Crassulacean acid metabolism and epiphytism linked to adaptive radiations in the Orchidaceae.

PubMed

Silvera, Katia; Santiago, Louis S; Cushman, John C; Winter, Klaus

2009-04-01

Species of the large family Orchidaceae display a spectacular array of adaptations and rapid speciations that are linked to several innovative features, including specialized pollination syndromes, colonization of epiphytic habitats, and the presence of Crassulacean acid metabolism (CAM), a water-conserving photosynthetic pathway. To better understand the role of CAM and epiphytism in the evolutionary expansion of tropical orchids, we sampled leaf carbon isotopic composition of 1,103 species native to Panama and Costa Rica, performed character state reconstruction and phylogenetic trait analysis of CAM and epiphytism, and related strong CAM, present in 10% of species surveyed, to climatic variables and the evolution of epiphytism in tropical regions. Altitude was the most important predictor of photosynthetic pathway when all environmental variables were taken into account, with CAM being most prevalent at low altitudes. By creating integrated orchid trees to reconstruct ancestral character states, we found that C3 photosynthesis is the ancestral state and that CAM has evolved at least 10 independent times with several reversals. A large CAM radiation event within the Epidendroideae, the most species-rich epiphytic clade of any known plant group, is linked to a Tertiary species radiation that originated 65 million years ago. Our study shows that parallel evolution of CAM is present among subfamilies of orchids, and correlated divergence between photosynthetic pathways and epiphytism can be explained by the prevalence of CAM in low-elevation epiphytes and rapid speciation of high-elevation epiphytes in the Neotropics, contributing to the astounding diversity in the Orchidaceae.

Update of global TC simulations using a variable resolution non-hydrostatic model

NASA Astrophysics Data System (ADS)

Park, S. H.

2017-12-01

Using in a variable resolution meshes in MPAS during 2017 summer., Tropical cyclone (TC) forecasts are simulated. Two physics suite are tested to explore performance and bias of each physics suite for TC forecasting. A WRF physics suite is selected from experience on weather forecasting and CAM (Community Atmosphere Model) physics is taken from a AMIP type climate simulation. Based on the last year results from CAM5 physical parameterization package and comparing with WRF physics, we investigated a issue with intensity bias using updated version of CAM physics (CAM6). We also compared these results with coupled version of TC simulations. During this talk, TC structure will be compared specially around of boundary layer and investigate their relationship between TC intensity and different physics package.

C-reactive protein as a predictor of chorioamnionitis.

PubMed

Smith, Erik J; Muller, Corinna L; Sartorius, Jennifer A; White, David R; Maslow, Arthur S

2012-10-01

Chorioamnionitis (CAM) affects many pregnancies complicated by preterm premature rupture of membranes (PPROM). Finding a serum factor that could accurately predict the presence of CAM could potentially lead to more efficient management of PPROM and improved neonatal outcomes. To determine if C-reactive protein (CRP) is an effective early marker of CAM in patients with PPROM. A retrospective evaluation of pregnant women with PPROM at Geisinger Medical Center in Danville, Pennsylvania, between January 2005 and January 2009. Nonparametric statistical tests (ie, Wilcoxon rank sum and Spearman rank correlation) were used to compare distributions that were skewed. Characteristics of the study population were compared using 2-sample t tests for continuous variables and Fisher exact tests for discrete variables. Logistic regression analysis was used to generate receiver operating characteristic curves and obtain area under the curve estimates in stepwise fashion for predicting histologic CAM. A secondary analysis compared the characteristics among patients with clinical CAM, histologic CAM, or non-CAM. The total population of 73 women was subdivided into patients with histologic CAM (n=26) and patients without histologic CAM (ie, no evidence of CAM on placental pathology; n=47). There was no difference between groups in CRP levels, days of pregnancy latency, white blood cell count, smoking status, antibiotic administration, or steroid benefit. The group with histologic CAM delivered at earlier gestational ages: mean (standard deviation) age was 29.5 (4.4) weeks vs 31.9 (3.5) weeks (P=.02). For our primary analysis, we found no difference in CRP levels (P=.32). Receiver operating characteristic curve plots of CRP levels, temperature at delivery, and white blood cell count resulted in an area under the curve estimate of 0.696, which was 70% predictive of histologic CAM. In the secondary analysis, after adjusting for gestational age, the estimated hazard ratio for CRP change was 1.05 (95% confidence interval, 1.02-1.08; P=.001). Therefore, increasing CRP levels from PPROM was statistically significant in predicting clinical CAM development over time. C-reactive protein levels were not effective independent predictors of clinical or histologic CAM, nor was sequential CRP testing statistically significant for the identification of clinical or histologic CAM in patients with PPROM.

Variable loading roller

DOEpatents

Williams, Daniel M.

1989-01-01

An automatic loading roller for transmitting torque in traction drive devices in manipulator arm joints includes a two-part camming device having a first cam portion rotatable in place on a shaft by an input torque and a second cam portion coaxially rotatable and translatable having a rotating drive surface thereon for engaging the driven surface of an output roller with a resultant force proportional to the torque transmitted. Complementary helical grooves on the respective cam portions interconnected through ball bearings interacting with those grooves effect the rotation and translation of the second cam portion in response to rotation of the first.

Variable loading roller

DOEpatents

Williams, D.M.

1988-01-21

An automatic loading roller for transmitting torque in traction drive devices in manipulator arm joints includes a two-part camming device having a first cam portion rotatable in place on a shaft by an input torque and a second cam portion coaxially rotatable and translatable having a rotating drive surface thereon for engaging the driven surface of an output roller with a resultant force proportional to the torque transmitted. Complementary helical grooves in the respective cam portions interconnected through ball bearings interacting with those grooves effect the rotation and translation of the second cam portion in response to rotation of the first. 14 figs.

Three New Z Cam Stars (Abstract)

NASA Astrophysics Data System (ADS)

Simonsen, M.

2016-12-01

(Abstract only) I will present the evidence and discovery stories of three cataclysmic variables who appear to be members of the Z Cam class of dwarf novae. One discovered by a lone visual observer and his unwavering patience and persistence, one through the directed effort of the ongoing Z CamPaign and one via survey data from the Gaia satellite.

X-Ray Variability of BL Lac Objects

NASA Astrophysics Data System (ADS)

McHardy, Ian

I present an overview of the X-ray temporal and spectral variability of BL Lacs on both short and long timescales. The previously observed behaviour of short (~days) flares superimposed on a relatively steady `quiescent' level is still broadly correct. However, for the brighter BL Lacs, the well sampled lightcurves from the RXTE ASM show that the `quiescent' level also varies considerably on timescales of ~100 days in a manner similar to that seen in Optically Violently Variable Quasars (OVVs) such as 3C279 and 3C273. Possible reasons for this behaviour are discussed. For the large majority of BL Lacs the soft and medium energy X-ray bands are dominated by synchrotron emission and, unlike the case of OVVs, the emission mechanism is not in doubt. Most interest then centres on the structure of the emitting region, and the electron acceleration processes, particularly during outbursts. That structure, and the acceleration processes, can be investigated by consideration of the spectral variability during flares, which is not simple. I review the observations of spectral variability and consider the evidence for and against homogeneous models. I also briefly compare the X-ray spectral variability of BL Lacs with that of OVVs such as 3C273.

Crassulacean Acid Metabolism and Epiphytism Linked to Adaptive Radiations in the Orchidaceae1[OA

PubMed Central

Silvera, Katia; Santiago, Louis S.; Cushman, John C.; Winter, Klaus

2009-01-01

Species of the large family Orchidaceae display a spectacular array of adaptations and rapid speciations that are linked to several innovative features, including specialized pollination syndromes, colonization of epiphytic habitats, and the presence of Crassulacean acid metabolism (CAM), a water-conserving photosynthetic pathway. To better understand the role of CAM and epiphytism in the evolutionary expansion of tropical orchids, we sampled leaf carbon isotopic composition of 1,103 species native to Panama and Costa Rica, performed character state reconstruction and phylogenetic trait analysis of CAM and epiphytism, and related strong CAM, present in 10% of species surveyed, to climatic variables and the evolution of epiphytism in tropical regions. Altitude was the most important predictor of photosynthetic pathway when all environmental variables were taken into account, with CAM being most prevalent at low altitudes. By creating integrated orchid trees to reconstruct ancestral character states, we found that C3 photosynthesis is the ancestral state and that CAM has evolved at least 10 independent times with several reversals. A large CAM radiation event within the Epidendroideae, the most species-rich epiphytic clade of any known plant group, is linked to a Tertiary species radiation that originated 65 million years ago. Our study shows that parallel evolution of CAM is present among subfamilies of orchids, and correlated divergence between photosynthetic pathways and epiphytism can be explained by the prevalence of CAM in low-elevation epiphytes and rapid speciation of high-elevation epiphytes in the Neotropics, contributing to the astounding diversity in the Orchidaceae. PMID:19182098

Quiet Clean Short-haul Experimental Engine (QCSEE): Hamilton Standard cam/harmonic drive variable pitch fan actuation system detail design report

NASA Technical Reports Server (NTRS)

1976-01-01

A variable pitch fan actuation system was designed which incorporates a remote nacelle-mounted blade angle regulator. The regulator drives a rotating fan-mounted mechanical actuator through a flexible shaft and differential gear train. The actuator incorporates a high ratio harmonic drive attached to a multitrack spherical cam which changes blade pitch through individual cam follower arms attached to each blade trunnion. Detail design parameters of the actuation system are presented. These include the following: design philosophies, operating limits, mechanical, hydraulic and thermal characteristics, mechanical efficiencies, materials, weights, lubrication, stress analyses, reliability and failure analyses.

MMP-8 Is Critical for Dexamethasone Therapy in Alkali-Burned Corneas Under Dry Eye Conditions.

PubMed

Bian, Fang; Wang, Changjun; Tukler-Henriksson, Johanna; Pflugfelder, Stephen C; Camodeca, Caterina; Nuti, Elisa; Rossello, Armando; Li, De-Quan; de Paiva, Cintia S

2016-11-01

Our previous studies have shown that Dexamethasone (Dex) reduced the expression of matrix-metalloproteinases (MMPs -1,-3,-9,-13), IL-1β and IL-6, while it significantly increased MMP-8 mRNA transcripts in a concomitant dry eye and corneal alkali burn murine model (CM). To investigate if MMP-8 induction is responsible for some of the protective effects of Dex in CM, MMP-8 knock out mice (MMP-8KO) were subjected to the CM for 2 or 5 days and topically treated either with 2 μl of 0.1% Dexamethasone (Dex), or saline QID. A separate group of C57BL/6 mice were topically treated with Dex or BSS and received either 100 nM CAM12 (MMP-8 inhibitor) or vehicle IP, QD. Here we demonstrate that topical Dex treated MMP-8KO mice subjected to CM showed reduced corneal clarity, increased expression of inflammatory mediators (IL-6, CXCL1, and MMP-1 mRNA) and increased neutrophil infiltration at 2D and 5D compared to Dex treated WT mice. C57BL/6 mice topically treated with Dex and CAM12 IP recapitulated findings seen with MMP-8KO mice. These results suggest that some of the anti-inflammatory effects of Dex are mediated through increased MMP-8 expression. J. Cell. Physiol. 231: 2506-2516, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Sleep variability and cardiac autonomic modulation in adolescents – Penn State Child Cohort (PSCC) study

PubMed Central

Rodríguez-Colón, Sol M.; He, Fan; Bixler, Edward O.; Fernandez-Mendoza, Julio; Vgontzas, Alexandros N.; Calhoun, Susan; Zheng, Zhi-Jie; Liao, Duanping

2015-01-01

Objective To investigate the effects of objectively measured habitual sleep patterns on cardiac autonomic modulation (CAM) in a population-based sample of adolescents. Methods We used data from 421 adolescents who completed the follow-up examination in the Penn State Children Cohort study. CAM was assessed by heart rate (HR) variability (HRV) analysis of beat-to-beat normal R-R intervals from a 39-h electrocardiogram, on a 30-min basis. The HRV indices included frequency domain (HF, LF, and LF/HF ratio), and time domain (SDNN, RMSSD, and heart rate or HR) variables. Actigraphy was used for seven consecutive nights to estimate nightly sleep duration and time in bed. The seven-night mean (SD) of sleep duration and sleep efficiency were used to represent sleep duration, duration variability, sleep efficiency, and efficiency variability, respectively. HF and LF were log-transformed for statistical analysis. Linear mixed-effect models were used to analyze the association between sleep patterns and CAM. Results After adjusting for major confounders, increased sleep duration variability and efficiency variability were significantly associated with lower HRV and higher HR during the 39-h, as well as separated by daytime and nighttime. For instance, a 1-h increase in sleep duration variability is associated with −0.14(0.04), −0.12(0.06), and −0.16(0.05) ms2 decrease in total, daytime, and nighttime HF, respectively. No associations were found between sleep duration, or sleep efficiency and HRV. Conclusion Higher habitual sleep duration variability and efficiency variability are associated with lower HRV and higher HR, suggesting that an irregular sleep pattern has an adverse impact on CAM, even in healthy adolescents. PMID:25555635

L1CAM in early-stage type I endometrial cancer: results of a large multicenter evaluation.

PubMed

Zeimet, Alain G; Reimer, Daniel; Huszar, Monica; Winterhoff, Boris; Puistola, Ulla; Azim, Samira Abdel; Müller-Holzner, Elisabeth; Ben-Arie, Alon; van Kempen, Léon C; Petru, Edgar; Jahn, Stephan; Geels, Yvette P; Massuger, Leon F; Amant, Frédéric; Polterauer, Stephan; Lappi-Blanco, Elisa; Bulten, Johan; Meuter, Alexandra; Tanouye, Staci; Oppelt, Peter; Stroh-Weigert, Monika; Reinthaller, Alexander; Mariani, Andrea; Hackl, Werner; Netzer, Michael; Schirmer, Uwe; Vergote, Ignace; Altevogt, Peter; Marth, Christian; Fogel, Mina

2013-08-07

Despite the excellent prognosis of Fédération Internationale de Gynécologie et d'Obstétrique (FIGO) stage I, type I endometrial cancers, a substantial number of patients experience recurrence and die from this disease. We analyzed the value of immunohistochemical L1CAM determination to predict clinical outcome. We conducted a retrospective multicenter cohort study to determine expression of L1CAM by immunohistochemistry in 1021 endometrial cancer specimens. The Kaplan-Meier method and Cox proportional hazard model were applied for survival and multivariable analyses. A machine-learning approach was used to validate variables for predicting recurrence and death. Of 1021 included cancers, 17.7% were rated L1CAM-positive. Of these L1CAM-positive cancers, 51.4% recurred during follow-up compared with 2.9% L1CAM-negative cancers. Patients bearing L1CAM-positive cancers had poorer disease-free and overall survival (two-sided Log-rank P < .001). Multivariable analyses revealed an increase in the likelihood of recurrence (hazard ratio [HR] = 16.33; 95% confidence interval [CI] = 10.55 to 25.28) and death (HR = 15.01; 95% CI = 9.28 to 24.26). In the L1CAM-negative cancers FIGO stage I subdivision, grading and risk assessment were irrelevant for predicting disease-free and overall survival. The prognostic relevance of these parameters was related strictly to L1CAM positivity. A classification and regression decision tree (CRT)identified L1CAM as the best variable for predicting recurrence (sensitivity = 0.74; specificity = 0.91) and death (sensitivity = 0.77; specificity = 0.89). To our knowledge, L1CAM has been shown to be the best-ever published prognostic factor in FIGO stage I, type I endometrial cancers and shows clear superiority over the standardly used multifactor risk score. L1CAM expression in type I cancers indicates the need for adjuvant treatment. This adhesion molecule might serve as a treatment target for the fully humanized anti-L1CAM antibody currently under development for clinical use.

Disclosure of Complementary and Alternative Medicine to Conventional Medical Providers: Variation by Race/Ethnicity and Type of CAM

PubMed Central

Chao, Maria T.; Wade, Christine; Kronenberg, Fredi

2009-01-01

Background Complementary and alternative medicine (CAM) is often used alongside conventional medical care, yet fewer than half of patients disclose CAM use to medical doctors. CAM disclosure is particularly low among racial/ethnic minorities, but reasons for differences, such as type of CAM used or quality of conventional healthcare, have not been explored. Objective We tested the hypotheses that disclosure of CAM use to medical doctors is higher for provider-based CAM and among non-Hispanic whites, and that access to and quality of conventional medical care account for racial/ethnic differences in CAM disclosure. Methods Bivariate and multiple variable analyses of the 2002 National Health Interview Survey and 2001 Health Care Quality Survey were performed. Results Disclosure of CAM use to medical providers was higher for provider-based than self-care CAM. Disclosure of any CAM was associated with access to and quality of conventional care and higher among non-Latino whites relative to minorities. Having a regular doctor and quality patient–provider relationship mitigated racial/ethnic differences in CAM disclosure. Conclusion Insufficient disclosure of CAM use to conventional providers, particularly for self-care practices and among minority populations, represents a serious challenge in medical encounter communications. Efforts to improve disclosure of CAM use should be aimed at improving consistency of care and patient–physician communication across racial/ethnic groups. PMID:19024232

Gender, symptom experience, and use of complementary and alternative medicine practices among cancer survivors in the U.S. cancer population.

PubMed

Fouladbakhsh, Judith M; Stommel, Manfred

2010-01-01

To identify relationships among gender, physical and psychological symptoms (pain, insomnia, fatigue, and depression), and use of specific complementary and alternative medicine (CAM) practices among survivors in the U.S. cancer population. Secondary analysis of the 2002 National Health Interview Survey (NHIS). The CAM Healthcare Model, an extension of the Behavioral Model for Health Services Use, guided the study. United States. 2,262 adults (aged 18 years and older) diagnosed with cancer representing more than 14.3 million cancer survivors in the United States . NHIS interview data on use of CAM practices (diet, yoga, tai chi, qigong, meditation, guided imagery, relaxation, and deep breathing) were examined in relationship to gender and symptoms. Analysis was conducted using Stata 9.2 software for population estimation. Binary logistic regression, the primary statistical model employed in the analysis, focused on between-subject differences in practice use. Dichotomous outcome variables included use of at least one CAM practice and use of specific individual CAM practices. Independent variables included gender, age, education, race, provider contact, cancer diagnosis, pain, insomnia, fatigue, depression, and health status. CAM practice use was more prevalent among female, middle-aged, Caucasian, and well-educated subjects. Pain, depression, and insomnia were strong predictors of practice use, with differences noted by gender and practice type. CAM practices are widely used in the U.S. cancer population, especially among women. Symptom experience influences likelihood of use, with increased odds when men report symptoms. Study findings inform oncology nurses on the benefits of integrating self-care CAM practices in relationship to gender into the symptom management care plan for cancer survivors. Findings reported in this study will help guide future CAM practice intervention studies.

Sex discrimination potential of buccolingual and mesiodistal tooth dimensions.

PubMed

Acharya, Ashith B; Mainali, Sneedha

2008-07-01

Tooth crown dimensions are reasonably accurate predictors of sex and are useful adjuncts in sex assessment. This study explores the utility of buccolingual (BL) and mesiodistal (MD) measurements in sex differentiation when used independently. BL and MD measurements of 28 teeth (third molars excluded) were obtained from a group of 53 Nepalese subjects (22 women and 31 men) aged 19-28 years. Stepwise discriminant analyses were undertaken separately for both types of tooth crown variables and their accuracy in sex classification compared with one another. MD dimensions had recognizably greater accuracy (77.4-83%) in sex identification than BL measurements (62.3-64.2%)--results that are consistent with previous reports. However, the accuracy of MD variables is not high enough to warrant their exclusive use in odontometric sex assessment--higher accuracy levels have been obtained when both types of dimensions were used concurrently, implying that BL variables contribute to sex assessment to some extent. Hence, it is inferred that optimal results in dental sex assessment are obtained when both MD and BL variables are used together.

Identification and period investigation of pulsation variable star UY Camelopardalis, an RR Lyrae star in binary system

NASA Astrophysics Data System (ADS)

Li, Lin-Jia; Qian, Sheng-Bang; Voloshina, Irina; Metlov, Vladimir G.; Zhu, Li-Ying; Liao, Wen-Ping

2018-06-01

We present photometric measurements of the short period variable star UY Cam, which has been classified as a δ Scuti or c-type RR Lyrae (RRc) variable in different catalogs. Based on the analyses on Fourier coefficients and (NUV - V)0, we find that UY Cam is probably an RRc star. We obtain 58 new times of light maximum for UY Cam based on several sky surveys and our observations. Combining these with the times of light maximum in literature, a total of 154 times of light maximum are used to analyze the O - C diagram of UY Cam. The results show that the O - C pattern can be described by a downward parabolic component with a rate of -6.86 ± 0.47 × 10-11 d d-1, and a cyclic variation with a period of 65.7 ± 2.4 yr. We suppose these components are caused by the stellar evolution and the light travel time effect (LiTE) of a companion in elliptical orbit, respectively. By calculation, the minimum mass of the potential companion is about 0.17 M⊙, and its mass should be less than or equal to the pulsation primary star when the inclination i > 22.5°D. Therefore, the companion should be a low-mass star, like a late-type main-sequence star or a white dwarf. Due to the unique property of UY Cam, we suggest that more observations and studies on UY Cam and other RRc stars are needed to check the nature of these stars, including the pulsations and binarities.

Adult Lifespan Cognitive Variability in the Cross-Sectional Cam-CAN Cohort

PubMed Central

Green, Emma; Shafto, Meredith A.; Matthews, Fiona E.; White, Simon R.

2015-01-01

This study examines variability across the age span in cognitive performance in a cross-sectional, population-based, adult lifespan cohort from the Cambridge Centre for Ageing and Neuroscience (Cam-CAN) study (n = 2680). A key question we highlight is whether using measures that are designed to detect age-related cognitive pathology may not be sensitive to, or reflective of, individual variability among younger adults. We present three issues that contribute to the debate for and against age-related increases in variability. Firstly, the need to formally define measures of central tendency and measures of variability. Secondly, in addition to the commonly addressed location-confounding (adjusting for covariates) there may exist changes in measures of variability due to confounder sub-groups. Finally, that increases in spread may be a result of floor or ceiling effects; where the measure is not sensitive enough at all ages. From the Cam-CAN study, a large population-based dataset, we demonstrate the existence of variability-confounding for the immediate episodic memory task; and show that increasing variance with age in our general cognitive measures is driven by a ceiling effect in younger age groups. PMID:26690191

Adult Lifespan Cognitive Variability in the Cross-Sectional Cam-CAN Cohort.

PubMed

Green, Emma; Shafto, Meredith A; Matthews, Fiona E; White, Simon R

2015-12-07

This study examines variability across the age span in cognitive performance in a cross-sectional, population-based, adult lifespan cohort from the Cambridge Centre for Ageing and Neuroscience (Cam-CAN) study (n = 2680). A key question we highlight is whether using measures that are designed to detect age-related cognitive pathology may not be sensitive to, or reflective of, individual variability among younger adults. We present three issues that contribute to the debate for and against age-related increases in variability. Firstly, the need to formally define measures of central tendency and measures of variability. Secondly, in addition to the commonly addressed location-confounding (adjusting for covariates) there may exist changes in measures of variability due to confounder sub-groups. Finally, that increases in spread may be a result of floor or ceiling effects; where the measure is not sensitive enough at all ages. From the Cam-CAN study, a large population-based dataset, we demonstrate the existence of variability-confounding for the immediate episodic memory task; and show that increasing variance with age in our general cognitive measures is driven by a ceiling effect in younger age groups.

Type II Cepheids: evidence for Na-O anticorrelation for BL Her type stars?

NASA Astrophysics Data System (ADS)

Kovtyukh, V.; Yegorova, I.; Andrievsky, S.; Korotin, S.; Saviane, I.; Lemasle, B.; Chekhonadskikh, F.; Belik, S.

2018-06-01

The chemical composition of 28 Population II Cepheids and one RR Lyrae variable has been studied using high-resolution spectra. The chemical composition of W Vir variable stars (with periods longer than 8 d) is typical for the halo and thick disc stars. However, the chemical composition of BL Her variables (with periods of 0.8-4 d) is drastically different, although it does not differ essentially from that of the stars belonging to globular clusters. In particular, the sodium overabundance ([Na/Fe] ≈ 0.4) is reported for most of these stars, and the Na-O anticorrelation is also possible. The evolutionary tracks for BL Her variables (with a progenitor mass value of 0.8 solar masses) indicate that mostly helium-overabundant stars (Y = 0.30-0.35) can fall into the instability strip region. We suppose that it is the helium overabundance that accounts not only for the existence of BL Her variable stars but also for the observed abnormalities in the chemical composition of this small group of pulsating variables.

The intraday variability in the radio-selected and X-ray-selected BL Lacertae objects

NASA Astrophysics Data System (ADS)

Bai, J. M.; Xie, G. Z.; Li, K. H.; Zhang, X.; Liu, W. W.

1998-10-01

Seven BL Lac objects have been photometrically observed in an effort to study the difference of optical intraday variability between the radio-selected BL Lac objects (RBLs) and X-ray-selected BL Lac objects (XBLs). The objects we observed are selected arbitrarily. They are four RBLs, PKS 0735+178, PKS 0754+101, OJ 287 and BL Lac, and three XBLs, H 0323+022, H 0548-322 and H 2154-304. During the observation all of them exhibited microvariation, and H 0323+022 and H 0548-322 sometimes showed brightness oscillation. PKS 0735+178 and BL Lac were in their faint states and not very active. It seems that RBLs do not show microvariability more frequently than XBLs. Table 2 is only available in electronic form at the CDS via anonymous ftp to cdsarc.u-strasbg.fr (130.79.128.5)

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

Ge Jin; Fishman, Jessica; Annenberg School for Communication at University of Pennsylvania, University of Pennsylvania Health System, Philadelphia, Pennsylvania

Purpose: Despite the extensive use of complementary and alternative medicine (CAM) among cancer patients, patient-physician communication regarding CAM therapies remains limited. This study quantified the extent of patient-physician communication about CAM and identified factors associated with its discussion in radiation therapy (RT) settings. Methods and Materials: We conducted a cross-sectional survey of 305 RT patients at an urban academic cancer center. Patients with different cancer types were recruited in their last week of RT. Participants self-reported their demographic characteristics, health status, CAM use, patient-physician communication regarding CAM, and rationale for/against discussing CAM therapies with physicians. Multivariate logistic regression was usedmore » to identify relationships between demographic/clinical variables and patients' discussion of CAM with radiation oncologists. Results: Among the 305 participants, 133 (43.6%) reported using CAM, and only 37 (12.1%) reported discussing CAM therapies with their radiation oncologists. In multivariate analyses, female patients (adjusted odds ratio [AOR] 0.45, 95% confidence interval [CI] 0.21-0.98) and patients with full-time employment (AOR 0.32, 95% CI 0.12-0.81) were less likely to discuss CAM with their radiation oncologists. CAM users (AOR 4.28, 95% CI 1.93-9.53) were more likely to discuss CAM with their radiation oncologists than were non-CAM users. Conclusions: Despite the common use of CAM among oncology patients, discussions regarding these treatments occur rarely in the RT setting, particularly among female and full-time employed patients. Clinicians and patients should incorporate discussions of CAM to guide its appropriate use and to maximize possible benefit while minimizing potential harm.« less

Ceramic dental biomaterials and CAD/CAM technology: state of the art.

PubMed

Li, Raymond Wai Kim; Chow, Tak Wah; Matinlinna, Jukka Pekka

2014-10-01

Ceramics are widely used as indirect restorative materials in dentistry because of their high biocompatibility and pleasing aesthetics. The objective is to review the state of the arts of CAD/CAM all-ceramic biomaterials. CAD/CAM all-ceramic biomaterials are highlighted and a subsequent literature search was conducted for the relevant subjects using PubMed followed by manual search. Developments in CAD/CAM technology have catalyzed researches in all-ceramic biomaterials and their applications. Feldspathic glass ceramic and glass infiltrated ceramic can be fabricated by traditional laboratory methods or CAD/CAM. The advent of polycrystalline ceramics is a direct result of CAD/CAM technology without which the fabrication would not have been possible. The clinical uses of these ceramics have met with variable clinical success. Multiple options are now available to the clinicians for the fabrication of aesthetic all ceramic restorations. Copyright © 2014 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

Complementary and alternative medicine use in dermatology in the United States.

PubMed

Landis, Erin T; Davis, Scott A; Feldman, Steven R; Taylor, Sarah

2014-05-01

Complementary and alternative medicine (CAM) has an increasing presence in dermatology. Complementary therapies have been studied in many skin diseases, including atopic dermatitis and psoriasis. This study sought to assess oral CAM use in dermatology relative to medicine as a whole in the United States, using the National Ambulatory Medical Care Survey. Variables studied include patient demographic characteristics, diagnoses, and CAM documented at the visits. A brief literature review of the top 5 CAM treatments unique to dermatology visits was performed. Most CAM users in both dermatology and medicine as a whole were female and white and were insured with private insurance or Medicare. Fish oil, glucosamine, glucosamine chondroitin, and omega-3 were the most common complementary supplements used in both samples. CAM use in dermatology appears to be part of a larger trend in medicine. Knowledge of common complementary therapies can help dermatologists navigate this expanding field.

Complementary and Alternative Medicine Use in Dermatology in the United States

PubMed Central

Landis, Erin T.; Davis, Scott A.; Taylor, Sarah

2014-01-01

Abstract Background: Complementary and alternative medicine (CAM) has an increasing presence in dermatology. Complementary therapies have been studied in many skin diseases, including atopic dermatitis and psoriasis. Objectives: This study sought to assess oral CAM use in dermatology relative to medicine as a whole in the United States, using the National Ambulatory Medical Care Survey. Design: Variables studied include patient demographic characteristics, diagnoses, and CAM documented at the visits. A brief literature review of the top 5 CAM treatments unique to dermatology visits was performed. Results: Most CAM users in both dermatology and medicine as a whole were female and white and were insured with private insurance or Medicare. Fish oil, glucosamine, glucosamine chondroitin, and omega-3 were the most common complementary supplements used in both samples. Conclusions: CAM use in dermatology appears to be part of a larger trend in medicine. Knowledge of common complementary therapies can help dermatologists navigate this expanding field. PMID:24517329

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

Balman, Şölen; Godon, Patrick; Sion, Edward M., E-mail: solen@astroa.physics.metu.edu.tr, E-mail: patrick.godon@villanova.edu, E-mail: edward.sion@villanova.edu

We present a total of ∼45 ks (3 × 15 ks) of Swift X-Ray Telescope (XRT) observations for three nonmagnetic nova-like (NL) cataclysmic variables (CVs; MV Lyr, BZ Cam, V592 Cas) in order to study characteristics of boundary layers (BLs) in CVs. The nonmagnetic NLs are found mostly in a state of high mass accretion rate (≥1 × 10{sup –9} M {sub ☉} yr{sup –1}), and some show occasional low states. Using the XRT data, we find optically thin multiple-temperature cooling flow type emission spectra with X-ray temperatures (kT {sub max}) of 21-50 keV. These hard X-ray-emitting BLs diverge frommore » simple isobaric cooling flows, indicating X-ray temperatures that are of virial values in the disk. In addition, we detect power-law emission components from MV Lyr and BZ Cam and plausibly from V592 Cas, which may be a result of the Compton scattering of the optically thin emission from the fast wind outflows in these systems and/or Compton upscattering of the soft disk photons. The X-ray luminosities of the (multitemperature) thermal plasma emission in the 0.1-50.0 keV range are (0.9-5.0) × 10{sup 32} erg s{sup –1}. The ratio of the X-ray and disk luminosities (calculated from the UV-optical wavelengths) yields an efficiency (L{sub x} /L {sub disk}) ∼ 0.01-0.001. Given this non-radiative ratio for the X-ray-emitting BLs with no significant optically thick blackbody emission in the soft X-rays (consistent with ROSAT observations), together with the high/virial X-ray temperatures, we suggest that high-state NL systems may have optically thin BLs merged with ADAF-like flows and/or X-ray coronae. In addition, we note that the axisymmetric bipolar and/or rotation-dominated fast-wind outflows detected in these three NLs (particularly BZ Cam and V592 Cas) or some other NL may also be explained in the context of ADAF-like BL regions.« less

An investigation of the rapid spectral variability of the AP stars 53 Cam, 41 Tau, and Beta CrB on the basis of the K CA II and H-delta lines

NASA Astrophysics Data System (ADS)

Kuvshinov, V. M.; Plachinda, S. I.

The flux is shown to vary with the phase of the period of axial rotation. For 53 Cam and Beta CrB, this variability is smooth and is well correlated with the intensity of the mean surface magnetic field. It is pointed out that in the case of 53 Cam, an analogous dependence between the equivalent width of the K Ca II line and the phase of the period of rotation was obtained by Faraggiana (1973). It is considered significant that the correlations between the flux in the K line and the intensity of the mean surface magnetic field for 53 Cam and Beta CrB have the same sign. With 41 Tau, as with the effective magnetic field, no smooth relationship is found between the fluxes in the K Ca II and H-delta lines and the phase of the period of rotation.

Complementary and alternative medicine (CAM) use by african american (AA) and caucasian american (CA) older adults in a rural setting: a descriptive, comparative study

PubMed Central

Cuellar, Norma; Aycock, Teresa; Cahill, Bridgett; Ford, Julie

2003-01-01

Background The use of CAM is at an all time high. There is very little research that compares the use of CAM in elders by ethnicity in rural settings. The purpose of the study was to determine if there was a difference between African American and Caucasian American rural elders on use of CAM and self-reported satisfaction with CAM. Methods The design was a descriptive, comparative study of 183 elders who reported the number of CAM used and satisfaction with CAM. A convenience sample was recruited through community service organizations in the state of Mississippi. The availability of elders through the support groups, sampling bias, subject effect, and self-report were limitations of the study. Results The commonest examples of CAM used by rural elders were prayer, vitamins, exercise, meditation, herbs, chiropractic medicine, glucosamine, and music therapy. Significant findings on SES and marital status were calculated. Differences on ethnicity and demographic variables were significant for age, education, and the use of glucosamine. Conclusions Health care providers must be aware that elders are using CAM and are satisfied with their use. Identifying different uses of CAM by ethnicity is important for health care practitioners, impacting how health care is provided. PMID:14622445

Complementary and alternative medicine (CAM) use by African American (AA) and Caucasian American (CA) older adults in a rural setting: a descriptive, comparative study.

PubMed

Cuellar, Norma; Aycock, Teresa; Cahill, Bridgett; Ford, Julie

2003-11-18

The use of CAM is at an all time high. There is very little research that compares the use of CAM in elders by ethnicity in rural settings. The purpose of the study was to determine if there was a difference between African American and Caucasian American rural elders on use of CAM and self-reported satisfaction with CAM. The design was a descriptive, comparative study of 183 elders who reported the number of CAM used and satisfaction with CAM. A convenience sample was recruited through community service organizations in the state of Mississippi. The availability of elders through the support groups, sampling bias, subject effect, and self-report were limitations of the study. The commonest examples of CAM used by rural elders were prayer, vitamins, exercise, meditation, herbs, chiropractic medicine, glucosamine, and music therapy. Significant findings on SES and marital status were calculated. Differences on ethnicity and demographic variables were significant for age, education, and the use of glucosamine. Health care providers must be aware that elders are using CAM and are satisfied with their use. Identifying different uses of CAM by ethnicity is important for health care practitioners, impacting how health care is provided.

Knowledge, Attitudes, and Personal Use of Complementary and Alternative Medicine among Occupational Therapy Educators in the United States.

PubMed

Bradshaw, Michelle L

2016-01-01

The purpose of this study was to establish a baseline description of American occupational therapy educators' knowledge, attitudes, and personal use of complementary and alternative medicine (CAM) as a first step in exploring the larger issue of future occupational therapy practitioners' preparedness for meeting clients' occupational needs in today's evolving healthcare environment. Results of this cross-sectional survey highlighted limitations of occupational therapy educators' knowledge of common CAM concepts and therapies across all demographic variables, varying attitudes towards CAM in general and its inclusion in occupational therapy education, and personal use of common CAM therapies. Without increased occupational therapy educator knowledge about CAM and engagement in the current healthcare practices, occupational therapy practitioners are at risk for having a limited role in integrative healthcare.

Belief in complementary and alternative medicine is related to age and paranormal beliefs in adults.

