with low frequency and damping typical of long span bridges. One solution is to apply 'third generation' operational modal analysis procedures using Bayesian approaches in both the planning and analysis stages. The paper presents an exercise on the Jiangyin Yangtze River Bridge, a suspension bridge with a 1385 m main span. The exercise comprised planning of a test campaign to optimise the reliability of operational modal analysis, the deployment of a set of independent data acquisition units synchronised using precision oven controlled crystal oscillators and the subsequent identification of a set of modal parameters in terms of mean and variance errors. Although the bridge has had structural health monitoring technology installed since it was completed, this was the first full modal survey, aimed at identifying important features of the modal behaviour rather than providing fine resolution of mode shapes through the whole structure. Therefore, measurements were made in only the (south) tower, while torsional behaviour was identified by a single measurement using a pair of recorders across the carriageway. The

  2. 43 CFR 2568.94 - Can I receive an allotment of land that is valuable for minerals?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... valuable for minerals? 2568.94 Section 2568.94 Public Lands: Interior Regulations Relating to Public Lands... be or believed to be valuable for coal, oil, or gas, but the ownership of these minerals remains with the Federal government. BLM cannot convey to you land valuable for other kinds of minerals such as...

  3. 43 CFR 2568.94 - Can I receive an allotment of land that is valuable for minerals?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... valuable for minerals? 2568.94 Section 2568.94 Public Lands: Interior Regulations Relating to Public Lands... be or believed to be valuable for coal, oil, or gas, but the ownership of these minerals remains with the Federal government. BLM cannot convey to you land valuable for other kinds of minerals such as...

  4. 43 CFR 2568.94 - Can I receive an allotment of land that is valuable for minerals?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... valuable for minerals? 2568.94 Section 2568.94 Public Lands: Interior Regulations Relating to Public Lands... be or believed to be valuable for coal, oil, or gas, but the ownership of these minerals remains with the Federal government. BLM cannot convey to you land valuable for other kinds of minerals such as...

  5. A neural basis for category and modality specificity of semantic knowledge.

    PubMed

    Thompson-Schill, S L; Aguirre, G K; D'Esposito, M; Farah, M J

    1999-06-01

    Prevalent theories hold that semantic memory is organized by sensorimotor modality (e.g., visual knowledge, motor knowledge). While some neuroimaging studies support this idea, it cannot account for the category specific (e.g., living things) knowledge impairments seen in some brain damaged patients that cut across modalities. In this article we test an alternative model of how damage to interactive, modality-specific neural regions might give rise to these categorical impairments. Functional MRI was used to examine a cortical area with a known modality-specific function during the retrieval of visual and non-visual knowledge about living and non-living things. The specific predictions of our model regarding the signal observed in this area were confirmed, supporting the notion that semantic memory is functionally segregated into anatomically discrete, but highly interactive, modality-specific regions.

  6. Nepalese patients’ perceptions of treatment modalities for type 2 diabetes

    PubMed Central

    Sapkota, Sujata; Brien, Jo-anne E; Aslani, Parisa

    2016-01-01

    Background Perceptions and beliefs about treatment can influence patients’ adherence to treatment regimens. Perceptions, in turn, are often shaped by patients’ sociocultural context. Nepal and the Nepalese have unique sociocultural traditions and beliefs, and their perceptions of diabetes treatment remain largely unexplored. This study explored Nepalese participants’ perceptions of diabetes treatment, and whether perceptions differed between the Nepalese living in Australia and Nepal. Methods Face-to-face qualitative interviews (n=48) were conducted with Nepalese participants with type 2 diabetes in Sydney and Kathmandu. All interviews were audio-recorded, transcribed verbatim, and thematically analyzed. Results Perceptions of diabetes treatment were similar among Nepalese participants in Australia and Nepal. There was a general reluctance to start oral antidiabetic medications and an even greater reluctance to commence parenteral (insulin) therapy. Participants preferred to try lifestyle modifications and alternative treatments such as herbs and “traditional” medicines, particularly as a first step. Unwillingness to take medications was primarily associated with the belief that, once started, these medications needed to be taken for life, and perceptions of long-term harms caused by such medications. Even when commenced on medication, participants were averse to any type of therapy escalation, for example, moving to insulin therapy. Insulin was perceived as the “last option” available for diabetes treatment. Most participants, however, did not find medication taking challenging once they had commenced treatment. Conclusion Antidiabetic medications were perceived to be harmful and unstoppable once initiated. These perceptions significantly impacted participants’ willingness to commence antidiabetic medications and therefore have the potential to adversely affect their medication-taking behavior. This study therefore highlights the need to explore

  7. Modal Auxiliaries and Their Semantic Functions Used by Advanced EFL Learners

    ERIC Educational Resources Information Center

    Torabiardakani, Najmeh; Khojasteh, Laleh; Shokrpour, Nasrin

    2015-01-01

    Since modal auxiliary verbs have been proved to be one of the most troublesome grammatical structures in English, the researchers of this study decided to do an analysis on the ways in which advanced EFL Iranian students use modal auxiliaries focusing specially on nine modals' semantic functions. Consequently, was conducted based on the following…

  8. Bronchoscopic modalities to diagnose sarcoidosis.

    PubMed

    Benzaquen, Sadia; Aragaki-Nakahodo, Alejandro Adolfo

    2017-09-01

    Several studies have investigated different bronchoscopic techniques to obtain tissue diagnosis in patients with suspected sarcoidosis when the diagnosis cannot be based on clinicoradiographic findings alone. In this review, we will describe the most recent and relevant evidence from different bronchoscopic modalities to diagnose sarcoidosis. Despite multiple available bronchoscopic modalities to procure tissue samples to diagnose sarcoidosis, the vast majority of evidence favors endobronchial ultrasound transbronchial needle aspiration to diagnose Scadding stages 1 and 2 sarcoidosis. Transbronchial lung cryobiopsy is a new technique that is mainly used to aid in the diagnosis of undifferentiated interstitial lung disease; however, we will discuss its potential use in sarcoidosis. This review illustrates the limited information about the different bronchoscopic techniques to aid in the diagnosis of pulmonary sarcoidosis. However, it demonstrates that the combination of available bronchoscopic techniques increases the diagnostic yield for suspected sarcoidosis.

  9. Modal Analysis for Grid Operation

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

    MANGO software is to provide a solution for improving small signal stability of power systems through adjusting operator-controllable variables using PMU measurement. System oscillation problems are one of the major threats to the grid stability and reliability in California and the Western Interconnection. These problems result in power fluctuations, lower grid operation efficiency, and may even lead to large-scale grid breakup and outages. This MANGO software aims to solve this problem by automatically generating recommended operation procedures termed Modal Analysis for Grid Operation (MANGO) to improve damping of inter-area oscillation modes. The MANGO procedure includes three steps: recognizing small signalmore » stability problems, implementing operating point adjustment using modal sensitivity, and evaluating the effectiveness of the adjustment. The MANGO software package is designed to help implement the MANGO procedure.« less

  10. Exploring mortality among drug treatment clients: The relationship between treatment type and mortality.

    PubMed

    Lloyd, Belinda; Zahnow, Renee; Barratt, Monica J; Best, David; Lubman, Dan I; Ferris, Jason

    2017-11-01

    Studies consistently identify substance treatment populations as more likely to die prematurely compared with age-matched general population, with mortality risk higher out-of-treatment than in-treatment. While opioid-using pharmacotherapy cohorts have been studied extensively, less evidence exists regarding effects of other treatment types, and clients in treatment for other drugs. This paper examines mortality during and following treatment across treatment modalities. A retrospective seven-year cohort was utilised to examine mortality during and in the two years following treatment among clients from Victoria, Australia, recorded on the Alcohol and Drug Information Service database by linking with National Death Index. 18,686 clients over a 12-month period were included. Crude (CMRs) and standardised mortality rates (SMRs) were analysed in terms of treatment modality, and time in or out of treatment. Higher risk of premature death was associated with residential withdrawal as the last type of treatment engagement, while mortality following counselling was significantly lower than all other treatment types in the year post-treatment. Both CMRs and SMRs were significantly higher in-treatment than post-treatment. Better understanding of factors contributing to elevated mortality risk for clients engaged in, and following treatment, is needed to ensure that treatment systems provide optimal outcomes during and after treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Integration of Multi-Modal Biomedical Data to Predict Cancer Grade and Patient Survival.

    PubMed

    Phan, John H; Hoffman, Ryan; Kothari, Sonal; Wu, Po-Yen; Wang, May D

    2016-02-01

    The Big Data era in Biomedical research has resulted in large-cohort data repositories such as The Cancer Genome Atlas (TCGA). These repositories routinely contain hundreds of matched patient samples for genomic, proteomic, imaging, and clinical data modalities, enabling holistic and multi-modal integrative analysis of human disease. Using TCGA renal and ovarian cancer data, we conducted a novel investigation of multi-modal data integration by combining histopathological image and RNA-seq data. We compared the performances of two integrative prediction methods: majority vote and stacked generalization. Results indicate that integration of multiple data modalities improves prediction of cancer grade and outcome. Specifically, stacked generalization, a method that integrates multiple data modalities to produce a single prediction result, outperforms both single-data-modality prediction and majority vote. Moreover, stacked generalization reveals the contribution of each data modality (and specific features within each data modality) to the final prediction result and may provide biological insights to explain prediction performance.

  12. Mixing Categories and Modal Logics in the Quantum Setting

    NASA Astrophysics Data System (ADS)

    Cinà, Giovanni

    The study of the foundations of Quantum Mechanics, especially after the advent of Quantum Computation and Information, has benefited from the application of category-theoretic tools and modal logics to the analysis of Quantum processes: we witness a wealth of theoretical frameworks casted in either of the two languages. This paper explores the interplay of the two formalisms in the peculiar context of Quantum Theory. After a review of some influential abstract frameworks, we show how different modal logic frames can be extracted from the category of finite dimensional Hilbert spaces, connecting the Categorical Quantum Mechanics approach to some modal logics that have been proposed for Quantum Computing. We then apply a general version of the same technique to two other categorical frameworks, the `topos approach' of Doering and Isham and the sheaf-theoretic work on contextuality by Abramsky and Brandenburger, suggesting how some key features can be expressed with modal languages.