PubMed

Van den Bulck, Jan; Custers, Kathleen

2010-04-01

The use of complementary and alternative medicine (CAM) is widespread, even among people who use conventional medicine. Positive beliefs about CAM are common among physicians and medical students. Little is known about the beliefs regarding CAM among the general public. Among science students, belief in CAM was predicted by belief in the paranormal. In a cross-sectional study, 712 randomly selected adults (>18 years old) responded to the CAM Health Belief Questionnaire (CHBQ) and a paranormal beliefs scale. CAM beliefs were very prevalent in this sample of adult Flemish men and women. Zero-order correlations indicated that belief in CAM was associated with age (r = 0.173 P < 0.001) level of education (r = -0.079 P = 0.039) social desirability (r = -0.119 P = 0.002) and paranormal belief (r = 0.365 P < 0.001). In a multivariate model, two variables predicted CAM beliefs. Support for CAM increased with age (regression coefficient: 0.01; 95% confidence interval (CI): 0.006 to 0.014), but the strongest relationship existed between support for CAM and beliefs in the paranormal. Paranormal beliefs accounted for 14% of the variance of the CAM beliefs (regression coefficient: 0.376; 95%: CI 0.30-0.44). The level of education (regression coefficient: 0.06; 95% CI: -0.014-0.129) and social desirability (regression coefficient: -0.023; 95% CI: -0.048-0.026) did not make a significant contribution to the explained variance (<0.1%, P = 0.867). Support of CAM was very prevalent in this Flemish adult population. CAM beliefs were strongly associated with paranormal beliefs.

SenseCam reminiscence and action recall in memory-unimpaired people.

PubMed

Seamon, John G; Moskowitz, Tacie N; Swan, Ashley E; Zhong, Boyuan; Golembeski, Amy; Liong, Christopher; Narzikul, Alexa C; Sosan, Olumide A

2014-01-01

Case studies of memory-impaired individuals consistently show that reminiscing with SenseCam images enhances event recall. This exploratory study examined whether a similar benefit would occur for the consolidation of memories in memory-unimpaired people. We tested delayed recall for atypical actions observed on a lengthy walk. Participants used SenseCam, a diary, or no external memory aid while walking, followed by reminiscence with SenseCam images, diary entries, or no aid, either alone (self-reminiscence) or with the experimenter (social reminiscence). One week later, when tested without SenseCam images or diary entries, prior social reminiscence produced greater recall than self-reminiscence, but there were no differences between memory aid conditions for action free recall or action order recall. When methodological variables were controlled, there was no recall advantage for SenseCam reminiscence with memory-unimpaired participants. The case studies and present study differ in multiple ways, making direct comparisons problematic. SenseCam is a valuable aid to the memory impaired, but its mnemonic value for non-clinical populations remains to be determined.

Prevalence, predictors, and perceived effectiveness of complementary, alternative and integrative medicine in adult-onset primary dystonia

PubMed Central

Fleming, Brandy M.; Schwab, Emiko L.; Nouer, Simonne S.; Wan, Jim Y.; LeDoux, Mark S.

2012-01-01

Background Complementary and Alternative Medicine (CAM) use is on the rise in both the US and Europe, despite questions about its safety, effectiveness and lack of national standards. We aimed to determine the prevalence and predictors of CAM and integrative medicine use (CAM-I) and perceived effectiveness compared to the standard treatment of botulinum toxin injections in patients with adult-onset primary dystonia. Methods This was a retrospective questionnaire study of 389 dystonia patients examining the effects age, gender, education level and number of anatomical regions affected on botulinum toxin and CAM-I use and their perceived effectiveness. Results 53% (208) of patients reported CAM-I use, while 90% (349) used the standard treatment (botulinum toxin), and 48% used both. Education was the only significant predictor of CAM-I use – individuals with bachelor’ s degrees were more likely to try CAM-I whereas those with high school diplomas were less likely. The mean effectiveness rate for botulinum toxin injections (59%) significantly exceeded that for and CAM-I (28%, p<0.0001). Conclusions Our work highlights the need for scientifically sound studies to determine the safety, effectiveness and expense of CAM-I treatments for dystonia and other neurological disorders given that CAM-I use is steadily increasing, there is great variability in what is classified as CAM-I, and the effectiveness of some modalities may be significantly less than conventional medical treatments. PMID:22633698

Prevalence, predictors, and perceived effectiveness of complementary, alternative and integrative medicine in adult-onset primary dystonia.

PubMed

Fleming, Brandy M; Schwab, Emiko L; Nouer, Simonne S; Wan, Jim Y; LeDoux, Mark S

2012-09-01

Complementary and Alternative Medicine (CAM) use is on the rise in both the US and Europe, despite questions about its safety and effectiveness, and lack of national standards. We aimed to determine the prevalence and predictors of CAM and integrative medicine use (CAM-I) and perceived effectiveness compared to the standard treatment of botulinum toxin injections in patients with adult-onset primary dystonia. This was a retrospective questionnaire study of 389 dystonia patients examining the effects age, gender, education level and number of affected anatomical regions on botulinum toxin and CAM-I use and their perceived effectiveness. 53% (208) of patients reported CAM-I use, while 90% (349) used the standard treatment (botulinum toxin), and 48% used both. Education was the only significant predictor of CAM-I use - individuals with bachelor's degrees were more likely to try CAM-I whereas those with high school diplomas were less likely. The mean effectiveness rate for botulinum toxin injections (59%) significantly exceeded that for CAM-I (28%, p < 0.0001). Our work highlights the need for scientifically sound studies to determine the safety, effectiveness and expense of CAM-I treatments for dystonia and other neurological disorders given that CAM-I use is steadily increasing, there is great variability in what is classified as CAM-I, and the effectiveness of some modalities may be significantly less than conventional medical treatments. Copyright © 2012 Elsevier Ltd. All rights reserved.

Complementary and alternative medicine among veterans and military personnel: a synthesis of population surveys.

PubMed

Davis, Margot T; Mulvaney-Day, Norah; Larson, Mary Jo; Hoover, Ronald; Mauch, Danna

2014-12-01

Recent reports reinforce the widespread interest in complementary and alternative medicine (CAM), not only among military personnel with combat-related disorders, but also among providers who are pressed to respond to patient demand for these therapies. However, an understanding of utilization of CAM therapies in this population is lacking. The goals of this study are to synthesize the content of self-report population surveys with information on use of CAM in military and veteran populations, assess gaps in knowledge, and suggest ways to address current limitations. The research team conducted a literature review of population surveys to identify CAM definitions, whether military status was queried, the medical and psychological conditions queried, and each specific CAM question. Utilization estimates specific to military/veterans were summarized and limitations to knowledge was classified. Seven surveys of CAM utilization were conducted with military/veteran groups. In addition, 7 household surveys queried military status, although there was no military/veteran subgroup analysis. Definition of CAM varied widely limiting cross-survey analysis. Among active duty and Reserve military, CAM use ranged between 37% and 46%. Survey estimates do not specify CAM use that is associated with a medical or behavioral health condition. Comparisons between surveys are hampered due to variation in methodologies. Too little is known about reasons for using CAM and conditions for which it is used. Additional information could be drawn from current surveys with additional subgroup analysis, and future surveys of CAM should include military status variable.

Solving the BM Camelopardalis puzzle

NASA Technical Reports Server (NTRS)

Teke, Mathias; Busby, Michael R.; Hall, Douglas S.

1989-01-01

BM Camelopardalis (=12 Cam) is a chromospherically active binary star with a relatively large orbital eccentricity. Systems with large eccentricities usually rotate pseudosynchronously. However, BM Cam has been a puzzle since its observed rotation rate is virtually equal to its orbital period indicating synchronization. All available photometry data for BM Cam have been collected and analyzed. Two models of modulated ellipticity effect are proposed, one based on equilibrium tidal deformation of the primary star and the other on a dynamical tidal effect. When the starspot variability is removed from the data, the dynamical tidal model was the better approximation to the real physical situation. The analysis indicates that BM Cam is not rotating pseudosynchronously but rotating in virtual synchronism after all.

Complementary and alternative healthcare use by participants in the PACE trial of treatments for chronic fatigue syndrome.

PubMed

Lewith, G; Stuart, B; Chalder, T; McDermott, C; White, P D

2016-08-01

Chronic Fatigue Syndrome (CFS) is characterised by persistent fatigue, disability and a range of other symptoms. The PACE trial was randomised to compare four non-pharmacological treatments for patients with CFS in secondary care clinics. The aims of this sub study were to describe the use of complementary and alternative medicine (CAM) in the trial sample and to test whether CAM use correlated with an improved outcome. CAM use was recorded at baseline and 52weeks. Logistic and multiple regression models explored relationships between CAM use and both patient characteristics and trial outcomes. At baseline, 450/640 (70%) of participants used any sort of CAM; 199/640 (31%) participants were seeing a CAM practitioner and 410/640 (64%) were taking a CAM medication. At 52weeks, those using any CAM fell to 379/589 (64%). Independent predictors of CAM use at baseline were female gender, local ME group membership, prior duration of CFS and treatment preference. At 52weeks, the associated variables were being female, local ME group membership, and not being randomised to the preferred trial arm. There were no significant associations between any CAM use and fatigue at either baseline or 52weeks. CAM use at baseline was associated with a mean (CI) difference of 4.10 (1.28, 6.91; p=0.024) increased SF36 physical function score at 52weeks, which did not reach the threshold for a clinically important difference. CAM use is common in patients with CFS. It was not associated with any clinically important trial outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

Long term monitoring of Gamma-Ray emission from the BL Lacertae object (1ES 2200+420)

NASA Astrophysics Data System (ADS)

Gunawardhana, Isuru; VERITAS Collaboration

2016-03-01

Blazars are a class of Active Galactic Nuclei (AGN) that have relativistic jets pointing along the observer line of sight. Blazars exhibit variable emission extending from radio to TeV energies. The variability timescale of the TeV flux is a key component of understanding the location of the very high energy emission zones. Deep observations of the quiescent state measurements are also required to disentangle the flaring state emission from quiescent state emission, a prerequisite for understanding the origin of blazar spectral variability. BL Lacertae (also known as 1ES 2200+420), as the namesake for all BL Lac objects, is a prime example of one such blazar. The VERITAS Observatory, an Imaging Atmospheric Cherenkov Telescope (IACT) array sensitive to gamma rays in the range from 85 GeV to 30 TeV, dedicates approximately 110 hours per year on deep observations of known gamma-ray blazars. In this talk, I will describe the TeV photon flux variability of BL Lacertae measured by VERITAS from 2013 to 2015.

Implications of leaf ontogeny on drought-induced gradients of CAM expression and ABA levels in rosettes of the epiphytic tank bromeliad Guzmania monostachia.

PubMed

Rodrigues, Maria Aurineide; Hamachi, Leonardo; Mioto, Paulo Tamaso; Purgatto, Eduardo; Mercier, Helenice

2016-11-01

Guzmania monostachia is an epiphytic heteroblastic bromeliad that exhibits rosette leaves forming water-holding tanks at maturity. Different portions along its leaf blades can display variable degrees of crassulacean acid metabolism (CAM) up-regulation under drought. Since abscisic acid (ABA) can act as an important long-distance signal, we conducted a joint investigation of ontogenetic and drought impacts on CAM intensity and ABA levels in different leaf groups within the G. monostachia rosette. For this, three groups of leaves were analysed according to their position within the mature-tank rosette (i.e., younger, intermediate, and older leaves) to characterize the general growth patterns and magnitude of drought-modulated CAM expression. CAM activity was evaluated by analysing key molecules in the biochemical machinery of this photosynthetic pathway, while endogenous ABA content was comparatively measured in different portions of each leaf group after seven days under well-watered (control) or drought treatment. The results revealed that G. monostachia shows more uniform morphological characteristics along the leaves when in the atmospheric stage. The drought treatment of mature-tank rosettes generally induced in older leaves a more severe water loss, followed by the lowest CAM activity and a higher increase in ABA levels, while younger leaves showed an opposite response. Therefore, leaf groups at distinct ontogenetic stages within the tank rosette of G. monostachia responded to drought with variable degrees of water loss and CAM expression. ABA seems to participate in this tissue-compartmented response as a long-distance signalling molecule, transmitting the drought-induced signals originated in older leaves towards the younger ones. Copyright © 2016. Published by Elsevier Masson SAS.

Assessment of marine boundary layer cloud simulations in the CAM with CLUBB and updated microphysics scheme based on ARM observations from the Azores

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

Zheng, Xue; Klein, S. A.; Ma, H. -Y.

To assess marine boundary layer (MBL) cloud simulations in three versions of the Community Atmosphere Model (CAM), three sets of short-term global hindcasts are performed and compared to Atmospheric Radiation Measurement Program (ARM) observations on Graciosa Island in the Azores from June 2009 to December 2010. Here, the three versions consist of CAM5.3 with default schemes (CAM5.3), CAM5.3 with Cloud Layers Unified By Binormals (CLUBB-MG1), and CAM5.3 with CLUBB and updated microphysics scheme (CLUBB-MG2). Our results show that relative to CAM5.3 default schemes, simulations with CLUBB better represent MBL cloud base height, the height of the major cloud layer, andmore » the daily cloud cover variability. CLUBB also better simulates the relationship of cloud fraction to cloud liquid water path (LWP) most likely due to CLUBB's consistent treatment of these variables through a probability distribution function (PDF) approach. Subcloud evaporation of precipitation is substantially enhanced in simulations with CLUBB-MG2 and is more realistic based on the limited observational estimate. Despite these improvements, all model versions underestimate MBL cloud cover. CLUBB-MG2 reduces biases in in-cloud LWP (clouds are not too bright) but there are still too few of MBL clouds due to an underestimate in the frequency of overcast scenes. Thus, combining CLUBB with MG2 scheme better simulates MBL cloud processes, but because biases remain in MBL cloud cover CLUBB-MG2 does not improve the simulation of the surface shortwave cloud radiative effect (CRE SW).« less

Assessment of marine boundary layer cloud simulations in the CAM with CLUBB and updated microphysics scheme based on ARM observations from the Azores

DOE PAGES

Zheng, Xue; Klein, S. A.; Ma, H. -Y.; ...

2016-07-19

To assess marine boundary layer (MBL) cloud simulations in three versions of the Community Atmosphere Model (CAM), three sets of short-term global hindcasts are performed and compared to Atmospheric Radiation Measurement Program (ARM) observations on Graciosa Island in the Azores from June 2009 to December 2010. Here, the three versions consist of CAM5.3 with default schemes (CAM5.3), CAM5.3 with Cloud Layers Unified By Binormals (CLUBB-MG1), and CAM5.3 with CLUBB and updated microphysics scheme (CLUBB-MG2). Our results show that relative to CAM5.3 default schemes, simulations with CLUBB better represent MBL cloud base height, the height of the major cloud layer, andmore » the daily cloud cover variability. CLUBB also better simulates the relationship of cloud fraction to cloud liquid water path (LWP) most likely due to CLUBB's consistent treatment of these variables through a probability distribution function (PDF) approach. Subcloud evaporation of precipitation is substantially enhanced in simulations with CLUBB-MG2 and is more realistic based on the limited observational estimate. Despite these improvements, all model versions underestimate MBL cloud cover. CLUBB-MG2 reduces biases in in-cloud LWP (clouds are not too bright) but there are still too few of MBL clouds due to an underestimate in the frequency of overcast scenes. Thus, combining CLUBB with MG2 scheme better simulates MBL cloud processes, but because biases remain in MBL cloud cover CLUBB-MG2 does not improve the simulation of the surface shortwave cloud radiative effect (CRE SW).« less

Medical students' knowledge and attitude towards complementary and alternative medicine - A survey in Ghana.

PubMed

Ameade, Evans Paul Kwame; Amalba, Anthony; Helegbe, Gideon Kofi; Mohammed, Baba Sulemana

2016-07-01

Interest, use of and research into Complementary and Alternative Medicine (CAM; bǔ chōng yǔ tì dài yī xué) is on the increase in recent times even in developed countries. It may therefore be appropriate if medical students who would become future physicians possess adequate knowledge and better attitude towards CAMS. This study assessed medical students' knowledge of, attitude towards, and usage of CAM as well as their opinion about integrating CAMs into the medical curriculum. In a cross-sectional study, 203 medical students in 2nd, 3rd and 4th year classes completed a questionnaire. Data was analyzed using SPSS 18 and GraphPad 5.01. Association between different variables was tested. The overall mean knowledge score was 19.6%. Students in higher years of study were significantly more knowledgeable in CAMs (p = 0.0006). The best known CAM was herbal medicine (63.6%), with relatives and friends being their main source of information. Students' attitude towards CAM was good (75.1%) with majority (71.5%) favouring introduction of CAM into the medical curriculum; preferably at the preclinical level (67.5%). Year of study, gender and locality where student grew up did not significantly affect attitude towards CAM use. Up to 117 (59.0%) of the students had ever used CAM especially herbal medicine. Although students in this study were deficient in knowledge on CAMs, their attitude and usage was good. Herbal medicine was the best known and used CAM. Majority of the students believed knowledge on CAM would be beneficial to their practice hence, desirous of its introduction into their medical curriculum.

Perception and use of complementary and alternative medicine for low back pain.

PubMed

Tsang, Vivian Hiu Man; Lo, Phoebe Hiu Wai; Lam, Fong Tao; Chung, Lulu Suet Wing; Tang, Tin Yan; Lui, Hoi Man; Lau, Jordan Tsz Gwan; Yee, Ho Fung; Lun, Yiu Kun; Chan, Hei Tung; Cheung, Jason Pui Yin

2017-01-01

To determine the prevalence of complementary and alternative medicine (CAM) use in patients with low back pain (LBP) and to identify its correlation with demographic factors, clinical condition and psychosocial factors. A cross-sectional study was conducted with 278 LBP patients. Use of CAM, demographic parameters and disease duration were determined. Self-reported health status and self-rated scales assessed the effect of disease on quality of life and emotional well-being, respectively. Satisfaction with orthopaedic care and belief partiality towards CAM were assessed. In all, 72.3% patients sought CAM treatment. The most common choice of CAM was traditional Chinese medicine (TCM; n = 166), followed by massage therapy ( n = 114) and chiropractic treatment ( n = 45). Within TCM, acupuncture was the most popular treatment for LBP ( n = 127). Only 32.5% patients informed their doctors of their CAM use. In univariate analyses, factors positively associated with CAM use included duration of LBP (odds ratio (OR) = 1.45, 95% confidence interval (CI): 1.06-1.97), use of CAM in close social circles (OR = 1.98, 95% CI: 1.15-3.43) and summary score for belief partiality towards CAM (OR = 1.18, 95% CI: 1.13-1.23). Variables negatively and significantly associated with status of CAM use include age (OR = 0.97, 95% CI: 0.95-0.99) and summary score for satisfaction with orthopaedic care (OR = 0.93, 95% CI: 0.88-0.99). CAM use in patients with LBP is prevalent and largely unknown to their doctors. Personal beliefs and their satisfaction with conventional medical treatment both play a part in their decisions to use CAM. Future studies may aim at understanding the effect of CAM on patient adherence to conventional medical treatment and patients' perception of well-being and pain.

Near-infrared Variability of Obscured and Unobscured X-Ray-selected AGNs in the COSMOS Field

NASA Astrophysics Data System (ADS)

Sánchez, P.; Lira, P.; Cartier, R.; Pérez, V.; Miranda, N.; Yovaniniz, C.; Arévalo, P.; Milvang-Jensen, B.; Fynbo, J.; Dunlop, J.; Coppi, P.; Marchesi, S.

2017-11-01

We present our statistical study of near-infrared (NIR) variability of X-ray-selected active galactic nuclei (AGNs) in the COSMOS field, using UltraVISTA data. This is the largest sample of AGN light curves in YJHKs bands, making it possible to have a global description of the nature of AGNs for a large range of redshifts and for different levels of obscuration. To characterize the variability properties of the sources, we computed the structure function. Our results show that there is an anticorrelation between the structure function A parameter (variability amplitude) and the wavelength of emission and a weak anticorrelation between A and the bolometric luminosity. We find that broad-line (BL) AGNs have a considerably larger fraction of variable sources than narrow-line (NL) AGNs and that they have different distributions of the A parameter. We find evidence that suggests that most of the low-luminosity variable NL sources correspond to BL AGNs, where the host galaxy could be damping the variability signal. For high-luminosity variable NL sources, we propose that they can be examples of “true type II” AGNs or BL AGNs with limited spectral coverage, which results in missing the BL emission. We also find that the fraction of variable sources classified as unobscured in the X-ray is smaller than the fraction of variable sources unobscured in the optical range. We present evidence that this is related to the differences in the origin of the obscuration in the optical and X-ray regimes.

Critical review of complementary and alternative medicine use in menopause: focus on prevalence, motivation, decision-making, and communication.

PubMed

Peng, Wenbo; Adams, Jon; Sibbritt, David W; Frawley, Jane E

2014-05-01

This study aims to undertake the first critical review of complementary and alternative medicine (CAM) use among menopausal women (a term here used to include premenopausal, perimenopausal and postmenopausal women) by focusing on the prevalence of CAM use and CAM users' characteristics, motivation, decision-making, and communication with healthcare providers. A comprehensive search of 2002-2012 international literature in the Medline, CINAHL, AMED, and SCOPUS databases was conducted. The search was confined to peer-reviewed articles published in English with abstracts and reporting new empirical research findings regarding CAM use and menopause. A considerable level of CAM use was observed among women in menopause. Many menopausal women use CAM concurrently with their conventional medicine. However, communication regarding CAM between menopausal women and healthcare providers seems less than optimal, with a demand for further information on the safety and efficacy of medicines. Existing literature is of variable methodological rigor, often presenting small sample sizes and low-quality data collection. Further rigorous research on this topic-including quantitative and qualitative methods using large national samples, where relevant-is required. The findings of this critical review provide insights for those practicing and managing health care in this area of women's health. Healthcare providers should prepare to inform menopausal women about all treatment options, including CAM, and should be aware of the possible adverse effects of CAM and potential interactions between CAM and conventional medicine among women in menopause who are under their care.

Predictors and Moderators of Treatment Response in Childhood Anxiety Disorders: Results from the CAMS Trial

PubMed Central

Compton, Scott N.; Peris, Tara S.; Almirall, Daniel; Birmaher, Boris; Sherrill, Joel; Kendall, Phillip C.; March, John S.; Gosch, Elizabeth A.; Ginsburg, Golda S.; Rynn, Moira A.; Piacentini, John C.; McCracken, James T.; Keeton, Courtney P.; Suveg, Cynthia M.; Aschenbrand, Sasha G.; Sakolsky, Dara; Iyengar, Satish; Walkup, John T.; Albano, Anne Marie

2014-01-01

Objective To examine predictors and moderators of treatment outcomes among 488 youth ages 7-17 years (50% female; 74% ≤ 12 years) with DSM-IV diagnoses of separation anxiety disorder, social phobia, or generalized anxiety disorder who were randomly assigned to receive either cognitive behavior therapy (CBT), sertraline (SRT), their combination (COMB), or medication management with pill placebo (PBO) in the Child/Adolescent Anxiety Multimodal Study (CAMS). Method Six classes of predictor and moderator variables (22 variables) were identified from the literature and examined using continuous (Pediatric Anxiety Ratings Scale; PARS) and categorical (Clinical Global Impression Scale-Improvement; CGI-I) outcome measures. Results Three baseline variables predicted better outcomes (independent of treatment condition) on the PARS, including low anxiety severity (as measured by parents and independent evaluators) and caregiver strain. No baseline variables were found to predict week 12 responder status (CGI-I). Participant's principal diagnosis moderated treatment outcomes, but only on the PARS. No baseline variables were found to moderate treatment outcomes on week 12 responder status (CGI-I). Discussion Overall, anxious children responded favorably to CAMS treatments. However, having more severe and impairing anxiety, greater caregiver strain, and a principal diagnosis of social phobia were associated with less favorable outcomes. Clinical implications of these findings are discussed. PMID:24417601

The use of complementary and alternative medicine in the general population: results from a longitudinal community study.

PubMed

Rössler, Wulf; Lauber, Christoph; Angst, Jules; Haker, Helene; Gamma, Alex; Eich, Dominique; Kessler, Ronald C; Ajdacic-Gross, Vladeta

2007-01-01

Many patients with psychological or physical problems are interested in non-medical approaches. The reasons for the growing popularity of complementary and alternative medicine (CAM) are not well understood considering that evidence of the effectiveness of conventional therapies is greater than ever before. We have examined data from the Zurich Study to determine trends and predictors of CAM use in Switzerland. The Zurich Study is a longitudinal community study that was started in 1979 with a sample of 591 participants born in 1958 and 1959. In 1999, the last of six interview waves with face-to-face interviews was conducted. CAM use was analyzed with data from interviews in 1993 and 1999. Polytomous logistic regression analysis focused on the personal, demographic and sociocultural background of CAM users. CAM use in the last 12 months was reported by 21.9% of the participants in 1993 and by 29.5% in 1999. CAM use among those exhibiting either physical or psychological problems was in the ratio of two to one. There was a trend from alternative variants of CAM (homeopathy) to complementary ones (massage, osteopathy, acupuncture). The vast majority of CAM use was in addition to conventional therapies. Predictors of CAM use were, among others, attribution of physical complaints to stress and other psychological variables, very low education level in parents, and lacking political interest. Besides the sociocultural background, characteristics such as the psychological attribution style play an important role in CAM use. CAM use in Switzerland is mainly of a complementary rather than an alternative nature.

Healthcare professional views and experiences of complementary and alternative therapies in obstetric practice in North East Scotland: a prospective questionnaire survey.

PubMed

Stewart, D; Pallivalappila, A R; Shetty, A; Pande, B; McLay, J S

2014-07-01

The aim of this study was to investigate the use of complementary and alternative medicines (CAMs) therapy by UK healthcare professionals involved in the care of pregnant women, and to identify key predictors of use. A prospective survey. Maternity services in Grampian, North East Scotland. All healthcare professionals (135) involved in the care of pregnant women (midwives, obstetricians, anaesthetists). Questionnaire development, piloting, and distribution. Descriptive and inferential statistical analysis. A response rate of 87% was achieved. A third of respondents (32.5%) had recommended (prescribed, referred, or advised) the use of CAMs to pregnant women. The most frequently recommended CAMs modalities were: vitamins and minerals (excluding folic acid) (55%); massage (53%); homeopathy (50%); acupuncture (32%); yoga (32%); reflexology (26%); aromatherapy (24%); and herbal medicine (21%). Although univariate analysis identified that those who recommended CAMs were significantly more likely to be midwives who had been in post for more than 5 years, had received training in CAMs, were interested in CAMs, and were themselves users of CAMs, the only variable retained in bivariate logistic regression was 'personal use of CAM', with an odds ratio of 8.26 (95% CI 3.09-22.05; P < 0.001). Despite the lack of safety or efficacy data, a wide variety of CAM therapies are recommended to pregnant women by approximately a third of healthcare professionals, with those recommending the use of CAMs being eight times more likely to be personal CAM users. © 2014 Royal College of Obstetricians and Gynaecologists.

Complementary and Alternative Medicine Use in Individuals Presenting for Care at a Comprehensive Cancer Center.

PubMed

Judson, Patricia L; Abdallah, Reem; Xiong, Yin; Ebbert, Judith; Lancaster, Johnathan M

2017-03-01

To define the use of complementary and alternative medicine (CAM) in individuals presenting for care at a comprehensive cancer center. A total of 17 639 individuals presenting to an NCI-designated Comprehensive Cancer Center (and consortium sites) completed a questionnaire regarding CAM use. Data were analyzed using the univariate χ 2 test to assess CAM use associated with a number of variables, including cancer status, age, gender, marital status, ethnicity, race, employment, and education level. Eighty-seven percent of individuals who completed the CAM survey acknowledged CAM therapy use within the previous 12 months. Of the 5 broad categories of CAM, the most commonly used were biologically based approaches (14 759/17 639 [83.67%]), mind-body interventions (4624/17 485 [26.45%]), manipulative and body-based therapies (3957/17 537 [22.56%]), alternative medical systems (429/15 952 [2.69%]), and energy therapies (270/15 872 [1.7%]). CAM use was more prevalent among women, non-Hispanics, Caucasians, patients 60 to 69 years of age, and those who are married, have a higher level of education, and are employed ( P < .005). This is the largest report of CAM use in individuals presenting for care at a comprehensive cancer center. Our analysis revealed that a very high percentage of patients utilize CAM. Because many of these CAM interventions are not studied in oncology patients, additional research on safety, efficacy, and mechanisms of action are essential. Furthermore, it is important that oncologists understand CAM modalities and counsel their patients about their use.

Intraperitoneal immunotherapy with T cells stably and transiently expressing anti-EpCAM CAR in xenograft models of peritoneal carcinomatosis

PubMed Central

Chi, Zhixia; Du, Shou-Hui; Chen, Can; Tay, Johan C.K.; Toh, Han Chong; Connolly, John E.; Xu, Xue Hu; Wang, Shu

2017-01-01

The epithelial cell adhesion molecule (EpCAM) is overexpressed in a wide variety of tumor types, including peritoneal carcinomatosis (PC) from gastrointestinal and gynecological malignancies. To develop a chimeric antigen receptor T (CART) cell therapy approach to treat patients with end-stage PC, we constructed third generation CARs specific to EpCAM using the 4D5MOC-B single chain variable fragment. CART cells were generated with lentiviral transduction and exhibited specific in vitro killing activity against EpCAM-positive human ovarian and colorectal cancer cells. A single intraperitoneal injection of the CART cells eradicated established ovarian xenografts and resulted in significantly prolonged animal survival. Since EpCAM is also expressed on normal epithelium, anti-EpCAM CART cells were generated by mRNA electroporation that display a controlled cytolytic activity with a limited CAR expression duration. Multiple repeated infusions of these RNA CAR-modified T cells delayed disease progression in immunodeficient mice bearing well-established peritoneal ovarian and colorectal xenografts. Thus, our study demonstrates the effectiveness of using anti-EpCAM CAR-expressing T cells for local treatment of PC in mice. The possibility of using this approach for clinical treatment of EpCAM-positive gastrointestinal and gynecological malignancies warrants further validation. PMID:28088790

Ecophysiology of Crassulacean Acid Metabolism (CAM).

PubMed

Lüttge, Ulrich

2004-06-01

Crassulacean Acid Metabolism (CAM) as an ecophysiological modification of photosynthetic carbon acquisition has been reviewed extensively before. Cell biology, enzymology and the flow of carbon along various pathways and through various cellular compartments have been well documented and discussed. The present attempt at reviewing CAM once again tries to use a different approach, considering a wide range of inputs, receivers and outputs. Input is given by a network of environmental parameters. Six major ones, CO(2), H(2)O, light, temperature, nutrients and salinity, are considered in detail, which allows discussion of the effects of these factors, and combinations thereof, at the individual plant level ('physiological aut-ecology'). Receivers of the environmental cues are the plant types genotypes and phenotypes, the latter including morphotypes and physiotypes. CAM genotypes largely remain 'black boxes', and research endeavours of genomics, producing mutants and following molecular phylogeny, are just beginning. There is no special development of CAM morphotypes except for a strong tendency for leaf or stem succulence with large cells with big vacuoles and often, but not always, special water storage tissues. Various CAM physiotypes with differing degrees of CAM expression are well characterized. Output is the shaping of habitats, ecosystems and communities by CAM. A number of systems are briefly surveyed, namely aquatic systems, deserts, salinas, savannas, restingas, various types of forests, inselbergs and paramós. While quantitative census data for CAM diversity and biomass are largely missing, intuition suggests that the larger CAM domains are those systems which are governed by a network of interacting stress factors requiring versatile responses and not systems where a single stress factor strongly prevails. CAM is noted to be a strategy for variable, flexible and plastic niche occupation rather than lush productivity. 'Physiological syn-ecology' reveals that phenotypic plasticity constitutes the ecophysiological advantage of CAM.

The health professional-patient-relationship in conventional versus complementary and alternative medicine. A qualitative study comparing the perceived use of medical shared decision-making between two different approaches of medicine.

PubMed

Berger, Stephanie; Braehler, Elmar; Ernst, Jochen

2012-07-01

To explore differences between conventional medicine (COM) and complementary and alternative medicine (CAM) regarding the attitude toward and the perceived use of shared decision-making (SDM) from the health professional perspective. Thirty guideline-based interviews with German GPs and nonmedical practitioners were conducted using qualitative analysis for interpretation. The health professional-patient-relationship in CAM differs from that in COM, as SDM is perceived more often. Reasons for this include external context variables (e.g., longer consultation time) and internal provider beliefs (e.g., attitude toward SDM). German health care policy was regarded as one of the most critical factors which affected the relationship between GPs and their patients and their practice of SDM. Differences between COM and CAM regarding the attitude toward and the perceived use of SDM are attributable to diverse concepts of medicine, practice context variables and internal provider factors. Therefore, the perceived feasibility of SDM depends on the complexity of different occupational socialization processes and thus, different value systems between COM and CAM. Implementation barriers such as insufficient communication skills, lacking SDM training or obedient patients should be reduced. Especially in COM, contextual variables such as political restrictions need to be eliminated to successfully implement SDM. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Use of complementary and alternative medicine in an urban county hospital epilepsy clinic.

PubMed

McConnell, B V; Applegate, M; Keniston, A; Kluger, B; Maa, E H

2014-05-01

We examined self-reported complementary and alternative medicine (CAM) use among a largely indigent population with epilepsy. Overall CAM use was 70%, with the most frequently reported complementary and alternative medicines (CAMs) being medical marijuana (33%), prayer/spirituality (31%), meditation (19%), vitamins (19%), and stress management (16%). Forty-four percent of patients reported improved seizure control with CAMs. Stress management accounted for perceived seizure reduction in 74%, followed by marijuana (54%), prayer (49%), and yoga (42%). Among the most commonly used and helpful CAMs, stress management was not associated with specific demographic or clinical variables; marijuana use was significantly associated with lower age (users=35.2±10 years vs. nonusers=41.6±12; p<0.01) and lower income (under $15,000 40% use vs. 14% over $15,000; p<0.05); and prayer was significantly associated with female gender (male=21% vs. female=45%; p<0.01) and Black ethnicity (Black=55% vs. Hispanic=30% vs. White=23%; p<0.05). Taken together, our study was notable for the high rate of CAM utilization in a largely indigent population, with high rates of perceived efficacy among several CAM modalities. Copyright © 2014 Elsevier Inc. All rights reserved.

Estimation of Error in Maximal Intensity Projection-Based Internal Target Volume of Lung Tumors: A Simulation and Comparison Study Using Dynamic Magnetic Resonance Imaging

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

Cai Jing; Read, Paul W.; Baisden, Joseph M.

Purpose: To evaluate the error in four-dimensional computed tomography (4D-CT) maximal intensity projection (MIP)-based lung tumor internal target volume determination using a simulation method based on dynamic magnetic resonance imaging (dMRI). Methods and Materials: Eight healthy volunteers and six lung tumor patients underwent a 5-min MRI scan in the sagittal plane to acquire dynamic images of lung motion. A MATLAB program was written to generate re-sorted dMRI using 4D-CT acquisition methods (RedCAM) by segmenting and rebinning the MRI scans. The maximal intensity projection images were generated from RedCAM and dMRI, and the errors in the MIP-based internal target area (ITA)more » from RedCAM ({epsilon}), compared with those from dMRI, were determined and correlated with the subjects' respiratory variability ({nu}). Results: Maximal intensity projection-based ITAs from RedCAM were comparatively smaller than those from dMRI in both phantom studies ({epsilon} = -21.64% {+-} 8.23%) and lung tumor patient studies ({epsilon} = -20.31% {+-} 11.36%). The errors in MIP-based ITA from RedCAM correlated linearly ({epsilon} = -5.13{nu} - 6.71, r{sup 2} = 0.76) with the subjects' respiratory variability. Conclusions: Because of the low temporal resolution and retrospective re-sorting, 4D-CT might not accurately depict the excursion of a moving tumor. Using a 4D-CT MIP image to define the internal target volume might therefore cause underdosing and an increased risk of subsequent treatment failure. Patient-specific respiratory variability might also be a useful predictor of the 4D-CT-induced error in MIP-based internal target volume determination.« less

Estimation of error in maximal intensity projection-based internal target volume of lung tumors: a simulation and comparison study using dynamic magnetic resonance imaging.

PubMed

Cai, Jing; Read, Paul W; Baisden, Joseph M; Larner, James M; Benedict, Stanley H; Sheng, Ke

2007-11-01

To evaluate the error in four-dimensional computed tomography (4D-CT) maximal intensity projection (MIP)-based lung tumor internal target volume determination using a simulation method based on dynamic magnetic resonance imaging (dMRI). Eight healthy volunteers and six lung tumor patients underwent a 5-min MRI scan in the sagittal plane to acquire dynamic images of lung motion. A MATLAB program was written to generate re-sorted dMRI using 4D-CT acquisition methods (RedCAM) by segmenting and rebinning the MRI scans. The maximal intensity projection images were generated from RedCAM and dMRI, and the errors in the MIP-based internal target area (ITA) from RedCAM (epsilon), compared with those from dMRI, were determined and correlated with the subjects' respiratory variability (nu). Maximal intensity projection-based ITAs from RedCAM were comparatively smaller than those from dMRI in both phantom studies (epsilon = -21.64% +/- 8.23%) and lung tumor patient studies (epsilon = -20.31% +/- 11.36%). The errors in MIP-based ITA from RedCAM correlated linearly (epsilon = -5.13nu - 6.71, r(2) = 0.76) with the subjects' respiratory variability. Because of the low temporal resolution and retrospective re-sorting, 4D-CT might not accurately depict the excursion of a moving tumor. Using a 4D-CT MIP image to define the internal target volume might therefore cause underdosing and an increased risk of subsequent treatment failure. Patient-specific respiratory variability might also be a useful predictor of the 4D-CT-induced error in MIP-based internal target volume determination.