  13. A gantry-based tri-modality system for bioluminescence tomography

    PubMed Central

    Yan, Han; Lin, Yuting; Barber, William C.; Unlu, Mehmet Burcin; Gulsen, Gultekin

    2012-01-01

    A gantry-based tri-modality system that combines bioluminescence (BLT), diffuse optical (DOT), and x-ray computed tomography (XCT) into the same setting is presented here. The purpose of this system is to perform bioluminescence tomography using a multi-modality imaging approach. As parts of this hybrid system, XCT and DOT provide anatomical information and background optical property maps. This structural and functional a priori information is used to guide and restrain bioluminescence reconstruction algorithm and ultimately improve the BLT results. The performance of the combined system is evaluated using multi-modality phantoms. In particular, a cylindrical heterogeneous multi-modality phantom that contains regions with higher optical absorption and x-ray attenuation is constructed. We showed that a 1.5 mm diameter bioluminescence inclusion can be localized accurately with the functional a priori information while its source strength can be recovered more accurately using both structural and the functional a priori information. PMID:22559540

  14. Radiation dose reduction and new image modalities development for interventional C-arm imaging system

    NASA Astrophysics Data System (ADS)

    Niu, Kai

    Cardiovascular disease and stroke are the leading health problems and causes of death in the US. Due to the minimally invasive nature of the evolution of image guided techniques, interventional radiological procedures are becoming more common and are preferred in treating many cardiovascular diseases and strokes. In addition, with the recent advances in hardware and device technology, the speed and efficacy of interventional treatment has significantly improved. This implies that more image modalities can be developed based on the current C-arm system and patients treated in interventional suites can potentially experience better health outcomes. However, during the treatment patients are irradiated with substantial amounts of ionizing radiation with a high dose rate (digital subtraction angiography (DSA) with 3muGy/frame and 3D cone beam CT image with 0.36muGy/frame for a Siemens Artis Zee biplane system) and/or a long irradiation time (a roadmapping image sequence can be as long as one hour during aneurysm embolization). As a result, the patient entrance dose is extremely high. Despite the fact that the radiation dose is already substantial, image quality is not always satisfactory. By default a temporal average is used in roadmapping images to overcome poor image quality, but this technique can result in motion blurred images. Therefore, reducing radiation dose while maintaining or even improving the image quality is an important area for continued research. This thesis is focused on improving the clinical applications of C-arm cone beam CT systems in two ways: (1) Improve the performance of current image modalities on the C-arm system. (2) Develop new image modalities based on the current system. To be more specific, the objectives are to reduce radiation dose for current modalities (e.g., DSA, fluoroscopy, roadmapping, and cone beam CT) and enable cone beam CT perfusion and time resolved cone beam CT angiography that can be used to diagnose and triage acute

  15. 43 CFR 2430.4 - Additional criteria for classification of lands valuable for public purposes.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Additional criteria for classification of... (2000) DISPOSAL CLASSIFICATIONS Criteria for Disposal Classifications § 2430.4 Additional criteria for classification of lands valuable for public purposes. (a) To be valuable for public purposes, lands must be...

  16. Letter position coding across modalities: the case of Braille readers.

    PubMed

    Perea, Manuel; García-Chamorro, Cristina; Martín-Suesta, Miguel; Gómez, Pablo

    2012-01-01

    The question of how the brain encodes letter position in written words has attracted increasing attention in recent years. A number of models have recently been proposed to accommodate the fact that transposed-letter stimuli like jugde or caniso are perceptually very close to their base words. Here we examined how letter position coding is attained in the tactile modality via Braille reading. The idea is that Braille word recognition may provide more serial processing than the visual modality, and this may produce differences in the input coding schemes employed to encode letters in written words. To that end, we conducted a lexical decision experiment with adult Braille readers in which the pseudowords were created by transposing/replacing two letters. We found a word-frequency effect for words. In addition, unlike parallel experiments in the visual modality, we failed to find any clear signs of transposed-letter confusability effects. This dissociation highlights the differences between modalities. The present data argue against models of letter position coding that assume that transposed-letter effects (in the visual modality) occur at a relatively late, abstract locus.

  17. Stimulus Modality and Smoking Behavior: Moderating Role of Implicit Attitudes.

    PubMed

    Ezeh, Valentine C; Mefoh, Philip

    2015-07-20

    This study investigated whether stimulus modality influences smoking behavior among smokers in South Eastern Nigeria and also whether implicit attitudes moderate the relationship between stimulus modality and smoking behavior. 60 undergraduate students of University of Nigeria, Nsukka were used. Participants were individually administered the IAT task as a measure of implicit attitude toward smoking and randomly assigned into either image condition that paired images of cigarette with aversive images of potential health consequences or text condition that paired images of cigarette with aversive texts of potential health consequences. A one- predictor and one-moderator binary logistic analysis indicates that stimulus modality significantly predicts smoking behavior (p = < .05) with those in the image condition choosing not to smoke with greater probability than the text condition. The interaction between stimulus modality and IAT scores was also significant (p = < .05). Specifically, the modality effect was larger for participants in the image group who held more negative implicit attitudes towards smoking. The finding shows the urgent need to introduce the use of aversive images of potential health consequences on cigarette packs in Nigeria.

  18. Field Trips as Valuable Learning Experiences in Geography Courses

    ERIC Educational Resources Information Center

    Krakowka, Amy Richmond

    2012-01-01

    Field trips have been acknowledged as valuable learning experiences in geography. This article uses Kolb's (1984) experiential learning model to discuss how students learn and how field trips can help enhance learning. Using Kolb's experiential learning theory as a guide in the design of field trips helps ensure that field trips contribute to…

  19. Chained lightning: part III--Emerging technology, novel therapeutic strategies, and new energy modalities for radiosurgery.

    PubMed

    Hoh, Daniel J; Liu, Charles Y; Chen, Joseph C T; Pagnini, Paul G; Yu, Cheng; Wang, Michael Y; Apuzzo, Michael L J

    2007-12-01

    Radiosurgery is fundamentally the harnessing of energy and delivering it to a focal target for a therapeutic effect. The evolution of radiosurgical technology and practice has served toward refining methodologies for better conformal energy delivery. In the past, this has resulted in developing strategies for improved beam generation and delivery. Ultimately, however, our current instrumentation and treatment modalities may be approaching a practical limit with regard to further optimizing energy containment. In looking forward, several strategies are emerging to circumvent these limitations and improve conformal radiosurgery. Refinement of imaging techniques through functional imaging and nanoprobes for cancer detection may benefit lesion localization and targeting. Methods for enhancing the biological effect while reducing radiation-induced changes are being examined through dose fractionation schedules. Radiosensitizers and photosensitizers are being investigated as agents for modulating the biological response of tissues to radiation and alternative energy forms. Discovery of new energy modalities is being pursued through development of microplanar beams, free electron lasers, and high-intensity focused ultrasound. The exploration of these future possibilities will provide the tools for radiosurgical treatment of a broader spectrum of diseases for the next generation.

  20. CM-2 Environmental / Modal Testing of Spacehab Racks

    NASA Technical Reports Server (NTRS)

    McNelis, Mark E.; Goodnight, Thomas W.; Farkas, Michael A.

    2001-01-01

    Combined environmental/modal vibration testing has been implemented at the NASA Glenn Research Center's Structural Dynamics Laboratory. The benefits of combined vibration testing are that it facilitates test article modal characterization and vibration qualification testing. The Combustion Module-2 (CM-2) is a space experiment that launches on Shuttle mission STS 107 in the SPACEHAB Research Double Module. The CM-2 flight hardware is integrated into a SPACEHAB single and double rack. CM-2 rack level combined vibration testing was recently completed on a shaker table to characterize the structure's modal response and verify the random vibration response. Control accelerometers and limit force gauges, located between the fixture and rack interface, were used to verify the input excitation. Results of the testing were used to verify the loads and environments for flight on the Shuttle.

  1. An 8-year follow-up of anti-vascular endothelial growth factor treatment with a treat-and-extend modality for neovascular age-related macular degeneration.

    PubMed

    Berg, Karina; Roald, Anca B; Navaratnam, Jesintha; Bragadóttir, Ragnheiður

    2017-12-01

    To investigate long-term visual results of treatment with anti-vascular endothelial growth factor (VEGF) agents for neovascular age-related macular degeneration (nAMD) following a treat-and-extend regimen. Retrospective review of 155 patients who initiated treatment with bevacizumab for nAMD in one eye. At the final 8-year visit, 40 patients (26%) remained for follow-up. Mean change in best-corrected visual acuity (BCVA) was calculated compared to baseline values. Mean BCVA improved significantly from baseline during the first year of treatment, with -0.11 logMAR units equivalent to 6.1 approximate Early Treatment Diabetic Retinopathy Study (approxETDRS) letters (p = <0.001). Mean BCVA was still significantly improved after 4 years of treatment for the entire group of patients and after 6 years of treatment for the subgroup of 40 patients who remained at the final 8-year visit. Thereafter, BCVA gradually declined and at 8 years, there was a mean change of 0.05 logMAR units equivalent to 2.1 approxETDRS letters below baseline (p = 0.530). Mean number of injections during the first year was 6.1 ± 2.8 and during year 8 was 5.4 ± 3.5. At 5 years, fundus autofluorescence showed some degree of macular atrophy in all eyes. At the final 8-year visit, 87.5% of the eyes had stable neovascular lesions with no fluid on optical coherence tomography (OCT). In an everyday clinical setting, treatment of nAMD patients with a treat-and-extend modality provided improvement and stability of vision for several years. After 8 years of follow-up, there was a decline in visual acuity (VA) that could be explained by macular atrophic development. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  2. Finding the Right Treatment for Achalasia Treatment: Risks, Efficacy, Complications.

    PubMed

    Moonen, An; Boeckxstaens, Guy

    2016-12-01

    Achalasia is a primary esophageal motor disorder of the esophagus that is characterized by the absence of esophageal peristalsis and a failure of the lower esophageal sphincter (LES) to relax upon swallowing. The defective relaxation leads to symptoms of dysphagia for solids and liquids, regurgitation, aspiration, chest pain, and weight loss. Achalasia is believed to result from a selective loss of enteric inhibitory neurons, most likely due to an autoimmune phenomenon in genetic susceptible individuals. As there is no curative treatment for achalasia, treatment is confined to disruption of the LES to improve bolus passage. The two most commonly used treatment modalities available are the endoscopic pneumodilation (PD) and the surgical laparoscopic Heller myotomy (LHM). A recent European randomized controlled trial showed that both treatment modalities have comparable success rates after a follow-up of at least 5 years. In view of these data, both treatments can be used as an initial therapy in achalasia and the choice should be based on the expertise available. Recently, a new endoscopic technique, peroral endoscopic myotomy (POEM), has been introduced with excellent short-term success rates. However, longer follow-up and data from randomized controlled trials are needed before accepting this technique as a new treatment option for achalasia in clinical practice.

  3. Encoding Modality Can Affect Memory Accuracy via Retrieval Orientation

    ERIC Educational Resources Information Center

    Pierce, Benton H.; Gallo, David A.