Flux variability in the K CA II and H-gamma lines of the AP stars 53 Cam, 41 Tau, Beta CrB, and Alpha(2) CVn

NASA Astrophysics Data System (ADS)

Kuvshinov, V. M.; Plachinda, S. I.

The rapid variability of the relative fluxes in the nuclei of the K Ca II and H-gamma lines of four typical Ap stars, 53 Cam, 41 Tau, Beta CrB, and Alpha(2) CVn, was studied during the period December 1979 - June 1980. Observations were carried out using the scanner-magnetograph of the 2.6-m reflector of the Crimean Astrophysical Observatory. In addition to relative flux variations with the phase of the axial rotation period of the stars, fluctuations of relative fluxes with characteristic times of several minutes to several hours were detected. The upper probability limit for such fluctuations, which are mostly irregular, is estimated at 35 percent for 53 Cam (K Ca II) and 56 percent for Alpha(2) CVn (H-gamma).

Nine time steps: ultra-fast statistical consistency testing of the Community Earth System Model (pyCECT v3.0)

NASA Astrophysics Data System (ADS)

Milroy, Daniel J.; Baker, Allison H.; Hammerling, Dorit M.; Jessup, Elizabeth R.

2018-02-01

The Community Earth System Model Ensemble Consistency Test (CESM-ECT) suite was developed as an alternative to requiring bitwise identical output for quality assurance. This objective test provides a statistical measurement of consistency between an accepted ensemble created by small initial temperature perturbations and a test set of CESM simulations. In this work, we extend the CESM-ECT suite with an inexpensive and robust test for ensemble consistency that is applied to Community Atmospheric Model (CAM) output after only nine model time steps. We demonstrate that adequate ensemble variability is achieved with instantaneous variable values at the ninth step, despite rapid perturbation growth and heterogeneous variable spread. We refer to this new test as the Ultra-Fast CAM Ensemble Consistency Test (UF-CAM-ECT) and demonstrate its effectiveness in practice, including its ability to detect small-scale events and its applicability to the Community Land Model (CLM). The new ultra-fast test facilitates CESM development, porting, and optimization efforts, particularly when used to complement information from the original CESM-ECT suite of tools.

Climate Simulations from Super-parameterized and Conventional General Circulation Models with a Third-order Turbulence Closure

NASA Astrophysics Data System (ADS)

Xu, Kuan-Man; Cheng, Anning

2014-05-01

A high-resolution cloud-resolving model (CRM) embedded in a general circulation model (GCM) is an attractive alternative for climate modeling because it replaces all traditional cloud parameterizations and explicitly simulates cloud physical processes in each grid column of the GCM. Such an approach is called "Multiscale Modeling Framework." MMF still needs to parameterize the subgrid-scale (SGS) processes associated with clouds and large turbulent eddies because circulations associated with planetary boundary layer (PBL) and in-cloud turbulence are unresolved by CRMs with horizontal grid sizes on the order of a few kilometers. A third-order turbulence closure (IPHOC) has been implemented in the CRM component of the super-parameterized Community Atmosphere Model (SPCAM). IPHOC is used to predict (or diagnose) fractional cloudiness and the variability of temperature and water vapor at scales that are not resolved on the CRM's grid. This model has produced promised results, especially for low-level cloud climatology, seasonal variations and diurnal variations (Cheng and Xu 2011, 2013a, b; Xu and Cheng 2013a, b). Because of the enormous computational cost of SPCAM-IPHOC, which is 400 times of a conventional CAM, we decided to bypass the CRM and implement the IPHOC directly to CAM version 5 (CAM5). IPHOC replaces the PBL/stratocumulus, shallow convection, and cloud macrophysics parameterizations in CAM5. Since there are large discrepancies in the spatial and temporal scales between CRM and CAM5, IPHOC used in CAM5 has to be modified from that used in SPCAM. In particular, we diagnose all second- and third-order moments except for the fluxes. These prognostic and diagnostic moments are used to select a double-Gaussian probability density function to describe the SGS variability. We also incorporate a diagnostic PBL height parameterization to represent the strong inversion above PBL. The goal of this study is to compare the simulation of the climatology from these three models (CAM5, CAM5-IPHOC and SPCAM-IPHOC), with emphasis on low-level clouds and precipitation. Detailed comparisons of scatter diagrams among the monthly-mean low-level cloudiness, PBL height, surface relative humidity and lower tropospheric stability (LTS) reveal the relative strengths and weaknesses for five coastal low-cloud regions among the three models. Observations from CloudSat and CALIPSO and ECMWF Interim reanalysis are used as the truths for the comparisons. We found that the standard CAM5 underestimates cloudiness and produces small cloud fractions at low PBL heights that contradict with observations. CAM5-IPHOC tends to overestimate low clouds but the ranges of LTS and PBL height variations are most realistic. SPCAM-IPHOC seems to produce most realistic results with relatively consistent results from one region to another. Further comparisons with other atmospheric environmental variables will be helpful to reveal the causes of model deficiencies so that SPCAM-IPHOC results will provide guidance to the other two models.

Optical polarimetry and photometry of X-ray selected BL Lacertae objects

NASA Technical Reports Server (NTRS)

Jannuzi, Buell T.; Smith, Paul S.; Elston, Richard

1993-01-01

We present the data from 3 years of monitoring the optical polarization and apparent brightness of 37 X-ray-selected BL Lacertae objects. The monitored objects include a complete sample drawn from the Einstein Extended Medium Sensitivity Survey. We confirm the BL Lac identifications for 15 of these 22 objects. We include descriptions of the objects and samples in our monitoring program and of the existing complete samples of BL Lac objects, highly polarized quasars, optically violent variable quasars, and blazars.

Variable Behavior and Repeated Learning in Two Mouse Strains: Developmental and Genetic Contributions.

PubMed

Arnold, Megan A; Newland, M Christopher

2018-06-16

Behavioral inflexibility is often assessed using reversal learning tasks, which require a relatively low degree of response variability. No studies have assessed sensitivity to reinforcement contingencies that specifically select highly variable response patterns in mice, let alone in models of neurodevelopmental disorders involving limited response variation. Operant variability and incremental repeated acquisition (IRA) were used to assess unique aspects of behavioral variability of two mouse strains: BALB/c, a model of some deficits in ASD, and C57Bl/6. On the operant variability task, BALB/c mice responded more repetitively during adolescence than C57Bl/6 mice when reinforcement did not require variability but responded more variably when reinforcement required variability. During IRA testing in adulthood, both strains acquired an unchanging, performance sequence equally well. Strain differences emerged, however, after novel learning sequences began alternating with the performance sequence: BALB/c mice substantially outperformed C57Bl/6 mice. Using litter-mate controls, it was found that adolescent experience with variability did not affect either learning or performance on the IRA task in adulthood. These findings constrain the use of BALB/c mice as a model of ASD, but once again reveal this strain is highly sensitive to reinforcement contingencies and they are fast and robust learners. Copyright © 2018. Published by Elsevier B.V.

Exploring the impacts of physics and resolution on aqua-planet simulations from a nonhydrostatic global variable-resolution modeling framework: IMPACTS OF PHYSICS AND RESOLUTION

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

Zhao, Chun; Leung, L. Ruby; Park, Sang-Hun

Advances in computing resources are gradually moving regional and global numerical forecasting simulations towards sub-10 km resolution, but global high resolution climate simulations remain a challenge. The non-hydrostatic Model for Prediction Across Scales (MPAS) provides a global framework to achieve very high resolution using regional mesh refinement. Previous studies using the hydrostatic version of MPAS (H-MPAS) with the physics parameterizations of Community Atmosphere Model version 4 (CAM4) found notable resolution dependent behaviors. This study revisits the resolution sensitivity using the non-hydrostatic version of MPAS (NH-MPAS) with both CAM4 and CAM5 physics. A series of aqua-planet simulations at global quasi-uniform resolutionsmore » ranging from 240 km to 30 km and global variable resolution simulations with a regional mesh refinement of 30 km resolution over the tropics are analyzed, with a primary focus on the distinct characteristics of NH-MPAS in simulating precipitation, clouds, and large-scale circulation features compared to H-MPAS-CAM4. The resolution sensitivity of total precipitation and column integrated moisture in NH-MPAS is smaller than that in H-MPAS-CAM4. This contributes importantly to the reduced resolution sensitivity of large-scale circulation features such as the inter-tropical convergence zone and Hadley circulation in NH-MPAS compared to H-MPAS. In addition, NH-MPAS shows almost no resolution sensitivity in the simulated westerly jet, in contrast to the obvious poleward shift in H-MPAS with increasing resolution, which is partly explained by differences in the hyperdiffusion coefficients used in the two models that influence wave activity. With the reduced resolution sensitivity, simulations in the refined region of the NH-MPAS global variable resolution configuration exhibit zonally symmetric features that are more comparable to the quasi-uniform high-resolution simulations than those from H-MPAS that displays zonal asymmetry in simulations inside the refined region. Overall, NH-MPAS with CAM5 physics shows less resolution sensitivity compared to CAM4. These results provide a reference for future studies to further explore the use of NH-MPAS for high-resolution climate simulations in idealized and realistic configurations.« less

Photometric monitoring of three BL Lacertae objects in 1993-1998

NASA Astrophysics Data System (ADS)

Bai, J. M.; Xie, G. Z.; Li, K. H.; Zhang, X.; Liu, W. W.

1999-05-01

The results of optical photometric (BVRI) monitoring of three BL Lac objects over a time interval of about four years are presented. The sources are three classical radio-selected BL Lac objects, BL Lac, OJ 287 and PKS 0735+178. During our observation OJ 287 was in the stage of a large periodic outburst which consisted of at least two peaks. Almost all the observations obtained over consecutive nights detected intranight variations. In 1995 and 1996 BL Lac kept in faint states, with fewer and smaller rapid flares and fluctuations. On the contrary, in late 1997 BL Lac was at the stage of a large outburst, accompanied with much more large amplitude rapid flares and fluctuations. PKS 0735+178 was almost at its faint end from 1994 to early 1998. Over this time interval, the intraday variations and microvariations in PKS 0735+178 were rare and the amplitude was very small, except a rapid darkening of ~ 0.4 mag on 24 January 1995. Previous work by \\cite[Webb et al. (1988);]{web88} \\cite[Wagner et al. (1996);]{wag96} \\cite[Pian et al. (1997)]{pia97} also showed the same behaviour of variability as BL Lac and PKS 0735+178 in BL Lac, S5 0716+714, PKS 2155-304, respectively. We propose that the motion of orientation of the relativistic jet in a BL Lac object be responsible for these variability behaviours. Table~1 is only available in electronic form at the CDS via anonymous ftp to cdsarc.u-strasbg.fr (130.79.128.5) or via http://cdsweb.u-strasbg.fr/Abstract.html

The Open-Ocean Sensible Heat Flux and Its Significance for Arctic Boundary Layer Mixing During Early Fall

NASA Technical Reports Server (NTRS)

Ganeshan, Manisha; Wu, Dongliang

2016-01-01

The increasing ice-free area during late summer has transformed the Arctic to a climate system with more dynamic boundary layer (BL) clouds and seasonal sea ice growth. The open-ocean sensible heat flux, a crucial mechanism of excessive ocean heat loss to the atmosphere during the fall freeze season, is speculated to play an important role in the recently observed cloud cover increase and BL instability. However, lack of observations and understanding of the resilience of the proposed mechanisms, especially in relation to meteorological and interannual variability, has left a poorly constrained BL parameterization scheme in Arctic climate models. In this study, we use multiyear Japanese cruise-ship observations from RV Mirai over the open Arctic Ocean to characterize the surface sensible heat flux (SSHF) during early fall and investigate its contribution to BL turbulence. It is found that mixing by SSHF is favored during episodes of high surface wind speed and is also influenced by the prevailing cloud regime. The deepest BLs and maximum ocean-atmosphere temperature difference are observed during cold air advection (associated with the stratocumulus regime), yet, contrary to previous speculation, the efficiency of sensible heat exchange is low. On the other hand, the SSHF contributes significantly to BL mixing during the uplift (low pressure) followed by the highly stable (stratus) regime. Overall, it can explain 10 of the open ocean BL height variability, whereas cloud-driven (moisture and radiative) mechanisms appear to be the other dominant source of convective turbulence. Nevertheless, there is strong interannual variability in the relationship between the SSHF and the BL height which can be intensified by the changing occurrence of Arctic climate patterns, such as positive surface wind speed anomalies and more frequent conditions of uplift. This study highlights the need for comprehensive BL observations like the RV Mirai for better understanding and predicting the dynamic nature of the Arctic climate.

Energy considerations in the Community Atmosphere Model (CAM)

DOE PAGES

Williamson, David L.; Olson, Jerry G.; Hannay, Cécile; ...

2015-06-30

An error in the energy formulation in the Community Atmosphere Model (CAM) is identified and corrected. Ten year AMIP simulations are compared using the correct and incorrect energy formulations. Statistics of selected primary variables all indicate physically insignificant differences between the simulations, comparable to differences with simulations initialized with rounding sized perturbations. The two simulations are so similar mainly because of an inconsistency in the application of the incorrect energy formulation in the original CAM. CAM used the erroneous energy form to determine the states passed between the parameterizations, but used a form related to the correct formulation for themore » state passed from the parameterizations to the dynamical core. If the incorrect form is also used to determine the state passed to the dynamical core the simulations are significantly different. In addition, CAM uses the incorrect form for the global energy fixer, but that seems to be less important. The difference of the magnitude of the fixers using the correct and incorrect energy definitions is very small.« less

X-ray flux variability of active galactic nuclei observed using NuSTAR

NASA Astrophysics Data System (ADS)

Rani, Priyanka; Stalin, C. S.; Rakshit, Suvendu

2017-04-01

We present results of a systematic study of flux variability on hourly time-scales in a large sample of active galactic nuclei (AGN) in the 3-79 keV band using data from Nuclear Spectroscopic Telescope Array. Our sample consists of four BL Lac objects (BL Lacs), three flat spectrum radio quasars (FSRQs) 24 Seyfert 1, 42 Seyfert 2 and eight narrow line Seyfert 1 (NLSy1) galaxies. We find that in the 3-79 keV band, about 65 per cent of the sources in our sample show significant variations on hourly time-scales. Using the Mann-Whitney U-test and the Kolmogorov-Smirnov test, we find no difference in the variability behaviour between Seyfert 1 and 2 galaxies. The blazar sources (FSRQs and BL Lacs) in our sample are more variable than Seyfert galaxies that include Seyfert 1 and Seyfert 2 in the soft (3-10 keV), hard (10-79 keV) and total (3-79 keV) bands. NLSy1 galaxies show the highest duty cycle of variability (87 per cent), followed by BL Lacs (82 per cent), Seyfert galaxies (56 per cent) and FSRQs (23 per cent). We obtained flux doubling/halving time in the hard X-ray band less than 10 min in 11 sources. The flux variations between the hard and soft bands in all the sources in our sample are consistent with zero lag.

The X-ray spectra of the BL Lacertae objects PKS 0548 - 322 and 3C 66A

NASA Technical Reports Server (NTRS)

Maccacaro, T.; Maccagni, D.; Tarenghi, M.

1983-01-01

Einstein Observatory simultaneous imaging proportional counter and monitor proportional counter data are combined in order to derive the energy spectra of the BL Lac objects PKS 0548-322 and 3C 66A between 0.2 and 10 keV. While the latter is found to be variable in both intensity and spectral shape, the former, although constant in the present data, is found to have experienced a spectrum variation in view of results from other experiments. Attention is given to the implications of flux and spectral variability in BL Lac objects for models of X-ray emission mechanisms. It is suggested that the wide spread of the spectral index distribution is due to the detection of the highly variable synchrotron-produced X-rays that are generally undetected in QSOs.

Ecophysiology of Crassulacean Acid Metabolism (CAM)

PubMed Central

LÜTTGE, ULRICH

2004-01-01

• Background and Scope Crassulacean Acid Metabolism (CAM) as an ecophysiological modification of photosynthetic carbon acquisition has been reviewed extensively before. Cell biology, enzymology and the flow of carbon along various pathways and through various cellular compartments have been well documented and discussed. The present attempt at reviewing CAM once again tries to use a different approach, considering a wide range of inputs, receivers and outputs. • Input Input is given by a network of environmental parameters. Six major ones, CO2, H2O, light, temperature, nutrients and salinity, are considered in detail, which allows discussion of the effects of these factors, and combinations thereof, at the individual plant level (‘physiological aut‐ecology’). • Receivers Receivers of the environmental cues are the plant types genotypes and phenotypes, the latter including morphotypes and physiotypes. CAM genotypes largely remain ‘black boxes’, and research endeavours of genomics, producing mutants and following molecular phylogeny, are just beginning. There is no special development of CAM morphotypes except for a strong tendency for leaf or stem succulence with large cells with big vacuoles and often, but not always, special water storage tissues. Various CAM physiotypes with differing degrees of CAM expression are well characterized. • Output Output is the shaping of habitats, ecosystems and communities by CAM. A number of systems are briefly surveyed, namely aquatic systems, deserts, salinas, savannas, restingas, various types of forests, inselbergs and paramós. • Conclusions While quantitative census data for CAM diversity and biomass are largely missing, intuition suggests that the larger CAM domains are those systems which are governed by a network of interacting stress factors requiring versatile responses and not systems where a single stress factor strongly prevails. CAM is noted to be a strategy for variable, flexible and plastic niche occupation rather than lush productivity. ‘Physiological syn‐ecology’ reveals that phenotypic plasticity constitutes the ecophysiological advantage of CAM. PMID:15150072

Time-dependent inhomogeneous jet models for BL Lac objects

NASA Technical Reports Server (NTRS)

Marlowe, A. T.; Urry, C. M.; George, I. M.

1992-01-01

Relativistic beaming can explain many of the observed properties of BL Lac objects (e.g., rapid variability, high polarization, etc.). In particular, the broadband radio through X-ray spectra are well modeled by synchrotron-self Compton emission from an inhomogeneous relativistic jet. We have done a uniform analysis on several BL Lac objects using a simple but plausible inhomogeneous jet model. For all objects, we found that the assumed power-law distribution of the magnetic field and the electron density can be adjusted to match the observed BL Lac spectrum. While such models are typically unconstrained, consideration of spectral variability strongly restricts the allowed parameters, although to date the sampling has generally been too sparse to constrain the current models effectively. We investigate the time evolution of the inhomogeneous jet model for a simple perturbation propagating along the jet. The implications of this time evolution model and its relevance to observed data are discussed.

Time-dependent inhomogeneous jet models for BL Lac objects

NASA Astrophysics Data System (ADS)

Marlowe, A. T.; Urry, C. M.; George, I. M.

1992-05-01

Relativistic beaming can explain many of the observed properties of BL Lac objects (e.g., rapid variability, high polarization, etc.). In particular, the broadband radio through X-ray spectra are well modeled by synchrotron-self Compton emission from an inhomogeneous relativistic jet. We have done a uniform analysis on several BL Lac objects using a simple but plausible inhomogeneous jet model. For all objects, we found that the assumed power-law distribution of the magnetic field and the electron density can be adjusted to match the observed BL Lac spectrum. While such models are typically unconstrained, consideration of spectral variability strongly restricts the allowed parameters, although to date the sampling has generally been too sparse to constrain the current models effectively. We investigate the time evolution of the inhomogeneous jet model for a simple perturbation propagating along the jet. The implications of this time evolution model and its relevance to observed data are discussed.

Relationships Among Use of Complementary and Alternative Interventions, Urinary Incontinence, Quality of Life, and Self-esteem in Women With Urinary Incontinence.

PubMed

Öz, Özge; Altay, Birsen

The purpose of this study was to examine associations among sociodemographic characteristics, urinary incontinence (UI) characteristics, UI-specific quality of life and self-esteem, and use of complementary and alternative medicine (CAM) interventions for UI. Correlational-descriptive research. This sample comprised 394 female patients 18 years or older cared for in the urology and gynecology outpatient clinics of a university hospital in Samsun, Turkey. Participants completed an investigator-developed questionnaire that included 2 validated instruments, King's Health Questionnaire (KHQ) and the Rosenberg Self-esteem Scale. Descriptive statistics were used for demographic data and use of CAM interventions. Variables associated with CAM use were assessed using χ analysis. The differences between using CAM and scales points of the KHQ and the Rosenberg Self-esteem Scale were assessed using the t test, and the relationship between the KHQ and the Rosenberg Self-esteem Scale was assessed using correlation analysis. Thirty-three percent (n = 130) of women indicated using CAM interventions to manage their UI. The most common CAM intervention, reported by 52.6% of respondents, was prayer. Women with lower UI-specific quality of life and self-esteem scores were more likely to report using CAM interventions (P < .05). Women with lower education level used CAM more frequently than others (P < .05). Analysis revealed weak but statistically significant positive correlations for role limitations, physical limitations, social limitations, emotions, sleep/energy level and the symptom severity (P < .001), and personal relationships (P < .01) subdimensions of the KHQ. One-third of women indicated using CAM methods to manage their UI; the most commonly used intervention was prayer. Women using CAM reported both higher self-esteem and condition-specific health-related quality of life than women who did not use these interventions.

Quiet Clean Short-haul Experimental Engine (QCSEE) whirl test of cam/harmonic pitch change actuation system

NASA Technical Reports Server (NTRS)

1976-01-01

A variable pitch fan actuation system, which incorporates a remote nacelle mounted blade angle regulator, was tested. The regulator drives a rotating fan mounted mechanical actuator through a flexible shaft and differential gear train. The actuator incorporates a high ratio harmonic drive attached to a multitrack spherical cam which changes blade pitch through individual cam follower arms attached to each blade trunnion. Testing of the actuator on a whirl rig, is reported. Results of tests conducted to verify that the unit satisfied the design requirements and was structurally adequate for use in an engine test are presented.

Impact of internal variability on projections of Sahel precipitation change

NASA Astrophysics Data System (ADS)

Monerie, Paul-Arthur; Sanchez-Gomez, Emilia; Pohl, Benjamin; Robson, Jon; Dong, Buwen

2017-11-01

The impact of the increase of greenhouse gases on Sahelian precipitation is very uncertain in both its spatial pattern and magnitude. In particular, the relative importance of internal variability versus external forcings depends on the time horizon considered in the climate projection. In this study we address the respective roles of the internal climate variability versus external forcings on Sahelian precipitation by using the data from the CESM Large Ensemble Project, which consists of a 40 member ensemble performed with the CESM1-CAM5 coupled model for the period 1920-2100. We show that CESM1-CAM5 is able to simulate the mean and interannual variability of Sahel precipitation, and is representative of a CMIP5 ensemble of simulations (i.e. it simulates the same pattern of precipitation change along with equivalent magnitude and seasonal cycle changes as the CMIP5 ensemble mean). However, CESM1-CAM5 underestimates the long-term decadal variability in Sahel precipitation. For short-term (2010-2049) and mid-term (2030-2069) projections the simulated internal variability component is able to obscure the projected impact of the external forcing. For long-term (2060-2099) projections external forcing induced change becomes stronger than simulated internal variability. Precipitation changes are found to be more robust over the central Sahel than over the western Sahel, where climate change effects struggle to emerge. Ten (thirty) members are needed to separate the 10 year averaged forced response from climate internal variability response in the western Sahel for a long-term (short-term) horizon. Over the central Sahel two members (ten members) are needed for a long-term (short-term) horizon.

Are some BL Lac objects artefacts of gravitational lensing?

NASA Technical Reports Server (NTRS)

Ostriker, J. P.; Vietri, M.

1985-01-01

It is proposed here that a significant fraction of BL Lac objects are optically violently variable quasars whose continuum emission has been greatly amplified, relative to the line emission, by pointlike gravitational lenses in intervening galaxies. Several anomalous physical and statistical properties of BL Lacs can be understood on the basis of this model, which is immediately testable on the basis of absorption line studies and by direct imaging.

Comparing Complementary and Alternative Medicine Use with or without Including Prayer as a Modality in a Local and Diverse United States Jurisdiction.

PubMed

Robles, Brenda; Upchurch, Dawn M; Kuo, Tony

2017-01-01

Few studies to date have examined the utilization of complementary and alternative medicine (CAM) in a local, ethnically diverse population in the United States (U.S.). Fewer have addressed the differences in their use based on inclusion or exclusion of prayer as a modality. Variable definitions of CAM are known to affect public health surveillance (i.e., continuous, systematic data collection, analysis, and interpretation) or benchmarking (i.e., identifying and comparing key indicators of health to inform community planning) related to this non-mainstream collection of health and wellness therapies. The present study sought to better understand how including or excluding prayer could affect reporting of CAM use among residents of a large, urban U.S. jurisdiction. Using population-weighted data from a cross-sectional Internet panel survey collected as part of a larger countywide population health survey, the study compared use of CAM based on whether prayer or no prayer was included in its definition. Patterns of CAM use by socio-demographic characteristics were described for the two operationalized definitions. Multivariable binomial regression analyses were performed to control for gender, age, race/ethnicity, education, employment, income, and health insurance status. One of the analyses explored the associations between CAM use and racial/ethnic characteristics in the study sample. Los Angeles County, California. A socio-demographically diverse sample of Los Angeles County residents. CAM use (with prayer) and CAM use (excluding prayer). Blacks were among the highest users of CAM when compared to Whites, especially when prayer was included as a CAM modality. Regardless of prayer inclusion, being a woman predicted higher use of CAM. How CAM is defined matters in gauging the utilization of this non-mainstream collection of therapies. Given that surveillance and/or benchmarking data are often used to inform resource allocation and planning decisions, results from the present study suggest that when prayer is included as part of the CAM definition, utilization/volume estimates of its use increased correspondingly, especially among non-White residents of the region.

Awareness, use, attitude and perceived need for Complementary and Alternative Medicine (CAM) education among undergraduate pharmacy students in Sierra Leone: a descriptive cross-sectional survey.

PubMed

James, Peter B; Bah, Abdulai J

2014-11-08

The widespread use of CAM around the world requires health professionals including pharmacists to have the required knowledge to better advise their patients. This has lead to an increased need for the inclusion of CAM instruction into the mainstream undergraduate Pharmacy education. This study was designed to describe pharmacy students awareness, use, attitude and perceived need for CAM education at COMAHS-USL and at the same time, determine how these descriptive outcomes are influenced by the socio-demographic variables considered in this study. A descriptive cross-sectional survey was conducted among undergraduate pharmacy students (n = 90) at the College of Medicine and Allied Health Sciences, University of Sierra Leone using a structured questionnaire. Chi square, fisher exact test, and general linear model univariate analysis were used to compare data between independent cohorts. All 90 (100%) of the students were aware and have used (except Ayurveda) at least one of the listed CAM modalities. Herbal/Botanical/Supplements followed by Spirituality/Prayer were the most commonly known and used CAM modalities. Almost two thirds of students considered the CAM modalities they have used to be effective and not harmful. Overall, pharmacy students had a positive attitude towards CAM (Mean attitudinal score = 34.9 ± 4. 5 (range 19-43)) with fourth and fifth year students showing a significantly less positive attitude as compared to the first, second and third year (B = -3.203 p = 0.001, 95% confidence interval -5.093 to -1.314). The media [53 (58.9%)] was the most frequent source of information about CAM. Nearly all students [89 (98.9%)] agreed that CAM knowledge is important to them as future pharmacist and that CAM should be included into the Pharmacy curriculum at COMAHS-USL [81 (90.0%)]. Pharmacy students in Sierra Leone are aware of and have used at least one of the CAM modalities and do show a positive attitude towards CAM. This was demonstrated by their overwhelming endorsement for CAM course to be part of the undergraduate pharmacy training at COMAHS-USL. This study among others will inform and guide the development and implementation of CAM instruction at COMAHS-USL.

Spatial patterns of photosynthesis in thin- and thick-leaved epiphytic orchids: unravelling C3–CAM plasticity in an organ-compartmented way

PubMed Central

Rodrigues, Maria Aurineide; Matiz, Alejandra; Cruz, Aline Bertinatto; Matsumura, Aline Tiemi; Takahashi, Cassia Ayumi; Hamachi, Leonardo; Félix, Lucas Macedo; Pereira, Paula Natália; Latansio-Aidar, Sabrina Ribeiro; Aidar, Marcos Pereira Marinho; Demarco, Diego; Freschi, Luciano; Mercier, Helenice; Kerbauy, Gilberto Barbante

2013-01-01

Background and Aims A positive correlation between tissue thickness and crassulacean acid metabolism (CAM) expression has been frequently suggested. Therefore, this study addressed the question of whether water availability modulates photosynthetic plasticity in different organs of two epiphytic orchids with distinct leaf thickness. Methods Tissue morphology and photosynthetic mode (C3 and/or CAM) were examined in leaves, pseudobulbs and roots of a thick-leaved (Cattleya walkeriana) and a thin-leaved (Oncidium ‘Aloha’) epiphytic orchid. Morphological features were studied comparing the drought-induced physiological responses observed in each organ after 30 d of either drought or well-watered treatments. Key Results Cattleya walkeriana, which is considered a constitutive CAM orchid, displayed a clear drought-induced up-regulation of CAM in its thick leaves but not in its non-leaf organs (pseudobulbs and roots). The set of morphological traits of Cattleya leaves suggested the drought-inducible CAM up-regulation as a possible mechanism of increasing water-use efficiency and carbon economy. Conversely, although belonging to an orchid genus classically considered as performing C3 photosynthesis, Oncidium ‘Aloha’ under drought seemed to express facultative CAM in its roots and pseudobulbs but not in its leaves, indicating that such photosynthetic responses might compensate for the lack of capacity to perform CAM in its thin leaves. Morphological features of Oncidium leaves also indicated lower efficiency in preventing water and CO2 losses, while aerenchyma ducts connecting pseudobulbs and leaves suggested a compartmentalized mechanism of nighttime carboxylation via phosphoenolpyruvate carboxylase (PEPC) (pseudobulbs) and daytime carboxylation via Rubisco (leaves) in drought-exposed Oncidium plants. Conclusions Water availability modulated CAM expression in an organ-compartmented manner in both orchids studied. As distinct regions of the same orchid could perform different photosynthetic pathways and variable degrees of CAM expression depending on the water availability, more attention should be addressed to this in future studies concerning the abundance of CAM plants. PMID:23618898

ChemCam Passive Sky Spectroscopy at Gale Crater, Mars: Interannual Variability in Dust Aerosol Particle Size, Missing Water Vapor, and the Molecular Oxygen Problem

NASA Astrophysics Data System (ADS)

McConnochie, T. H.; Smith, M. D.; Wolff, M. J.; Bender, S. C.; Lemmon, M. T.; Wiens, R. C.; Maurice, S.; Gasnault, O.; Lasue, J.; Meslin, P. Y.; Harri, A. M.; Genzer, M.; Kemppinen, O.; Martinez, G.; DeFlores, L. P.; Blaney, D. L.; Johnson, J. R.; Bell, J. F., III; Trainer, M. G.; Lefèvre, F.; Atreya, S. K.; Mahaffy, P. R.; Wong, M. H.; Franz, H. B.; Guzewich, S.; Villanueva, G. L.; Khayat, A. S.

2017-12-01

The Mars Science Laboratory's (MSL) ChemCam spectrometer measures atmospheric aerosol properties and gas abundances by operating in passive mode and observing scattered sky light at two different elevation angles. We have previously [e. g. 1, 2] presented the methodology and results of these ChemCam Passive Sky observations. Here we will focus on three of the more surprising results that we have obtained: (1) depletion of the column water vapor at Gale Crater relative to that of the surrounding region combined with a strong enhancement of the local column water vapor relative to pre-dawn in-situ measurements, (2) an interannual change in the effective particle size of dust aerosol during the aphelion season, and (3) apparent seasonal and interannual variability in molecular oxygen that differs significantly from the expected behavior of a non-condensable trace gas and differs significantly from global climate model expectations. The ChemCam passive sky water vapor measurements are quite robust but their interpretation depends on the details of measurements as well as on the types of water vapor vertical distributions that can be produced by climate models. We have a high degree of confidence in the dust particle size changes but since aerosol results in general are subject to a variety of potential systematic effects our particle size results would benefit from confirmation by other techniques [c.f. 3]. For the ChemCam passive sky molecular oxygen results we are still working to constrain the uncertainties well enough to confirm the observed surprising behavior, motivated by similarly surprising atmospheric molecular oxygen variability observed by MSL's Sample Analysis at Mars (SAM) instrument [4]. REFERENCES: [1] McConnochie, et al. (2017), Icarus (submitted). [2] McConnochie, et al. (2017), abstract # 3201, The 6th International Workshop on the Mars Atmosphere: Granada, Spain. [3] Vicente-Retortillo et al. (2017), GRL, 44. [4] Trainer et al. (2017), 2017 AGU Fall Meeting.

X-Ray Spectral Variability Signatures of Flares in BL Lac Objects

NASA Technical Reports Server (NTRS)

Boettcher, Markus; Chiang, James; White, Nicholas E. (Technical Monitor)

2002-01-01

We are presenting a detailed parameter study of the time-dependent electron injection and kinematics and the self-consistent radiation transport in jets of intermediate and low-frequency peaked BL Lac objects. Using a time-dependent, combined synchrotron-self-Compton and external-Compton jet model, we study the influence of variations of several essential model parameters, such as the electron injection compactness, the relative contribution of synchrotron to external soft photons to the soft photon compactness, the electron- injection spectral index, and the details of the time profiles of the electron injection episodes giving rise to flaring activity. In the analysis of our results, we focus on the expected X-ray spectral variability signatures in a region of parameter space particularly well suited to reproduce the broadband spectral energy distributions of intermediate and low-frequency peaked BL Lac objects. We demonstrate that SSC- and external-Compton dominated models for the gamma-ray emission from blazars are producing significantly different signatures in the X-ray variability, in particular in the soft X-ray light curves and the spectral hysteresis at soft X-ray energies, which can be used as a powerful diagnostic to unveil the nature of the high-energy emission from BL Lac objects.

Collaborative Research: Quantifying the Uncertainties of Aerosol Indirect Effects and Impacts on Decadal-Scale Climate Variability in NCAR CAM5 and CESM1

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

Nenes, Athanasios

The goal of this proposed project is to assess the climatic importance and sensitivity of aerosol indirect effect (AIE) to cloud and aerosol processes and feedbacks, which include organic aerosol hygroscopicity, cloud condensation nuclei (CCN) activation kinetics, Giant CCN, cloud-scale entrainment, ice nucleation in mixed-phase and cirrus clouds, and treatment of subgrid variability of vertical velocity. A key objective was to link aerosol, cloud microphysics and dynamics feedbacks in CAM5 with a suite of internally consistent and integrated parameterizations that provide the appropriate degrees of freedom to capture the various aspects of the aerosol indirect effect. The proposal integrated newmore » parameterization elements into the cloud microphysics, moist turbulence and aerosol modules used by the NCAR Community Atmospheric Model version 5 (CAM5). The CAM5 model was then used to systematically quantify the uncertainties of aerosol indirect effects through a series of sensitivity tests with present-day and preindustrial aerosol emissions. New parameterization elements were developed as a result of these efforts, and new diagnostic tools & methodologies were also developed to quantify the impacts of aerosols on clouds and climate within fully coupled models. Observations were used to constrain key uncertainties in the aerosol-cloud links. Advanced sensitivity tools were developed and implements to probe the drivers of cloud microphysical variability with unprecedented temporal and spatial scale. All these results have been published in top and high impact journals (or are in the final stages of publication). This proposal has also supported a number of outstanding graduate students.« less

Isolation of circulating tumor cells from pancreatic cancer by automated filtration

PubMed Central

Brychta, Nora; Drosch, Michael; Driemel, Christiane; Fischer, Johannes C.; Neves, Rui P.; Esposito, Irene; Knoefel, Wolfram; Möhlendick, Birte; Hille, Claudia; Stresemann, Antje; Krahn, Thomas; Kassack, Matthias U.; Stoecklein, Nikolas H.; von Ahsen, Oliver

2017-01-01

It is now widely recognized that the isolation of circulating tumor cells based on cell surface markers might be hindered by variability in their protein expression. Especially in pancreatic cancer, isolation based only on EpCAM expression has produced very diverse results. Methods that are independent of surface markers and therefore independent of phenotypical changes in the circulating cells might increase CTC recovery also in pancreatic cancer. We compared an EpCAM-dependent (IsoFlux) and a size-dependent (automated Siemens Healthineers filtration device) isolation method for the enrichment of pancreatic cancer CTCs. The recovery rate of the filtration based approach is dramatically superior to the EpCAM-dependent approach especially for cells with low EpCAM-expression (filtration: 52%, EpCAM-dependent: 1%). As storage and shipment of clinical samples is important for centralized analyses, we also evaluated the use of frozen diagnostic leukapheresis (DLA) as source for isolating CTCs and subsequent genetic analysis such as KRAS mutation detection analysis. Using frozen DLA samples of pancreatic cancer patients we detected CTCs in 42% of the samples by automated filtration. PMID:29156783

Isolation of circulating tumor cells from pancreatic cancer by automated filtration.