    2011-01-01

    Research indicates that false memory is lower following visual than auditory study, potentially because visual information is more distinctive. In the present study we tested the extent to which retrieval orientation can cause a modality effect on memory accuracy. Participants studied unrelated words in different modalities, followed by criterial…

  4. Large-scale Cross-modality Search via Collective Matrix Factorization Hashing.

    PubMed

    Ding, Guiguang; Guo, Yuchen; Zhou, Jile; Gao, Yue

    2016-09-08

    By transforming data into binary representation, i.e., Hashing, we can perform high-speed search with low storage cost, and thus Hashing has collected increasing research interest in the recent years. Recently, how to generate Hashcode for multimodal data (e.g., images with textual tags, documents with photos, etc) for large-scale cross-modality search (e.g., searching semantically related images in database for a document query) is an important research issue because of the fast growth of multimodal data in the Web. To address this issue, a novel framework for multimodal Hashing is proposed, termed as Collective Matrix Factorization Hashing (CMFH). The key idea of CMFH is to learn unified Hashcodes for different modalities of one multimodal instance in the shared latent semantic space in which different modalities can be effectively connected. Therefore, accurate cross-modality search is supported. Based on the general framework, we extend it in the unsupervised scenario where it tries to preserve the Euclidean structure, and in the supervised scenario where it fully exploits the label information of data. The corresponding theoretical analysis and the optimization algorithms are given. We conducted comprehensive experiments on three benchmark datasets for cross-modality search. The experimental results demonstrate that CMFH can significantly outperform several state-of-the-art cross-modality Hashing methods, which validates the effectiveness of the proposed CMFH.

  5. What is the role of imaging in the clinical diagnosis of osteoarthritis and disease management?

    PubMed

    Wang, Xia; Oo, Win Min; Linklater, James M

    2018-05-01

    While OA is predominantly diagnosed on the basis of clinical criteria, imaging may aid with differential diagnosis in clinically suspected cases. While plain radiographs are traditionally the first choice of imaging modality, MRI and US also have a valuable role in assessing multiple pathologic features of OA, although each has particular advantages and disadvantages. Although modern imaging modalities provide the capability to detect a wide range of osseous and soft tissue (cartilage, menisci, ligaments, synovitis, effusion) OA-related structural damage, this extra information has not yet favourably influenced the clinical decision-making and management process. Imaging is recommended if there are unexpected rapid changes in clinical outcomes to determine whether it relates to disease severity or an additional diagnosis. On developing specific treatments, imaging serves as a sensitive tool to measure treatment response. This narrative review aims to describe the role of imaging modalities to aid in OA diagnosis, disease progression and management. It also provides insight into the use of these modalities in finding targeted treatment strategies in clinical research.

  6. Clean Intermittent Self-Catheterization as a Treatment Modality for Urinary Retention: Perceptions of Urologists

    PubMed Central

    2017-01-01

    Purpose Clean intermittent self-catheterization (CISC) is now considered the gold standard for the management of urinary retention. In the literature, several articles on patients’ perspectives on CISC and adherence to this technique have been published. No studies have yet explored the points of view of professional caregivers, such as nurses and doctors. The aim of this study was to explore the opinions of urologists about CISC and to evaluate the need for dedicated nurses specialized in CISC through a self-administered questionnaire. Methods A questionnaire was developed to explore the opinions of professional caregivers about self-catheterization and to evaluate the need to provide nurses with specialized education in CISC. Questionnaires were sent to 244 urologists through email. We received 101 completed questionnaires. The response rate was 41.4%. Results Hand function, the presence or absence of tremor, and visual acuity were rated as the most important determinants for proposing CISC to a patient. Twenty-five percent of the urologists reported that financial remuneration would give them a greater incentive to propose CISC. The lack of dedicated nurses was reported by half of the urologists as a factor preventing them from proposing CISC. A meaningful number of urologists thought that patients perceive CISC as invasive and unpleasant. Although most urologists would choose CISC as a treatment option for themselves, almost 1 urologist out of 5 would prefer a permanent catheter. Conclusions This questionnaire gave valuable insights into urologists’ perceptions of CISC, and could serve as the basis for a subsequent broader international study. Further research should also focus on the opinions of nurses and other caregivers involved in incontinence management. Apart from financial remuneration, it is also clear that ensuring sufficient expertise and time for high-quality CISC care is important. This could be a potential role for dedicated nurses. PMID

  7. Central Cross-Talk in Task Switching : Evidence from Manipulating Input-Output Modality Compatibility

    ERIC Educational Resources Information Center

    Stephan, Denise Nadine; Koch, Iring

    2010-01-01

    Two experiments examined the role of compatibility of input and output (I-O) modality mappings in task switching. We define I-O modality compatibility in terms of similarity of stimulus modality and modality of response-related sensory consequences. Experiment 1 included switching between 2 compatible tasks (auditory-vocal vs. visual-manual) and…

  8. Prospective study of combined modality treatment or radiotherapy alone in the management of early-stage adult Hodgkin's disease.

    PubMed

    Yildiz, Ferah; Zengin, Nurullah; Engin, Hüseyin; Güllü, Ibrahim; Barista, Ibrahim; Caglar, Meltem; Ozyar, Enis; Cengiz, Mustafa; Gürkaynak, Murat; Zorlu, Faruk; Caner, Biray; Atahan, I Lale; Tekuzman, Gülten

    2004-11-01

    To determine the efficacy and toxicity of combined modality treatment (CMT) or radiotherapy (RT) alone in the management of clinical Stage I-IIA adult Hodgkin's disease patients. Forty-seven patients with supradiaphragmatic clinical Stage I-IIA Hodgkin's disease without bulky mediastinal lymphadenopathy were enrolled into this prospective study between September 1997 and February 2002. Patients with very favorable criteria presenting with one or two nonbulky nodal areas involved, an erythrocyte sedimentation rate of <50 mm/h, age <40 years, and either lymphocyte predominant or nodular sclerosing histologic findings were treated by RT alone. Patients missing any of these favorable criteria were classified as the other favorable group and were treated with three courses of doxorubicin, bleomycin, vinblastine, and dacarbazine chemotherapy followed by involved-field RT. The median age was 36 years (range, 19-53 years). Of the 47 patients, 15 were women and 32 were men. Only 3 patients were classified as the most favorable group and treated with mantle RT alone; the remaining 44 were treated with CMT. The median follow-up was 51 months (range, 20-74 months). Only 2 patients developed recurrence, both out of the irradiated field, one in the contralateral neck and the other in the abdomen. The 5-year relapse-free and overall survival rate was 95.4% and 97.8%, respectively. Although none of the prognostic factors were statistically significant for relapse-free survival, a trend was noted for the response to chemotherapy (p = 0.06). Only 2 patients developed treatment-related complications. One patient treated with mantle RT alone developed severe ischemic heart disease and one in the CMT arm developed subclinical hypothyroidism. Despite the short follow-up, CMT or RT alone tailored according to the clinical prognostic factors were successful in terms of disease control in clinical Stage I-IIA Hodgkin's disease. Longer follow-up is required to make definitive conclusions.

  9. Illness Beliefs in End Stage Renal Disease and Associations with Self-Care Modality Choice

    PubMed Central

    Jayanti, Anuradha; Foden, Philip; Wearden, Alison; Mitra, Sandip

    2016-01-01

    Background Interest in self-care haemodialysis (HD) has increased because it improves patients’clinical and quality-of-life outcomes. Patients who undertake self-management for haemodialysis may hold illness beliefs differently to those choosing institutional care at the time of making the modality choice or moulded by their illness and dialysis treatment experience. Illness perceptions amongst predialysis patients and in those undertaking fully-assisted and self-care haemodialysis are being investigated in a combined cross-sectional and longitudinal study. Study Design The study data are derived from the BASIC-HHD study, a multicentre observational study on factors influencing home haemodialysis uptake. 535 patients were enrolled into three groups: Predialysis CKD-5 group, prevalent ‘in-centre’ HD and self-care HD groups (93% at home). We explore illness perceptions in the cross-sectional analyses of the three study groups, using the revised Illness Perception Questionnaire (IPQ-R). Predialysis patients’ illness beliefs were reassessed prospectively, typically between 4 and 12 months after dialysis commencement. Results Illness belief subscales are significantly different between in-centre and self-care HD groups. In a step-wise hierarchical regression analysis, after adjustment for age, education, marital status, diabetes, dialysis vintage, depression, anxiety scores, and IPQ-R subscales, personal control (p = 0.01) and illness coherence (p = 0.04) are significantly higher in the self-care HD group. In the predialysis group, no significant associations were found between illness representations and modality choices. In prospectively observed predialysis group, scores for personal control, treatment control, timeline cyclical and emotional representations reduced significantly after commencing dialysis and increased significantly for illness coherence. Conclusions Illness beliefs differ between hospital and self-care haemodialysis patients. Patient

  10. Characterization and Recovery of Valuables from Waste Copper Smelting Slag

    NASA Astrophysics Data System (ADS)

    Prince, Sarfo; Young, Jamie; Ma, Guojun; Young, Courtney

    Silicate slags produced from smelting copper concentrates contains valuables such as Cu and Fe as well as heavy metals such as Pb and As which are considered hazardous. In this paper, various slags were characterized with several techniques: SEM-MLA, XRD, TG-DTA and ICP-MS. A recovery process was developed to separate the valuables from the silicates thereby producing value-added products and simultaneously reducing environmental concerns. Results show that the major phases in air-cooled slag are fayalite and magnetite whereas the water-cooled slag is amorphous. Thermodynamic calculations and carbothermal reduction experiments indicate that most of Cu and Fe can be recovered from both types using minor amounts of lime and alumina and treating at 1350°C (1623K) or higher for 30 min. The secondary slag can be recycled to the glass and/or ceramic industries.

  11. Quantitative multi-modal NDT data analysis

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

    Heideklang, René; Shokouhi, Parisa

    2014-02-18

    A single NDT technique is often not adequate to provide assessments about the integrity of test objects with the required coverage or accuracy. In such situations, it is often resorted to multi-modal testing, where complementary and overlapping information from different NDT techniques are combined for a more comprehensive evaluation. Multi-modal material and defect characterization is an interesting task which involves several diverse fields of research, including signal and image processing, statistics and data mining. The fusion of different modalities may improve quantitative nondestructive evaluation by effectively exploiting the augmented set of multi-sensor information about the material. It is the redundantmore » information in particular, whose quantification is expected to lead to increased reliability and robustness of the inspection results. There are different systematic approaches to data fusion, each with its specific advantages and drawbacks. In our contribution, these will be discussed in the context of nondestructive materials testing. A practical study adopting a high-level scheme for the fusion of Eddy Current, GMR and Thermography measurements on a reference metallic specimen with built-in grooves will be presented. Results show that fusion is able to outperform the best single sensor regarding detection specificity, while retaining the same level of sensitivity.« less

  12. Results from EuCliD (European Clinical Dialysis Database): impact of shifting treatment modality.

    PubMed

    Merello Godino, J I; Rentero, R; Orlandini, G; Marcelli, D; Ronco, C

    2002-11-01

    (3.93 +/- 0.43 vs. 3.94 +/- 0.43 g/dL) between the two modalities of treatment. The level of beta2-microglobulin significantly decreased during high-flux dialysis (33.5 +/- 14.4 vs. 26.3 +/- 8.6 mg/dL, p < 0.001). All above mentioned results may have as a common denominator an improved blood purification from uremic toxins and a reduced level of chronic sub-clinical inflammation. All together, these results seem to confirm the superiority of high-flux dialysis in terms of clinical and physiological outcomes.

  13. Treatments of traumatic neuropathic pain: a systematic review

    PubMed Central

    Yao, Chenglun; Zhou, Xijie; Zhao, Bin; Sun, Chao; Poonit, Keshav; Yan, Hede

    2017-01-01

    Traumatic neuropathic pain caused by traumatic neuroma has long been bothering both doctors and patients, the mechanisms of traumatic neuropathic pain are widely discussed by researchers and the treatment is challenging. Clinical treatment of painful neuroma is unclear. Numerous treatment modalities have been introduced by experts in this field. However, there is still no single standard recognized treatment. Different forms of treatments have been tested in animals and humans, but pharmacotherapies (antidepressants, antiepileptics) remain the basis of traumatic neuropathic pain management. For intractable cases, nerve stump transpositions into a muscle, vein or bone are seen as traditional surgical procedures which provide a certain degree of efficacy. Novel surgical techniques have emerged in recent years, such as tube guided nerve capping, electrical stimulation and adipose autograft have substantially enriched the abundance of the treatment for traumatic neuropathic pain. Several treatments show advantages over the others in terms of pain relief and prevention of neuroma formation, making it difficult to pick out a single modality as the reference. An effective and standardized treatment for traumatic neuropathic pain would provide better choice for researchers and clinical workers. In this review, we summarized current knowledge on the treatment of traumatic neuropathic pain, and found a therapeutic strategy for this intractable pain. We tried to provide a useful guideline for choosing the right modality in management of traumatic neuropathic pain. PMID:28915703

  14. Etiology and Treatment Modalities of Occipital Artery Aneurysms.

    PubMed

    Chaudhry, Nauman S; Gaynor, Brandon G; Hussain, Shahrose; Dernbach, Paul D; Aziz-Sultan, Mohammad A

    2017-06-01

    Aneurysms of the external carotid artery represent approximately 2% of cervical carotid aneurysms, with the majority being traumatic pseudoaneurysms. Given the paucity of literature available for guidance, the diagnosis, treatment, and follow-up of such lesions are completely individualized. We report an 83-year-old woman with an 8-week history of headache in the occipital region, transient episode of gait disturbance, and pulsatile tinnitus on the right. She had no history of trauma, surgery, autoimmune disease, or infection. Physical examination revealed a pulsatile mass tender to palpation in the right occipital scalp. The mass was surgically excised, and histopathological diagnosis of a true aneurysm was made. Postoperatively, the patient's symptoms resolved; however, 1 month after the procedure, she developed occipital neuralgia, which was successfully treated with a percutaneous nerve block. To the best of our knowledge, this is the second reported case of a true aneurysm of the occipital artery in a patient with no history of trauma. The clinical examination, diagnosis, and treatment are discussed and the literature is reviewed for previously reported cases. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Matrix basis for plane and modal waves in a Timoshenko beam

    PubMed Central

    Tolfo, Daniela de Rosso; Tonetto, Leticia

    2016-01-01

    Plane waves and modal waves of the Timoshenko beam model are characterized in closed form by introducing robust matrix basis that behave according to the nature of frequency and wave or modal numbers. These new characterizations are given in terms of a finite number of coupling matrices and closed form generating scalar functions. Through Liouville’s technique, these latter are well behaved at critical or static situations. Eigenanalysis is formulated for exponential and modal waves. Modal waves are superposition of four plane waves, but there are plane waves that cannot be modal waves. Reflected and transmitted waves at an interface point are formulated in matrix terms, regardless of having a conservative or a dissipative situation. The matrix representation of modal waves is used in a crack problem for determining the reflected and transmitted matrices. Their euclidean norms are seen to be dominated by certain components at low and high frequencies. The matrix basis technique is also used with a non-local Timoshenko model and with the wave interaction with a boundary. The matrix basis allows to characterize reflected and transmitted waves in spectral and non-spectral form. PMID:28018668

  16. Matrix basis for plane and modal waves in a Timoshenko beam.

    PubMed

    Claeyssen, Julio Cesar Ruiz; Tolfo, Daniela de Rosso; Tonetto, Leticia

    2016-11-01

    Plane waves and modal waves of the Timoshenko beam model are characterized in closed form by introducing robust matrix basis that behave according to the nature of frequency and wave or modal numbers. These new characterizations are given in terms of a finite number of coupling matrices and closed form generating scalar functions. Through Liouville's technique, these latter are well behaved at critical or static situations. Eigenanalysis is formulated for exponential and modal waves. Modal waves are superposition of four plane waves, but there are plane waves that cannot be modal waves. Reflected and transmitted waves at an interface point are formulated in matrix terms, regardless of having a conservative or a dissipative situation. The matrix representation of modal waves is used in a crack problem for determining the reflected and transmitted matrices. Their euclidean norms are seen to be dominated by certain components at low and high frequencies. The matrix basis technique is also used with a non-local Timoshenko model and with the wave interaction with a boundary. The matrix basis allows to characterize reflected and transmitted waves in spectral and non-spectral form.

  17. HISTORICAL ANALYSIS, A VALUABLE TOOL IN COMMUNITY-BASED ENVIRONMENTAL PROTECTION

    EPA Science Inventory

    A historical analysis of the ecological consequences of development can be a valuable tool in community-based environmental protection. These studies can engage the public in environmental issues and lead to informed decision making. Historical studies provide an understanding of...

  18. Quantifying and managing uncertainty in operational modal analysis

    NASA Astrophysics Data System (ADS)

    Au, Siu-Kui; Brownjohn, James M. W.; Mottershead, John E.

    2018-03-01

    Operational modal analysis aims at identifying the modal properties (natural frequency, damping, etc.) of a structure using only the (output) vibration response measured under ambient conditions. Highly economical and feasible, it is becoming a common practice in full-scale vibration testing. In the absence of (input) loading information, however, the modal properties have significantly higher uncertainty than their counterparts identified from free or forced vibration (known input) tests. Mastering the relationship between identification uncertainty and test configuration is of great interest to both scientists and engineers, e.g., for achievable precision limits and test planning/budgeting. Addressing this challenge beyond the current state-of-the-art that are mostly concerned with identification algorithms, this work obtains closed form analytical expressions for the identification uncertainty (variance) of modal parameters that fundamentally explains the effect of test configuration. Collectively referred as 'uncertainty laws', these expressions are asymptotically correct for well-separated modes, small damping and long data; and are applicable under non-asymptotic situations. They provide a scientific basis for planning and standardization of ambient vibration tests, where factors such as channel noise, sensor number and location can be quantitatively accounted for. The work is reported comprehensively with verification through synthetic and experimental data (laboratory and field), scientific implications and practical guidelines for planning ambient vibration tests.

  19. CM-2 Environmental/Modal Testing of SPACEHAB Racks

    NASA Technical Reports Server (NTRS)

    McNelis, Mark E.; Goodnight, Thomas W.

    2001-01-01

    Combined environmental/modal vibration testing has been implemented at the NASA Glenn Research Center's Structural Dynamics Laboratory. The benefits of combined vibration testing are that it facilitates test article modal characterization and vibration qualification testing. The Combustion Module-2 (CM-2) is a space experiment that will launch on shuttle mission STS-107 in the SPACEHAB Research Double Module. The CM-2 flight hardware is integrated into a SPACEHAB single and double rack. CM-2 rack-level combined vibration testing was recently completed on a shaker table to characterize the structure's modal response and verify the random vibration response. Control accelerometers and limit force gauges, located between the fixture and rack interface, were used to verify the input excitation. Results of the testing were used to verify the loads and environments for flight on the shuttles.

  20. The Development of Modal Testing Technology for Wind Turbines: A Historical Perspective

    NASA Technical Reports Server (NTRS)

    James, George H., III; Carne, Thomas G.

    2007-01-01

    Wind turbines are very large, flexible structures, with aerodynamic forces on the rotating blades producing periodic forces with frequencies at the harmonics of the rotation frequency. Due to design consideration, these rotational frequencies are comparable to the modal frequencies; thus avoiding resonant conditions is a critical consideration. Consequently, predicting and experimentally validating the modal frequencies of wind turbines has been important to their successful design and operation. Performing modal tests on flexible structures over 120 meters tall is a substantial challenge, which has inspired innovative developments in modal test technology. A further trial to the analyst and experimentalist is that the modal frequencies are dependent on the turbine rotation speed, so testing a parked turbine does not fully validate the analytical predictions. The history and development of this modal testing technology will be reviewed, showing historical tests and techniques, ranging from two-meter to 100-meter turbines for both parked and rotating tests. The NExT (Natural Excitation Technique) was developed in the 1990's, as a predecessor to OMA to overcome these challenges. We will trace the difficulties and successes of wind turbine modal testing over the past twenty-five years from 1982 to the present.

  1. Modal characterization of the ASCIE segmented optics testbed: New algorithms and experimental results

    NASA Technical Reports Server (NTRS)

    Carrier, Alain C.; Aubrun, Jean-Noel

    1993-01-01

    New frequency response measurement procedures, on-line modal tuning techniques, and off-line modal identification algorithms are developed and applied to the modal identification of the Advanced Structures/Controls Integrated Experiment (ASCIE), a generic segmented optics telescope test-bed representative of future complex space structures. The frequency response measurement procedure uses all the actuators simultaneously to excite the structure and all the sensors to measure the structural response so that all the transfer functions are measured simultaneously. Structural responses to sinusoidal excitations are measured and analyzed to calculate spectral responses. The spectral responses in turn are analyzed as the spectral data become available and, which is new, the results are used to maintain high quality measurements. Data acquisition, processing, and checking procedures are fully automated. As the acquisition of the frequency response progresses, an on-line algorithm keeps track of the actuator force distribution that maximizes the structural response to automatically tune to a structural mode when approaching a resonant frequency. This tuning is insensitive to delays, ill-conditioning, and nonproportional damping. Experimental results show that is useful for modal surveys even in high modal density regions. For thorough modeling, a constructive procedure is proposed to identify the dynamics of a complex system from its frequency response with the minimization of a least-squares cost function as a desirable objective. This procedure relies on off-line modal separation algorithms to extract modal information and on least-squares parameter subset optimization to combine the modal results and globally fit the modal parameters to the measured data. The modal separation algorithms resolved modal density of 5 modes/Hz in the ASCIE experiment. They promise to be useful in many challenging applications.