PubMed

Brychta, Nora; Drosch, Michael; Driemel, Christiane; Fischer, Johannes C; Neves, Rui P; Esposito, Irene; Knoefel, Wolfram; Möhlendick, Birte; Hille, Claudia; Stresemann, Antje; Krahn, Thomas; Kassack, Matthias U; Stoecklein, Nikolas H; von Ahsen, Oliver

2017-10-17

It is now widely recognized that the isolation of circulating tumor cells based on cell surface markers might be hindered by variability in their protein expression. Especially in pancreatic cancer, isolation based only on EpCAM expression has produced very diverse results. Methods that are independent of surface markers and therefore independent of phenotypical changes in the circulating cells might increase CTC recovery also in pancreatic cancer. We compared an EpCAM-dependent (IsoFlux) and a size-dependent (automated Siemens Healthineers filtration device) isolation method for the enrichment of pancreatic cancer CTCs. The recovery rate of the filtration based approach is dramatically superior to the EpCAM-dependent approach especially for cells with low EpCAM-expression (filtration: 52%, EpCAM-dependent: 1%). As storage and shipment of clinical samples is important for centralized analyses, we also evaluated the use of frozen diagnostic leukapheresis (DLA) as source for isolating CTCs and subsequent genetic analysis such as KRAS mutation detection analysis. Using frozen DLA samples of pancreatic cancer patients we detected CTCs in 42% of the samples by automated filtration.

Polar Lipids Analysis of Cultured Phytoplankton Reveals Significant Inter-taxa Changes, Low Influence of Growth Stage, and Usefulness in Chemotaxonomy.

PubMed

Cañavate, José Pedro; Armada, Isabel; Hachero-Cruzado, Ismael

2017-05-01

The high lipid diversity of microalgae has been used to taxonomically differentiate phytoplankton taxa at the class level. However, important lipids such as phospholipids (PL) and betaine lipids (BL) with potential chemotaxonomy application in phytoplankton ecology have been scarcely studied. The chemotaxonomy value of PL and BL depends on their intraspecific extent of variation as microalgae respond to external changing factors. To determine such effects, lipid class changes occurring at different growth stages in 15 microalgae from ten different classes were analyzed. BL occurred in 14 species and were the less affected lipids by growth stage with diacylglyceryl-hydroxymethyl-N,N,N-trimethyl-b-alanine (DGTA) showing the highest stability. PL were more influenced by growth stage with phosphatidylcholine (PC), phosphatidylglycerol (PG), and phosphatidyletanolamine (PE) declining towards older culture stages in some species. Glycolipids were the more common lipids, and no evident age-related variability pattern could be associated to taxonomic diversity. Selecting BL and PL as descriptor variables optimally distinguished microalgae taxonomic variability at all growth stages. Principal coordinate analysis arranged species through a main tendency from diacylglyceryl-hydroxymethyl-N,N,N-trimethyl-b-alanine (DGCC) containing species (mainly dinoflagellates and haptophytes) to DGTA or PC containing species (mainly cryptophytes). Two diatom classes with similar fatty acid profiles could be distinguished from their respective content in DGTA (Bacillariophyceae) or DGCC (Mediophyceae). In green lineage classes (Trebouxiophyceae, Porphyridophyceae, and Chlorodendrophyceae), PC was a better descriptor than BL. BL and PL explained a higher proportion of microalgae taxonomic variation than did fatty acids and played a complementary role as lipid markers.

Nurses' knowledge, clinical practice and attitude towards unconventional medicine: Implications for intercultural healthcare.

PubMed

Gyasi, Razak Mohammed; Abass, Kabila; Adu-Gyamfi, Samuel; Accam, Burnett Tetteh

2017-11-01

The aim of this hospital-based, cross-sectional study was to examine nurses' knowledge, personal and professional practices and attitude towards complementary and alternative medical therapies in urban Ghana. Using convenience sampling technique, cross-sectional data were collected from 210 registered and practicing nurses with self-administered questionnaire based on the Complementary and Alternative Medicine (CAM) Health Belief Questionnaire (CHBQ). Descriptive statistics and the associations between variables were calculated using Pearson's Chi-square test and/or Fisher's exact test with p < 0.05. The mean score of nurses' knowledge on CAM therapies was low (mean ± SD, 38.39 ± 10.11; possible range, 18-72) which was built on nurses' personal experiences. Nurses, therefore, lacked the confidence to recommend CAM therapies to patients. Despite the isolated cases of non-herbal supplements, relaxation techniques, massage and prayer healing, the study found an overall low personal use of CAM (mean ± SD, 32.97 ± 10.78; possible range, 18-72) among nurses over the last 12 months. Yet, nurses exhibited a positive attitude towards CAM (mean ± SD, 72.7 ± 12.5, possible range, 67-110). We observed significant associations among nurses' CAM knowledge and education [χ 2 (2) = 6.69, p = 0.035] and religion [χ 2 (2) = 7.96, p = 0.019]; nurses' personal use of CAM and income [χ 2 (2) = 16.07, p < 0.001] and religion [χ 2 (2) = 18.65, p < 0.001]; and nurses' clinical CAM use and income [χ 2 (2) = 7.01, p = 0.030]. Despite the overall positive attitude towards CAM therapies, Ghanaian nurses do not perceive themselves to have sufficient knowledge of CAM. Integrating CAM education into the nurses' training curriculum can improve CAM knowledge and professional practice among nurses, and in turn, enhance evidence-based patient care within the framework of intercultural healthcare system in Ghana. Copyright © 2017 Elsevier Ltd. All rights reserved.

Comparison of several satellite-derived databases of surface solar radiation against ground measurement in Morocco

NASA Astrophysics Data System (ADS)

Marchand, Mathilde; Ghennioui, Abdellatif; Wey, Etienne; Wald, Lucien

2018-04-01

HelioClim-3v4 (HC3v4), HelioClim-3v5 (HC3v5) and the radiation service version 2 of the Copernicus Atmosphere Monitoring Service (CAMS-Rad) are databases that contain hourly values of solar radiation at ground level. These estimated hourly irradiations are compared to coincident measurements made at five stations in Morocco. The correlation coefficients between measurements and estimates are similar for the three databases and around 0.97-0.98 for global irradiation. For the direct irradiation, the correlation coefficients are around 0.70-0.79 for HC3v4, 0.79-0.84 for HC3v5 and 0.78-0.87 for CAMS-Rad. For global irradiation, the bias relative to the average of the measurements is small and ranges between -6 and -1 % for HC3v4, -4 and 0 % for HC3v5, and -4 and 7 % for CAMS-Rad; HC3v4 and HC3v5 exhibit a tendency to slightly underestimate the global irradiation. The root mean square error (RMSE) ranges between 53 (12 %) and 72 Wh m-2 (13 %) for HC3v4, 55 (12 %) and 71 Wh m-2 (13 %) for HC3v5, and 59 (11 %) and 97 Wh m-2 (21 %) for CAMS-Rad. For the direct irradiation, the relative bias ranges between -16 and 21 % for HC3v4, -7 and 22 % for HC3v5, and -18 and 7 % for CAMS-Rad. The RMSE ranges between 170 (28 %) and 210 Wh m-2 (33 %) for HC3v4, 153 (25 %) and 209 Wh m-2 (40 %) for HC3v5, and 159 (26 %) and 244 Wh m-2 (39 %) for CAMS-Rad. HC3v5 captures the temporal and spatial variability of the irradiation field well. The performance is poorer for HC3v4 and CAMS-Rad which exhibit more variability from site to site. As a whole, the three databases are reliable sources on solar radiation in Morocco.

Complementary and Conventional Medicine Use Among Youth With Recurrent Headaches

PubMed Central

Kemper, Kathi J.; Gombojav, Narangerel; Koch, Thomas K.

2013-01-01

OBJECTIVE: To identify prevalence and patterns of complementary and alternative medicine (CAM) use among youth with recurrent headaches (HA) and evaluate associations with co-occurring health problems and limitations as well as with the use and expenditures for conventional medical care. METHODS: Variables were constructed for youth aged 10 to 17 by using linked data from the 2007 National Health Interview Survey and the 2008 Medical Expenditures Panel Survey. Bivariate, logistic, and 2-part regression analyses were used. RESULTS: Of the 10.6% of youth experiencing HA, 29.6% used CAM, rising to 41% for the many HA sufferers who also experienced difficulties with emotions, concentration, behavior, school attendance, or daily activities. Biologically based products (16.2%) and mind-body therapies (13.3%) were most commonly used, especially by the 86.4% of youth with HA experiencing at least 1 other chronic condition. Compared with non-CAM users, youth with HA who used CAM also had higher expenditures for and use of most types of conventional care. CONCLUSIONS: CAM use is most common among youth with HA experiencing multiple chronic conditions and difficulties in daily functioning. Associations among CAM use, multiple chronic conditions, and higher use of conventional care highlight the need for medical providers to routinely ask about CAM use to meet the complex health needs of their patients and facilitate the optimal integration of care. Research is needed to identify models for coordinating complementary and conventional care within a medical home and to understand the health benefits or risks associated with CAM use in conjunction with conventional treatments for patients with HA. PMID:24127466

Medical students' attitudes to complementary and alternative medicine: further validation of the IMAQ and findings from an international longitudinal study.

PubMed

Rees, Charlotte E; Wearn, Andy M; Dennis, Ian; Amri, Hakima; Greenfield, Sheila M

2009-02-01

Current research mainly employs cross-sectional designs to examine changes in medical students' attitudes towards complementary and alternative medicine (CAM). This paper reports the findings of a longitudinal study to further validate the Integrative Medicine Attitude Questionnaire (IMAQ) and examine changes in medical students' attitudes over 3 years. A total of 154 medical students from four schools in three countries completed a modified version of the IMAQ during their first (T1) and fourth year (T2). We established the validity of a three-factor model for the IMAQ: (1) attitudes towards holism; (2) attitudes towards the effectiveness of CAM therapies, and (3) attitudes towards introspection and the doctor-patient relationship. We found that IMAQ factor scores did not differ significantly from T1 to T2, emphasizing the relative stability in attitudes across time. Various student characteristics were significantly associated with IMAQ factor scores at T2: age, gender, CAM use, CAM education and school; and two variables (gender and CAM use) predicted changes in medical students' attitudes between T1 and T2. We urge medical educators to continue exploring medical students' attitude changes towards CAM and we provide examples of what further research is needed.

Ecophysiological Significance of CO2-Recycling via Crassulacean Acid Metabolism in Talinum calycinum Engelm. (Portulacaceae) 1

PubMed Central

Martin, Craig E.; Higley, Michael; Wang, Wei-Zhong

1988-01-01

High levels of variability in gas exchange characteristics and degree of CAM-cycling were found in the same and different individuals of Talinum calycinum Engelm. collected from rock outcrops in Missouri. Differences in CO2 assimilation were mostly correlated with differences in shoot conductance to CO2 not shoot internal CO2 concentration. As found previously, CAM acid fluctuations were evident in well-watered plants exhibiting C3 gas exchange patterns (CAM-cycling) and also in drought-stressed plants with stomata closed, or nearly so, day and night (CAM-idling). Drought stress also resulted in rapid stomatal closure, conserving water during droughts. Maximal CO2 uptake rates occurred below 35°C; higher temperatures induced decreases in CO2 assimilation and conductance while shoot internal CO2 concentrations remained similar. Plant water-use-efficiency was severely curtailed at temperatures above 30°C. Tissue acid fluctuations were the result of changes in malic acid concentrations. Calculations of the amount of water potentially conserved by CAM-cycling yielded values of approximately 5 to 44% of daytime water loss. Thus, CAM-cycling may be an important adaptation minimizing water loss by perennial succulents growing in shallow soil on rock outcrops. PMID:16665946

Analyzing and leveraging self-similarity for variable resolution atmospheric models

NASA Astrophysics Data System (ADS)

O'Brien, Travis; Collins, William

2015-04-01

Variable resolution modeling techniques are rapidly becoming a popular strategy for achieving high resolution in a global atmospheric models without the computational cost of global high resolution. However, recent studies have demonstrated a variety of resolution-dependent, and seemingly artificial, features. We argue that the scaling properties of the atmosphere are key to understanding how the statistics of an atmospheric model should change with resolution. We provide two such examples. In the first example we show that the scaling properties of the cloud number distribution define how the ratio of resolved to unresolved clouds should increase with resolution. We show that the loss of resolved clouds, in the high resolution region of variable resolution simulations, with the Community Atmosphere Model version 4 (CAM4) is an artifact of the model's treatment of condensed water (this artifact is significantly reduced in CAM5). In the second example we show that the scaling properties of the horizontal velocity field, combined with the incompressibility assumption, necessarily result in an intensification of vertical mass flux as resolution increases. We show that such an increase is present in a wide variety of models, including CAM and the regional climate models of the ENSEMBLES intercomparision. We present theoretical arguments linking this increase to the intensification of precipitation with increasing resolution.

Impact of Stochastic Parameterization Schemes on Coupled and Uncoupled Climate Simulations with the Community Earth System Model

NASA Astrophysics Data System (ADS)

Christensen, H. M.; Berner, J.; Coleman, D.; Palmer, T.

2015-12-01

Stochastic parameterizations have been used for more than a decade in atmospheric models to represent the variability of unresolved sub-grid processes. They have a beneficial effect on the spread and mean state of medium- and extended-range forecasts (Buizza et al. 1999, Palmer et al. 2009). There is also increasing evidence that stochastic parameterization of unresolved processes could be beneficial for the climate of an atmospheric model through noise enhanced variability, noise-induced drift (Berner et al. 2008), and by enabling the climate simulator to explore other flow regimes (Christensen et al. 2015; Dawson and Palmer 2015). We present results showing the impact of including the Stochastically Perturbed Parameterization Tendencies scheme (SPPT) in coupled runs of the National Center for Atmospheric Research (NCAR) Community Atmosphere Model, version 4 (CAM4) with historical forcing. The SPPT scheme accounts for uncertainty in the CAM physical parameterization schemes, including the convection scheme, by perturbing the parametrised temperature, moisture and wind tendencies with a multiplicative noise term. SPPT results in a large improvement in the variability of the CAM4 modeled climate. In particular, SPPT results in a significant improvement to the representation of the El Nino-Southern Oscillation in CAM4, improving the power spectrum, as well as both the inter- and intra-annual variability of tropical pacific sea surface temperatures. References: Berner, J., Doblas-Reyes, F. J., Palmer, T. N., Shutts, G. J., & Weisheimer, A., 2008. Phil. Trans. R. Soc A, 366, 2559-2577 Buizza, R., Miller, M. and Palmer, T. N., 1999. Q.J.R. Meteorol. Soc., 125, 2887-2908. Christensen, H. M., I. M. Moroz & T. N. Palmer, 2015. Clim. Dynam., doi: 10.1007/s00382-014-2239-9 Dawson, A. and T. N. Palmer, 2015. Clim. Dynam., doi: 10.1007/s00382-014-2238-x Palmer, T.N., R. Buizza, F. Doblas-Reyes, et al., 2009, ECMWF technical memorandum 598.

Survey of UK dentists regarding the use of CAD/CAM technology.

PubMed

Tran, D; Nesbit, M; Petridis, H

2016-11-18

Statement of the problem Digital workflows (CAD/CAM) have been introduced in dentistry during recent years. No published information exists on dentists' use and reporting of this technology.Purpose The purpose of this survey was to identify the infiltration of CAD/CAM technology in UK dental practices and to investigate the relationship of various demographic factors to the answers regarding use or non-use of this technology.Materials and methods One thousand and thirty-one online surveys were sent to a sample of UK dentists composing of both users and non-users of CAD/CAM. It aimed to reveal information regarding type of usage, materials, perceived benefits, barriers to access, and disadvantages of CAD/CAM dentistry. Statistical analysis was undertaken to test the influence of various demographic variables such as country of work, dentist experience, level of training and type of work (NHS or private).Results The number of completed responses totalled 385. Most of the respondents did not use any part of a digital workflow, and the main barriers to CAD/CAM use were initial costs and a lack of perceived benefit over conventional methods. Dentists delivering mostly private work were most likely to have adopted CAD/CAM technology (P <0.001). Further training also correlated with a greater likelihood of CAD/CAM usage (P <0.001). Most users felt that the technology had led to a change in the use of dental materials, leading to increased use of, for example, zirconia and lithium disilicate. Most users were trained either by companies or self-trained, and a third felt that their training was insufficient. The majority of respondents (89%) felt that CAD/CAM had a big role to play in the future.Conclusion Most of the respondents did not use any part of a digital workflow. However, the majority of surveyed dentists were interested in incorporating CAD/CAM into their workflow, while most believed that it will have a big role in the future. There are still some concerns from dentists about the quality of chairside CAD/CAM restorations while the costs are still in the main hugely prohibitive (especially for NHS dentistry).

Use of complementary and alternative medicine for treatment among African-Americans: a multivariate analysis.

PubMed

Barner, Jamie C; Bohman, Thomas M; Brown, Carolyn M; Richards, Kristin M

2010-09-01

The use of complementary and alternative medicine (CAM) is substantial among African-Americans; however, research on characteristics of African-Americans who use CAM to treat specific conditions is scarce. To determine what predisposing, enabling, need, and disease-state factors are related to CAM use for treatment among a nationally representative sample of African-Americans. A cross-sectional study design was employed using the 2002 National Health Interview Survey (NHIS). A nationwide representative sample of adult (> or =18 years) African-Americans who used CAM in the past 12 months (n=16,113,651 weighted; n=2,952 unweighted) was included. The Andersen Health Care Utilization Model served as the framework with CAM use for treatment as the main outcome measure. Independent variables included the following: predisposing (eg, age, gender, and education); enabling (eg, income, employment, and access to care); need (eg, health status, physician visits, and prescription medication use); and disease state (ie, most prevalent conditions among African-Americans) factors. Multivariate logistic regression was used to address the study objective. Approximately 1 in 5 (20.2%) who used CAM in the past 12 months used CAM to treat a specific condition. Ten of the 15 CAM modalities were used primarily for treatment by African-Americans. CAM for treatment was significantly (P<.05) associated with the following factors: graduate education, smaller family size, higher income, region (northeast, midwest, west more likely than south), depression/anxiety, more physician visits, less likely to engage in preventive care, more frequent exercise behavior, more activities of daily living (ADL) limitations, and neck pain. Twenty percent of African-Americans who used CAM in the past year were treating a specific condition. Alternative medical systems, manipulative and body-based therapies, and folk medicine, prayer, biofeedback, and energy/Reiki were used most often. Health care professionals should routinely ask patients about the use of CAM, but when encountering African-Americans, there may be a number of factors that may serve as cues for further inquiry. Copyright 2010 Elsevier Inc. All rights reserved.

Modeling dust as component minerals in the Community Atmosphere Model: development of framework and impact on radiative forcing

DOE PAGES

Scanza, R. A.; Mahowald, N.; Ghan, S.; ...

2014-07-02

The mineralogy of desert dust is important due to its effect on radiation, clouds and biogeochemical cycling of trace nutrients. This study presents the simulation of dust radiative forcing as a function of both mineral composition and size at the global scale using mineral soil maps for estimating emissions. Externally mixed mineral aerosols in the bulk aerosol module in the Community Atmosphere Model version 4 (CAM4) and internally mixed mineral aerosols in the modal aerosol module in the Community Atmosphere Model version 5.1 (CAM5) embedded in the Community Earth System Model version 1.0.5 (CESM) are speciated into common mineral componentsmore » in place of total dust. The simulations with mineralogy are compared to available observations of mineral atmospheric distribution and deposition along with observations of clear-sky radiative forcing efficiency. Based on these simulations, we estimate the all-sky direct radiative forcing at the top of the atmosphere as +0.05 W m −2 for both CAM4 and CAM5 simulations with mineralogy and compare this both with simulations of dust in release versions of CAM4 and CAM5 (+0.08 and +0.17 W m −2) and of dust with optimized optical properties, wet scavenging and particle size distribution in CAM4 and CAM5, −0.05 and −0.17 W m −2, respectively. The ability to correctly include the mineralogy of dust in climate models is hindered by its spatial and temporal variability as well as insufficient global in-situ observations, incomplete and uncertain source mineralogies and the uncertainties associated with data retrieved from remote sensing methods.« less

Modeling dust as component minerals in the Community Atmosphere Model: development of framework and impact on radiative forcing

DOE PAGES

Scanza, Rachel; Mahowald, N.; Ghan, Steven J.; ...

2015-01-01

The mineralogy of desert dust is important due to its effect on radiation, clouds and biogeochemical cycling of trace nutrients. This study presents the simulation of dust radiative forcing as a function of both mineral composition and size at the global scale, using mineral soil maps for estimating emissions. Externally mixed mineral aerosols in the bulk aerosol module in the Community Atmosphere Model version 4 (CAM4) and internally mixed mineral aerosols in the modal aerosol module in the Community Atmosphere Model version 5.1 (CAM5) embedded in the Community Earth System Model version 1.0.5 (CESM) are speciated into common mineral componentsmore » in place of total dust. The simulations with mineralogy are compared to available observations of mineral atmospheric distribution and deposition along with observations of clear-sky radiative forcing efficiency. Based on these simulations, we estimate the all-sky direct radiative forcing at the top of the atmosphere as + 0.05 Wm⁻² for both CAM4 and CAM5 simulations with mineralogy. We compare this to the radiative forcing from simulations of dust in release versions of CAM4 and CAM5 (+0.08 and +0.17 Wm⁻²) and of dust with optimized optical properties, wet scavenging and particle size distribution in CAM4 and CAM5, -0.05 and -0.17 Wm⁻², respectively. The ability to correctly include the mineralogy of dust in climate models is hindered by its spatial and temporal variability as well as insufficient global in situ observations, incomplete and uncertain source mineralogies and the uncertainties associated with data retrieved from remote sensing methods.« less

Normal forms for reduced stochastic climate models

PubMed Central

Majda, Andrew J.; Franzke, Christian; Crommelin, Daan

2009-01-01

The systematic development of reduced low-dimensional stochastic climate models from observations or comprehensive high-dimensional climate models is an important topic for atmospheric low-frequency variability, climate sensitivity, and improved extended range forecasting. Here techniques from applied mathematics are utilized to systematically derive normal forms for reduced stochastic climate models for low-frequency variables. The use of a few Empirical Orthogonal Functions (EOFs) (also known as Principal Component Analysis, Karhunen–Loéve and Proper Orthogonal Decomposition) depending on observational data to span the low-frequency subspace requires the assessment of dyad interactions besides the more familiar triads in the interaction between the low- and high-frequency subspaces of the dynamics. It is shown below that the dyad and multiplicative triad interactions combine with the climatological linear operator interactions to simultaneously produce both strong nonlinear dissipation and Correlated Additive and Multiplicative (CAM) stochastic noise. For a single low-frequency variable the dyad interactions and climatological linear operator alone produce a normal form with CAM noise from advection of the large scales by the small scales and simultaneously strong cubic damping. These normal forms should prove useful for developing systematic strategies for the estimation of stochastic models from climate data. As an illustrative example the one-dimensional normal form is applied below to low-frequency patterns such as the North Atlantic Oscillation (NAO) in a climate model. The results here also illustrate the short comings of a recent linear scalar CAM noise model proposed elsewhere for low-frequency variability. PMID:19228943

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

Williamson, David L.; Olson, Jerry G.; Hannay, Cécile

An error in the energy formulation in the Community Atmosphere Model (CAM) is identified and corrected. Ten year AMIP simulations are compared using the correct and incorrect energy formulations. Statistics of selected primary variables all indicate physically insignificant differences between the simulations, comparable to differences with simulations initialized with rounding sized perturbations. The two simulations are so similar mainly because of an inconsistency in the application of the incorrect energy formulation in the original CAM. CAM used the erroneous energy form to determine the states passed between the parameterizations, but used a form related to the correct formulation for themore » state passed from the parameterizations to the dynamical core. If the incorrect form is also used to determine the state passed to the dynamical core the simulations are significantly different. In addition, CAM uses the incorrect form for the global energy fixer, but that seems to be less important. The difference of the magnitude of the fixers using the correct and incorrect energy definitions is very small.« less

The usage of complementary and alternative medicine in gastrointestinal patients visiting the outpatients’ department of a large tertiary care centre-views from Pakistan

PubMed Central

Lail, Ghulamullah; Luck, Nasir; Tasneem, Abbas Ali; Rai, AyeshaAslam; Laeeq, Syed Mudasir; Majid, Zain

2016-01-01

Introduction The use of complementary and alternative medicine (CAM) has increased over the last few years, and an emergent data suggests that some CAM modalities may be helpful in addressing gastrointestinal (GI) conditions. Our aim was to find out the prevalence of such practices for GI condition amongst patients visiting an OPD of a large tertiary care centre of Karachi, Pakistan. Methods Patients visiting outpatient department of Hepatogastroenterology department at SIUT, Pakistan from March 2014 to March 2015, were included in this cross sectional study. A pre designed questionnaire was used that included the demographic data, primary disease of the patient, CAM modality used, reason for the use of CAM therapy and reasons for stopping it. Frequencies of different variables were computed using SPSS version 18. Results 906 patients were interviewed, out of which 52% (471) were males. The mean age at presentation was 39.81±12.4 years. 234 (25.8%) of the participants used one of the CAM modalities; Herbal medicine being most common one, seen in 122 (52.13%) followed by spiritual 61 (26%), and homeopathy 33 (14%). The duration of therapy was limited to six months in 161(68%), whereas 7 patients (2.9%) had prolonged duration of use of more than five years. Reasons for using CAM therapy included advice by family and friends in 66 patients (28%), personal will in 42 (17.94%), no benefit from allopathic treatment in 34 (14.5%), while high cost was the reason of use in 3(5%) of the patients. The most common reason for discontinuation of CAM was no benefit, seen in 113 patients (48.30%), followed by physician's advice in 32 (17%) patients, and side effects in 19 (8%). On the other hand 44 patients (18.80%) reported benefit from the therapy while 14 (5.9%) were still continuing with CAM modality. Among the CAM users 140 (60.09%) were un-educated or had primary education while CAM nonusers had 328 (47%) were either uneducated or had primary education only correlation reveals P value 0.004. Conclusion Significant numbers of patients used CAM therapy. A lower level of education was associated with increased usage of CAM while cost had no major impact on its usage. PMID:27800102

Precision Fit of Screw-Retained Implant-Supported Fixed Dental Prostheses Fabricated by CAD/CAM, Copy-Milling, and Conventional Methods.

PubMed

de França, Danilo Gonzaga; Morais, Maria Helena; das Neves, Flávio D; Carreiro, Adriana Fonte; Barbosa, Gustavo As

The aim of this study was to evaluate the effectiveness of fabrication methods (computer-aided design/computer-aided manufacture [CAD/CAM], copy-milling, and conventional casting) in the fit accuracy of three-unit, screw-retained fixed dental prostheses. Sixteen three-unit implant-supported screw-retained frameworks were fabricated to fit an in vitro model. Eight frameworks were fabricated using the CAD/CAM system, four in zirconia and four in cobalt-chromium. Four zirconia frameworks were fabricated using the copy-milled system, and four were cast in cobalt-chromium using conventional casting with premachined abutments. The vertical and horizontal misfit at the implant-framework interface was measured using scanning electron microscopy at ×250. The results for vertical misfit were analyzed using Kruskal-Wallis and Mann-Whitney tests. The horizontal misfits were categorized as underextended, equally extended, or overextended. Statistical analysis established differences between groups according to the chi-square test (α = .05). The mean vertical misfit was 5.9 ± 3.6 μm for CAD/CAM-fabricated zirconia, 1.2 ± 2.2 μm for CAD/CAM-fabricated cobalt-chromium frameworks, 7.6 ± 9.2 μm for copy-milling-fabricated zirconia frameworks, and 11.8 (9.8) μm for conventionally fabricated frameworks. The Mann-Whitney test revealed significant differences between all but the zirconia-fabricated frameworks. A significant association was observed between the horizontal misfits and the fabrication method. The percentage of horizontal misfits that were underextended and overextended was higher in milled zirconia (83.3%), CAD/CAM cobaltchromium (66.7%), cast cobalt-chromium (58.3%), and CAD/CAM zirconia (33.3%) frameworks. CAD/CAM-fabricated frameworks exhibit better vertical misfit and low variability compared with copy-milled and conventionally fabricated frameworks. The percentage of interfaces equally extended was higher when CAD/CAM and zirconia were used.

Structure of the Madden-Julian oscillation in coupled and uncoupled versions of the superparameterized community atmosphere model

NASA Astrophysics Data System (ADS)

Benedict, James J.

The Madden-Julian Oscillation (MJO), an eastward-propagating atmospheric disturbance resembling a transient Walker cell, dominates intraseasonal (20--100 days) variability in the tropical Indian and West Pacific Ocean regions. The phenomenon is most active during the Northern Hemisphere winter and is characterized by cyclic periods of suppressed (dry phase) and active (wet phase) cloudiness and precipitation. Numerous complexities---multi-scale interactions of moist convection and large-scale wave dynamics, air-sea fluxes and feedbacks, topographical impacts, and tropical-extratropical interactions---challenge our ability to fully understand the MJO and result in its poor representation in most current general circulation models (GCMs). This study examines the representation of the MJO in a modified version of the NCAR Community Atmosphere Model (CAM). The modifications involve substituting conventional boundary layer, turbulence, and cloud parameterizations with a configuration of cloud-resolving models (CRMs) embedded into each GCM grid cell in a technique termed "superparameterization" (SP). Unlike many GCMs including the standard CAM, the SP-CAM displays robust intraseasonal convective variability. Two SP-CAM simulations are utilized in this study: one forced by observed sea-surface temperatures (SSTs; "uncoupled") and a second identical to the first except for a new treatment of tropical SSTs in which a simplified mixed-layer ocean model is used to predict SST anomalies that are coupled to the atmosphere ("coupled"). Key physical features of the MJO are captured in the uncoupled SP-CAM. Ahead (east) of the disturbance there is meridional boundary layer moisture convergence and a vertical progression of warmth, moisture, and convective heating from the lower to upper troposphere. The space-time dynamical response to convective heating is also reproduced, especially the vertical structure of anomalous westerly wind and its migration into the region of heavy rainfall as the disturbance propagates eastward. Advective drying processes in the MJO wake are also represented well. The coupled SP-CAM shows more realistic MJO eastward propagation, signal coherence and spatial structure relative to the uncoupled SP-CAM. The improvement varies with longitude but generally stems from better space-time relationships among MJO convective heating, its dynamical response, SSTs, surface fluxes, boundary layer properties, and vertical moisture structure. Coupled MJO events in the Indian Ocean display more realistic intensity; in the West Pacific, the coupled SP-CAM overestimates convective strength but shows an improved vertical structure relative to the uncoupled SP-CAM. Biases related to MJO convection are also examined. Overestimated convective intensity in the West Pacific appears to be linked to basic state biases, Maritime Continent topographical impacts, unrealistic convection-wind-evaporation feedbacks, and the neglect of convective momentum transport in the model. Phase errors between observed and simulated boundary layer moisture appear to stem from an unrealistic representation of shallow cumuli.

Optical and radio properties of X-ray selected BL Lacertae objects

NASA Technical Reports Server (NTRS)

Stocke, J. T.; Liebert, J.; Schmidt, G.; Gioia, I. M.; Maccacaro, T.

1985-01-01

The eight BL Lac objects from the HEAO 1 A-2 all-sky survey and from the Einstein medium-sensitivity survey (MSS) form a flux-limited complete X-ray selected sample. The optical and radio properties of the MSS BL Lac objects are presented and compared with those of the HEAO 1 A-2 sample and with those of radio-selected BL Lac objects. The X-ray selected BL Lac objects possess smaller polarized fractions and less violent optical variability than radio-selected BL Lac objects. These properties are consistent with the substantial starlight fraction seen in the optical spectra of a majority of these objects. This starlight allows a determination of definite redshifts for two of four MSS BL Lac objects and a probable redshift for a third. These redshifts are 0.2, 0.3, and 0.6. Despite the differences in characteristics between the X-ray selected and radio-selected samples, it is concluded that these eight objects possess most of the basic qualities of BL Lac objects and should be considered members of that class. Moreover, as a class, these X-ray selected objects have the largest ratio of X-ray to optical flux of any active galactic nuclei yet discovered.

The contribution of weak CAM to the photosynthetic metabolic activities of a bromeliad species under water deficit.

PubMed

Pikart, Filipe C; Marabesi, Mauro A; Mioto, Paulo T; Gonçalves, Ana Z; Matiz, Alejandra; Alves, Frederico R R; Mercier, Helenice; Aidar, Marcos P M

2018-02-01

The Crassulacean acid metabolism (CAM) can be a transitory strategy for saving water during unfavourable conditions, like a dry season. In some cases, CAM can also contribute to the maintenance of photosynthetic integrity, even if carbon gain and growth are impaired. CAM occurs in different intensities, being stronger or weaker depending on the degree of nocturnal malic acid accumulation. For example, Guzmania monostachia is an epiphytic tank bromeliad that shows an increase in its nocturnal organic acid accumulation and a variable CAM behaviour when exposed to water deficit. In this context, this study aimed at investigating whether the weak CAM displayed by this species may mitigate the harmful effects of water limitation on its photosynthetic activity. To this, bromeliads were submitted to well-watered and water deficit conditions. Guzmania monostachia plants under water deficiency conditions showed a reduction on atmospheric carbon assimilation without exhibiting changes in PSII integrity and carbohydrate production while showed an increase in nocturnal malic acid accumulation. Additionally, spots with high PSII efficiency in the leaf portion with a greater nocturnal malic acid accumulation were observed in plants exposed to water shortage conditions. These high-efficiency spots might be associated with a greater malate decarboxylation capacity. Also, the malic acid contributed to approximately 50% of the total carbon assimilated under water deficit. These results suggest that weak CAM may participate in photo-protection and it appears to meaningfully contribute to the overall carbon balance, being an important metabolic strategy to maintain plant fitness during water deficit periods. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Are some BL Lacs artefacts of gravitational lensing?

PubMed

Ostriker, J P; Vietri, M

1990-03-01

WE suggested in 1985 that a significant fraction of BL Lacertae objects, a kind of lineless quasar, seen in nearby galaxies are in fact images, gravitationally lensed and substantially amplified by stars in the nearby galaxy, of background objects, optically violent variable (OVV) quasars at redshifts z > 1 (ref. 1). This hypothesis was made on the basis of certain general similarities between BL Lacs and O Ws, but for two recently observed BL Lacs(2,3) a strong case can be made that the accompanying elliptical galaxy is a foreground object. In addition, we argue that the distribution of BL Lac redshifts is hard to understand without gravitational lensing, unless we happen to be at a very local maximum of the spatial cosmic distribution of BL Lacs. Our analysis also indicates that the galaxies whose stars are likely to act as microlenses will be found in two peaks, one nearby, with redshift 0.05-0.10, and the other near the distant quasar.

The quantity and quality of complementary and alternative medicine clinical practice guidelines on herbal medicines, acupuncture and spinal manipulation: systematic review and assessment using AGREE II.

PubMed

Ng, Jeremy Y; Liang, Laurel; Gagliardi, Anna R

2016-10-29

Complementary and alternative medicine (CAM) use is often not disclosed by patients, and can be unfamiliar to health care professionals. This may lead to underuse of beneficial CAM therapies, and overuse of other CAM therapies with little proven benefit or known contraindications. No prior research has thoroughly evaluated the credibility of knowledge-based resources. The purpose of this research was to assess the quantity and quality of CAM guidelines. A systematic review was conducted to identify CAM guidelines. MEDLINE, EMBASE and CINAHL were searched in January 2016 from 2003 to 2015. The National Guideline Clearinghouse, National Center for Complementary and Integrative Health web site, and two CAM journals were also searched. Eligible guidelines published in English language by non-profit agencies on herbal medicine, acupuncture, or spinal manipulation for adults with any condition were assessed with the Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument. From 3,126 unique search results, 17 guidelines (two herbal medicine, three acupuncture, four spinal manipulation, eight mixed CAM therapies) published in 2003 or later and relevant to several clinical conditions were eligible. Scaled domain percentages from highest to lowest were clarity of presentation (85.3 %), scope and purpose (83.3 %), rigour of development (61.2 %), editorial independence (60.1 %), stakeholder involvement (52.0 %) and applicability (20.7 %). Quality varied within and across guidelines. None of the 17 guidelines were recommended by both appraisers; 14 were recommended as Yes or Yes with modifications. Guidelines that scored well could be used by patients and health care professionals as the basis for discussion about the use of these CAM therapies. In future updates, guidelines that achieved variable or lower scores could be improved according to specifications in the AGREE II instrument, and with insight from a large number of resources that are available to support guideline development and implementation. Future research should identify CAM therapies other than those reviewed here for which guidelines are available. Research is also needed on the safety and effectiveness of CAM therapies.