  2. Emergence of ion channel modal gating from independent subunit kinetics.

    PubMed

    Bicknell, Brendan A; Goodhill, Geoffrey J

    2016-09-06

    Many ion channels exhibit a slow stochastic switching between distinct modes of gating activity. This feature of channel behavior has pronounced implications for the dynamics of ionic currents and the signaling pathways that they regulate. A canonical example is the inositol 1,4,5-trisphosphate receptor (IP3R) channel, whose regulation of intracellular Ca(2+) concentration is essential for numerous cellular processes. However, the underlying biophysical mechanisms that give rise to modal gating in this and most other channels remain unknown. Although ion channels are composed of protein subunits, previous mathematical models of modal gating are coarse grained at the level of whole-channel states, limiting further dialogue between theory and experiment. Here we propose an origin for modal gating, by modeling the kinetics of ligand binding and conformational change in the IP3R at the subunit level. We find good agreement with experimental data over a wide range of ligand concentrations, accounting for equilibrium channel properties, transient responses to changing ligand conditions, and modal gating statistics. We show how this can be understood within a simple analytical framework and confirm our results with stochastic simulations. The model assumes that channel subunits are independent, demonstrating that cooperative binding or concerted conformational changes are not required for modal gating. Moreover, the model embodies a generally applicable principle: If a timescale separation exists in the kinetics of individual subunits, then modal gating can arise as an emergent property of channel behavior.

  3. Children's On-Line Processing of Epistemic Modals

    ERIC Educational Resources Information Center

    Moscati, Vincenzo; Zhan, Likan; Zhou, Peng

    2017-01-01

    In this paper we investigated the real-time processing of epistemic modals in five-year-olds. In a simple reasoning scenario, we monitored children's eye-movements while processing a sentence with modal expressions of different force ("might/must"). Children were also asked to judge the truth-value of the target sentences at the end of…

  4. How Much is Remembered as a Function of Presentation Modality?

    NASA Technical Reports Server (NTRS)

    Schneider, Vivian I.; Healy, Alice F.; Carlson, Kenneth W.; Buck-Gengler, Carolyn J.; Barshi, Immanuel

    2017-01-01

    According to a widespread claim often used for teaching recommendations, students remember 10 percent of what they read, 20 percent of what they hear, 30 percent of what they see, and 50 percent of what they see and hear. Clearly, the percentages cannot be correct, and there is no empirical evidence even for the ordering. To investigate the ordering, we used a laboratory paradigm that has already revealed some findings regarding the ordering of modalities for remembering information. In this paradigm, subjects are given messages instructing them to move in a grid of four stacked matrices by clicking a computer mouse. The current experiment compared 3 modalities presented either once, see (visual arrows), hear (auditory words), read (visual words); twice in succession, see see, hear hear, read read; or in two different successive modalities, see hear, hear see, see read, read see, hear read, read hear. We found better performance for messages presented twice than for those presented once, regardless of modality. For the twice-presented messages performance varied as a function of the second modality, with best performance for see and worst for read.

  5. Letter Position Coding Across Modalities: The Case of Braille Readers

    PubMed Central

    Perea, Manuel; García-Chamorro, Cristina; Martín-Suesta, Miguel; Gómez, Pablo

    2012-01-01

    Background The question of how the brain encodes letter position in written words has attracted increasing attention in recent years. A number of models have recently been proposed to accommodate the fact that transposed-letter stimuli like jugde or caniso are perceptually very close to their base words. Methodology Here we examined how letter position coding is attained in the tactile modality via Braille reading. The idea is that Braille word recognition may provide more serial processing than the visual modality, and this may produce differences in the input coding schemes employed to encode letters in written words. To that end, we conducted a lexical decision experiment with adult Braille readers in which the pseudowords were created by transposing/replacing two letters. Principal Findings We found a word-frequency effect for words. In addition, unlike parallel experiments in the visual modality, we failed to find any clear signs of transposed-letter confusability effects. This dissociation highlights the differences between modalities. Conclusions The present data argue against models of letter position coding that assume that transposed-letter effects (in the visual modality) occur at a relatively late, abstract locus. PMID:23071522

  6. Medication burden in CKD-5D: impact of dialysis modality and setting.

    PubMed

    Parker, Kathrine; Nikam, Milind; Jayanti, Anuradha; Mitra, Sandip

    2014-12-01

    Medication adherence is thought to be around 50% in the general and dialysis population. Reducing the pill burden (PB) reduces regime complexity and can improve adherence. Increased adherence should lead to improvement in treatment outcomes and patient quality of life. There is currently little published data on PB in CKD-5D across dialysis modalities. This is a retrospective, single renal network study. All in-centre HD (MHD), peritoneal dialysis (PD) and home HD (HHD) patients were identified in the Greater Manchester East sector renal network. Information collected included age, sex, comorbidities, daily PB, dialysis vintage and adequacy. Data were retrieved from a customized renal database, clinic and discharge letters with cross validation from the general practitioner when needed. Two hundred and thirty-six prevalent dialysis patients were studied. HHD patients had a significantly lower PB (11 ± 7 pills/day) compared with PD and MHD (16 ± 7 pills/day). The HHD patients required fewer BP medications to meet the recommended target. HD setting was the only significant factor for reducing PB. For home therapies (HHD versus PD), weekly Kt/v and serum phosphate were significant factors influencing PB. When comparing all modalities, OR of PB ≥ 15/day for MHD versus HHD was 3.9 and PD versus HHD was 4.9. The influence of HHD is dominant above factors such as comorbidities or clinical variables in reducing PB for MHD. Higher clearances achieved by HHD could explain differences in PB with PD. This is the first comparative study of PB across all dialysis modalities and factors that influence it. The PB advantage in HHD may result in greater adherence and might contribute to the outcome benefit often seen with this modality. Higher clearances achieved by HHD could explain differences in PB with PD but the precise reasons for lower PB remain speculative and deserve further research in larger settings.

  7. LongoVital- An Imminent Therapeutic Modality: An Unseen Drug Review with Advanced Features and Hypothesis

    PubMed Central

    Dua, Nisha; Kumar, Anand; Khanna, Ruchit; Khanna, Pyare Mohan Lal

    2016-01-01

    Herbal medication still happens to be the backbone of the major world’s population essentially because of the assumption that these drugs are free of any side effects and easily available. LongoVital (LV) is a herbal preparation with documented immune-modulatory and immune-stimulatory effects in man. Various studies conducted to date, have shown LV to have prolonged and beneficial impact in the treatment of orofacial diseases, when administered in recommended daily doses. With its combined antimicrobial and immunostimulatory effects, LV can be regarded as an emerging therapeutic modality in the treatment of orofacial diseases. PMID:27190969

  8. Time domain modal identification/estimation of the mini-mast testbed

    NASA Technical Reports Server (NTRS)

    Roemer, Michael J.; Mook, D. Joseph

    1991-01-01

    The Mini-Mast is a 20 meter long 3-dimensional, deployable/retractable truss structure designed to imitate future trusses in space. Presented here are results from a robust (with respect to measurement noise sensitivity), time domain, modal identification technique for identifying the modal properties of the Mini-Mast structure even in the face of noisy environments. Three testing/analysis procedures are considered: sinusoidal excitation near resonant frequencies of the Mini-Mast, frequency response function averaging of several modal tests, and random input excitation with a free response period.

  9. A generalized modal shock spectra method for spacecraft loads analysis

    NASA Technical Reports Server (NTRS)

    Trubert, M.; Salama, M.

    1979-01-01

    Unlike the traditional shock spectra approach, the generalization presented in this paper permits elastic interaction between the spacecraft and launch vehicle in order to obtain accurate bounds on the spacecraft response and structural loads. In addition, the modal response from a previous launch vehicle transient analysis - with or without a dummy spacecraft - is exploited in order to define a modal impulse as a simple idealization of the actual forcing function. The idealized modal forcing function is then used to derive explicit expressions for an estimate of the bound on the spacecraft structural response and forces.

  10. An operational modal analysis method in frequency and spatial domain

    NASA Astrophysics Data System (ADS)

    Wang, Tong; Zhang, Lingmi; Tamura, Yukio

    2005-12-01

    A frequency and spatial domain decomposition method (FSDD) for operational modal analysis (OMA) is presented in this paper, which is an extension of the complex mode indicator function (CMIF) method for experimental modal analysis (EMA). The theoretical background of the FSDD method is clarified. Singular value decomposition is adopted to separate the signal space from the noise space. Finally, an enhanced power spectrum density (PSD) is proposed to obtain more accurate modal parameters by curve fitting in the frequency domain. Moreover, a simulation case and an application case are used to validate this method.

  11. Model mismatch analysis and compensation for modal phase measuring deflectometry

    DOE PAGES

    Huang, Lei; Xue, Junpeng; Gao, Bo; ...

    2017-01-11

    The correspondence residuals due to the discrepancy between the reality and the shape model in use are analyzed for the modal phase measuring deflectometry. Slope residuals are calculated from these discrepancies between the modal estimation and practical acquisition. Since the shape mismatch mainly occurs locally, zonal integration methods which are good at dealing with local variations are used to reconstruct the height residual for compensation. Finally, results of both simulation and experiment indicate the proposed height compensation method is effective, which can be used as a post-complement for the modal phase measuring deflectometry.

  12. A Multi-Modality CMOS Sensor Array for Cell-Based Assay and Drug Screening.

    PubMed

    Chi, Taiyun; Park, Jong Seok; Butts, Jessica C; Hookway, Tracy A; Su, Amy; Zhu, Chengjie; Styczynski, Mark P; McDevitt, Todd C; Wang, Hua

    2015-12-01

    In this paper, we present a fully integrated multi-modality CMOS cellular sensor array with four sensing modalities to characterize different cell physiological responses, including extracellular voltage recording, cellular impedance mapping, optical detection with shadow imaging and bioluminescence sensing, and thermal monitoring. The sensor array consists of nine parallel pixel groups and nine corresponding signal conditioning blocks. Each pixel group comprises one temperature sensor and 16 tri-modality sensor pixels, while each tri-modality sensor pixel can be independently configured for extracellular voltage recording, cellular impedance measurement (voltage excitation/current sensing), and optical detection. This sensor array supports multi-modality cellular sensing at the pixel level, which enables holistic cell characterization and joint-modality physiological monitoring on the same cellular sample with a pixel resolution of 80 μm × 100 μm. Comprehensive biological experiments with different living cell samples demonstrate the functionality and benefit of the proposed multi-modality sensing in cell-based assay and drug screening.

  13. Design and implementation of a novel modal space active force control concept for spatial multi-DOF parallel robotic manipulators actuated by electrical actuators.