Determining the attitudes and use of complementary, alternative, and integrative medicine among undergraduates.

PubMed

Liu, Michael A; Huynh, Ngoc-Tram; Broukhim, Michael; Cheung, Douglas H; Schuster, Tonya L; Najm, Wadie

2014-09-01

To (1) determine the attitudes, perceptions, and use of complementary, alternative, and integrative medicine among undergraduate students; (2) assess whether these students would benefit from more academic exposure to complementary and alternative medicine (CAM) and promotion of integrative medicine (IM); and (3) gauge the need and desire of undergraduates, particularly pre-health learners, to take courses about CAM/IM. This cross-sectional electronic survey study was conducted on the campus of the University of California (UC) Irvine. Selection criteria included being at least 18 years of age and a current undergraduate at UC Irvine. All survey responses were collected between November 20, 2010, and June 1, 2011. The data were analyzed by using Stata software, version 11-SE (Stata Corp., College Station, TX). Completed surveys were received from 2839 participants (mean age of respondents, 20.2 years). Thirty-five percent had used CAM within the past 12 months, and 92.8% believed CAM to be at least somewhat effective; however, only 31% had prior education on CAM. After adjustment for variables, familiarity and belief in effectiveness were both highly linked to the use of CAM, with ascending odds ratios (ORs; 95% confidence interval [CI]) of 3.9 (3.1-4.9), 8.1 (5.7-11.5), 13.4 (6.0-30.2), 2.1 (1.3-3.4), 4.9 (3.0-7.8), and 12.7 (6.9-23.4) among increasing categories (all p<0.01). Sex (OR, 1.26 [95% CI, 1.01-1.56]; p<0.05), Asian ethnicity (1.46 [1.14-1.88]; p<0.01), and prior education (1.26 [1.01-1.57]; p<0.05) were also significantly correlated to the use of CAM after adjustment. Most respondents indicated that they were likely to take a CAM college course if it fulfilled a graduation requirement (63.6%) or was offered within their major (56.4%). Overall, this large-scale study supports the ideas that education plays a pivotal factor in the decision to use CAM and that there is a large demand for additional CAM knowledge among college students.

Comparison of the Effects of Manual Acupuncture, Laser Acupuncture, and Electromagnetic Field Stimulation at Acupuncture Point BL15 on Heart Rate Variability.

PubMed

Lee, Na Ra; Kim, Soo Byeong; Heo, Hyun; Lee, Yong Heum

2016-10-01

The aim of this study was to compare the influences of manual acupuncture, laser acupuncture, and electromagnetic field stimulation on the autonomic nervous system. We monitored the heart rate variability before and after stimulation to check the influence on the autonomic nervous system. The heart rate variabilities at low frequency (LF; 0.04-0.15 Hz) and high frequency (HF; 0.15-0.4 Hz) were analyzed to acquire LF/HF ratio. Xinshu (BL15) was selected as the stimulation point. Methods included manual acupuncture with a 1-cm depth and laser acupuncture at a wavelength of 660 nm and output power of 50 mW. An electromagnetic field of 2 Hz and 460 gauss (46 mT) was chosen. The LF and the LF/HF ratio were found to be lower in the manual acupuncture and the electromagnetic field groups, but to be higher in the laser acupuncture group. The HF was found to be lower in the laser acupuncture group, but higher in the manual acupuncture and the electromagnetic field groups. In conclusion, we found that manual acupuncture and electromagnetic field stimulation at BL15 activated the parasympathetic nervous system, whereas laser acupuncture at BL15 activated the sympathetic nervous system. Copyright © 2016. Published by Elsevier B.V.

Identification of anaerobic threshold by analysis of heart rate variability during discontinuous dynamic and resistance exercise protocols in healthy older men.

PubMed

Simões, Rodrigo Polaquini; Castello-Simões, Viviane; Mendes, Renata Gonçalves; Archiza, Bruno; Dos Santos, Daniel Augusto; Bonjorno, José Carlos; de Oliveira, Claudio Ricardo; Catai, Aparecida Maria; Arena, Ross; Borghi-Silva, Audrey

2014-03-01

The purposes of this study were to determine anaerobic threshold (AT) during discontinuous dynamic and resistive exercise protocols by analysing of heart rate variability (HRV) and blood lactate (BL) in healthy elderly subjects and compare the cardiovascular, metabolic and autonomic variables obtained from these two forms of exercise. Fourteen elderly (70 ± 4 years) apparently healthy males underwent the following tests: (i) incremental ramp test on cycle ergometer, (ii) one repetition maximum (1RM) leg press at 45°, (iii) a discontinuous exercise test on a cycle ergometer (DET-C) protocol and (iv) a resistance exercise leg press (DET-L) protocol. Heart rate, blood pressure and BL were obtained during each increment of exercise intensity. No significant differences (P>0·05) were found between methods of AT determination (BL and HRV) nor the relative intensity corresponding to AT (30% of maximum intensity) between the types of exercise (DET-C and DET-L). Furthermore, no significant differences (P>0·05) were found between the DET-C and DET-L in relation to HRV, however, the DET-L provided higher values of systolic blood pressure and BL (P<0·05) from the intensity corresponding to AT. We conclude that HRV was effective in determination of AT, and the parasympathetic modulation responses obtained during dynamic and resistive exercise protocols were similar when compared at the same relative intensity. However, DET-L resulted in higher values of blood pressure and BL at workloads beyond AT. © 2013 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

In God and CAM we trust. Religious faith and use of complementary and alternative medicine (CAM) in a nationwide cohort of women treated for early breast cancer.

PubMed

Pedersen, Christina Gundgaard; Christensen, Søren; Jensen, Anders Bonde; Zachariae, Robert

2013-09-01

Turning to faith in God or a higher spiritual power is a common way of coping with life-threatening disease such as cancer. Little, however, is known about religious faith among cancer patients in secular societies. The present study aimed at exploring the prevalence of religious faith among Danish breast cancer patients and at identifying whether socio-demographic, pre-cancer health status, clinical, and health behavior characteristics, including their use of complementary and alternative medicine (CAM), were associated with their degree of faith. Information on faith in God or a higher spiritual power and use of CAM was provided by a nationwide sample of 3,128 recurrence-free Danish women who had received surgery for early-stage breast cancer 15-16 months earlier. Socio-demographic, clinical, and health status variables were obtained from national longitudinal registries, and health behaviors had been assessed at 3-4 months post-surgery. Of the women, 47.3% reported a high degree of faith (unambiguous believers), 35.9% some degree of faith (ambiguous believers), while the remaining 16.8% were non-believers. Unambiguous believers were more likely than ambiguous believers to experience their faith as having a positive impact on their disease and their disease-related quality-of-life. When compared to non-believers, unambiguous believers were also older, had poorer physical function, and were more frequent users of CAM, and more inclined to believe that their use of CAM would have a beneficial influence on their cancer. Disease- and treatment-related variables were unrelated to faith. While overall religious faith appears equally prevalent among Danish and US breast cancer patients, the majority of Danish breast cancer patients experienced ambiguous faith, whereas the majority of US patients have been found to express unambiguous faith. Our results suggest that future studies may benefit from exploring the role of faith for health behaviors, adherence to conventional treatment, and impact upon quality of life.

Description and evaluation of tropospheric chemistry and aerosols in the Community Earth System Model (CESM1.2)

DOE PAGES

Tilmes, S.; Lamarque, J. -F.; Emmons, L. K.; ...

2015-01-01

The Community Atmosphere Model (CAM), version 5, is now coupled to extensive tropospheric and stratospheric chemistry, called CAM5-chem, and is available in addition to CAM4-chem in the Community Earth System Model (CESM) version 1.2. The main focus of this paper is to compare the performance of configurations with internally derived "free running" (FR) meteorology and "specified dynamics" (SD) against observations from surface, aircraft, and satellite, as well as understand the origin of the identified differences. We focus on the representation of aerosols and chemistry. All model configurations reproduce tropospheric ozone for most regions based on in situ and satellite observations.more » However, shortcomings exist in the representation of ozone precursors and aerosols. Tropospheric ozone in all model configurations agrees for the most part with ozonesondes and satellite observations in the tropics and the Northern Hemisphere within the variability of the observations. Southern hemispheric tropospheric ozone is consistently underestimated by up to 25%. Differences in convection and stratosphere to troposphere exchange processes are mostly responsible for differences in ozone in the different model configurations. Carbon monoxide (CO) and other volatile organic compounds are largely underestimated in Northern Hemisphere mid-latitudes based on satellite and aircraft observations. Nitrogen oxides (NO x) are biased low in the free tropical troposphere, whereas peroxyacetyl nitrate (PAN) is overestimated in particular in high northern latitudes. The present-day methane lifetime estimates are compared among the different model configurations. These range between 7.8 years in the SD configuration of CAM5-chem and 8.8 years in the FR configuration of CAM4-chem and are therefore underestimated compared to observational estimations. We find that differences in tropospheric aerosol surface area between CAM4 and CAM5 play an important role in controlling the burden of the tropical tropospheric hydroxyl radical (OH), which causes differences in tropical methane lifetime of about half a year between CAM4-chem and CAM5-chem. In addition, different distributions of NO x from lightning explain about half of the difference between SD and FR model versions in both CAM4-chem and CAM5-chem. Remaining differences in the tropical OH burden are due to enhanced tropical ozone burden in SD configurations compared to the FR versions, which are not only caused by differences in chemical production or loss but also by transport and mixing. For future studies, we recommend the use of CAM5-chem configurations, due to improved aerosol description and inclusion of aerosol–cloud interactions. However, smaller tropospheric surface area density in the current version of CAM5-chem compared to CAM4-chem results in larger oxidizing capacity in the troposphere and therefore a shorter methane lifetime.« less

Description and evaluation of tropospheric chemistry and aerosols in the Community Earth System Model (CESM1.2)

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

Tilmes, S.; Lamarque, J. -F.; Emmons, L. K.

The Community Atmosphere Model (CAM), version 5, is now coupled to extensive tropospheric and stratospheric chemistry, called CAM5-chem, and is available in addition to CAM4-chem in the Community Earth System Model (CESM) version 1.2. The main focus of this paper is to compare the performance of configurations with internally derived "free running" (FR) meteorology and "specified dynamics" (SD) against observations from surface, aircraft, and satellite, as well as understand the origin of the identified differences. We focus on the representation of aerosols and chemistry. All model configurations reproduce tropospheric ozone for most regions based on in situ and satellite observations.more » However, shortcomings exist in the representation of ozone precursors and aerosols. Tropospheric ozone in all model configurations agrees for the most part with ozonesondes and satellite observations in the tropics and the Northern Hemisphere within the variability of the observations. Southern hemispheric tropospheric ozone is consistently underestimated by up to 25%. Differences in convection and stratosphere to troposphere exchange processes are mostly responsible for differences in ozone in the different model configurations. Carbon monoxide (CO) and other volatile organic compounds are largely underestimated in Northern Hemisphere mid-latitudes based on satellite and aircraft observations. Nitrogen oxides (NO x) are biased low in the free tropical troposphere, whereas peroxyacetyl nitrate (PAN) is overestimated in particular in high northern latitudes. The present-day methane lifetime estimates are compared among the different model configurations. These range between 7.8 years in the SD configuration of CAM5-chem and 8.8 years in the FR configuration of CAM4-chem and are therefore underestimated compared to observational estimations. We find that differences in tropospheric aerosol surface area between CAM4 and CAM5 play an important role in controlling the burden of the tropical tropospheric hydroxyl radical (OH), which causes differences in tropical methane lifetime of about half a year between CAM4-chem and CAM5-chem. In addition, different distributions of NO x from lightning explain about half of the difference between SD and FR model versions in both CAM4-chem and CAM5-chem. Remaining differences in the tropical OH burden are due to enhanced tropical ozone burden in SD configurations compared to the FR versions, which are not only caused by differences in chemical production or loss but also by transport and mixing. For future studies, we recommend the use of CAM5-chem configurations, due to improved aerosol description and inclusion of aerosol–cloud interactions. However, smaller tropospheric surface area density in the current version of CAM5-chem compared to CAM4-chem results in larger oxidizing capacity in the troposphere and therefore a shorter methane lifetime.« less

The role of sex and body weight on the metabolic effects of high-fat diet in C57BL/6N mice.

PubMed

Ingvorsen, C; Karp, N A; Lelliott, C J

2017-04-10

Metabolic disorders are commonly investigated using knockout and transgenic mouse models on the C57BL/6N genetic background due to its genetic susceptibility to the deleterious metabolic effects of high-fat diet (HFD). There is growing awareness of the need to consider sex in disease progression, but limited attention has been paid to sexual dimorphism in mouse models and its impact in metabolic phenotypes. We assessed the effect of HFD and the impact of sex on metabolic variables in this strain. We generated a reference data set encompassing glucose tolerance, body composition and plasma chemistry data from 586 C57BL/6N mice fed a standard chow and 733 fed a HFD collected as part of a high-throughput phenotyping pipeline. Linear mixed model regression analysis was used in a dual analysis to assess the effect of HFD as an absolute change in phenotype, but also as a relative change accounting for the potential confounding effect of body weight. HFD had a significant impact on all variables tested with an average absolute effect size of 29%. For the majority of variables (78%), the treatment effect was modified by sex and this was dominated by male-specific or a male stronger effect. On average, there was a 13.2% difference in the effect size between the male and female mice for sexually dimorphic variables. HFD led to a significant body weight phenotype (24% increase), which acts as a confounding effect on the other analysed variables. For 79% of the variables, body weight was found to be a significant source of variation, but even after accounting for this confounding effect, similar HFD-induced phenotypic changes were found to when not accounting for weight. HFD and sex are powerful modifiers of metabolic parameters in C57BL/6N mice. We also demonstrate the value of considering body size as a covariate to obtain a richer understanding of metabolic phenotypes.

The Radio-optical Spectra of BL Lacs and Possible Relatives

NASA Astrophysics Data System (ADS)

Dennett-Thorpe, J.

I consider the suggestion that, in a complete sample of flat-spectrum radio sources with available optical spectra (Marcha et al 1996), the strong emission line objects, or those with passive elliptical spectra are close relatives of the BL Lacs. New observations at four frequencies from 8 to 43GHz are presented, together with evidence for radio variability. Combined with other radio and optical data from the literature, we are able to construct the non-thermal SEDs and use these to address the questions: are the optically passive objects potentially `unrecognised' BL Lacs (either intrinsically weak and/or hidden by starlight)? What is the relationship between the surprising number of strong emission-line objects and the BL Lacs?

Testing the Pairs-Reflection Model with X-Ray Spectral Variability and X-Ray Properties of Complete Samples of Radio-Selected BL Lacertae Objects

NASA Astrophysics Data System (ADS)

Urry, C. Megan

1997-01-01

This grant was awarded to Dr. C. Megan Urry of the Space Telescope Science Institute in response to two successful ADP proposals to use archival Ginga and Rosat X-ray data for 'Testing the Pairs-Reflection model with X-Ray Spectral Variability' (in collaboration with Paola Grandi, now at the University of Rome) and 'X-Ray Properties of Complete Samples of Radio-Selected BL Lacertae Objects' (in collaboration with then-graduate student Rita Sambruna, now a post-doc at Goddard Space Flight Center). In addition, post-docs Joseph Pesce and Elena Pian, and graduate student Matthew O'Dowd, have worked on several aspects of these projects. The grant was originally awarded on 3/01/94; this report covers the full period, through May 1997. We have completed our project on the X-ray properties of radio-selected BL Lacs.

VizieR Online Data Catalog: Equivalent width of 21 RR Lyrae stars (Pancino+, 2015)

NASA Astrophysics Data System (ADS)

Pancino, E.; Britavskiy, N.; Romano, D.; Cacciari, C.; Mucciarelli, A.; Clementini, G.

2015-02-01

Equivalent widths and atomic data of the absorption lines used in the abundance analysis, for each separate exposure at different phases. Observations of 15 RR Lyrae stars (DR And, X Ari, TW Boo, RZ Cam, RX Cet, U Com, RV CrB, SW CVn, UZ CVn, AE Dra, SZ Gem, VX Her, DH Hya, TU UMa, and RV UMa) and one BL Her star (UY Eri) were carried out with SARG@TNG, operated on the island of La Palma, Spain, during two separate runs in 2009 March and between September and November. Eight stars (SW Aqr, TW Cap, DH Hya, V Ind, SS Leo, V716 Oph, BK Tuc, and UV Vir) were observed with UVES@VLT, between 2009 April and August in service mode. (3 data files).

Diet of Australopithecus afarensis from the Pliocene Hadar Formation, Ethiopia

NASA Astrophysics Data System (ADS)

Wynn, Jonathan G.; Sponheimer, Matt; Kimbel, William H.; Alemseged, Zeresenay; Reed, Kaye; Bedaso, Zelalem K.; Wilson, Jessica N.

2013-06-01

The enhanced dietary flexibility of early hominins to include consumption of C4/crassulacean acid metabolism (CAM) foods (i.e., foods derived from grasses, sedges, and succulents common in tropical savannas and deserts) likely represents a significant ecological and behavioral distinction from both extant great apes and the last common ancestor that we shared with great apes. Here, we use stable carbon isotopic data from 20 samples of Australopithecus afarensis from Hadar and Dikika, Ethiopia (>3.4-2.9 Ma) to show that this species consumed a diet with significant C4/CAM foods, differing from its putative ancestor Au. anamensis. Furthermore, there is no temporal trend in the amount of C4/CAM food consumption over the age of the samples analyzed, and the amount of C4/CAM food intake was highly variable, even within a single narrow stratigraphic interval. As such, Au. afarensis was a key participant in the C4/CAM dietary expansion by early australopiths of the middle Pliocene. The middle Pliocene expansion of the eastern African australopith diet to include savanna-based foods represents a shift to use of plant food resources that were already abundant in hominin environments for at least 1 million y and sets the stage for dietary differentiation and niche specialization by subsequent hominin taxa.

Knowledge, perceptions, and attitudes toward complementary and alternative medicines among pharmacy students of a Malaysian Public University

PubMed Central

Jamshed, Shazia Qasim; Khan, Muhammad Umair; Ahmad, Akram; Elkalmi, Ramadan M.

2016-01-01

Background: The use of complementary and alternative medicine (CAM) is consistently on the rise worldwide. Consumers often consider pharmacists as a major source of information about CAM products and their safety. Due to the limitation of data, it is worth exploring the knowledge, perceptions, and attitudes of pharmacy students toward CAM. Objective: The objective of this study was to explore the knowledge, perceptions, and attitudes of pharmacy students regarding the use of CAM in Malaysia. Materials and Methods: A cross-sectional study was conducted for 3 months among Bachelor of Pharmacy students in a public sector University of Malaysia. A pretested, self-administered questionnaire, comprised four sections, was used to collect the data from 440 participants. Descriptive analysis was used, and Chi-square test was used to test the association between dependent and independent variables. Results: Of 440 questionnaire distributed, 287 were returned giving a response rate of (65.2%). The results showed that 38.6% participants gave correct answers when asked about the use of herbal products with digoxin. Majority of the participants were knowledgeable about supplementary therapy (25.3%) while the lack of knowledge was mostly evident in traditional Chinese medicines (73.7%). Majority of the students were either neutral (49.5%) or disagreed that (42.8%) CAM use is unsafe. Females were more in disagreement to the statements than males (P = 0.007). Majority of students also agreed to use CAM therapies for their health and well-being (51.2%). Conclusion: The study revealed that pharmacy students did not have adequate knowledge of CAM though their attitudes and perceptions were relatively positive. PMID:26957866

Survey on the use of CAD-CAM technology by UK and Irish dental technicians.

PubMed

Blackwell, E; Nesbit, M; Petridis, H

2017-05-12

Statement of the problem Digital workflows (CAD/CAM) have been introduced in dentistry during recent years. No published information exists on dental technicians' use and reporting of this technology.Purpose The aim of this cross sectional survey was to identify the extent digital technology has infiltrated the workplace and to investigate the factors affecting the use of CAD-CAM technology by dental laboratory technicians within Ireland and the UK.Materials and methods A web-based questionnaire was composed (Opinio, Object Planet Inc. Oslo, Norway) and distributed to UK and Irish dental technicians. Answers to all questions were anonymous and grouped such that general information was gathered initially, followed by branching of the survey into two sections depending on whether or not the respondent worked with CAD-CAM technology. Results were compiled and statistical analysis (Fisher's Exact test, SPSS, IBM, Armonk, New York, USA) was performed in order to investigate any correlation between various demographic variables and the answers provided.Results The survey was distributed to 760 UK technicians and 77 Irish technicians. The total number of completed surveys was 105, which yielded a total response rate of 14%. Most technicians reported using some form of CAD/CAM aspect in the workflow, and this was more significant for technicians working in large laboratories. Most training received was company-led. Large laboratories were also significantly correlated with less outsourcing of CAD/CAM work and a change in dental material use leading to the increase of zirconia and the decrease of noble alloys. Dental technicians did not report any significant change in working relationships and staffing as a result of CAD/CAM incorporation. High initial investment cost was the most common reason quoted from non-users, along with the lack of such technology in their working environment.

Implications of atmospheric conditions for analysis of surface temperature variability derived from landscape-scale thermography.

PubMed

Hammerle, Albin; Meier, Fred; Heinl, Michael; Egger, Angelika; Leitinger, Georg

2017-04-01

Thermal infrared (TIR) cameras perfectly bridge the gap between (i) on-site measurements of land surface temperature (LST) providing high temporal resolution at the cost of low spatial coverage and (ii) remotely sensed data from satellites that provide high spatial coverage at relatively low spatio-temporal resolution. While LST data from satellite (LST sat ) and airborne platforms are routinely corrected for atmospheric effects, such corrections are barely applied for LST from ground-based TIR imagery (using TIR cameras; LST cam ). We show the consequences of neglecting atmospheric effects on LST cam of different vegetated surfaces at landscape scale. We compare LST measured from different platforms, focusing on the comparison of LST data from on-site radiometry (LST osr ) and LST cam using a commercially available TIR camera in the region of Bozen/Bolzano (Italy). Given a digital elevation model and measured vertical air temperature profiles, we developed a multiple linear regression model to correct LST cam data for atmospheric influences. We could show the distinct effect of atmospheric conditions and related radiative processes along the measurement path on LST cam , proving the necessity to correct LST cam data on landscape scale, despite their relatively low measurement distances compared to remotely sensed data. Corrected LST cam data revealed the dampening effect of the atmosphere, especially at high temperature differences between the atmosphere and the vegetated surface. Not correcting for these effects leads to erroneous LST estimates, in particular to an underestimation of the heterogeneity in LST, both in time and space. In the most pronounced case, we found a temperature range extension of almost 10 K.

Perception and use of complementary and alternative medicine among children and adults with epilepsy: the importance of the decision makers.

PubMed

Asadi-Pooya, Ali A; Emami, Mehrdad

2014-01-01

The aim of the current study was to assess the extent to which complementary and alternative medicine (CAM) has been used in children and adults to treat seizures and to compare the perceptions and usage of CAM between adult patients who decides for themselves and adults who decide for their sick children.In this cross-sectional study, patients who have been treated for epilepsy for at least one year at the outpatient epilepsy clinic at the Shiraz University of Medical Sciences were interviewed from January 2012 through March 2012. The questionnaire collected specific information of CAM perceptions and usage among patients. Pearson Chi-Square and Student's t-test were used to compare variables among children group with adults group. Ninety-eight children (their caregivers) and 158 adults (themselves) participated. Adult patients (53%) more frequently believed that CAM might be useful in treating seizures than adults with sick kids (35%) (P = 0.0004). Herbal drugs, traditional medicine and exercise were more often considered as being helpful in treating seizures among adult patients compared to adults with sick children. CAM usage was not different among adult patients compared to adults with sick kids (P = 0.3). CAM is an option considered by many people with epilepsy to treat seizures. The individual who makes the decision as to use any of these unconventional treatment options is probably not different when it comes to self (the patient himself) vs. non-self (the parents/care-givers), despite the observed difference that adult patients more frequently believed that CAM might be useful in treating seizures than adults with sick kids.

Environmental regulation of carbon isotope composition and crassulacean acid metabolism in three plant communities along a water availability gradient.

PubMed

Ricalde, M Fernanda; Andrade, José Luis; Durán, Rafael; Dupuy, Juan Manuel; Simá, J Luis; Us-Santamaría, Roberth; Santiago, Louis S

2010-12-01

Expression of crassulacean acid metabolism (CAM) is characterized by extreme variability within and between taxa and its sensitivity to environmental variation. In this study, we determined seasonal fluctuations in CAM photosynthesis with measurements of nocturnal tissue acidification and carbon isotopic composition (δ(13)C) of bulk tissue and extracted sugars in three plant communities along a precipitation gradient (500, 700, and 1,000 mm year(-1)) on the Yucatan Peninsula. We also related the degree of CAM to light habitat and relative abundance of species in the three sites. For all species, the greatest tissue acid accumulation occurred during the rainy season. In the 500 mm site, tissue acidification was greater for the species growing at 30% of daily total photon flux density (PFD) than species growing at 80% PFD. Whereas in the two wetter sites, the species growing at 80% total PFD had greater tissue acidification. All species had values of bulk tissue δ(13)C less negative than -20‰, indicating strong CAM activity. The bulk tissue δ(13)C values in plants from the 500 mm site were 2‰ less negative than in plants from the wetter sites, and the only species growing in the three communities, Acanthocereus tetragonus (Cactaceae), showed a significant negative relationship between both bulk tissue and sugar δ(13)C values and annual rainfall, consistent with greater CO(2) assimilation through the CAM pathway with decreasing water availability. Overall, variation in the use of CAM photosynthesis was related to water and light availability and CAM appeared to be more ecologically important in the tropical dry forests than in the coastal dune.

Assessment of need for transport tubes when continuously monitoring for radioactive aerosols.

PubMed

Whicker, J J; Rodgers, J C; Lopez, R C

1999-09-01

Aerosol transport tubes are often used to draw aerosol from desirable sampling locations to nearby air sampling equipment that cannot be placed at that location. In many plutonium laboratories at Los Alamos National Laboratory, aerosol transport tubes are used to transport aerosol from the front of room ventilation exhaust registers to continuous air monitors (CAMs) that are mounted on nearby walls. Transport tubes are used because past guidance suggests that extraction of aerosol samples from exhaust locations provides the most sensitive and reliable detection under conditions where the rooms have unpredictable release locations and significant spatial variability in aerosol concentrations after releases, and where CAMs cannot be located in front of exhaust registers without blocking worker walkways. Despite designs to minimize particle loss in tubes, aerosol transport model predictions suggest losses occur lowering the sensitivity of CAMs to accidentally released plutonium aerosol. The goal of this study was to test the hypotheses that the reliability, speed, and sensitivity of aerosol detection would be equal whether the sample was extracted from the front of the exhaust register or from the wall location of CAMs. Polydisperse oil aerosols were released from multiple locations in two plutonium laboratories to simulate plutonium aerosol releases. Networked laser particle counters (LPCs) were positioned to simultaneously measure time-resolved aerosol concentrations at each exhaust register (representative of sampling with transport tubes) and at each wall-mounted CAM location (representative of sampling without transport tubes). Results showed no significant differences in detection reliability, speed, or sensitivity for LPCs positioned at exhaust locations when compared to LPCs positioned at the CAM wall location. Therefore, elimination of transport tubes would likely improve CAM performance.

VizieR Online Data Catalog: BVIc light curves of SZ Cam (Tamajo+, 2012)

NASA Astrophysics Data System (ADS)

Tamajo, E.; Munari, U.; Siviero, A.; Tomasella, L.; Dallaporta, S.

2012-01-01

We present a spectroscopic and photometric analysis of the multiple system and early-type eclipsing binary SZ Cam (O9 IV + B0.5 V), which consists of an eclipsing SB2 pair of orbital period P=2.7-days in a long orbit (~55yrs) around a non-eclipsing SB1 pair of orbital period P=2.8-days. We have reconstructed the spectra of the individual components of SZ Cam from the observed composite spectra using the technique of spectral disentangling. We used them together with extensive and accurate BV IC CCD photometry to obtain an orbital solution. Our photometry revealed the presence of a beta Cep variable in the SZ Cam hierarchical system, probably located within the non-eclipsing SB1 pair. The pulsation period is 0.33265+/-0.00005-days and the observed total amplitude in the B band is 0.0105+/-0.0005mag. NLTE analysis of the disentangled spectra provided atmospheric parameters for all three components, consistent with those derived from orbital solution. (1 data file).

The boundary layer moist static energy budget: Convection picks up moisture and leaves footprints in the marine boundary layer

NASA Astrophysics Data System (ADS)

de Szoeke, S. P.

2017-12-01

Averaged over the tropical marine boundary layer (BL), 130 W m-2 turbulent surface moist static energy (MSE) flux, 120 W m-2 of which is evaporation, is balanced by upward MSE flux at the BL top due to 1) incorporation of cold air by downdrafts from deep convective clouds, and 2) turbulent entrainment of dry air into the BL. Cold saturated downdraft air, and warm clear air entrained into the BL have distinct thermodynamic properties. This work observationally quantifies their respective MSE fluxes in the central Indian Ocean in 2011, under different convective conditions of the intraseasonal (40-90 day) Madden Julian oscillation (MJO). Under convectively suppressed conditions, entrainment and downdraft fluxes export equal shares (60 W m-2) of MSE from the BL. Downdraft fluxes are more variable, increasing for stronger convection. In the convectively active phase of the MJO, downdrafts export 90 W m-2 from the BL, compared to 40 W m-2 by entrainment. These processes that control the internal, latent (condensation), and MSE of the tropical marine atmospheric BL determine the parcel buoyancy and strength of tropical deep convection.

The first Fermi multifrequency campaign on BL Lacertae: Characterizing the low-activity state of the eponymous blazar

DOE PAGES

Abdo, A. A.; Ackermann, M.; Ajello, M.; ...

2011-03-10

Here, we report on observations of BL Lacertae during the first 18 months of Fermi LAT science operations and present results from a 48 day multifrequency coordinated campaign from 2008 August 19 to 2008 October 7. The radio to gamma-ray behavior of BL Lac is unveiled during a low-activity state thanks to the coordinated observations of radio-band (Metsähovi and VLBA), near-IR/optical (Tuorla, Steward, OAGH, and MDM), and X-ray ( RXTE and Swift) observatories. No variability was resolved in gamma rays during the campaign, and the brightness level was 15 times lower than the level of the 1997 EGRET outburst. Moderatemore » and uncorrelated variability has been detected in UV and X-rays. The X-ray spectrum is found to be concave, indicating the transition region between the low- and high-energy components of the spectral energy distribution (SED). VLBA observation detected a synchrotron spectrum self-absorption turnover in the innermost part of the radio jet appearing to be elongated and inhomogeneous, and constrained the average magnetic field there to be less than 3 G. Over the following months, BL Lac appeared variable in gamma rays, showing flares (in 2009 April and 2010 January). There is no evidence for the correlation of gamma rays with the optical flux monitored from the ground in 18 months. The SED may be described by a single-zone or a two-zone synchrotron self-Compton (SSC) model, but a hybrid SSC plus external radiation Compton model seems to be preferred based on the observed variability and the fact that it provides a fit closest to equipartition.« less

Determining the Attitudes and Use of Complementary, Alternative, and Integrative Medicine Among Undergraduates

PubMed Central

Huynh, Ngoc-Tram; Broukhim, Michael; Cheung, Douglas H.; Schuster, Tonya L.; Najm, Wadie

2014-01-01

Abstract Objectives: To (1) determine the attitudes, perceptions, and use of complementary, alternative, and integrative medicine among undergraduate students; (2) assess whether these students would benefit from more academic exposure to complementary and alternative medicine (CAM) and promotion of integrative medicine (IM); and (3) gauge the need and desire of undergraduates, particularly pre-health learners, to take courses about CAM/IM. Methods: This cross-sectional electronic survey study was conducted on the campus of the University of California (UC) Irvine. Selection criteria included being at least 18 years of age and a current undergraduate at UC Irvine. All survey responses were collected between November 20, 2010, and June 1, 2011. The data were analyzed by using Stata software, version 11-SE (Stata Corp., College Station, TX). Results: Completed surveys were received from 2839 participants (mean age of respondents, 20.2 years). Thirty-five percent had used CAM within the past 12 months, and 92.8% believed CAM to be at least somewhat effective; however, only 31% had prior education on CAM. After adjustment for variables, familiarity and belief in effectiveness were both highly linked to the use of CAM, with ascending odds ratios (ORs; 95% confidence interval [CI]) of 3.9 (3.1–4.9), 8.1 (5.7–11.5), 13.4 (6.0–30.2), 2.1 (1.3–3.4), 4.9 (3.0–7.8), and 12.7 (6.9–23.4) among increasing categories (all p<0.01). Sex (OR, 1.26 [95% CI, 1.01–1.56]; p<0.05), Asian ethnicity (1.46 [1.14–1.88]; p<0.01), and prior education (1.26 [1.01–1.57]; p<0.05) were also significantly correlated to the use of CAM after adjustment. Most respondents indicated that they were likely to take a CAM college course if it fulfilled a graduation requirement (63.6%) or was offered within their major (56.4%). Conclusions: Overall, this large-scale study supports the ideas that education plays a pivotal factor in the decision to use CAM and that there is a large demand for additional CAM knowledge among college students. PMID:24992360

Using the Markov chain Monte Carlo method to study the physical properties of GeV-TeV BL Lac objects

NASA Astrophysics Data System (ADS)

Qin, Longhua; Wang, Jiancheng; Yang, Chuyuan; Yuan, Zunli; Mao, Jirong; Kang, Shiju

2018-01-01

We fit the spectral energy distributions (SEDs) of 46 GeV-TeV BL Lac objects in the frame of leptonic one-zone synchrotron self-Compton (SSC) model and investigate the physical properties of these objects. We use the Markov chain Monte Carlo (MCMC) method to obtain the basic parameters, such as magnetic field (B), the break energy of the relativistic electron distribution (γ ^' }b), and the electron energy spectral index. Based on the modeling results, we support the following scenarios for GeV-TeV BL Lac objects. (1) Some sources have large Doppler factors, implying other radiation mechanism should be considered. (2) Compared with flat spectrum quasars (FSRQs), GeV-TeV BL Lac objects have weaker magnetic fields and larger Doppler factors, which cause the ineffective cooling and shift the SEDs to higher bands. Their jet powers are around 4.0 × 1045 erg s-1, compared with radiation power, 5.0 × 1042 erg s-1, indicating that only a small fraction of jet power is transformed into the emission power. (3) For some BL Lacs with large Doppler factors, their jet components could have two substructures, e.g., the fast core and the slow sheath. For most GeV-TeV BL Lacs, Kelvin-Helmholtz instabilities are suppressed by their higher magnetic fields, leading to micro-variability or intro-day variability in the optical bands. (4) Combined with a sample of FSRQs, an anti-correlation between the peak luminosity, Lpk, and the peak frequency, νpk, is obtained, favoring the blazar sequence scenario. In addition, an anti-correlation between the jet power, Pjet, and the break Lorentz factor, γb, also supports the blazar sequence.

Prenatal factors associated with birth weight and length and current nutritional status of hospitalized children aged 4-24 months.