    PubMed

    Yang, Chifu; Zhao, Jinsong; Li, Liyi; Agrawal, Sunil K

    2018-01-01

    Robotic spine brace based on parallel-actuated robotic system is a new device for treatment and sensing of scoliosis, however, the strong dynamic coupling and anisotropy problem of parallel manipulators result in accuracy loss of rehabilitation force control, including big error in direction and value of force. A novel active force control strategy named modal space force control is proposed to solve these problems. Considering the electrical driven system and contact environment, the mathematical model of spatial parallel manipulator is built. The strong dynamic coupling problem in force field is described via experiments as well as the anisotropy problem of work space of parallel manipulators. The effects of dynamic coupling on control design and performances are discussed, and the influences of anisotropy on accuracy are also addressed. With mass/inertia matrix and stiffness matrix of parallel manipulators, a modal matrix can be calculated by using eigenvalue decomposition. Making use of the orthogonality of modal matrix with mass matrix of parallel manipulators, the strong coupled dynamic equations expressed in work space or joint space of parallel manipulator may be transformed into decoupled equations formulated in modal space. According to this property, each force control channel is independent of others in the modal space, thus we proposed modal space force control concept which means the force controller is designed in modal space. A modal space active force control is designed and implemented with only a simple PID controller employed as exampled control method to show the differences, uniqueness, and benefits of modal space force control. Simulation and experimental results show that the proposed modal space force control concept can effectively overcome the effects of the strong dynamic coupling and anisotropy problem in the physical space, and modal space force control is thus a very useful control framework, which is better than the current joint

  14. Short-term memory for event duration: modality specificity and goal dependency.

    PubMed

    Takahashi, Kohske; Watanabe, Katsumi

    2012-11-01

    Time perception is involved in various cognitive functions. This study investigated the characteristics of short-term memory for event duration by examining how the length of the retention period affects inter- and intramodal duration judgment. On each trial, a sample stimulus was followed by a comparison stimulus, after a variable delay period (0.5-5 s). The sample and comparison stimuli were presented in the visual or auditory modality. The participants determined whether the comparison stimulus was longer or shorter than the sample stimulus. The distortion pattern of subjective duration during the delay period depended on the sensory modality of the comparison stimulus but was not affected by that of the sample stimulus. When the comparison stimulus was visually presented, the retained duration of the sample stimulus was shortened as the delay period increased. Contrarily, when the comparison stimulus was presented in the auditory modality, the delay period had little to no effect on the retained duration. Furthermore, whenever the participants did not know the sensory modality of the comparison stimulus beforehand, the effect of the delay period disappeared. These results suggest that the memory process for event duration is specific to sensory modality and that its performance is determined depending on the sensory modality in which the retained duration will be used subsequently.

  15. Analysis of swept-sine runs during modal identification

    NASA Astrophysics Data System (ADS)

    Gloth, G.; Sinapius, M.

    2004-11-01

    Experimental modal analysis of large aerospace structures in Europe combine nowadays the benefits of the very reliable but time-consuming phase resonance method and the application of phase separation techniques evaluating frequency response functions (FRF). FRFs of a test structure can be determined by a variety of means. Applied excitation signal waveforms include harmonic signals like stepped-sine excitation, periodic signals like multi-sine excitation, transient signals like impulse and swept-sine excitation, and stochastic signals like random. The current article focuses on slow swept-sine excitation which is a good trade-off between magnitude of excitation level needed for large aircraft and testing time. However, recent ground vibration tests (GVTs) brought up that reliable modal data from swept-sine test runs depend on a proper data processing. The article elucidates the strategy of modal analysis based on swept-sine excitation. The standards for the application of slowly swept sinusoids defined by the international organisation for standardisation in ISO 7626 part 2 are critically reviewed. The theoretical background of swept-sine testing is expounded with particular emphasis to the transition through structural resonances. The effect of different standard procedures of data processing like tracking filter, fast Fourier transform (FFT), and data reduction via averaging are investigated with respect to their influence on the FRFs and modal parameters. Particular emphasis is given to FRF distortions evoked by unsuitable data processing. All data processing methods are investigated on a numerical example. Their practical usefulness is demonstrated on test data taken from a recent GVT on a large aircraft. The revision of ISO 7626 part 2 is suggested regarding the application of slow swept-sine excitation. Recommendations about the proper FRF estimation from slow swept-sine excitation are given in order to enable the optimisation on these applications for

  16. International Survey Regarding the Use of Rehabilitation Modalities in Horses.

    PubMed

    Wilson, Janine M; McKenzie, Erica; Duesterdieck-Zellmer, Katja

    2018-01-01

    To define which biologic, electrophysical and other modalities are used in horses for injury or performance issues, a questionnaire regarding 38 modalities was distributed to eight veterinary groups. A total of 305 complete or partial responses were obtained from over 10 geographic regions; 75.4% from private equine practice or regional private equine referral hospitals, 14.1% from university teaching hospitals or satellite clinics, 8.2% from private mixed animal practice, and 2.3% from veterinary rehabilitation centers. The majority of respondents were located in the USA (60%), Europe (25.6%), and Canada (5.6%). Respondents reported working with athletic horses primarily in the disciplines of hunter-jumper (26.9%), dressage (16.0%), and pleasure riding (14.7%), followed by Western riding, track racing, and eventing. Warmbloods (39.7%) were the predominant breed presenting to respondents, followed by Thoroughbreds (20.3%) and Quarter Horses (17.3%) ahead of other breeds. All 38 modalities were used by respondents. The 10 most prominently utilized were controlled hand walking (97.3%), therapeutic shoeing (96.1%), ice (95.2%), compression bandaging (89.5%), platelet rich plasma (PRP; 86.5%), therapeutic exercises (84.3%), interleukin-1 receptor antagonist protein therapy (IRAP; 81.4%), stretching (83.3%), and cold water hydrotherapy (82.9%). Heat (77.6%), massage (69.0%), and acupuncture (68.3%) were also commonly utilized. The least prominently used modalities were hyperbaric oxygen therapy (9.4%), cytowave (8.3%), and radiofrequency (6.4%). Injectable modalities (IRAP, PRP, mesotherapy, stem cells) were almost solely administered by veterinarians; other modalities were variably applied by veterinarians, technicians, veterinary assistants, farriers, physical therapists, trainers, and other entities. A total of 33% of respondents reported working collaboratively with physical therapists on equine patients. Findings indicate that a broad range of invasive and non

  17. Monitoring tumor growth and treatment in small animals with magnetic resonance and optical tomographic imaging

    NASA Astrophysics Data System (ADS)

    Masciotti, J.; Provenzano, F.; Papa, J.; Klose, A.; Hur, J.; Gu, X.; Yamashiro, D.; Kandel, J.; Hielscher, A. H.

    2006-02-01

    Small animal models are employed to simulate disease in humans and to study its progression, what factors are important to the disease process, and to study the disease treatment. Biomedical imaging modalities such as magnetic resonance imaging (MRI) and Optical Tomography make it possible to non-invasively monitor the progression of diseases in living small animals and study the efficacy of drugs and treatment protocols. MRI is an established imaging modality capable of obtaining high resolution anatomical images and along with contrast agents allow the studying of blood volume. Optical tomography, on the other hand, is an emerging imaging modality, which, while much lower in spatial resolution, can separate the effects of oxyhemoglobin, deoxyhemoglobin, and blood volume with high temporal resolution. In this study we apply these modalities to imaging the growth of kidney tumors and then there treatment by an anti-VEGF agent. We illustrate how these imaging modalities have their individual uses, but can still supplement each other and cross validation can be performed.

  18. Topical modalities for treatment and prevention of postsurgical hypertrophic scars.

    PubMed

    Foo, Chong Wee; Tristani-Firouzi, Payam

    2011-08-01

    There is no universally accepted treatment regimen and no evidence-based literature to guide management of hypertrophic scars. This article summarizes the existing literature regarding topical treatments such as silicone gel sheeting and ointment, onion extract, vitamin E, pressure garment therapy, massage therapy, and topical imiquimod 5% cream in the management of hypertrophic scars. 2011 Elsevier Inc. All rights reserved.

  19. The Modality Shift Experiment in Adults and Children with High Functioning Autism

    ERIC Educational Resources Information Center

    Williams, Diane L.; Goldstein, Gerald; Minshew, Nancy J.

    2013-01-01

    This study used the modality shift experiment, a relatively simple reaction time measure to visual and auditory stimuli, to examine attentional shifting within and across modalities in 33 children and 42 adults with high-functioning autism as compared to matched numbers of age- and ability-matched typical controls. An exaggerated "modality shift…

  20. Limited Angle Dual Modality Breast Imaging

    NASA Astrophysics Data System (ADS)

    More, Mitali J.; Li, Heng; Goodale, Patricia J.; Zheng, Yibin; Majewski, Stan; Popov, Vladimir; Welch, Benjamin; Williams, Mark B.

    2007-06-01

    We are developing a dual modality breast scanner that can obtain x-ray transmission and gamma ray emission images in succession at multiple viewing angles with the breast held under mild compression. These views are reconstructed and fused to obtain three-dimensional images that combine structural and functional information. Here, we describe the dual modality system and present results of phantom experiments designed to test the system's ability to obtain fused volumetric dual modality data sets from a limited number of projections, acquired over a limited (less than 180 degrees) angular range. We also present initial results from phantom experiments conducted to optimize the acquisition geometry for gamma imaging. The optimization parameters include the total number of views and the angular range over which these views should be spread, while keeping the total number of detected counts fixed. We have found that in general, for a fixed number of views centered around the direction perpendicular to the direction of compression, in-plane contrast and SNR are improved as the angular range of the views is decreased. The improvement in contrast and SNR with decreasing angular range is much greater for deeper lesions and for a smaller number of views. However, the z-resolution of the lesion is significantly reduced with decreasing angular range. Finally, we present results from limited angle tomography scans using a system with dual, opposing heads.