PubMed

Mariante Giesta, Juliana; Ramón da Rosa, Suélen; Moura Pessoa, Juliana Salino; Lúcia Bosa, Vera

2015-06-01

The objective of the present study was to investigate the associations of prenatal factors with birth weight and length, as well as current nutritional status, of children hospitalized in southern Brazil. We conducted a cross-sectional study of 300 child-mother pairs. Children were between 4 and 24 months old. They were at the inpatient unit or pediatric emergency department of the Hospital de Clínicas de Porto Alegre. Anthropometric data were collected, and a questionnaire on gestational data was answered by the children's mothers. Maternal variables of interest were: prepregnancy body mass index (BMI), gestational weight gain, smoking and/or use of alcohol, use of illicit drugs, gestational diabetes and/ or high blood pressure. Children's variables of interest were: sex, gestational age, birth weight (BW) and birth length (BL), and current anthropometric data [body mass index for age (BMI/A), height for age (H/A), and weight for age (W/A)]. The gestational weight gain and smoking were associated with BW. We also found that H/A was associated with BW and BL, W/A was associated with BW, and BMI/A was associated with BL. The gestational weight gain was associated with BL, diabetes was associated with BW and BL, and high blood pressure was associated with low height in the first two years of life. We concluded that prenatal factors may have an influence on both BW and BL, causing the birth of small and large for gestational age children, and thus affecting their growth rate during the first years of life. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Exploring the symbiotic pangenome of the nitrogen-fixing bacterium Sinorhizobium meliloti

PubMed Central

2011-01-01

Background Sinorhizobium meliloti is a model system for the studies of symbiotic nitrogen fixation. An extensive polymorphism at the genetic and phenotypic level is present in natural populations of this species, especially in relation with symbiotic promotion of plant growth. AK83 and BL225C are two nodule-isolated strains with diverse symbiotic phenotypes; BL225C is more efficient in promoting growth of the Medicago sativa plants than strain AK83. In order to investigate the genetic determinants of the phenotypic diversification of S. meliloti strains AK83 and BL225C, we sequenced the complete genomes for these two strains. Results With sizes of 7.14 Mbp and 6.97 Mbp, respectively, the genomes of AK83 and BL225C are larger than the laboratory strain Rm1021. The core genome of Rm1021, AK83, BL225C strains included 5124 orthologous groups, while the accessory genome was composed by 2700 orthologous groups. While Rm1021 and BL225C have only three replicons (Chromosome, pSymA and pSymB), AK83 has also two plasmids, 260 and 70 Kbp long. We found 65 interesting orthologous groups of genes that were present only in the accessory genome, consequently responsible for phenotypic diversity and putatively involved in plant-bacterium interaction. Notably, the symbiosis inefficient AK83 lacked several genes required for microaerophilic growth inside nodules, while several genes for accessory functions related to competition, plant invasion and bacteroid tropism were identified only in AK83 and BL225C strains. Presence and extent of polymorphism in regulons of transcription factors involved in symbiotic interaction were also analyzed. Our results indicate that regulons are flexible, with a large number of accessory genes, suggesting that regulons polymorphism could also be a key determinant in the variability of symbiotic performances among the analyzed strains. Conclusions In conclusions, the extended comparative genomics approach revealed a variable subset of genes and regulons that may contribute to the symbiotic diversity. PMID:21569405

Radio emission of cataclysmic variable stars

NASA Technical Reports Server (NTRS)

Fuerst, E.; Benz, A.; Hirth, W.; Geffert, M.; Kiplinger, A.

1986-01-01

Eight cataclysmic variable stars were observed at 6 cm wavelength using the Very Large Array (VLA). The objects were: CN-Ori, SS-Aur, YZ-Cnc, SU-Uma, Z-Cam, V603-Aql, EM-Cyg, and RZ-Sge. Most of these objects were in optical high stage, but none were detected beyond flux limits between 0.1 and 0.3 mJy.

Acoustic ground impedance meter

NASA Technical Reports Server (NTRS)

Zuckerwar, A. J.

1981-01-01

A compact, portable instrument was developed to measure the acoustic impedance of the ground, or other surfaces, by direct pressure-volume velocity measurement. A Helmholz resonator, constructed of heavy-walled stainless steel but open at the bottom, is positioned over the surface having the unknown impedance. The sound source, a cam-driven piston of known stroke and thus known volume velocity, is located in the neck of the resonator. The cam speed is a variable up to a maximum 3600 rpm. The sound pressure at the test surface is measured by means of a microphone flush-mounted in the wall of the chamber. An optical monitor of the piston displacement permits measurement of the phase angle between the volume velocity and the sound pressure, from which the real and imaginary parts of the impedance can be evaluated. Measurements using a 5-lobed cam can be made up to 300 Hz. Detailed design criteria and results on a soil sample are presented.

Three new BL Lacertae objects in the Palomar-Green survey

NASA Technical Reports Server (NTRS)

Fleming, Thomas A.; Green, Richard F.; Jannuzi, Buell T.; Liebert, James; Smith, Paul S.; Fink, Henner

1993-01-01

We have identified three BL Lacertae objects in the Palomar-Green Survey which were previously misclassified as DC white dwarfs, namely PG 1246+586, PG 1424+240, and PG 1437+398. Our reclassification is based on the detection of these objects as x-ray sources in the ROSAT all-sky survey and upon our subsequent detection of intrinsic linearly polarized and variable optical emission from these sources. As a result of the ROSAT survey, the number of identified BL Lac objects in the Palomar-Green catalog of UV excess objects has been doubled. Corrected optical positions are presented for PG 1246+586 and PG 1437+398.

The role of sex and body weight on the metabolic effects of high-fat diet in C57BL/6N mice

PubMed Central

Ingvorsen, C; Karp, N A; Lelliott, C J

2017-01-01

Background: Metabolic disorders are commonly investigated using knockout and transgenic mouse models on the C57BL/6N genetic background due to its genetic susceptibility to the deleterious metabolic effects of high-fat diet (HFD). There is growing awareness of the need to consider sex in disease progression, but limited attention has been paid to sexual dimorphism in mouse models and its impact in metabolic phenotypes. We assessed the effect of HFD and the impact of sex on metabolic variables in this strain. Methods: We generated a reference data set encompassing glucose tolerance, body composition and plasma chemistry data from 586 C57BL/6N mice fed a standard chow and 733 fed a HFD collected as part of a high-throughput phenotyping pipeline. Linear mixed model regression analysis was used in a dual analysis to assess the effect of HFD as an absolute change in phenotype, but also as a relative change accounting for the potential confounding effect of body weight. Results: HFD had a significant impact on all variables tested with an average absolute effect size of 29%. For the majority of variables (78%), the treatment effect was modified by sex and this was dominated by male-specific or a male stronger effect. On average, there was a 13.2% difference in the effect size between the male and female mice for sexually dimorphic variables. HFD led to a significant body weight phenotype (24% increase), which acts as a confounding effect on the other analysed variables. For 79% of the variables, body weight was found to be a significant source of variation, but even after accounting for this confounding effect, similar HFD-induced phenotypic changes were found to when not accounting for weight. Conclusion: HFD and sex are powerful modifiers of metabolic parameters in C57BL/6N mice. We also demonstrate the value of considering body size as a covariate to obtain a richer understanding of metabolic phenotypes. PMID:28394359

Anxiety Level and Cardiac Autonomic Modulations in Coronary Artery Disease and Cardiac Syndrome X Patients.

PubMed

Lutfi, Mohamed Faisal

2017-01-01

Anxiety and cardiac autonomic modulations (CAM) were thoroughly investigated in coronary artery disease (CAD) and cardiac syndrome X (CSX) patients worldwide, but not among Sudanese with similar pathology. To compare levels of anxiety and CAM between Sudanese patients with CSX and CAD. Anxiety was evaluated in 51 CAD and 26 CSX patients using Taylor Manifest anxiety score (TMAS) questionnaire while heart rate variability derived indices were used to assess CAM, namely natural logarithm of low frequency (LnLF), high frequency (LnHF) and LF/HF ratio (LnLF/HF). Low anxiety levels were achieved by 6 (23.1%) and 9 (17.6%) patients with CSX and CAD respectively. High anxiety level was achieved by only one (3.8%) patient, who was suffering from CSX. TMAS was significantly higher in CSX (31.27 (21.97)) compared to CAD (21.86 (12.97), P = 0.021). However, abnormally increased anxiety was not associated with higher risk of CSX. LnLF, LnHF and LnLF/HF were comparable in CAD and CSX patients. CSX and CAD patients showed comparable CAM. Although anxiety levels were higher in CSX compared to CAD, TMAS ≥ 35 failed to show significant association with CSX.

Impact of a Stochastic Parameterization Scheme on El Nino-Southern Oscillation in the Community Climate System Model

NASA Astrophysics Data System (ADS)

Christensen, H. M.; Berner, J.; Sardeshmukh, P. D.

2017-12-01

Stochastic parameterizations have been used for more than a decade in atmospheric models. They provide a way to represent model uncertainty through representing the variability of unresolved sub-grid processes, and have been shown to have a beneficial effect on the spread and mean state for medium- and extended-range forecasts. There is increasing evidence that stochastic parameterization of unresolved processes can improve the bias in mean and variability, e.g. by introducing a noise-induced drift (nonlinear rectification), and by changing the residence time and structure of flow regimes. We present results showing the impact of including the Stochastically Perturbed Parameterization Tendencies scheme (SPPT) in coupled runs of the National Center for Atmospheric Research (NCAR) Community Atmosphere Model, version 4 (CAM4) with historical forcing. SPPT results in a significant improvement in the representation of the El Nino-Southern Oscillation in CAM4, improving the power spectrum, as well as both the inter- and intra-annual variability of tropical pacific sea surface temperatures. We use a Linear Inverse Modelling framework to gain insight into the mechanisms by which SPPT has improved ENSO-variability.

Role of Updraft Velocity in Temporal Variability of Global Cloud Hydrometeor Number

NASA Technical Reports Server (NTRS)

Sullivan, Sylvia C.; Lee, Dong Min; Oreopoulos, Lazaros; Nenes, Athanasios

2016-01-01

Understanding how dynamical and aerosol inputs affect the temporal variability of hydrometeor formation in climate models will help to explain sources of model diversity in cloud forcing, to provide robust comparisons with data, and, ultimately, to reduce the uncertainty in estimates of the aerosol indirect effect. This variability attribution can be done at various spatial and temporal resolutions with metrics derived from online adjoint sensitivities of droplet and crystal number to relevant inputs. Such metrics are defined and calculated from simulations using the NASA Goddard Earth Observing System Model, Version 5 (GEOS-5) and the National Center for Atmospheric Research Community Atmosphere Model Version 5.1 (CAM5.1). Input updraft velocity fluctuations can explain as much as 48% of temporal variability in output ice crystal number and 61% in droplet number in GEOS-5 and up to 89% of temporal variability in output ice crystal number in CAM5.1. In both models, this vertical velocity attribution depends strongly on altitude. Despite its importance for hydrometeor formation, simulated vertical velocity distributions are rarely evaluated against observations due to the sparsity of relevant data. Coordinated effort by the atmospheric community to develop more consistent, observationally based updraft treatments will help to close this knowledge gap.

Role of updraft velocity in temporal variability of global cloud hydrometeor number

DOE PAGES

Sullivan, Sylvia C.; Lee, Dongmin; Oreopoulos, Lazaros; ...

2016-05-16

Understanding how dynamical and aerosol inputs affect the temporal variability of hydrometeor formation in climate models will help to explain sources of model diversity in cloud forcing, to provide robust comparisons with data, and, ultimately, to reduce the uncertainty in estimates of the aerosol indirect effect. This variability attribution can be done at various spatial and temporal resolutions with metrics derived from online adjoint sensitivities of droplet and crystal number to relevant inputs. Such metrics are defined and calculated from simulations using the NASA Goddard Earth Observing System Model, Version 5 (GEOS-5) and the National Center for Atmospheric Research Communitymore » Atmosphere Model Version 5.1 (CAM5.1). Input updraft velocity fluctuations can explain as much as 48% of temporal variability in output ice crystal number and 61% in droplet number in GEOS-5 and up to 89% of temporal variability in output ice crystal number in CAM5.1. In both models, this vertical velocity attribution depends strongly on altitude. Despite its importance for hydrometeor formation, simulated vertical velocity distributions are rarely evaluated against observations due to the sparsity of relevant data. Finally, coordinated effort by the atmospheric community to develop more consistent, observationally based updraft treatments will help to close this knowledge gap.« less

Role of updraft velocity in temporal variability of global cloud hydrometeor number

NASA Astrophysics Data System (ADS)

Sullivan, Sylvia C.; Lee, Dongmin; Oreopoulos, Lazaros; Nenes, Athanasios

2016-05-01

Understanding how dynamical and aerosol inputs affect the temporal variability of hydrometeor formation in climate models will help to explain sources of model diversity in cloud forcing, to provide robust comparisons with data, and, ultimately, to reduce the uncertainty in estimates of the aerosol indirect effect. This variability attribution can be done at various spatial and temporal resolutions with metrics derived from online adjoint sensitivities of droplet and crystal number to relevant inputs. Such metrics are defined and calculated from simulations using the NASA Goddard Earth Observing System Model, Version 5 (GEOS-5) and the National Center for Atmospheric Research Community Atmosphere Model Version 5.1 (CAM5.1). Input updraft velocity fluctuations can explain as much as 48% of temporal variability in output ice crystal number and 61% in droplet number in GEOS-5 and up to 89% of temporal variability in output ice crystal number in CAM5.1. In both models, this vertical velocity attribution depends strongly on altitude. Despite its importance for hydrometeor formation, simulated vertical velocity distributions are rarely evaluated against observations due to the sparsity of relevant data. Coordinated effort by the atmospheric community to develop more consistent, observationally based updraft treatments will help to close this knowledge gap.

An evaluation of the completeness of safety reporting in reports of complementary and alternative medicine trials

PubMed Central

2011-01-01

Background Adequate reporting of safety in publications of randomized controlled trials (RCTs) is a pre-requisite for accurate and comprehensive profile evaluation of conventional as well as complementary and alternative medicine (CAM) treatments. Clear and concise information on the definition, frequency, and severity of adverse events (AEs) is necessary for assessing the benefit-harm ratio of any intervention. The objectives of this study are to assess the quality of safety reporting in CAM RCTs; to explore the influence of different trial characteristics on the quality of safety reporting. Methods Survey of safety reporting in RCTs published in 2009 across 15 widely used CAM interventions identified from the Cochrane Collaboration's CAM Field specialized register of trials. Primary outcome measures, the adequacy of reporting of AEs; was defined and categorized according to the CONSORT for harms extension; the percentage of words devoted to the reporting of safety in the entire report and in the results section. Results Two-hundred and five trials were included in the review. Of these, 15% (31/205) reported that no harms were observed during the trial period. Of the remaining 174 trials reporting any safety information, only 21% (36/174) had adequate safety reporting. For all trials, the median percentage of words devoted to the reporting of safety in the results section was 2.6. Moreover, 69% (n = 141) of all trials devoted a lesser or equal percentage of words to safety compared to author affiliations. Of the predictor variables used in regression analysis, multicenter trials had more words devoted to safety in the results section than single centre trials (P = 0.045). Conclusions An evaluation of safety reporting in the reports of CAM RCTs across 15 different CAM interventions demonstrated that the reporting of harms was largely inadequate. The quality of reporting safety information in primary reports of CAM randomized trials requires improvement. PMID:21859470

Complementary medicine for treatment of agitation and delirium in older persons: a systematic review and narrative synthesis.

PubMed

Levy, Ilana; Attias, Samuel; Ben-Arye, Eran; Bloch, Boaz; Schiff, Elad

2017-05-01

Agitation and delirium frequently occur in cognitively impaired older people. We conducted a systematic review with narrative synthesis of the literature aiming to assess effectiveness of complementary and alternative medicine (CAM) modalities to address these conditions. Following preliminary search, we included 40 original researches on CAM treatment of delirium and agitation in older persons. Then, the quality of these studies was assessed using the Downs and Black Checklist and Quality Assessment Tool for Studies with Diverse Designs, and the effect sizes were calculated. We subsequently conducted a narrative synthesis of the main findings, including theory development, preliminary synthesis, exploration of relationships within and between studies, and assessment of synthesis robustness. Forty articles that met the inclusion criteria were analyzed. Sixteen of these were randomized controlled trials. One article specifically addressed CAM treatment of delirium in patients without dementia, and the remaining 39 articles described treatments of agitated older persons with dementia. Thirty-five of the 40 included studies suggested that the investigated CAM therapies may ameliorate the severity of agitation and delirium. The physiological surrogates of agitation assessed in these studies included cortisol level, chromogranin A level, and heart rate variability. Very few of the studies systematically assessed safety issues, although no major adverse effects were reported. Overall, the systematic review of the literature suggests that several CAM modalities are potentially beneficial in the treatment of agitation and delirium among older persons. We suggest that promising CAM modalities should be further explored through large-scale randomized controlled trials in different clinical settings. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

The Impact of Varying the Physics Grid Resolution Relative to the Dynamical Core Resolution in CAM-SE-CSLAM

NASA Astrophysics Data System (ADS)

Herrington, A. R.; Lauritzen, P. H.; Reed, K. A.

2017-12-01

The spectral element dynamical core of the Community Atmosphere Model (CAM) has recently been coupled to an approximately isotropic, finite-volume grid per implementation of the conservative semi-Lagrangian multi-tracer transport scheme (CAM-SE-CSLAM; Lauritzen et al. 2017). In this framework, the semi-Lagrangian transport of tracers are computed on the finite-volume grid, while the adiabatic dynamics are solved using the spectral element grid. The physical parameterizations are evaluated on the finite-volume grid, as opposed to the unevenly spaced Gauss-Lobatto-Legendre nodes of the spectral element grid. Computing the physics on the finite-volume grid reduces numerical artifacts such as grid imprinting, possibly because the forcing terms are no longer computed at element boundaries where the resolved dynamics are least smooth. The separation of the physics grid and the dynamics grid allows for a unique opportunity to understand the resolution sensitivity in CAM-SE-CSLAM. The observed large sensitivity of CAM to horizontal resolution is a poorly understood impediment to improved simulations of regional climate using global, variable resolution grids. Here, a series of idealized moist simulations are presented in which the finite-volume grid resolution is varied relative to the spectral element grid resolution in CAM-SE-CSLAM. The simulations are carried out at multiple spectral element grid resolutions, in part to provide a companion set of simulations, in which the spectral element grid resolution is varied relative to the finite-volume grid resolution, but more generally to understand if the sensitivity to the finite-volume grid resolution is consistent across a wider spectrum of resolved scales. Results are interpreted in the context of prior ideas regarding resolution sensitivity of global atmospheric models.

Seasonal Variation of Barrier Layer in the Southern Ocean

NASA Astrophysics Data System (ADS)

Pan, Li; Zhong, Yisen; Liu, Hailong; Zhou, Lei; Zhang, Zhaoru; Zhou, Meng

2018-03-01

The seasonal variability of barrier layer (BL) and its formation mechanism in the Southern Ocean are investigated using the most recent Argo data. The results reveal that the BL is a persistent feature in the Southern Ocean with a strong seasonal cycle. The thickest BL appears in winter with the maximum amplitude exceeding 250 m while it dramatically decreases to less than 50 m in summer. The spatial distribution of BL is zonally oriented in the Pacific and Indian Ocean sectors, which is in agreement with that of the mixed layer depth (MLD) and the isothermal layer depth (ILD). Two areas with the most prominent BL are identified. One is located south of Australia and the other in the southeastern Pacific. The BL formation in both areas is generally attributed to a shallow mixed layer controlled by surface freshwater intrusion and a deep isothermal layer modulated by seasonal vertical convection. In the former region, the cold and fresh Antarctic Surface Water (ASW) is transported northward across the Subantarctic Front (SAF) by the Ekman effect and overlies the warm Subantarctic Mode Water (SAMW). The resulting inverse temperature structure facilitates the development of thick BLs. In the latter region, the BL emerges in the ventilation area where the shallow Surface Salinity Minimum Water (SSMW) coming from north leans against the deep vertical isotherms. In summer, positive surface heat flux into the ocean overwhelms other thermodynamic effects in the mixed layer heat budget. The MLD and ILD coincide and thus the BL is destroyed.

Results of tests CS4 and CS5 to investigate dynamic loads and pressures on 0.03-scale models (Ax1319-3/4 and 45-0) of mated 747 cam and space shuttle orbiter in the Boeing transonic wind tunnel

NASA Technical Reports Server (NTRS)

1976-01-01

A 0.03-scale model of the 747 CAM/Orbiter was tested in an 8 x 12 foot transonic wind tunnel. Dynamic loads, pressure, and empennage flow field data were obtained using pressure transducers, strain gages, and a split film anemometer. The test variables included Mach number, angle of attack, sideslip angle, orbiter tailcone on and off, orbiter partial tailcone, orbiter nozzle air scoops, orbiter body flap angle, and orbiter elevon angle.

Properties of optically selected BL Lacertae candidates from the SDSS

NASA Astrophysics Data System (ADS)

Kügler, S. D.; Nilsson, K.; Heidt, J.; Esser, J.; Schultz, T.

2014-09-01

Context. Deep optical surveys open the avenue for finding large numbers of BL Lac objects that are hard to identify because they lack the unique properties classifying them as such. While radio or X-ray surveys typically reveal dozens of sources, recent compilations based on optical criteria alone have increased the number of BL Lac candidates considerably. However, these compilations are subject to biases and may contain a substantial number of contaminating sources. Aims: In this paper we extend our analysis of 182 optically selected BL Lac object candidates from the SDSS with respect to an earlier study. The main goal is to determine the number of bona fide BL Lac objects in this sample. Methods: We examine their variability characteristics, determine their broad-band radio-UV spectral energy distributions (SEDs), and search for the presence of a host galaxy. In addition we present new optical spectra for 27 targets with improved signal-to-noise ratio with respect to the SDSS spectra. Results: At least 59% of our targets have shown variability between SDSS DR2 and our observations by more than 0.1-0.27 mag depending on the telescope used. A host galaxy was detected in 36% of our targets. The host galaxy type and luminosities are consistent with earlier studies of BL Lac host galaxies. Simple fits to broad-band SEDs for 104 targets of our sample derived synchrotron peak frequencies between 13.5 ≤ log 10(νpeak) ≤ 16 with a peak at log 10 ~ 14.5. Our new optical spectra do not reveal any new redshift for any of our objects. Thus the sample contains a large number of bona fide BL Lac objects and seems to contain a substantial fraction of intermediate-frequency peaked BL Lacs. Based on observations collected with the NTT on La Silla (Chile) operated by the European Southern Observatory under proposal 082.B-0133.Based on observations collected at the Centro Astronómico Hispano Alemán (CAHA), operated jointly by the Max-Planck-Institut für Astronomie and the Instituto de Astrofisica de Canarias.Based on observations made with the Nordic Optical Telescope, operated on the island of La Palma jointly by Denmark, Finland, Iceland, Norway, and Sweden, in the Spanish Observatorio del Roque de los Muchachos of the Instituto de Astrofisica de Canarias.

Observing continental boundary-layer structure and evolution over the South African savannah using a ceilometer

NASA Astrophysics Data System (ADS)

Gierens, Rosa T.; Henriksson, Svante; Josipovic, Micky; Vakkari, Ville; van Zyl, Pieter G.; Beukes, Johan P.; Wood, Curtis R.; O'Connor, Ewan J.

2018-05-01

The atmospheric boundary layer (BL) is the atmospheric layer coupled to the Earth's surface at relatively short timescales. A key quantity is the BL depth, which is important in many applied areas of weather and climate such as air-quality forecasting. Studying BLs in climates and biomes across the globe is important, particularly in the under-sampled southern hemisphere. The present study is based on a grazed grassland-savannah area in northwestern South Africa during October 2012-August 2014. Ceilometers are probably the cheapest method for measuring continuous aerosol profiles up to several kilometers above ground and are thus an ideal tool for long-term studies of BLs. A ceilometer-estimated BL depth is based on profiles of attenuated backscattering coefficients from atmospheric aerosols; the sharpest drop often occurs at BL top. Based on this, we developed a new method for layer detection that we call the signal-limited layer method. The new algorithm was applied to ceilometer profiles which thus classified BL into classic regime types: daytime convective mixing, and a double layer at night of surface-based stable with a residual layer above it. We employed wavelet fitting to increase successful BL estimation for noisy profiles. The layer-detection algorithm was supported by an eddy-flux station, rain gauges, and manual inspection. Diurnal cycles were often clear, with BL depth detected for 50% of the daytime typically being 1-3 km, and for 80% of the night-time typically being a few hundred meters. Variability was also analyzed with respect to seasons and years. Finally, BL depths were compared with ERA-Interim estimates of BL depth to show reassuring agreement.

Subcellular distributions of rat CaM kinase phosphatase N and other members of the CaM kinase regulatory system.

PubMed

Kitani, Takako; Okuno, Sachiko; Takeuchi, Masayuki; Fujisawa, Hitoshi

2003-07-01

Ca2+/Calmodulin-dependent protein kinase (CaM kinase) regulatory system is composed of multifunctional CaM kinases such as CaM kinases IV and I, upstream CaM kinases such as CaM kinase kinases alpha and beta, which activate multifunctional CaM kinases, and CaM kinase phosphatases such as CaM kinase phosphatase and CaM kinase phosphatase N, which deactivate the activated multifunctional CaM kinases. To understand the combinations of CaM kinases I and IV, CaM kinase kinases alpha and beta, and CaM kinase phosphatases, the locations of the enzymes in the cell were examined by immunocytochemical studies of cultured cells. The results indicate that CaM kinase I, CaM kinase kinase beta, and CaM kinase phosphatase occur in the cytoplasm and that CaM kinase IV, CaM kinase kinase alpha (and CaM kinase kinase beta in some cell types and tissues), and CaM kinase phosphatase N occur inside the cellular nucleus, suggesting that there are at least two different sets of CaM kinase regulatory systems, one consisting of CaM kinase I, CaM kinase kinase beta, and CaM kinase phosphatase in the cytoplasm and the other consisting of CaM kinase IV, CaM kinase kinase alpha (and CaM kinase kinase beta in some cell types and tissues), and CaM kinase phosphatase N in the nucleus.

Observations of CI Cam needed to support spectroscopy

NASA Astrophysics Data System (ADS)

Waagen, Elizabeth O.

2016-10-01

Kelly Gourdji and Marcella Wijngaarden (graduate students at the University of Amsterdam/Anton Pannekoek Institute for Astronomy) have requested AAVSO observers' assistance in providing optical photometry of CI Cam in support of their high-resolution spectroscopy from now through January 2017. They write: "...We are currently observing the variable star CI Cam (the B[e] optical counterpart of a HMXB system) with the HERMES spectrograph at the Mercator Telescope in La Palma. Having observed the star for three nights now, the object appears to be in outburst. In particular, H alpha was measured to be 80 times the continuum flux, and increasing between Oct. 9 and 12. This is similar to the previous outburst in 2004/5. Photometric data obtained during the 2004/5 outburst suggested an outburst duration of about 3 months and a peak brightness of 11.2 in the V band." More information is available in ATel #9634 (Wijngaarden et al.). Multiple snapshot observations per night in BVRI are requested beginning immediately and continuing through January 2017. Time series are not necessary unless requested later via an AAVSO Special Notice. Observations made using other filters will be useful as well as long as there are multiple observations in these bands. Finder charts with sequence may be created using the AAVSO Variable Star Plotter (https://www.aavso.org/vsp). Observations should be submitted to the AAVSO International Database. See full Alert Notice for more details.

The Micro-Arcsecond Scintillation-Induced Variability (MASIV) Survey III. Optical Identifications and New Redshifts

NASA Technical Reports Server (NTRS)

Pursimo, Tapio; Ojha, Roopesh; Jauncey, David L.; Rickett, Barney J.; Dutka, Michael S.; Koay, Jun Yi; Lovell, James E. J.; Bignall, Hayley E.; Kedziora-Chudczer, Lucyna; Macquart, Jean-Pierre

2013-01-01

Intraday variability (IDV) of the radio emission from active galactic nuclei is now known to be predominantly due to interstellar scintillation (ISS). The MASIV (The Microarcsecond Scintillation Induced Variability) survey of 443 at spectrum sources revealed that the IDV is related to the radio flux density and redshift. A study of the physical properties of these sources has been severely handicapped by the absence of reliable redshift measurements for many of these objects. This paper presents 79 new redshifts and a critical evaluation of 233 redshifts obtained from the literature. We classify spectroscopic identifications based on emission line properties, finding that 78% of the sources have broad emission lines and are mainly FSRQs. About 16% are weak lined objects, chiefly BL Lacs, and the remaining 6% are narrow line objects. The gross properties (redshift, spectroscopic class) of the MASIV sample are similar to those of other blazar surveys. However, the extreme compactness implied by ISS favors FSRQs and BL Lacs in the MASIV sample as these are the most compact object classes. We confirm that the level of IDV depends on the 5 GHz flux density for all optical spectral types. We find that BL Lac objects tend to be more variable than broad line quasars. The level of ISS decreases substantially above a redshift of about two. The decrease is found to be generally consistent with ISS expected for beamed emission from a jet that is limited to a fixed maximum brightness temperature in the source rest frame.

Optical Variability of BL Lacertae During the Major Outburst of 1997

NASA Technical Reports Server (NTRS)

Ghosh, K. K.; Ramsey, B. D.; Sadun, A. C.; Soundararajaperumal, S.; Wang, J.

2000-01-01

We have undertaken an investigation of recent flux variability in BL Lac. We present optical observations taken over 22 nights documenting major as well as minor outbursts. This has been combined, for purposes of multifrequency analysis, with published X-ray and T-ray data taken for an additional single night, On two nights in particular, including the night of the X-ray observations, a major outburst of about a full magnitude of variation was recorded. All the data have been analyzed with theoretical models. Attempts were made to use synchrotron self-Compton and external Comptonization models to explain the data; however, both classes of models were found lacking. More satisfactory results were obtained using an analytical model proposed by Wang et al. that involves the evolution of synchrotron spectra in a homogeneous jet due to the injection of relativistic electrons, taking into account radiation losses during the outbursts. It is hoped that the results of this study of BL Lac, an archetype for the class of blazars in general, represent a more generic phenomenon applicable to the entire class.

Optical Variability of BL Lacertae During the Major Outburst of 1997

NASA Technical Reports Server (NTRS)

Ghosh, K. K.; Ramsey, B. D.; Sadun, A. C.; Soundarajaperumal, S.; Wang, J.

1999-01-01

We have undertaken an investigation of recent flux variability in BL Lac. We present optical observations taken over 12 nights documenting major as well as minor outbursts. This has been combined, for purposes of multifrequency analysis, with published X-ray and gamma ray data taken for an additional single night. On two nights in particular, which includes the night of the X-ray observations, a major outburst of about a full magnitude of variation was recorded. All the data have been analyzed with theoretical models. Attempts were made to use synchrotron self-Compton and external Comptonization models to explain the data; however both classes of models were found lacking. More satisfactory results were obtained using an analytical model proposed by Wang et al. that involves the evolution of synchrotron spectra in a homogeneous jet due to the injection of relativistic electrons, taking into account radiation losses during the outbursts. It is hoped that the results of this study of BL Lac, an archetype for the class of blazars in general, represent a more generic phenomenon applicable to the entire class.

An ensemble constrained variational analysis of atmospheric forcing data and its application to evaluate clouds in CAM5: Ensemble 3DCVA and Its Application

DOE PAGES

Tang, Shuaiqi; Zhang, Minghua; Xie, Shaocheng

2016-01-05

Large-scale atmospheric forcing data can greatly impact the simulations of atmospheric process models including Large Eddy Simulations (LES), Cloud Resolving Models (CRMs) and Single-Column Models (SCMs), and impact the development of physical parameterizations in global climate models. This study describes the development of an ensemble variationally constrained objective analysis of atmospheric large-scale forcing data and its application to evaluate the cloud biases in the Community Atmospheric Model (CAM5). Sensitivities of the variational objective analysis to background data, error covariance matrix and constraint variables are described and used to quantify the uncertainties in the large-scale forcing data. Application of the ensemblemore » forcing in the CAM5 SCM during March 2000 intensive operational period (IOP) at the Southern Great Plains (SGP) of the Atmospheric Radiation Measurement (ARM) program shows systematic biases in the model simulations that cannot be explained by the uncertainty of large-scale forcing data, which points to the deficiencies of physical parameterizations. The SCM is shown to overestimate high clouds and underestimate low clouds. These biases are found to also exist in the global simulation of CAM5 when it is compared with satellite data.« less

An ensemble constrained variational analysis of atmospheric forcing data and its application to evaluate clouds in CAM5: Ensemble 3DCVA and Its Application

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

Tang, Shuaiqi; Zhang, Minghua; Xie, Shaocheng

Large-scale atmospheric forcing data can greatly impact the simulations of atmospheric process models including Large Eddy Simulations (LES), Cloud Resolving Models (CRMs) and Single-Column Models (SCMs), and impact the development of physical parameterizations in global climate models. This study describes the development of an ensemble variationally constrained objective analysis of atmospheric large-scale forcing data and its application to evaluate the cloud biases in the Community Atmospheric Model (CAM5). Sensitivities of the variational objective analysis to background data, error covariance matrix and constraint variables are described and used to quantify the uncertainties in the large-scale forcing data. Application of the ensemblemore » forcing in the CAM5 SCM during March 2000 intensive operational period (IOP) at the Southern Great Plains (SGP) of the Atmospheric Radiation Measurement (ARM) program shows systematic biases in the model simulations that cannot be explained by the uncertainty of large-scale forcing data, which points to the deficiencies of physical parameterizations. The SCM is shown to overestimate high clouds and underestimate low clouds. These biases are found to also exist in the global simulation of CAM5 when it is compared with satellite data.« less

Dash Cam videos on YouTube™ offer insights into factors related to moose-vehicle collisions.

PubMed

Rea, Roy V; Johnson, Chris J; Aitken, Daniel A; Child, Kenneth N; Hesse, Gayle

2018-03-26

To gain a better understanding of the dynamics of moose-vehicle collisions, we analyzed 96 videos of moose-vehicle interactions recorded by vehicle dash-mounted cameras (Dash Cams) that had been posted to the video-sharing website YouTube™. Our objective was to determine the effects of road conditions, season and weather, moose behavior, and driver response to actual collisions compared to near misses when the collision was avoided. We identified 11 variables that were consistently observable in each video and that we hypothesized would help to explain a collision or near miss. The most parsimonious logistic regression model contained variables for number of moose, sight time, vehicle slows, and vehicle swerves (AIC c w = 0.529). This model had good predictive accuracy (AUC = 0.860, SE = 0.041). The only statistically significant variable from this model that explained the difference between moose-vehicle collisions and near misses was 'Vehicle slows'. Our results provide no evidence that road surface conditions (dry, wet, ice or snow), roadside habitat type (forested or cleared), the extent to which roadside vegetation was cleared, natural light conditions (overcast, clear, twilight, dark), season (winter, spring and summer, fall), the presence of oncoming traffic, or the direction from which the moose entered the roadway had any influence on whether a motorist collided with a moose. Dash Cam videos posted to YouTube™ provide a unique source of data for road safety planners trying to understand what happens in the moments just before a moose-vehicle collision and how those factors may differ from moose-vehicle encounters that do not result in a collision. Copyright © 2018 Elsevier Ltd. All rights reserved.

How much of the interannual variability of East Asian summer rainfall is forced by SST?

NASA Astrophysics Data System (ADS)

He, Chao; Wu, Bo; Li, Chunhui; Lin, Ailan; Gu, Dejun; Zheng, Bin; Zhou, Tianjun

2016-07-01

It is widely accepted that the interannual variability of East Asian summer rainfall is forced by sea surface temperature (SST), and SST anomalies are widely used as predictors of East Asian summer rainfall. But it is still not very clear what percentage of the interannual rainfall variability is contributed by SST anomalies. In this study, Atmospheric general circulation model simulations forced by observed interannual varying SST are compared with those forced by the fixed annual cycle of SST climatology, and their ratios of interannual variance (IAV) are analyzed. The output of 12 models from the 5th Phase of Coupled Model Intercomparison Project (CMIP5) are adopted, and idealized experiments are done by Community Atmosphere Model version 4 (CAM4). Both the multi-model median of CMIP5 models and CAM4 experiments show that only about 18 % of the IAV of rainfall over East Asian land (EAL) is explained by SST, which is significantly lower than the tropical western Pacific, but comparable to the mid-latitude western Pacific. There is no significant difference between the southern part and the northern part of EAL in the percentages of SST contribution. The remote SST anomalies regulates rainfall over EAL probably by modulating the horizontal water vapor transport rather than the vertical motion, since the horizontal water vapor transport into EAL is strongly modulated by SST but the vertical motion over EAL is not. Previous studies argued about the relative importance of tropical Indian Ocean and tropical Pacific Ocean to East Asian summer rainfall anomalies. Our idealized experiments performed by CAM4 suggest that the contributions from these two ocean basins are comparable to each other, both of which account for approximately 6 % of the total IAV of rainfall over EAL.

Quantifying particulate matter deposition in Niwot Ridge, Colorado: Collection of dry deposition using marble inserts and particle imaging using the FlowCAM

NASA Astrophysics Data System (ADS)

Goss, Natasha R.; Mladenov, Natalie; Seibold, Christine M.; Chowanski, Kurt; Seitz, Leslie; Wellemeyer, T. Barret; Williams, Mark W.

2013-12-01

Atmospheric wet and dry deposition are important sources of carbon for remote alpine lakes and soils. The carbon inputs from dry deposition in alpine National Atmospheric Deposition Program (NADP) collectors, including aeolian dust and biological material, are not well constrained due to difficulties in retaining particulate matter in the collectors. Here, we developed and tested a marble insert for dry deposition collection at the Niwot Ridge Long Term Ecological Research Station (NWT LTER) Soddie site (3345 m) between 24 May and 8 November 2011. We conducted laboratory tests of the insert's effect on particulate matter (PM) mass and non-purgeable organic carbon (DOC) and found that the insert did not significantly change either measurement. Thus, the insert may enable dry deposition collection of PM and DOC at NADP sites. We then developed a method for enumerating the collected wet and dry deposition with the Flow Cytometer and Microscope (FlowCAM), a dynamic-image particle analysis tool. The FlowCAM has the potential to establish morphology, which affects particle settling and retention, through particle diameter and aspect ratio. Particle images were used to track the abundance of pollen grains over time. Qualitative image examination revealed that most particles were biological in nature, such as intact algal cells and pollen. Dry deposition loading to the Soddie site as determined by FlowCAM measurements was highly variable, ranging from 100 to >230 g ha-1 d-1 in June-August 2011 and peaking in late June. No significant difference in diameter or aspect ratio was found between wet and dry deposition, suggesting fundamental similarities between those deposition types. Although FlowCAM statistics and identification of particle types proved insightful, our total-particle enumeration method had a high variance and underestimated the total number of particles when compared to imaging of relatively large volumes (60-125 mL) from a single sample. We recommend use of the FlowCAM, especially for subclasses of particles, but in light of uncertainty in particle counts, believe that it should be paired with traditional methods such as microscopy in this stage of the technique's development. Analysis of well-mixed samples produced lower variability than settling methods used for algae samples. Use of the marble inserts in the dry deposition collector in the NADP context is recommended, and the implications of various particle counting and identification methods are explored.

Split-mouth comparison of the accuracy of computer-generated and conventional surgical guides.

PubMed

Farley, Nathaniel E; Kennedy, Kelly; McGlumphy, Edwin A; Clelland, Nancy L

2013-01-01

Recent clinical studies have shown that implant placement is highly predictable with computer-generated surgical guides; however, the reliability of these guides has not been compared to that of conventional guides clinically. This study aimed to compare the accuracy of reproducing planned implant positions with computer-generated and conventional surgical guides using a split-mouth design. Ten patients received two implants each in symmetric locations. All implants were planned virtually using a software program and information from cone beam computed tomographic scans taken with scan appliances in place. Patients were randomly selected for computer-aided design/computer-assisted manufacture (CAD/CAM)-guided implant placement on their right or left side. Conventional guides were used on the contralateral side. Patients underwent operative cone beam computed tomography postoperatively. Planned and actual implant positions were compared using three-dimensional analyses capable of measuring volume overlap as well as differences in angles and coronal and apical positions. Results were compared using a mixed-model repeated-measures analysis of variance and were further analyzed using a Bartlett test for unequal variance (α = .05). Implants placed with CAD/CAM guides were closer to the planned positions in all eight categories examined. However, statistically significant differences were shown only for coronal horizontal distances. It was also shown that CAD/CAM guides had less variability than conventional guides, which was statistically significant for apical distance. Implants placed using CAD/CAM surgical guides provided greater accuracy in a lateral direction than conventional guides. In addition, CAD/CAM guides were more consistent in their deviation from the planned locations than conventional guides.

Are patients with coeliac disease seeking alternative therapies to a gluten-free diet?

PubMed

Aziz, Imran; Evans, Kate E; Papageorgiou, Vasiliki; Sanders, David S

2011-03-01

The cornerstone of treatment for coeliac disease is a gluten-free diet (GFD). However, adherence to a GFD is variable. Recently investigators have been reporting their preliminary findings using novel therapies. In addition, there is a growing interest in the use of complementary or alternative medicine (CAM) in gastrointestinal illnesses. These observations suggest that patients with coeliac disease may be dissatisfied with a GFD and possibly are seeking/using alternative therapies for their disease. Our aim was to assess the satisfaction levels of adults with coeliac disease towards a GFD, their use of oral CAM and views regarding novel therapies. 310 patients with coeliac disease completed a questionnaire survey while attending their out-patient appointment. The control group comprised 477 individuals. Over 40% of patients with coeliac disease were dissatisfied with a GFD. The frequency of CAM use in patients with coeliac disease was 21.6% (67/310) vs 27% in the control group (129/477), p=0.09. All patients expressed an interest in novel therapies, with a vaccine being the first choice in 42% of patients, 35% and 23% for anti- zonulin and peptidases, respectively. Universally, patients placed genetically modified wheat as the lowest preference. A large proportion of patients with coeliac disease are dissatisfied with a GFD. Coeliac patients are not taking CAM any more than controls, suggesting they do not view CAM as an alternative to a GFD. However, all the patients in this survey were keen to consider novel therapies, with a vaccine being the most preferred option.

Complementary and alternative medical therapies for interstitial cystitis: an update from the United States

PubMed Central

Atchley, Megan Danielle; Shah, Nima M.

2015-01-01

The diagnosis and treatment of interstitial cystitis/bladder pain syndrome (IC/BPS) has shifted from organ-specific to a multifactorial, multidisciplinary and individualized approach. Patients with refractory and debilitating symptoms may respond to complementary and alternative medical treatments (CAM). Through CAM therapies, practitioners assist the patient to be at the center of their care, empowering them to be emotionally and physically involved. Multi-disciplinary care, including urology, gynecology, gastroenterology, neurology, psychology, physiotherapy and pain medicine, is also identified to be the crux of adequate management of patients with chronic pelvic pain because of its variable etiology. The purpose of this review is to emphasize these changes and discuss management strategies. PMID:26816868

Complementary and alternative medical therapies for interstitial cystitis: an update from the United States.

PubMed

Atchley, Megan Danielle; Shah, Nima M; Whitmore, Kristene E

2015-12-01

The diagnosis and treatment of interstitial cystitis/bladder pain syndrome (IC/BPS) has shifted from organ-specific to a multifactorial, multidisciplinary and individualized approach. Patients with refractory and debilitating symptoms may respond to complementary and alternative medical treatments (CAM). Through CAM therapies, practitioners assist the patient to be at the center of their care, empowering them to be emotionally and physically involved. Multi-disciplinary care, including urology, gynecology, gastroenterology, neurology, psychology, physiotherapy and pain medicine, is also identified to be the crux of adequate management of patients with chronic pelvic pain because of its variable etiology. The purpose of this review is to emphasize these changes and discuss management strategies.

Toward Realistic Simulation of low-Level Clouds Using a Multiscale Modeling Framework With a Third-Order Turbulence Closure in its Cloud-Resolving Model Component

NASA Technical Reports Server (NTRS)

Xu, Kuan-Man; Cheng, Anning

2010-01-01

This study presents preliminary results from a multiscale modeling framework (MMF) with an advanced third-order turbulence closure in its cloud-resolving model (CRM) component. In the original MMF, the Community Atmosphere Model (CAM3.5) is used as the host general circulation model (GCM), and the System for Atmospheric Modeling with a first-order turbulence closure is used as the CRM for representing cloud processes in each grid box of the GCM. The results of annual and seasonal means and diurnal variability are compared between the modified and original MMFs and the CAM3.5. The global distributions of low-level cloud amounts and precipitation and the amounts of low-level clouds in the subtropics and middle-level clouds in mid-latitude storm track regions in the modified MMF show substantial improvement relative to the original MMF when both are compared to observations. Some improvements can also be seen in the diurnal variability of precipitation.

Proposal of a new electromechanical total artificial heart: the TAH Serpentina.

PubMed

Sauer, I M; Frank, J; Bücherl, E S

1999-03-01

A new type of energy converter for an electro-mechanical total artificial heart (TAH) based on the principle of a unidirectional moving motor is described. Named the TAH Serpentina, the concept consists of 2 major parts, a pendulum shaped movable element fixed on one side using a joint bearing and a special shaped drum cam. Pusher plates are mounted flexibly to the crossbar of the pendulum. A motor drives the special shaped drum cam linked to the pendulum through a ball bearing. The circular motion of the unidirectional moving brushless DC motor is transferred into the linear motion of the pendulum to drive the pusher plates. Using a crossbar with a variable length, the stroke of the pendulum and therefore the displaced blood volume is alterable. To achieve a variable length, an electric driven screw thread or a hydraulic system is possible. Comparable to the natural heart, cardiac output would be determined by frequency and stroke volume.

Magnetic Doppler imaging of 53 Camelopardalis in all four Stokes parameters

NASA Astrophysics Data System (ADS)

Kochukhov, O.; Bagnulo, S.; Wade, G. A.; Sangalli, L.; Piskunov, N.; Landstreet, J. D.; Petit, P.; Sigut, T. A. A.

2004-02-01

We present the first investigation of the structure of the stellar surface magnetic field using line profiles in all four Stokes parameters. We extract the information about the magnetic field geometry and abundance distributions of the chemically peculiar star 53 Cam by modelling time-series of high-resolution spectropolarimetric observations with the help of a new magnetic Doppler imaging code. This combination of the unique four Stokes parameter data and state-of-the-art magnetic imaging technique makes it possible to infer the stellar magnetic field topology directly from the rotational variability of the Stokes spectra. In the magnetic imaging of 53 Cam we discard the traditional multipolar assumptions about the structure of magnetic fields in Ap stars and explore the stellar magnetic topology without introducing any global a priori constraints on the field structure. The complex magnetic model of 53 Cam derived with our magnetic Doppler imaging method achieves a good fit to the observed intensity, circular and linear polarization profiles of strong magnetically sensitive Fe II spectral lines. Such an agreement between observations and model predictions was not possible with any earlier multipolar magnetic models, based on modelling Stokes I spectra and fitting surface averaged magnetic observables (e.g., longitudinal field, magnetic field modulus, etc.). Furthermore, we demonstrate that even the direct inversion of the four Stokes parameters of 53 Cam assuming a low-order multipolar magnetic geometry is incapable of achieving an adequate fit to our spectropolarimetric observations. Thus, as a main result of our investigation, we discover that the magnetic field topology of 53 Cam is considerably more complex than any low-order multipolar expansion, raising a general question about the validity of the multipolar assumption in the studies of magnetic field structures of Ap stars. In addition to the analysis of the magnetic field of 53 Cam, we reconstruct surface abundance distributions of Si, Ca, Ti, Fe and Nd. These abundance maps confirm results of the previous studies of 53 Cam, in particular dramatic antiphase variation of Ca and Ti abundances. Based on observations obtained with the Bernard Lyot telescope of the Pic du Midi Observatory and Isaac Newton Telescope of the La Palma Observatory.

Observations of the boundary layer, cloud, and aerosol variability in the southeast Pacific near-coastal marine stratocumulus during VOCALS-REx

NASA Astrophysics Data System (ADS)

Zheng, X.; Albrecht, B.; Jonsson, H. H.; Khelif, D.; Feingold, G.; Minnis, P.; Ayers, K.; Chuang, P.; Donaher, S.; Rossiter, D.; Ghate, V.; Ruiz-Plancarte, J.; Sun-Mack, S.

2011-09-01

Aircraft observations made off the coast of northern Chile in the Southeastern Pacific (20° S, 72° W; named Point Alpha) from 16 October to 13 November 2008 during the VAMOS Ocean-Cloud- Atmosphere-Land Study-Regional Experiment (VOCALS-REx), combined with meteorological reanalysis, satellite measurements, and radiosonde data, are used to investigate the boundary layer (BL) and aerosol-cloud-drizzle variations in this region. On days without predominately synoptic and meso-scale influences, the BL at Point Alpha was typical of a non-drizzling stratocumulus-topped BL. Entrainment rates calculated from the near cloud-top fluxes and turbulence in the BL at Point Alpha appeared to be weaker than those in the BL over the open ocean west of Point Alpha and the BL near the coast of the northeast Pacific. The cloud liquid water path (LWP) varied between 15 g m-2 and 160 g m-2. The BL had a depth of 1140 ± 120 m, was generally well-mixed and capped by a sharp inversion without predominately synoptic and meso-scale influences. The wind direction generally switched from southerly within the BL to northerly above the inversion. On days when a synoptic system and related mesoscale costal circulations affected conditions at Point Alpha (29 October-4 November), a moist layer above the inversion moved over Point Alpha, and the total-water mixing ratio above the inversion was larger than that within the BL. The accumulation mode aerosol varied from 250 to 700 cm-3 within the BL, and CCN at 0.2 % supersaturation within the BL ranged between 150 and 550 cm-3. The main aerosol source at Point Alpha was horizontal advection within the BL from south. The average cloud droplet number concentration ranged between 80 and 400 cm-3. While the mean LWP retrieved from GOES was in good agreement with the in situ measurements, the GOES-derived cloud droplet effective radius tended to be larger than that from the aircraft in situ observations near cloud top. The aerosol and cloud LWP relationship reveals that during the typical well-mixed BL days the cloud LWP increased with the CCN concentrations. On the other hand, meteorological factors and the decoupling processes have large influences on the cloud LWP variation as well.

Differences in cocaine-induced place preference persistence, locomotion and social behaviors between C57BL/6J and BALB/cJ mice

PubMed Central

WANG, Jian-Li; WANG, Bei; CHEN, Wen

2014-01-01

C57BL/6J and BALB/cJ mice display significant differences in sociability and response to drugs, but the phenotypic variability of their susceptibility to cocaine is still not well known. In this study, the differences between these two mice strains in the persistence of cocaine-induced conditioned place preference (CPP), as well as the locomotion and social behaviors after the 24-hour withdrawal from a four-day cocaine (20 mg/kg/day) administration were investigated. The results showed that the cocaine-induced CPP persisted over two weeks in C57BL/6J mice, while it diminished within one week among BALB/cJ mice. After 24-hours of cocaine withdrawal, high levels of locomotion as well as low levels of social interaction and aggressive behavior were found in C57BL/6J mice, but no significant changes were found in BALB/cJ mice, indicating that cocaine-induced CPP persistence, locomotion and social behavior are not consistent between these two strains, and that overall C57BL/6J mice are more susceptible to cocaine than BALB/cJ mice at the tested doses. PMID:25297083

Differences in cocaine-induced place preference persistence, locomotion and social behaviors between C57BL/6J and BALB/cJ mice.

PubMed

Wang, Jian-Li; Wang, Bei; Chen, Wen

2014-09-01

C57BL/6J and BALB/cJ mice display significant differences in sociability and response to drugs, but the phenotypic variability of their susceptibility to cocaine is still not well known. In this study, the differences between these two mice strains in the persistence of cocaine-induced conditioned place preference (CPP), as well as the locomotion and social behaviors after the 24-hour withdrawal from a four-day cocaine (20 mg/kg/day) administration were investigated. The results showed that the cocaine-induced CPP persisted over two weeks in C57BL/6J mice, while it diminished within one week among BALB/cJ mice. After 24-hours of cocaine withdrawal, high levels of locomotion as well as low levels of social interaction and aggressive behavior were found in C57BL/6J mice, but no significant changes were found in BALB/cJ mice, indicating that cocaine-induced CPP persistence, locomotion and social behavior are not consistent between these two strains, and that overall C57BL/6J mice are more susceptible to cocaine than BALB/cJ mice at the tested doses.

First-principles X-ray absorption dose calculation for time-dependent mass and optical density.

PubMed

Berejnov, Viatcheslav; Rubinstein, Boris; Melo, Lis G A; Hitchcock, Adam P

2018-05-01

A dose integral of time-dependent X-ray absorption under conditions of variable photon energy and changing sample mass is derived from first principles starting with the Beer-Lambert (BL) absorption model. For a given photon energy the BL dose integral D(e, t) reduces to the product of an effective time integral T(t) and a dose rate R(e). Two approximations of the time-dependent optical density, i.e. exponential A(t) = c + aexp(-bt) for first-order kinetics and hyperbolic A(t) = c + a/(b + t) for second-order kinetics, were considered for BL dose evaluation. For both models three methods of evaluating the effective time integral are considered: analytical integration, approximation by a function, and calculation of the asymptotic behaviour at large times. Data for poly(methyl methacrylate) and perfluorosulfonic acid polymers measured by scanning transmission soft X-ray microscopy were used to test the BL dose calculation. It was found that a previous method to calculate time-dependent dose underestimates the dose in mass loss situations, depending on the applied exposure time. All these methods here show that the BL dose is proportional to the exposure time D(e, t) ≃ K(e)t.

75 FR 25210 - Procurement List Proposed Additions and Deletions

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-07

...-9276--Multi Cam NSN: 8415-01-579-9272--Multi Cam NSN: 8415-01-579-9267--Multi Cam NSN: 8415-01-579-9260--Multi Cam NSN: 8415-01-579-9219--Multi Cam NSN: 8415-01-579-9210--Multi Cam NSN: 8415-01-579-9197--Multi Cam NSN: 8415-01-579-9189--Multi Cam NSN: 8415-01-579-9182--Multi Cam NSN: 8415-01-579-9175--Multi Cam...

Microbial fuel cells for inexpensive continuous in-situ monitoring of groundwater quality.

PubMed

Velasquez-Orta, S B; Werner, D; Varia, J C; Mgana, S

2017-06-15

Online monitoring of groundwater quality in shallow wells to detect faecal or organic pollution could dramatically improve understanding of health risks in unplanned peri-urban settlements. Microbial fuel cells (MFC) are devices able to generate electricity from the organic matter content in faecal pollution making them suitable as biosensors. In this work, we evaluate the suitability of four microbial fuel cell systems placed in different regions of a groundwater well for the low-cost monitoring of a faecal pollution event. Concepts created include the use of a sediment/bulk liquid MFC (SED/BL), a sediment/sediment MFC (SED/SED), a bulk liquid/air MFC (BL/Air), and a bulk liquid/bulk liquid MFC (BL/BL). MFC electrodes assembly aimed to use inexpensive, durable, materials, which would produce a signal after a contamination event without external energy or chemical inputs. All MFC configurations were responsive to a contamination event, however SED/SED and BL/Air MFC concepts failed to deliver a reproducible output within the tested period of time. BL/BL MFC and SED/BL MFCs presented an increase in the average current after contamination from -0.75 ± 0.35 μA to -0.66 ± 0.41 μA, and 0.07 ± 0.2 mA to 0.11 ± 0.03 mA, respectively. Currents produced by the SED/BL MFC (SMFC) were considerably higher than for the BL/BL MFCs, making them more responsive, readable and graphically visible. A factorial design of experiments (DOE) was applied to evaluate which environmental and design factors had the greatest effect on current response in a contamination event. Within the ranges of variables tested, salinity, temperature and external resistance, only temperature presented a statistically significant effect (p = 0.045). This showed that the biosensor response would be sensitive to fluctuations in temperature but not to changes in salinity, or external resistances produced from placing electrodes at different distances within a groundwater well. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

24- and 36-week outcomes for the Child/Adolescent Anxiety Multimodal Study (CAMS).

PubMed

Piacentini, John; Bennett, Shannon; Compton, Scott N; Kendall, Phillip C; Birmaher, Boris; Albano, Anne Marie; March, John; Sherrill, Joel; Sakolsky, Dara; Ginsburg, Golda; Rynn, Moira; Bergman, R Lindsey; Gosch, Elizabeth; Waslick, Bruce; Iyengar, Satish; McCracken, James; Walkup, John

2014-03-01

We report active treatment group differences on response and remission rates and changes in anxiety severity at weeks 24 and 36 for the Child/Adolescent Anxiety Multimodal Study (CAMS). CAMS youth (N = 488; 74% ≤ 12 years of age) with DSM-IV separation, generalized, or social anxiety disorder were randomized to 12 weeks of cognitive-behavioral therapy (CBT), sertraline (SRT), CBT+SRT (COMB), or medication management/pill placebo (PBO). Responders attended 6 monthly booster sessions in their assigned treatment arm; youth in COMB and SRT continued on their medication throughout this period. Efficacy of COMB, SRT, and CBT (n = 412) was assessed at 24 and 36 weeks postrandomization. Youth randomized to PBO (n = 76) were offered active CAMS treatment if nonresponsive at week 12 or over follow-up and were not included here. Independent evaluators blind to study condition assessed anxiety severity, functioning, and treatment response. Concomitant treatments were allowed but monitored over follow-up. The majority (>80%) of acute responders maintained positive response at both weeks 24 and 36. Consistent with acute outcomes, COMB maintained advantage over CBT and SRT, which did not differ, on dimensional outcomes; the 3 treatments did not differ on most categorical outcomes over follow-up. Compared to COMB and CBT, youth in SRT obtained more concomitant psychosocial treatments, whereas those in SRT and CBT obtained more concomitant combined (medication plus psychosocial) treatment. COMB maintained advantage over CBT and SRT on some measures over follow-up, whereas the 2 monotherapies remained indistinguishable. The observed convergence of COMB and monotherapy may be related to greater use of concomitant treatment during follow-up among youth receiving the monotherapies, although other explanations are possible. Although outcomes were variable, most CAMS-treated youth experienced sustained treatment benefit. Clinical trial registration information-Child and Adolescent Anxiety Disorders (CAMS); URL: http://clinicaltrials.gov. Unique identifier: NCT00052078. Copyright © 2014 American Academy of Child and Adolescent Psychiatry. All rights reserved.

Cross-sectional study of self-reported physical activity, eating habits and use of complementary medicine in breast cancer survivors.

PubMed

Templeton, Arnoud J; Thürlimann, Beat; Baumann, Michael; Mark, Michael; Stoll, Sarah; Schwizer, Madeleine; Dietrich, Daniel; Ruhstaller, Thomas

2013-03-25

Besides conventional adjuvant therapies, many breast cancer survivors engage in various activities like exercise, diet and complementary and alternative medicine (CAM) in order to improve their prognosis. Little is known about specific interests and willingness to participate in institutional programs (e.g. exercise classes). We conducted a cross-sectional study in patients with early breast cancer assessing current physical activity (PA, e.g. 30 minutes brisk walking), attention to eating habits ("diet"), use of CAM, and interest in learning more about these fields. Patients indicating interest in PA counselling received a voucher for a free instruction by a certified physiotherapist. Data were analysed for factors predictive for engagement in the three fields using a stepwise multivariate logistic approach. Of 342 consecutive patients, 232 (69%) reported to be physically active more than once per week, 299 (87%) paying special attention to nutrition (in most cases fruits, "balanced diet", low fat), and 159 (46%) use of CAM (vitamins, special teas, homeopathy, herbal medicine, mistletoe). Factors predictive for PA were use of CAM, higher age, and fewer worries about the future. Swiss nationality at birth, physical activity and higher education were predictive for diet; whereas physical activity, higher education and lower age were predictive for use of CAM. No associations between any of the above variables and breast cancer characteristics were found. Around half of the patients reported interest in receiving more information and willingness to attend special counselling. Of 166 vouchers, only 7 (4%) were eventually utilized. A high proportion of breast cancer survivors report PA, following a specific diet and use of CAM. There were no disease related factors associated with such pursuits, but an association between patient related factors and these fields was observed suggesting general health awareness in some patients. Around half of the patients were interested in more information and indicated willingness to participate in institutional programs. Impact on disease specific and general health including health economic aspects warrants further research.

Multi-year application of WRF-CAM5 over East Asia-Part I: Comprehensive evaluation and formation regimes of O 3 and PM 2.5

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

He, Jian; Zhang, Yang; Wang, Kai

Accurate simulations of air quality and climate require robust model parameterizations on regional and global scales. The Weather Research and Forecasting model with Chemistry version 3.4.1 has been coupled with physics packages from the Community Atmosphere Model version 5 (CAM5) (WRF-CAM5) to assess the robustness of the CAM5 physics package for regional modeling at higher grid resolutions than typical grid resolutions used in global modeling. In this two-part study, Part I describes the application and evaluation of WRF-CAM5 over East Asia at a horizontal resolution of 36-km for six years: 2001, 2005, 2006, 2008, 2010, and 2011. The simulations aremore » evaluated comprehensively with a variety of datasets from surface networks, satellites, and aircraft. The results show that meteorology is relatively well simulated by WRF-CAM5. However, cloud variables are largely or moderately underpredicted, indicating uncertainties in the model treatments of dynamics, thermodynamics, and microphysics of clouds/ices as well as aerosol-cloud interactions. For chemical predictions, the tropospheric column abundances of CO, NO2, and O3 are well simulated, but those of SO2 and HCHO are moderately overpredicted, and the column HCHO/NO2 indicator is underpredicted. Large biases exist in the surface concentrations of CO, NO2, and PM10 due to uncertainties in the emissions as well as vertical mixing. The underpredictions of NO lead to insufficient O3 titration, thus O3 overpredictions. The model can generally reproduce the observed O3 and PM indicators. These indicators suggest to control NOx emissions throughout the year, and VOCs emissions in summer in big cities and in winter over North China Plain, North/South Korea, and Japan to reduce surface O3, and to control SO2, NH3, and NOx throughout the year to reduce inorganic surface PM.« less

Translation and cross-cultural adaptation of a standardized international questionnaire on use of alternative and complementary medicine (I-CAM - Q) for Argentina.

PubMed

Esteban, Santiago; Vázquez Peña, Fernando; Terrasa, Sergio

2016-03-31

The widespread and growing use of alternative and complementary medicine (CAM) worldwide has been thoroughly described. In Argentina the limited information on the use of CAM has been reported between 40 and 55 %. However, the rate of use is extremely variable worldwide. For this purpose the international questionnaire on the use of complementary and alternative medicines (I-CAM - Q), was developed. The implementation of a translated and cross-culturally adapted version of the questionnaire would allow for a reliable and standardized evaluation of the rate of use of CAM in Argentina. It would be a great step towards improving what we know about the healing habits of our population. The forward and back-translation method was used. Four translators were involved. A committee was commissioned to reconcile the different versions. The process of cross-cultural adaptation was made by consulting 17 alternative and complementary medicine experts using the DELPHI method. The retrieved questionnaire was evaluated in 18 patients sampled by convenience (9 men, different educational and self-reported health levels). The interviews consisted of three parts: an initial demographics questionnaire; the administration of the I-CAM-Q and finally the cognitive interview, which included reviewing the questionnaire and reexamining questions that generated doubts during the interview. The comprehension of the questions was also evaluated. As a last step, using the information obtained from the interviews, the final version of the questionnaire was drafted. The questionnaire seems to have been accepted by most patients during the interviews. Conflictive elements that emerged did not seem to have an impact on its administration. The flexibility of the questionnaire allowed to add professionals and practices which contributed to a more accurate local adaptation. Further research should focus on assessing the questionnaire's psychometric performance and validity, which so far has not been done.

Complementary and alternative medicine and supportive care at leading cancer centers: a systematic analysis of websites.

PubMed

Brauer, Jeremy A; El Sehamy, Adam; Metz, James M; Mao, Jun J

2010-02-01

With increasing frequency, patients with cancer and their family members are turning to the Internet to educate themselves about their disease and treatment options, including complementary and alternative medicine (CAM) and supportive care. However, very little is known about how national leading cancer centers represent these therapies via their websites. Simulating the perspective of an information-seeking patient or family member, we performed a systematic analysis of the websites of 41 National Cancer Institute designated comprehensive cancer centers. Two researchers independently evaluated websites, recorded CAM information, and rated quality of the websites using a 4-item Likert scale (overall, information, presentation, and navigation) with Cronbach's alpha = 0.97. Rating was adequately correlated between the two raters (correlation coefficient 0.8). Of 41 centers, 12 (29%) did not have functional websites with regard to information related to CAM. The most common CAM approaches mentioned were: acupuncture (59%), meditation/nutrition/spiritual support/yoga (56% for each), massage therapy (54%), and music therapy (51%). Twenty-three (23; 56%) presented information on support groups, 19 (46%) on patient seminars, 18 (44%) on survivorship effort, and 17 (41%) on symptom management clinics. Twenty-nine (29) (71%) of these websites had a telephone number available, 22 (54%) mentioned at least one ongoing research opportunity, and 19 (46%) provided links to the National Center for Complementary and Alternative Medicine website. Median rating of the quality of websites was 50 of 100, with only 7 (17%) of centers receiving a composite score 80 (excellent) or better. While a growing number of leading cancer centers provide information about CAM and supportive oncology information for patients via their websites, the quality and ease of navigation of these sites remain highly variable. Effective development and redesign of many of the websites is needed to better inform and empower patients and families seeking CAM and supportive care information.

THE MICRO-ARCSECOND SCINTILLATION-INDUCED VARIABILITY (MASIV) SURVEY. III. OPTICAL IDENTIFICATIONS AND NEW REDSHIFTS

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

Pursimo, Tapio; Ojha, Roopesh; Jauncey, David L.

2013-04-10

Intraday variability (IDV) of the radio emission from active galactic nuclei is now known to be predominantly due to interstellar scintillation (ISS). The MASIV (The Micro-Arcsecond Scintillation-Induced Variability) survey of 443 flat spectrum sources revealed that the IDV is related to the radio flux density and redshift. A study of the physical properties of these sources has been severely handicapped by the absence of reliable redshift measurements for many of these objects. This paper presents 79 new redshifts and a critical evaluation of 233 redshifts obtained from the literature. We classify spectroscopic identifications based on emission line properties, finding thatmore » 78% of the sources have broad emission lines and are mainly FSRQs. About 16% are weak lined objects, chiefly BL Lacs, and the remaining 6% are narrow line objects. The gross properties (redshift, spectroscopic class) of the MASIV sample are similar to those of other blazar surveys. However, the extreme compactness implied by ISS favors FSRQs and BL Lacs in the MASIV sample as these are the most compact object classes. We confirm that the level of IDV depends on the 5 GHz flux density for all optical spectral types. We find that BL Lac objects tend to be more variable than broad line quasars. The level of ISS decreases substantially above a redshift of about two. The decrease is found to be generally consistent with ISS expected for beamed emission from a jet that is limited to a fixed maximum brightness temperature in the source rest frame.« less

Modifying the Standard Disk Model for the Ultraviolet Spectral Analysis of Disk-dominated Cataclysmic Variables. I. The Novalikes MV Lyrae, BZ Camelopardalis, and V592 Cassiopeiae

NASA Astrophysics Data System (ADS)

Godon, Patrick; Sion, Edward M.; Balman, Şölen; Blair, William P.

2017-09-01

The standard disk is often inadequate to model disk-dominated cataclysmic variables (CVs) and generates a spectrum that is bluer than the observed UV spectra. X-ray observations of these systems reveal an optically thin boundary layer (BL) expected to appear as an inner hole in the disk. Consequently, we truncate the inner disk. However, instead of removing the inner disk, we impose the no-shear boundary condition at the truncation radius, thereby lowering the disk temperature and generating a spectrum that better fits the UV data. With our modified disk, we analyze the archival UV spectra of three novalikes that cannot be fitted with standard disks. For the VY Scl systems MV Lyr and BZ Cam, we fit a hot inflated white dwarf (WD) with a cold modified disk (\\dot{M} ˜ a few 10-9 M ⊙ yr-1). For V592 Cas, the slightly modified disk (\\dot{M}˜ 6× {10}-9 {M}⊙ {{yr}}-1) completely dominates the UV. These results are consistent with Swift X-ray observations of these systems, revealing BLs merged with ADAF-like flows and/or hot coronae, where the advection of energy is likely launching an outflow and heating the WD, thereby explaining the high WD temperature in VY Scl systems. This is further supported by the fact that the X-ray hardness ratio increases with the shallowness of the UV slope in a small CV sample we examine. Furthermore, for 105 disk-dominated systems, the International Ultraviolet Explorer spectra UV slope decreases in the same order as the ratio of the X-ray flux to optical/UV flux: from SU UMa’s, to U Gem’s, Z Cam’s, UX UMa’s, and VY Scl’s.

A Methodological Review and Critique of the "Intergenerational Transmission of Violence" Literature.

PubMed

Haselschwerdt, Megan L; Savasuk-Luxton, Rachel; Hlavaty, Kathleen

2017-01-01

Exposure to interpersonal or interparental violence (EIPV) and child abuse and maltreatment (CAM) are associated with an increased risk of maladaptive outcomes, including later involvement in adulthood intimate partner violence (IPV; often referred to as the theory of intergenerational transmission of violence). Recent meta-analyses, however, have documented a weak effect size when examining this association. By focusing on young adulthood, a development stage in which identity development and romantic relationship formation are salient tasks, we can provide insight into the association between EIPV, CAM, and IPV. Guided by the methodological critiques from the IPV and EIPV literatures, the present study reviewed the methodology used in 16 studies (published between 2002 and 2016) that tested the theory of intergenerational transmission of violence. The review study focused on how EIPV, CAM, and young adult dating violence were measured and analyzed, with the initial goal of better understanding how methodological decision informed the study's findings. Ultimately, we determined that there was simply too much methodological variability and yet too little methodological complexity to truly inform a review and discussion of the results; therefore, our review solely focused on the study's methodological decisions. Based on our review, we suggest that both of these challenges, too much variability and too little complexity, hinder our ability to examine the theory of intergenerational transmission of violence. Future research must strike a balance between methodological consistency and complexity to better understand the intricate nuances of IPV experiences and inform practice.

Fourier analysis of blazar variability

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

Finke, Justin D.; Becker, Peter A., E-mail: justin.finke@nrl.navy.mil

Blazars display strong variability on multiple timescales and in multiple radiation bands. Their variability is often characterized by power spectral densities (PSDs) and time lags plotted as functions of the Fourier frequency. We develop a new theoretical model based on the analysis of the electron transport (continuity) equation, carried out in the Fourier domain. The continuity equation includes electron cooling and escape, and a derivation of the emission properties includes light travel time effects associated with a radiating blob in a relativistic jet. The model successfully reproduces the general shapes of the observed PSDs and predicts specific PSD and timemore » lag behaviors associated with variability in the synchrotron, synchrotron self-Compton, and external Compton emission components, from submillimeter to γ-rays. We discuss applications to BL Lacertae objects and to flat-spectrum radio quasars (FSRQs), where there are hints that some of the predicted features have already been observed. We also find that FSRQs should have steeper γ-ray PSD power-law indices than BL Lac objects at Fourier frequencies ≲ 10{sup –4} Hz, in qualitative agreement with previously reported observations by the Fermi Large Area Telescope.« less

Use of complementary and alternative medicine by lymphoma survivors in South Korea.

PubMed

Kim, Kisook; Kim, Soo Hyun; Ok, Oh Nam; Kim, Im-Ryung; Lee, Suyeon; Kim, So Hee; Kim, Won Seog; Ryu, Min-Hee; Lee, Moon Hee

2018-04-01

We aimed to examine the experience of complementary and alternative medicine (CAM) use and its association with health-related quality of life (HRQOL) in lymphoma survivors in South Korea. The participants were 869 lymphoma survivors from three hospitals in South Korea, all diagnosed with lymphoma at least 24 months prior to participation. Self-reported questionnaires were used to assess CAM use. The questionnaire addressed types of CAM used, sources of information about CAM, reason for CAM use, satisfaction with CAM use, discussion of CAM use with doctors, experience of side effects, costs of CAM use, and intentions to continue using CAM. HRQOL was measured with the EORTC QLQ-C30. Of the 869 participants, 42.2% had experience using CAM, and there were statistically significant differences among CAM users and non-users in terms of sex, religion, and time since diagnosis. A special diet (e.g., ginseng, chitosan, mixed cereals) was the most commonly used type of CAM, and most CAM users (82.1%) were satisfied with their CAM use. Most CAM users (77.5%) did not discuss the use of CAM with their doctors, and only 9.2% reported any side effects from CAM. CAM users showed significantly lower HRQOL scores than did non-users. A significant number of lymphoma survivors in Korea have used CAM, and most CAM users are satisfied with their CAM use. Oncology nurses should be aware of the range of CAM use among patients and reflect their responses in their treatment and/or follow-up care. Copyright © 2018 Elsevier Ltd. All rights reserved.

Optical polarization of high-energy BL Lacertae objects

NASA Astrophysics Data System (ADS)

Hovatta, T.; Lindfors, E.; Blinov, D.; Pavlidou, V.; Nilsson, K.; Kiehlmann, S.; Angelakis, E.; Fallah Ramazani, V.; Liodakis, I.; Myserlis, I.; Panopoulou, G. V.; Pursimo, T.