  1. TESS Lens-Bezel Assembly Modal Testing

    NASA Technical Reports Server (NTRS)

    Dilworth, Brandon J.; Karlicek, Alexandra

    2017-01-01

    The Transiting Exoplanet Survey Satellite (TESS) program, led by the Kavli Institute for Astrophysics and Space Research at the Massachusetts Institute of Technology (MIT) will be the first-ever spaceborne all-sky transit survey. MIT Lincoln Laboratory is responsible for the cameras, including the lens assemblies, detector assemblies, lens hoods, and camera mounts. TESS is scheduled to be launched in August of 2017 with the primary goal to detect small planets with bright host starts in the solar neighborhood, so that detailed characterizations of the planets and their atmospheres can be performed. The TESS payload consists of four identical cameras and a data handling unit. Each camera consists of a lens assembly with seven optical elements and a detector assembly with four charge-coupled devices (CCDs) including their associated electronics. The optical prescription requires that several of the lenses are in close proximity to a neighboring element. A finite element model (FEM) was developed to estimate the relative deflections between each lens-bezel assembly under launch loads to predict that there are adequate clearances preventing the lenses from making contact. Modal tests using non-contact response measurements were conducted to experimentally estimate the modal parameters of the lens-bezel assembly, and used to validate the initial FEM assumptions. Key Words Non-contact measurements, modal analysis, model validation

  2. Modal kinematics for multisection continuum arms.

    PubMed

    Godage, Isuru S; Medrano-Cerda, Gustavo A; Branson, David T; Guglielmino, Emanuele; Caldwell, Darwin G

    2015-05-13

    This paper presents a novel spatial kinematic model for multisection continuum arms based on mode shape functions (MSF). Modal methods have been used in many disciplines from finite element methods to structural analysis to approximate complex and nonlinear parametric variations with simple mathematical functions. Given certain constraints and required accuracy, this helps to simplify complex phenomena with numerically efficient implementations leading to fast computations. A successful application of the modal approximation techniques to develop a new modal kinematic model for general variable length multisection continuum arms is discussed. The proposed method solves the limitations associated with previous models and introduces a new approach for readily deriving exact, singularity-free and unique MSF's that simplifies the approach and avoids mode switching. The model is able to simulate spatial bending as well as straight arm motions (i.e., pure elongation/contraction), and introduces inverse position and orientation kinematics for multisection continuum arms. A kinematic decoupling feature, splitting position and orientation inverse kinematics is introduced. This type of decoupling has not been presented for these types of robotic arms before. The model also carefully accounts for physical constraints in the joint space to provide enhanced insight into practical mechanics and impose actuator mechanical limitations onto the kinematics thus generating fully realizable results. The proposed method is easily applicable to a broad spectrum of continuum arm designs.

  3. Multishaker modal testing

    NASA Technical Reports Server (NTRS)

    Craig, R. R., Jr.

    1985-01-01

    A component mode synthesis method for damped structures was developed and modal test methods were explored which could be employed to determine the relevant parameters required by the component mode synthesis method. Research was conducted on the following topics: (1) Development of a generalized time-domain component mode synthesis technique for damped systems; (2) Development of a frequency-domain component mode synthesis method for damped systems; and (3) Development of a system identification algorithm applicable to general damped systems. Abstracts are presented of the major publications which have been previously issued on these topics.

  4. Two-stage palatoplasty, is it still a valuable treatment protocol for patients with a cleft of lip, alveolus, and palate?

    PubMed

    Gundlach, Karsten K H; Bardach, Janusz; Filippow, Daniel; Stahl-de Castrillon, Franka; Lenz, Jan-Hendrik

    2013-01-01

    Speech development is of utmost importance and requires early closure of a palatal cleft. On the other hand, it is well known that all types and timings of surgical repair of facial clefts are detrimental to maxillary growth. Nevertheless, these days one is more and more confronted with a world-wide tendency in favour of the one-in-all operation to close clefts of the lip, alveolus, and palate. Therefore, a three-centre study was performed for testing - once more - the value of two-stage palatoplasty as a means to reduce the detrimental effects of surgery on palatal growth and at the same time to also enable early speech development. Plaster casts from 85 patients have been re-evaluated. All of them had a complete unilateral cleft of lip, alveolus, and palate. They had been treated according to the old therapy protocols followed in either one of the three different cleft centres many years ago, namely in Hamburg, (Western) Germany, Iowa City, IO, USA, and Rostock, (in those days still Eastern) Germany. The impressions had been taken already in 1987 from patients being either 8 years (36 pts.) or 16 years of age (49 pts.). Three different treatment protocols had been followed for these patients in those centres in those days: The main difference was that in centres A and B the palates were closed in two stages whilst in centre C palatoplasty was performed in just one operation. The most interesting results regarding the palatal growth were that: 1. In centre C (one-stage palatoplasty) the patients had more constricted palates. 2. In centre A (two-stage palatoplasty) the patients had least often an anterior cross-bite. It appears that it was possible to show once more that closing the palate in one stage at age 1 year or less is interfering most with maxillary growth. This study leads us to conclude that two-stage palatoplasty is still a valuable treatment protocol for patients with a complete unilateral cleft of lip, alveolus, and palate, especially as apparently

  5. MO-DE-210-03: Ultrasound imaging is an attractive method for image guided radiation treatment (IGRT), by itself or to complement other imaging modalities

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

    Ding, K.

    Ultrasound imaging is an attractive method for image guided radiation treatment (IGRT), by itself or to complement other imaging modalities. It is inexpensive, portable and provides good soft tissue contrast. For challenging soft tissue targets such as pancreatic cancer, ultrasound imaging can be used in combination with pre-treatment MRI and/or CT to transfer important anatomical features for target localization at time of treatment. The non-invasive and non-ionizing nature of ultrasound imaging is particularly powerful for intra-fraction localization and monitoring. Recognizing these advantages, efforts are being made to incorporate novel robotic approaches to position and manipulate the ultrasound probe during irradiation.more » These recent enabling developments hold potential to bring ultrasound imaging to a new level of IGRT applications. However, many challenges, not limited to image registration, robotic deployment, probe interference and image acquisition rate, need to be addressed to realize the full potential of IGRT with ultrasound imaging. Learning Objectives: Understand the benefits and limitations in using ultrasound to augment MRI and/or CT for motion monitoring during radiation therapy delivery. Understanding passive and active robotic approaches to implement ultrasound imaging for intra-fraction monitoring. Understand issues of probe interference with radiotherapy treatment. Understand the critical clinical workflow for effective and reproducible IGRT using ultrasound guidance. The work of X.L. is supported in part by Elekta; J.W. and K.D. is supported in part by a NIH grant R01 CA161613 and by Elekta; D.H. is support in part by a NIH grant R41 CA174089.« less

  6. Determining the best treatment for simple bone cyst: a decision analysis.

    PubMed

    Lee, Seung Yeol; Chung, Chin Youb; Lee, Kyoung Min; Sung, Ki Hyuk; Won, Sung Hun; Choi, In Ho; Cho, Tae-Joon; Yoo, Won Joon; Yeo, Ji Hyun; Park, Moon Seok

    2014-03-01

    The treatment of simple bone cysts (SBC) in children varies significantly among physicians. This study examined which procedure is better for the treatment of SBC, using a decision analysis based on current published evidence. A decision tree focused on five treatment modalities of SBC (observation, steroid injection, autologous bone marrow injection, decompression, and curettage with bone graft) were created. Each treatment modality was further branched, according to the presence and severity of complications. The probabilities of all cases were obtained by literature review. A roll back tool was utilized to determine the most preferred treatment modality. One-way sensitivity analysis was performed to determine the threshold value of the treatment modalities. Two-way sensitivity analysis was utilized to examine the joint impact of changes in probabilities of two parameters. The decision model favored autologous bone marrow injection. The expected value of autologous bone marrow injection was 0.9445, while those of observation, steroid injection, decompression, and curettage and bone graft were 0.9318, 0.9400, 0.9395, and 0.9342, respectively. One-way sensitivity analysis showed that autologous bone marrow injection was better than that of decompression for the expected value when the rate of pathologic fracture, or positive symptoms of SBC after autologous bone marrow injection, was lower than 20.4%. In our study, autologous bone marrow injection was found to be the best choice of treatment of SBC. However, the results were sensitive to the rate of pathologic fracture after treatment of SBC. Physicians should consider the possibility of pathologic fracture when they determine a treatment method for SBC.

  7. Sortase A-mediated site-specific labeling of camelid single-domain antibody-fragments: a versatile strategy for multiple molecular imaging modalities.

    PubMed

    Massa, Sam; Vikani, Niravkumar; Betti, Cecilia; Ballet, Steven; Vanderhaegen, Saskia; Steyaert, Jan; Descamps, Benedicte; Vanhove, Christian; Bunschoten, Anton; van Leeuwen, Fijs W B; Hernot, Sophie; Caveliers, Vicky; Lahoutte, Tony; Muyldermans, Serge; Xavier, Catarina; Devoogdt, Nick

    2016-09-01

    A generic site-specific conjugation method that generates a homogeneous product is of utmost importance in tracer development for molecular imaging and therapy. We explored the protein-ligation capacity of the enzyme Sortase A to label camelid single-domain antibody-fragments, also known as nanobodies. The versatility of the approach was demonstrated by conjugating independently three different imaging probes: the chelating agents CHX-A"-DTPA and NOTA for single-photon emission computed tomography (SPECT) with indium-111 and positron emission tomography (PET) with gallium-68, respectively, and the fluorescent dye Cy5 for fluorescence reflectance imaging (FRI). After a straightforward purification process, homogeneous single-conjugated tracer populations were obtained in high yield (30-50%). The enzymatic conjugation did not affect the affinity of the tracers, nor the radiolabeling efficiency or spectral characteristics. In vivo, the tracers enabled the visualization of human epidermal growth factor receptor 2 (HER2) expressing BT474M1-tumors with high contrast and specificity as soon as 1 h post injection in all three imaging modalities. These data demonstrate Sortase A-mediated conjugation as a valuable strategy for the development of site-specifically labeled camelid single-domain antibody-fragments for use in multiple molecular imaging modalities. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  8. Control of large flexible spacecraft by the independent modal-space control method

    NASA Technical Reports Server (NTRS)

    Meirovitch, L.; Shenar, J.

    1984-01-01

    The problem of control of a large-order flexible structure in the form of a plate-like lattice by the Independent Modal-Space Control (IMSC) method is presented. The equations of motion are first transformed to the modal space, thus obtaining internal (plant) decoupling of the system. Then, the control laws are designed in the modal space for each mode separately, so that the modal equations of motion are rendered externally (controller) decoupled. This complete decoupling applies both to rigid-body modes and elastic modes. The application of linear optimal control, in conjunction with a quadratic performance index, is first reviewed. A solution for high-order systems is proposed here by the IMSC method, whereby the problem is reduced to a number of modal minimum-fuel problems for the controlled modes.

  9. Distinct cognitive control mechanisms as revealed by modality-specific conflict adaptation effects.

    PubMed

    Yang, Guochun; Nan, Weizhi; Zheng, Ya; Wu, Haiyan; Li, Qi; Liu, Xun

    2017-04-01

    Cognitive control is essential to resolve conflict in stimulus-response compatibility (SRC) tasks. The SRC effect in the current trial is reduced after an incongruent trial as compared with a congruent trial, a phenomenon being termed conflict adaptation (CA). The CA effect is found to be domain-specific , such that it occurs when adjacent trials contain the same type of conflict, but disappears when the conflicts are of different types. Similar patterns have been observed when tasks involve different modalities, but the modality-specific effect may have been confounded by task switching. In the current study, we investigated whether or not cognitive control could transfer across auditory and visual conflicts when task-switching was controlled. Participants were asked to respond to a visual or auditory (Experiments 1A/B) stimulus, with conflict coming from either the same or a different modality. CA effects showed modality-specific patterns. To account for potential confounding effects caused by differences in task-irrelevant properties, we specifically examined the influence of task-irrelevant properties on CA effects within the visual modality (Experiments 2A/B). Significant CA effects were observed across different conflicts from distinct task-irrelevant properties, ruling out that the lack of cross-modal CA effects in Experiments 1A/B resulted from differences in task-irrelevant information. Task-irrelevant properties were further matched in Experiments 3A/B to examine the pure effect of modality. Results replicated Experiments 1A/B showing robust modality-specific CA effects. Taken together, we provide supporting evidences that modality affects cognitive control in conflict resolution, which should be taken into account in theories of cognitive control. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  10. Closed treatment of unilateral mandibular condyle fractures in adults: a systematic review.

    PubMed

    Rozeboom, A V J; Dubois, L; Bos, R R M; Spijker, R; de Lange, J

    2017-04-01

    Of all mandibular fractures, 25-35% are condylar. Many studies have focused on whether to treat such fractures via open or closed modalities. A uniform protocol for closed treatment is lacking, but such a protocol could ensure good clinical practice. The aims of this systematic review were to provide an overview of the published studies exclusively pertaining to closed treatment and to summarize the existing modalities for closed treatment and their clinical outcomes. Sixteen studies were selected for detailed analysis. The treatments given were highly variable, ranging from doing nothing to applying maxillomandibular fixation with stainless steel wires. The results of the different studies and the treatment modalities used were difficult to interpret; however no clear differences in the outcome measures were seen between the treatment modalities applied. Complications encountered after closed treatment included malocclusion, limited mouth opening, reduced range of motion, and persistent pain. Due to the heterogeneity between groups, high loss-to-follow-up, poor descriptions of the treatments given, and variability in outcome measurement methods, no clear associations between adverse outcomes and the treatments applied could be determined. This review suggests that due to the high level of methodological variability in the relevant studies published to date, there are currently no uniform standards for the closed treatment of condylar fractures that can be expected to yield good clinical results. The establishment of such standards could potentially improve treatment outcomes. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  11. [Current treatment of bacterial vaginosis].

    PubMed

    Borisov, I

    1999-01-01

    Therapeutic options for the treatment of accurately diagnosed bacterial vaginosis are reviewed on the basis of current concepts for treatment of bacterial vaginosis. The importance for screening for bacterial vaginosis is pointed out especially before intrauterine procedures and in pregnant women at risk for premature deliveries. Treatment regimens for pregnant women are discussed as well. Emphasis is given to treatment modalities for recurrent bacterial vaginosis.

  12. Autonomous Modal Identification of the Space Shuttle Tail Rudder

    NASA Technical Reports Server (NTRS)

    Pappa, Richard S.; James, George H., III; Zimmerman, David C.

    1997-01-01

    Autonomous modal identification automates the calculation of natural vibration frequencies, damping, and mode shapes of a structure from experimental data. This technology complements damage detection techniques that use continuous or periodic monitoring of vibration characteristics. The approach shown in the paper incorporates the Eigensystem Realization Algorithm (ERA) as a data analysis engine and an autonomous supervisor to condense multiple estimates of modal parameters using ERA's Consistent-Mode Indicator and correlation of mode shapes. The procedure was applied to free-decay responses of a Space Shuttle tail rudder and successfully identified the seven modes of the structure below 250 Hz. The final modal parameters are a condensed set of results for 87 individual ERA cases requiring approximately five minutes of CPU time on a DEC Alpha computer.

  13. The Inception of OMA in the Development of Modal Testing Technology for Wind Turbines

    NASA Technical Reports Server (NTRS)

    James, George H., III; Carne. Thomas G.

    2008-01-01

    Wind turbines are immense, flexible structures with aerodynamic forces acting on the rotating blades at harmonics of the turbine rotational frequency, which are comparable to the modal frequencies of the structure. Predicting and experimentally measuring the modal frequencies of wind turbines has been important to their successful design and operation. Performing modal tests on wind turbine structures over 100 meters tall is a substantial challenge, which has inspired innovative developments in modal test technology. For wind turbines, a further complication is that the modal frequencies are dependent on the turbine rotation speed. The history and development of a new technique for acquiring the modal parameters using output-only response data, called the Natural Excitation Technique (NExT), will be reviewed, showing historical tests and techniques. The initial attempts at output-only modal testing began in the late 1980's with the development of NExT in the 1990's. NExT was a predecessor to OMA, developed to overcome these challenges of testing immense structures excited with environmental inputs. We will trace the difficulties and successes of wind turbine modal testing from 1982 to the present. Keywords: OMA, Modal Analysis, NExT, Wind Turbines, Wind Excitation

  14. Surgical treatment of solitary brain metastases.

    PubMed

    Gates, Marilyn; Alsaidi, Mohammed; Kalkanis, Steven

    2012-01-01

    Brain metastases are the most common form of brain tumors and are diagnosed in about 40% of all patients with systemic malignancies. Although the percentage of solitary brain metastases has dropped in recent estimates from about 50-30% of all patients with brain metastases, this percentage still represents a significant number of patients, and the overall incidence of brain metastases is still on the rise. Historically, brain metastases carried a grim prognosis with a median survival of only a few weeks. The utilization of whole-brain radiation therapy (WBRT) and steroids improved the prognosis to few months. However, it was not until the advent of advanced surgical techniques in conjunction with other treatment modalities such as WBRT and stereotactic radiosurgery that patients became less likely to succumb to neurological complications. In the last few decades, surgical resection has evolved from a mere emergent palliative treatment to a standard treatment modality that has led to improved clinical outcomes in carefully selected patients with brain metastases. This positive contribution has been made possible by randomized clinical trials, advancement of surgical techniques and tools, imaging modalities, and better understanding of the pathophysiology and perioperative care. Copyright © 2012 S. Karger AG, Basel.

  15. Colon Cancer Treatment (PDQ®)—Health Professional Version

    Cancer.gov

    Colon cancer treatment often involves open surgical resection as the primary treatment for localized disease. Other modalities include chemotherapy, targeted therapy, radiation therapy, and local ablation. Get detailed information about colon cancer treatment in this summary for clinicians.

  16. Anti-extinction in the tactile modality.

    PubMed

    White, Rebekah C; Aimola Davies, Anne M

    2013-01-01

    Patients with extinction fail to report a contralesional stimulus when it is presented at the same time as an ipsilesional stimulus, and patients with unilateral neglect fail to report a contralesional stimulus even when there is no competing ipsilesional stimulus. Whereas extinction and neglect are common following stroke, the related phenomenon of anti-extinction is rare--there are four cases of anti-extinction in the literature, and all four cases demonstrated anti-extinction in the visual modality. Patients with anti-extinction do report a contralesional stimulus when it is presented at the same time as an ipsilesional stimulus; but, like patients with neglect, they fail to report a contralesional stimulus when there is no competing ipsilesional stimulus. We present the first case ofanti-extinction in the tactile modality.

  17. Digital multishaker modal testing

    NASA Technical Reports Server (NTRS)

    Blair, M.; Craig, R. R., Jr.

    1983-01-01

    A review of several modal testing techniques is made, along with brief discussions of their advantages and limitations. A new technique is presented which overcomes many of the previous limitations. Several simulated experiments are included to verify the validity and accuracy of the new method. Conclusions are drawn from the simulation studies and recommendations for further work are presented. The complete computer code configured for the simulation study is presented.

  18. Modal testing of a rotating wind turbine

    NASA Astrophysics Data System (ADS)

    Carne, T. G.; Nord, A. R.

    1982-11-01

    A testing technique was developed to measure the modes of vibration of a rotating vertical-axis wind turbine. This technique was applied to the Sandia Two-Meter Turbine, where the changes in individual modal frequencies as a function of the rotational speed were tracked from 0 rpm (parked) to 600 rpm. During rotational testing, the structural response was measured using a combination of strain gages and accelerometers, passing the signals through slip rings. Excitation of the turbine structure was provided by a scheme which suddenly released a pretensioned cable, thus plucking the turbine as it was rotating at a set speed. In addition to calculating the real modes of the parked turbine, the modes of the rotating turbine were also determined at several rotational speeds. The modes of the rotating system proved to be complex due to centrifugal and Coriolis effects. The modal data for the parked turbine were used to update a finite-element model. Also, the measured modal parameters for the rotating turbine were compared to the analytical results, thus verifying the analytical procedures used to incorporate the effects of the rotating coordinate system.

  19. Modal sensing and control of paraboloidal shell structronic system

    NASA Astrophysics Data System (ADS)

    Yue, Honghao; Lu, Yifan; Deng, Zongquan; Tzou, Hornsen

    2018-02-01

    Paraboloidal shells of revolution are commonly used as important components in the field of advanced aerospace structures and aviation mechanical systems. This study is to investigate the modal sensing behavior and the modal vibration control effect of distributed PVDF patches laminated on the paraboloidal shell. A paraboloidal shell sensing and control testing platform is set up first. Frequencies of lower order modes of the shell are obtained with the PVDF sensor and compared with the previous testing results to prove its accuracy. Then sensor patches are laminated on different positions (or different sides) of the shell and tested to reveal the relation between the sensing behaviors and their locations. Finally, a mathematical model of the structronic system is built by parameter identifications and the transfer function is derived. Independent and coupled modal controllers are designed based on the pole placement method and modal vibration control experiments are performed. The amplitude suppression ratio of each mode controlled by the pole placement controller is calculated and compared with the results obtained by using a PPF controller. Advantages of both methods are concluded and suggestions are given on how to choose control algorithm for different purpose.

  20. Colorectal Cancer Screening: Stool DNA and Other Noninvasive Modalities.

    PubMed

    Bailey, James R; Aggarwal, Ashish; Imperiale, Thomas F

    2016-03-01

    Colorectal cancer screening dates to the discovery of precancerous adenomatous tissue. Screening modalities and guidelines directed at prevention and early detection have evolved and resulted in a significant decrease in the prevalence and mortality of colorectal cancer via direct visualization or using specific markers. Despite continued efforts and an overall reduction in deaths attributed to colorectal cancer over the last 25 years, colorectal cancer remains one of the most common causes of malignancy-associated deaths. In attempt to further reduce the prevalence of colorectal cancer and associated deaths, continued improvement in screening quality and adherence remains key. Noninvasive screening modalities are actively being explored. Identification of specific genetic alterations in the adenoma-cancer sequence allow for the study and development of noninvasive screening modalities beyond guaiac-based fecal occult blood testing which target specific alterations or a panel of alterations. The stool DNA test is the first noninvasive screening tool that targets both human hemoglobin and specific genetic alterations. In this review we discuss stool DNA and other commercially available noninvasive colorectal cancer screening modalities in addition to other targets which previously have been or are currently under study.