2016-12-01

Context. We investigate the optical polarization properties of high-energy BL Lac objects using data from the RoboPol blazar monitoring program and the Nordic Optical Telescope. Aims: We wish to understand if there are differences between the BL Lac objects that have been detected with the current-generation TeV instruments and those objects that have not yet been detected. Methods: We used a maximum-likelihood method to investigate the optical polarization fraction and its variability in these sources. In order to study the polarization position angle variability, we calculated the time derivative of the electric vector position angle (EVPA) change. We also studied the spread in the Stokes Q/I-U/I plane and rotations in the polarization plane. Results: The mean polarization fraction of the TeV-detected BL Lacs is 5%, while the non-TeV sources show a higher mean polarization fraction of 7%. This difference in polarization fraction disappears when the dilution by the unpolarized light of the host galaxy is accounted for. The TeV sources show somewhat lower fractional polarization variability amplitudes than the non-TeV sources. Also the fraction of sources with a smaller spread in the Q/I-U/I plane and a clumped distribution of points away from the origin, possibly indicating a preferred polarization angle, is larger in the TeV than in the non-TeV sources. These differences between TeV and non-TeV samples seem to arise from differences between intermediate and high spectral peaking sources instead of the TeV detection. When the EVPA variations are studied, the rate of EVPA change is similar in both samples. We detect significant EVPA rotations in both TeV and non-TeV sources, showing that rotations can occur in high spectral peaking BL Lac objects when the monitoring cadence is dense enough. Our simulations show that we cannot exclude a random walk origin for these rotations. Conclusions: These results indicate that there are no intrinsic differences in the polarization properties of the TeV-detected and non-TeV-detected high-energy BL Lac objects. This suggests that the polarization properties are not directly related to the TeV-detection, but instead the TeV loudness is connected to the general flaring activity, redshift, and the synchrotron peak location. The polarization curve data are only available at the CDS via anonymous ftp to http://cdsarc.u-strasbg.fr (http://130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/596/A78

Stock Versus CAD/CAM Customized Zirconia Implant Abutments – Clinical and Patient‐Based Outcomes in a Randomized Controlled Clinical Trial

PubMed Central

Meijer, Henny J.A.; Kerdijk, Wouter; Raghoebar, Gerry M.; Cune, Marco

2016-01-01

Abstract Background Single‐tooth replacement often requires a prefabricated dental implant and a customized crown. The benefits of individualization of the abutment remain unclear. Purpose This randomized controlled clinical trial aims to study potential benefits of individualization of zirconia implant abutments with respect to preservation of marginal bone level and several clinical and patient‐based outcome measures. Material and Methods Fifty participants with a missing premolar were included and randomly assigned to standard (ZirDesign, DentsplySirona Implants, Mölndal, Sweden) or computer aided design/computer aided manufacturing (CAD/CAM) customized (Atlantis, DentsplySirona Implants, Mölndal, Sweden) zirconia abutment therapy. Peri‐implant bone level (primary outcome), Plaque‐index, calculus formation, bleeding on probing, gingiva index, probing pocket depth, recession, appearance of soft tissues and patients' contentment were assessed shortly after placement and one year later. Results No implants were lost and no complications related to the abutments were observed. Statistically significant differences between stock and CAD/CAM customized zirconia abutments could not be demonstrated for any of the operationalized variables. Conclusion The use of a CAD/CAM customized zirconia abutment in single tooth replacement of a premolar is not associated with an improvement in clinical performance or patients' contentment when compared to the use of a stock zirconia abutment. PMID:27476829

Stock Versus CAD/CAM Customized Zirconia Implant Abutments - Clinical and Patient-Based Outcomes in a Randomized Controlled Clinical Trial.

PubMed

Schepke, Ulf; Meijer, Henny J A; Kerdijk, Wouter; Raghoebar, Gerry M; Cune, Marco

2017-02-01

Single-tooth replacement often requires a prefabricated dental implant and a customized crown. The benefits of individualization of the abutment remain unclear. This randomized controlled clinical trial aims to study potential benefits of individualization of zirconia implant abutments with respect to preservation of marginal bone level and several clinical and patient-based outcome measures. Fifty participants with a missing premolar were included and randomly assigned to standard (ZirDesign, DentsplySirona Implants, Mölndal, Sweden) or computer aided design/computer aided manufacturing (CAD/CAM) customized (Atlantis, DentsplySirona Implants, Mölndal, Sweden) zirconia abutment therapy. Peri-implant bone level (primary outcome), Plaque-index, calculus formation, bleeding on probing, gingiva index, probing pocket depth, recession, appearance of soft tissues and patients' contentment were assessed shortly after placement and one year later. No implants were lost and no complications related to the abutments were observed. Statistically significant differences between stock and CAD/CAM customized zirconia abutments could not be demonstrated for any of the operationalized variables. The use of a CAD/CAM customized zirconia abutment in single tooth replacement of a premolar is not associated with an improvement in clinical performance or patients' contentment when compared to the use of a stock zirconia abutment. © 2016 The Authors. Clinical Implant Dentistry and Related Research Published by Wiley Periodicals, Inc.

BL Lacertae Objects Beyond Redshift 1.3 - UV-to-NIR Photometry and Photometric Redshift for Fermi/LAT Blazars

NASA Technical Reports Server (NTRS)

Rau, A.; Schady, P.; Greiner, J.; Salvato, M.; Ajello, M.; Bottacini, E.; Gehrels, N.; Afonso, P. M. J.; Elliott, J.; Filgas, R.;

Cryogenic expansion machine

DOEpatents

Pallaver, Carl B.; Morgan, Michael W.

1978-01-01

A cryogenic expansion engine includes intake and exhaust poppet valves each controlled by a cam having adjustable dwell, the valve seats for the valves being threaded inserts in the valve block. Each cam includes a cam base and a ring-shaped cam insert disposed at an exterior corner of the cam base, the cam base and cam insert being generally circular but including an enlarged cam dwell, the circumferential configuration of the cam base and cam dwell being identical, the cam insert being rotatable with respect to the cam base. GI CONTRACTUAL ORIGIN OF THE INVENTION The invention described herein was made in the course of, or under, a contract with the UNITED STATES ENERGY RESEARCH AND DEVELOPMENT ADMINISTRATION.

Westerly wind bursts simulated in CAM4 and CCSM4

NASA Astrophysics Data System (ADS)

Lian, Tao; Tang, Youmin; Zhou, Lei; Islam, Siraj Ul; Zhang, Chan; Li, Xiaojing; Ling, Zheng

2018-02-01

The equatorial westerly wind bursts (WWBs) play an important role in modulating and predicting the El Niño-Southern Oscillation (ENSO). In this study, the ability of the Community Atmospheric Model version 4 (CAM4) and the Community Climate System Model version 4 (CCSM4) in simulating WWBs is systematically evaluated. Many characteristics of WWBs, including their longitude distributions, durations, zonal extensions, variabilities at seasonal, intraseasonal, and interannual timescales, as well as their relations with the Madden-Julian Oscillation (MJO) and ENSO, are discussed. Generally speaking, these characteristics of WWBs can be successfully reproduced by CAM4, owning to the improvement of the deep convection in the model. In CCSM4, significant bias such as the lack of the equatorial Pacific WWBs in boreal spring season and the weak modulation by a strong MJO are found. Our findings confirm the fact that the WWBs are greatly modulated by the surface temperature. It's also suggested that improving the air-sea coupling in CCSM4 may improve model performance in simulating WWBs, and may further improve the predictability of ENSO in the coupled model.

Manufacturing information system

NASA Astrophysics Data System (ADS)

Allen, D. K.; Smith, P. R.; Smart, M. J.

1983-12-01

The size and cost of manufacturing equipment has made it extremely difficult to perform realistic modeling and simulation of the manufacturing process in university research laboratories. Likewise the size and cost factors, coupled with many uncontrolled variables of the production situation has even made it difficult to perform adequate manufacturing research in the industrial setting. Only the largest companies can afford manufacturing research laboratories; research results are often held proprietary and seldom find their way into the university classroom to aid in education and training of new manufacturing engineers. It is the purpose for this research to continue the development of miniature prototype equipment suitable for use in an integrated CAD/CAM Laboratory. The equipment being developed is capable of actually performing production operations (e.g. drilling, milling, turning, punching, etc.) on metallic and non-metallic workpieces. The integrated CAD/CAM Mini-Lab is integrating high resolution, computer graphics, parametric design, parametric N/C parts programmings, CNC machine control, automated storage and retrieval, with robotics materials handling. The availability of miniature CAD/CAM laboratory equipment will provide the basis for intensive laboratory research on manufacturing information systems.

Complementary and alternative medicine in paediatrics: a systematic overview/synthesis of Cochrane Collaboration reviews.

PubMed

Meyer, Sascha; Gortner, Ludwig; Larsen, Alexander; Kutschke, Georg; Gottschling, Sven; Gräber, Stefan; Schroeder, Nicole

2013-05-27

A high prevalence of complementary and alternative medicine (CAM) use has been documented in children with chronic illnesses. Conversely, evidence-based medicine is considered an important contributor in providing the best quality of care. We performed a systematic overview/synthesis of all Cochrane reviews published between 1995 and 2012 in paediatrics that assessed the efficacy, and clinical implications and limitations of CAM use in children. Main outcome variables were: percentage of reviews that concluded that a certain intervention provides a benefit, percentage of reviews that concluded that a certain intervention should not be performed, and percentage of studies that concluded that the current level of evidence is inconclusive. A total of 135 reviews were included - most from the United Kingdom (29/135), Australia (24/135) and China (24/135). Only 5/135 (3.7%) reviews gave a recommendation in favour of a certain intervention; 26/135 (19.4%) issued a conditional positive recommendation, and 9/135 (6.6%) reviews concluded that certain interventions should not be performed. Ninety-five reviews (70.3%) were inconclusive. The proportion of inconclusive reviews increased during three, a priori-defined, time intervals (1995-2000: 15/27 [55.6%]; 2001-2006: 33/44 [75%]; and 2007-2012: 47/64 [73.4%]). The three most common criticisms of the quality of the studies included were: more research needed (82/135), low methodological quality (57/135) and small number of study participants (48/135). Given the disproportionate number of inconclusive reviews, there is an ongoing need for high quality research to assess the potential role of CAM in children. Unless the study of CAM is performed to the same science-based standards as conventional therapies, CAM therapies risk being perpetually marginalised by mainstream medicine.

CAD/CAM milled removable complete dentures: an in vitro evaluation of trueness.

PubMed

Srinivasan, Murali; Cantin, Yoann; Mehl, Albert; Gjengedal, Harald; Müller, Frauke; Schimmel, Martin

2017-07-01

This study aimed to compare the trueness of one type of CAD/CAM milled complete removable dental prostheses (CRDPs) with injection-molding and conventionally manufactured CRDPs. Thirty-three CRDPs were fabricated by three different manufacturing techniques (group CAD/CAM (AvaDent™): n = 11; group injection molding (Ivocap™): n = 11; group flask-pack-press: n = 11) using a single master reference model and incubated in artificial saliva for 21 days. The trueness of the entire intaglio surface along with five specific regions of interest (vestibular-flange, palate, tuberosities, alveolar crest, and post-dam areas) was compared. Non-parametric tests were used with a level of significance set at p < 0.05. At baseline, there was no difference in the trueness of the total intaglio surfaces between the groups. After incubation, only the conventional CRDPs showed a significant improvement in trueness of the entire intaglio surface (p = 0.0044), but improved trueness was confirmed for all three techniques in most individual regions of interest. The 80-20 % /2 median quantile of the CAD/CAM group demonstrated the highest variability of individual readings, probably due to the size of the milling instrument. However, for all three techniques, 80 % of all deviations of the complete intaglio surface after incubation in saliva were below 0.1 mm. In this in vitro study, the trueness of the intaglio surface of all three investigated techniques seems to remain within a clinically acceptable range. Additional research is warranted on material-related aspects, cost-effectiveness, clinical performance, patient-centered outcomes, as well as other CAD/CAM techniques for CRDP fabrication. The intaglio surface trueness is an essential aspect in the clinical performance of CRDPs.

Seasonal photosynthetic gas exchange and water-use efficiency in a constitutive CAM plant, the giant saguaro cactus (Carnegiea gigantea).

PubMed

Bronson, Dustin R; English, Nathan B; Dettman, David L; Williams, David G

2011-11-01

Crassulacean acid metabolism (CAM) and the capacity to store large quantities of water are thought to confer high water use efficiency (WUE) and survival of succulent plants in warm desert environments. Yet the highly variable precipitation, temperature and humidity conditions in these environments likely have unique impacts on underlying processes regulating photosynthetic gas exchange and WUE, limiting our ability to predict growth and survival responses of desert CAM plants to climate change. We monitored net CO(2) assimilation (A(net)), stomatal conductance (g(s)), and transpiration (E) rates periodically over 2 years in a natural population of the giant columnar cactus Carnegiea gigantea (saguaro) near Tucson, Arizona USA to investigate environmental and physiological controls over carbon gain and water loss in this ecologically important plant. We hypothesized that seasonal changes in daily integrated water use efficiency (WUE(day)) in this constitutive CAM species would be driven largely by stomatal regulation of nighttime transpiration and CO(2) uptake responding to shifts in nighttime air temperature and humidity. The lowest WUE(day) occurred during time periods with extreme high and low air vapor pressure deficit (D(a)). The diurnal with the highest D(a) had low WUE(day) due to minimal net carbon gain across the 24 h period. Low WUE(day) was also observed under conditions of low D(a); however, it was due to significant transpiration losses. Gas exchange measurements on potted saguaro plants exposed to experimental changes in D(a) confirmed the relationship between D(a) and g(s). Our results suggest that climatic changes involving shifts in air temperature and humidity will have large impacts on the water and carbon economy of the giant saguaro and potentially other succulent CAM plants of warm desert environments.

Kepler Observations of Rapid Optical Variability in the BL Lac Object W2r192+42

NASA Technical Reports Server (NTRS)

R.Edelson; Mushotzky, R.; Vaughn, S.; Scargle, J.; Gandhi, P.; Malkan, M.; Baumgartner, W.

2013-01-01

We present the first Kepler monitoring of a strongly variable BL Lac, W2R1926+42. The light curve covers 181 days with approx. 0.2% errors, 30 minute sampling and >90% duty cycle, showing numerous delta-I/I > 25% flares over timescales as short as a day. The flux distribution is highly skewed and non-Gaussian. The variability shows a strong rms-flux correlation with the clearest evidence to date for non-linearity in this relation. We introduce a method to measure periodograms from the discrete autocorrelation function, an approach that may be well-suited to a wide range of Kepler data. The periodogram is not consistent with a simple power-law, but shows a flattening at frequencies below 7x10(exp -5) Hz. Simple models of the power spectrum, such as a broken power law, do not produce acceptable fits, indicating that the Kepler blazar light curve requires more sophisticated mathematical and physical descriptions than currently in use.

The impact of short-term stochastic variability in solar irradiance on optimal microgrid design

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

Schittekatte, Tim; Stadler, Michael; Cardoso, Gonçalo

2016-07-01

This paper proposes a new methodology to capture the impact of fast moving clouds on utility power demand charges observed in microgrids with photovoltaic (PV) arrays, generators, and electrochemical energy storage. It consists of a statistical approach to introduce sub-hourly events in the hourly economic accounting process. The methodology is implemented in the Distributed Energy Resources Customer Adoption Model (DER-CAM), a state of the art mixed integer linear model used to optimally size DER in decentralized energy systems. Results suggest that previous iterations of DER-CAM could undersize battery capacities. The improved model depicts more accurately the economic value of PVmore » as well as the synergistic benefits of pairing PV with storage.« less

An integrated assessment modeling framework for uncertainty studies in global and regional climate change: the MIT IGSM-CAM (version 1.0)

NASA Astrophysics Data System (ADS)

Monier, E.; Scott, J. R.; Sokolov, A. P.; Forest, C. E.; Schlosser, C. A.

2013-12-01

This paper describes a computationally efficient framework for uncertainty studies in global and regional climate change. In this framework, the Massachusetts Institute of Technology (MIT) Integrated Global System Model (IGSM), an integrated assessment model that couples an Earth system model of intermediate complexity to a human activity model, is linked to the National Center for Atmospheric Research (NCAR) Community Atmosphere Model (CAM). Since the MIT IGSM-CAM framework (version 1.0) incorporates a human activity model, it is possible to analyze uncertainties in emissions resulting from both uncertainties in the underlying socio-economic characteristics of the economic model and in the choice of climate-related policies. Another major feature is the flexibility to vary key climate parameters controlling the climate system response to changes in greenhouse gases and aerosols concentrations, e.g., climate sensitivity, ocean heat uptake rate, and strength of the aerosol forcing. The IGSM-CAM is not only able to realistically simulate the present-day mean climate and the observed trends at the global and continental scale, but it also simulates ENSO variability with realistic time scales, seasonality and patterns of SST anomalies, albeit with stronger magnitudes than observed. The IGSM-CAM shares the same general strengths and limitations as the Coupled Model Intercomparison Project Phase 3 (CMIP3) models in simulating present-day annual mean surface temperature and precipitation. Over land, the IGSM-CAM shows similar biases to the NCAR Community Climate System Model (CCSM) version 3, which shares the same atmospheric model. This study also presents 21st century simulations based on two emissions scenarios (unconstrained scenario and stabilization scenario at 660 ppm CO2-equivalent) similar to, respectively, the Representative Concentration Pathways RCP8.5 and RCP4.5 scenarios, and three sets of climate parameters. Results of the simulations with the chosen climate parameters provide a good approximation for the median, and the 5th and 95th percentiles of the probability distribution of 21st century changes in global mean surface air temperature from previous work with the IGSM. Because the IGSM-CAM framework only considers one particular climate model, it cannot be used to assess the structural modeling uncertainty arising from differences in the parameterization suites of climate models. However, comparison of the IGSM-CAM projections with simulations of 31 CMIP5 models under the RCP4.5 and RCP8.5 scenarios show that the range of warming at the continental scale shows very good agreement between the two ensemble simulations, except over Antarctica, where the IGSM-CAM overestimates the warming. This demonstrates that by sampling the climate system response, the IGSM-CAM, even though it relies on one single climate model, can essentially reproduce the range of future continental warming simulated by more than 30 different models. Precipitation changes projected in the IGSM-CAM simulations and the CMIP5 multi-model ensemble both display a large uncertainty at the continental scale. The two ensemble simulations show good agreement over Asia and Europe. However, the ranges of precipitation changes do not overlap - but display similar size - over Africa and South America, two continents where models generally show little agreement in the sign of precipitation changes and where CCSM3 tends to be an outlier. Overall, the IGSM-CAM provides an efficient and consistent framework to explore the large uncertainty in future projections of global and regional climate change associated with uncertainty in the climate response and projected emissions.

Detection and characterization of murine colitis and carcinogenesis by molecularly targeted contrast-enhanced ultrasound

PubMed Central

Brückner, Markus; Heidemann, Jan; Nowacki, Tobias M; Cordes, Friederike; Stypmann, Jörg; Lenz, Philipp; Gohar, Faekah; Lügering, Andreas; Bettenworth, Dominik

2017-01-01

AIM To study mucosal addressin cellular adhesion molecule-1 (MAdCAM-1) and vascular endothelial growth factor (VEGF)-targeted contrast enhanced ultrasound (CEUS) for the assessment of murine colitis and carcinogenesis. METHODS C57BL/6 mice were challenged with 3% dextran sodium-sulfate (DSS) for three, six or nine days to study the development of acute colitis. Ultrasound was performed with and without the addition of unspecific contrast agents. MAdCAM-1-targeted contrast agent was used to detect and quantify MAdCAM-1 expression. Inflammatory driven colorectal azoxymethane (AOM)/DSS-induced carcinogenesis was examined on day 42 and 84 using VEGF-targeted contrast agent. Highly specific tissue echogenicity was quantified using specialized software. Sonographic findings were correlated to tissue staining, western blot analysis and immunohistochemistry to quantify the degree of inflammation and stage of carcinogenesis. RESULTS Native ultrasound detected increased general bowel wall thickening that correlated with more progressed and more severe DSS-colitis (healthy mice: 0.3 mm ± 0.03 vs six days DSS: 0.5 mm ± 0.2 vs nine days DSS: 0.6 mm ± 0.2, P < 0.05). Moreover, these sonographic findings correlated well with clinical parameters such as weight loss (r2 = 0.74) and histological damage (r2 = 0.86) (P < 0.01). In acute DSS-induced murine colitis, CEUS targeted against MAdCAM-1 detected and differentiated stages of mild, moderate and severe colitis via calculation of mean pixel contrast intensity in decibel (9.6 dB ± 1.6 vs 12.9 dB ± 1.4 vs 18 dB ± 3.33, P < 0.05). Employing the AOM/DSS-induced carcinogenesis model, tumor development was monitored by CEUS targeted against VEGF and detected a significantly increased echogenicity in tumors as compared to adjacent healthy mucosa (healthy mucosa, 1.6 dB ± 1.4 vs 42 d, 18.2 dB ± 3.3 vs 84 d, 18.6 dB ± 4.9, P < 0.01). Tissue echogenicity strongly correlated with histological analysis and immunohistochemistry findings (VEGF-positive cells in 10 high power fields of healthy mucosa: 1 ± 1.2 vs 42 d after DSS start: 2.4 ± 1.6 vs 84 d after DSS start: 3.5 ± 1.3, P < 0.01). CONCLUSION Molecularly targeted CEUS is a highly specific and non-invasive imaging modality, which characterizes murine intestinal inflammation and carcinogenesis in vivo. PMID:28522908

Detection and characterization of murine colitis and carcinogenesis by molecularly targeted contrast-enhanced ultrasound.

PubMed

Brückner, Markus; Heidemann, Jan; Nowacki, Tobias M; Cordes, Friederike; Stypmann, Jörg; Lenz, Philipp; Gohar, Faekah; Lügering, Andreas; Bettenworth, Dominik

2017-04-28

To study mucosal addressin cellular adhesion molecule-1 (MAdCAM-1) and vascular endothelial growth factor (VEGF)-targeted contrast enhanced ultrasound (CEUS) for the assessment of murine colitis and carcinogenesis. C57BL/6 mice were challenged with 3% dextran sodium-sulfate (DSS) for three, six or nine days to study the development of acute colitis. Ultrasound was performed with and without the addition of unspecific contrast agents. MAdCAM-1-targeted contrast agent was used to detect and quantify MAdCAM-1 expression. Inflammatory driven colorectal azoxymethane (AOM)/DSS-induced carcinogenesis was examined on day 42 and 84 using VEGF-targeted contrast agent. Highly specific tissue echogenicity was quantified using specialized software. Sonographic findings were correlated to tissue staining, western blot analysis and immunohistochemistry to quantify the degree of inflammation and stage of carcinogenesis. Native ultrasound detected increased general bowel wall thickening that correlated with more progressed and more severe DSS-colitis (healthy mice: 0.3 mm ± 0.03 vs six days DSS: 0.5 mm ± 0.2 vs nine days DSS: 0.6 mm ± 0.2, P < 0.05). Moreover, these sonographic findings correlated well with clinical parameters such as weight loss ( r 2 = 0.74) and histological damage ( r 2 = 0.86) ( P < 0.01). In acute DSS-induced murine colitis, CEUS targeted against MAdCAM-1 detected and differentiated stages of mild, moderate and severe colitis via calculation of mean pixel contrast intensity in decibel (9.6 dB ± 1.6 vs 12.9 dB ± 1.4 vs 18 dB ± 3.33, P < 0.05). Employing the AOM/DSS-induced carcinogenesis model, tumor development was monitored by CEUS targeted against VEGF and detected a significantly increased echogenicity in tumors as compared to adjacent healthy mucosa (healthy mucosa, 1.6 dB ± 1.4 vs 42 d, 18.2 dB ± 3.3 vs 84 d, 18.6 dB ± 4.9, P < 0.01). Tissue echogenicity strongly correlated with histological analysis and immunohistochemistry findings (VEGF-positive cells in 10 high power fields of healthy mucosa: 1 ± 1.2 vs 42 d after DSS start: 2.4 ± 1.6 vs 84 d after DSS start: 3.5 ± 1.3, P < 0.01). Molecularly targeted CEUS is a highly specific and non-invasive imaging modality, which characterizes murine intestinal inflammation and carcinogenesis in vivo .

Web Conversations About Complementary and Alternative Medicines and Cancer: Content and Sentiment Analysis.

PubMed

Mazzocut, Mauro; Truccolo, Ivana; Antonini, Marialuisa; Rinaldi, Fabio; Omero, Paolo; Ferrarin, Emanuela; De Paoli, Paolo; Tasso, Carlo

2016-06-16

The use of complementary and alternative medicine (CAM) among cancer patients is widespread and mostly self-administrated. Today, one of the most relevant topics is the nondisclosure of CAM use to doctors. This general lack of communication exposes patients to dangerous behaviors and to less reliable information channels, such as the Web. The Italian context scarcely differs from this trend. Today, we are able to mine and analyze systematically the unstructured information available in the Web, to get an insight of people's opinions, beliefs, and rumors concerning health topics. Our aim was to analyze Italian Web conversations about CAM, identifying the most relevant Web sources, therapies, and diseases and measure the related sentiment. Data have been collected using the Web Intelligence tool ifMONITOR. The workflow consisted of 6 phases: (1) eligibility criteria definition for the ifMONITOR search profile; (2) creation of a CAM terminology database; (3) generic Web search and automatic filtering, the results have been manually revised to refine the search profile, and stored in the ifMONITOR database; (4) automatic classification using the CAM database terms; (5) selection of the final sample and manual sentiment analysis using a 1-5 score range; (6) manual indexing of the Web sources and CAM therapies type retrieved. Descriptive univariate statistics were computed for each item: absolute frequency, percentage, central tendency (mean sentiment score [MSS]), and variability (standard variation σ). Overall, 212 Web sources, 423 Web documents, and 868 opinions have been retrieved. The overall sentiment measured tends to a good score (3.6 of 5). Quite a high polarization in the opinions of the conversation partaking emerged from standard variation analysis (σ≥1). In total, 126 of 212 (59.4%) Web sources retrieved were nonhealth-related. Facebook (89; 21%) and Yahoo Answers (41; 9.7%) were the most relevant. In total, 94 CAM therapies have been retrieved. Most belong to the "biologically based therapies or nutrition" category: 339 of 868 opinions (39.1%), showing an MSS of 3.9 (σ=0.83). Within nutrition, "diets" collected 154 opinions (18.4%) with an MSS of 3.8 (σ=0.87); "food as CAM" overall collected 112 opinions (12.8%) with a MSS of 4 (σ=0.68). Excluding diets and food, the most discussed CAM therapy is the controversial Italian "Di Bella multitherapy" with 102 opinions (11.8%) with an MSS of 3.4 (σ=1.21). Breast cancer was the most mentioned disease: 81 opinions of 868. Conversations about CAM and cancer are ubiquitous. There is a great concern about the biologically based therapies, perceived as harmless and useful, under-rating all risks related to dangerous interactions or malnutrition. Our results can be useful to doctors to be aware of the implications of these beliefs for the clinical practice. Web conversation exploitation could be a strategy to gain insights of people's perspective for other controversial topics.

Beliefs, decision-making, and dialogue about complementary and alternative medicine (CAM) within families using CAM: a qualitative study.

PubMed

Nichol, James; Thompson, Elizabeth A; Shaw, Alison

2011-02-01

The rise in complementary and alternative medicine (CAM) use is well documented. Surveys provide varying estimates of the prevalence of CAM use. Qualitative research has explored individuals' decision-making regarding CAM. This study aimed to examine the family as a context for beliefs, decision-making, and dialogue about CAM. Families were recruited via the Avon Longitudinal Study of Parents and Children. A subsample of CAM users was targeted using purposeful sampling. Focus groups and interviews were conducted with 15 families and the data were analyzed thematically. Family understandings and beliefs about CAM: CAM was understood as treatments provided outside mainstream care, offering a more "natural" and "holistic" approach, tailored to individual needs and overlapping with wider healthy lifestyle practices. Hierarchies of acceptability of CAM: Physical and "mainstream" therapies were widely supported, with "fringe" therapies producing the most polarized views. There was a belief particularly among fathers and young people that certain therapies rely on "placebo" effects and their value was contested. Types of CAM users within families: Family members were predominantly "pragmatic" CAM users, with "committed" users (all mothers) characterized by deeper philosophical commitment to CAM and skepticism toward conventional medicine. Family dynamics of CAM decision-making: Mothers tended to "champion" CAM within families, while not determining family CAM use. Fathers largely positioned themselves as lacking expertise or skeptical of CAM. Young people were beginning to articulate independent and more critical views of CAM, some directly challenging their mother's perspective. However, all families shared openness to CAM as part of broader beliefs in proactive healthy lifestyles. Family focus groups and interviews allow a window on beliefs, decision-making, and dialogue about CAM within families, illuminating the CAM "champion" role held by mothers, and young people's developing autonomy regarding health beliefs and decision-making.

Objective Measurements of Energy Balance Are Associated With Sleep Architecture in Healthy Adults.

PubMed

Spaeth, Andrea M; Dinges, David F; Goel, Namni

2017-01-01

We objectively measured body composition, energy expenditure, caloric intake, and sleep in a large, diverse sample of healthy men and women and determined how energy balance and diet associated with sleep physiology. Healthy adults (n = 50; 21-50 years) participated in an in-laboratory study involving two baseline sleep nights (BL1-2, 10 hours time-in-bed/night, 2200-0800 hours). Polysomnography was recorded on BL2. Demographic information, body composition, and energy expenditure measurements were collected at study admittance and on BL1. Daily food/drink intake was recorded both before (on BL1) and after (on BL2) the sleep measurement. Partial Pearson's correlations assessed the relationship between energy balance and sleep physiology variables. At baseline, greater fat-free mass associated with lower total sleep time (r = -0.52, p = .030), lower sleep efficiency (r = -0.53, p = .004), and greater wake after sleep onset (r = 0.55, p = .002). Higher body fat percentage (r = 0.39, p = .038) and being overweight (Body Mass Index [BMI] 25-30; p = .026) associated with more rapid eye movement (REM) sleep. Higher protein intake (r's = 0.46-0.52; p's < .001-.002) and lower carbohydrate intake (r's = -0.31 to -0.34; p's = .027-.046) on BL1 and BL2 associated with more REM sleep. Greater fiber consumption on BL1 and BL2 associated with more slow-wave sleep (SWS; r's = 0.33-0.35; p's = .02-.03). More SWS related to increased carbohydrate intake the following day (BL2, r = 0.32, p = .037). Body composition and diet were related to baseline sleep characteristics, including SWS and REM sleep duration and sleep maintenance. Future studies should further evaluate the influence of energy balance measures on sleep physiology, since dietary interventions may be useful in treating insufficient sleep, poor sleep quality, excessive sleepiness or other sleep disorders. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Quantifying the uncertainties of aerosol indirect effects and impacts on decadal-scale climate variability in NCAR CAM5 and CESM1

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

Park, Sungsu

2014-12-12

The main goal of this project is to systematically quantify the major uncertainties of aerosol indirect effects due to the treatment of moist turbulent processes that drive aerosol activation, cloud macrophysics and microphysics in response to anthropogenic aerosol perturbations using the CAM5/CESM1. To achieve this goal, the P.I. hired a postdoctoral research scientist (Dr. Anna Fitch) who started her work from the Nov.1st.2012. In order to achieve the project goal, the first task that the Postdoc. and the P.I. did was to quantify the role of subgrid vertical velocity variance on the activation and nucleation of cloud liquid droplets andmore » ice crystals and its impact on the aerosol indirect effect in CAM5. First, we analyzed various LES cases (from dry stable to cloud-topped PBL) to check whether this isotropic turbulence assumption used in CAM5 is really valid. It turned out that this isotropic turbulence assumption is not universally valid. Consequently, from the analysis of LES, we derived an empirical formulation relaxing the isotropic turbulence assumption used for the CAM5 aerosol activation and ice nucleation, and implemented the empirical formulation into CAM5/CESM1, and tested in the single-column and global simulation modes, and examined how it changed aerosol indirect effects in the CAM5/CESM1. These results were reported in the poster section in the 18th Annual CESM workshop held in Breckenridge, CO during Jun.17-20.2013. While we derived an empirical formulation from the analysis of couple of LES from the first task, the general applicability of that empirical formulation was questionable, because it was obtained from the limited number of LES simulations. The second task we did was to derive a more fundamental analytical formulation relating vertical velocity variance to TKE using other information starting from basic physical principles. This was a somewhat challenging subject, but if this could be done in a successful way, it could be directly implemented into the CAM5 as a practical parameterization, and substantially contributes to achieving the project goal. Through an intensive research for about one year, we found appropriate mathematical formulation and tried to implement it into the CAM5 PBL and activation routine as a practical parameterized numerical code. During these processes, however, the Postdoc applied for another position in Sweden, Europe, and accepted a job offer there, and left NCAR in August 2014. In Sweden, Dr. Anna Fitch is still working on this subject in a part time, planning to finalize the research and to write the paper in a near future.« less

A search for J-band variability from late-L and T brown dwarfs

NASA Astrophysics Data System (ADS)

Clarke, F. J.; Hodgkin, S. T.; Oppenheimer, B. R.; Robertson, J.; Haubois, X.

2008-06-01

We present J-band photometric observations of eight late-L and T type brown dwarfs designed to search for variability. We detect small amplitude periodic variability from three of the objects on time-scales of several hours, probably indicating the rotation period of the objects. The other targets do not show any variability down to the level of 0.5-5 per cent This work is based on observations obtained at the European Southern Observatory, La Silla, Chile (ESO Programme 72.C-0006). E-mail: fclarke@astro.ox.ac.uk (FJC); sth@ast.cam.ac.uk (STH); bro@amnh.org (BRO); xavier.haubois@obspm.fr (XH)

Discrepant Views of Oncologists and Cancer Patients on Complementary and Alternative Medicine in a Chinese General Hospital.

PubMed

Yang, Geliang; Zhang, Huiqing; Gan, Zheng; Fan, Yifu; Gu, Wei; Ling, Changquan

2018-06-01

Complementary and alternative medicine (CAM) has been widely used by cancer patients but rarely discussed by oncologists. This study was designed to evaluate the communication gap between China's oncologists and cancer patients on CAM. Two parallel cross-sectional studies assessed 83 oncologists and 402 cancer patients on CAM communication between patients and oncologists, and attitudes toward CAM use and clinical decisions about CAM. A majority (75.1%) of the cancer patients (302/402) were identified as CAM users within the most recent three months while 77.6% of the cancer patients (312/402) were identified as CAM users since diagnosis of cancer. Oncologists and patients responded differently ( P < .001) on CAM communications. Both oncologists and patients expected that CAM could improve the immune system. They both agreed that oncologists usually discouraged their patients from using CAM. Regarding the effectiveness of CAM, cancer patients were more likely to believe that CAM was effective while oncologists had more concerns about adverse effects of CAM use. CAM use by patients was predicted by disease duration (≥9 months) in the multivariable logistic regression model. China's oncologists and cancer patients may hold discrepant views on CAM. China's oncologists are encouraged to improve their knowledge on CAM and to initiate more discussions with their patients regarding effective and the safe use of CAM.

Strain differences in arsenic-induced oxidative lesion via arsenic biomethylation between C57BL/6J and 129X1/SvJ mice

NASA Astrophysics Data System (ADS)

Wu, Ruirui; Wu, Xiafang; Wang, Huihui; Fang, Xin; Li, Yongfang; Gao, Lanyue; Sun, Guifan; Pi, Jingbo; Xu, Yuanyuan

2017-03-01

Arsenic is a common environmental and occupational toxicant with dramatic species differences in its susceptibility and metabolism. Mouse strain variability may provide a better understanding of the arsenic pathological profile but is largely unknown. Here we investigated oxidative lesion induced by acute arsenic exposure in the two frequently used mouse strains C57BL/6J and 129X1/SvJ in classical gene targeting technique. A dose of 5 mg/kg body weight arsenic led to a significant alteration of blood glutathione towards oxidized redox potential and increased hepatic malondialdehyde content in C57BL/6J mice, but not in 129X1/SvJ mice. Hepatic antioxidant enzymes were induced by arsenic in transcription in both strains and many were higher in C57BL/6J than 129X1/SvJ mice. Arsenic profiles in the liver, blood and urine and transcription of genes encoding enzymes involved in arsenic biomethylation all indicate a higher arsenic methylation capacity, which contributes to a faster hepatic arsenic excretion, in 129X1/SvJ mice than C57BL/6J mice. Taken together, C57BL/6J mice are more susceptible to oxidative hepatic injury compared with 129X1/SvJ mice after acute arsenic exposure, which is closely associated with arsenic methylation pattern of the two strains.

Comparison between laser speckle contrast imaging and laser Doppler imaging to assess skin blood flow in humans.

PubMed

Millet, C; Roustit, M; Blaise, S; Cracowski, J L

2011-09-01

We tested the linearity between skin blood flux recorded with laser speckle contrast imaging (LSCI) and laser Doppler imaging (LDI), comparing different ways of expressing data. A secondary objective was to test within-subject variability of baseline flux with the two techniques. We performed local heating at 36, 39, 42, and 44°C on the forearm of healthy volunteers, and measured cutaneous blood flux with LDI and LSCI. Biological zero (BZ) was obtained by occluding the brachial artery. We expressed data as raw arbitrary perfusion units (APUs) and as a percentage increase from baseline (%BL), with and without subtracting BZ. Inter-site variability was expressed as a within subject coefficient of variation (CV). Twelve participants were enrolled. Inter-site variability at baseline was lower with LSCI (CV=9.2%) than with LDI (CV=20.7%). We observed an excellent correlation between both techniques when data were expressed as raw APUs or APU-BZ (R=0.90; p<0.001). The correlation remained correct for %BL (R=0.77, p<0.001), but decreased for %BL-BZ (R=0.44, p=0.003). Bland-Altman plots revealed a major proportional bias between the two techniques. This study suggests that skin blood flux measured with LSCI is linearly related to the LDI signal over a wide range of perfusion. Subtracting BZ does not affect this linearity but introduces variability in baseline flux, thus decreasing the correlation when data are expressed as a function of baseline. Finally, systematic bias makes it impossible to assimilate arbitrary perfusion units provided by the two systems. Copyright © 2011 Elsevier Inc. All rights reserved.

Comparison of improved range of motion between cam-type femoroacetabular impingement and borderline developmental dysplasia of the hip -evaluation by virtual osteochondroplasty using computer simulation.

PubMed

Kubota, So; Inaba, Yutaka; Kobayashi, Naomi; Choe, Hyonmin; Tezuka, Taro; Saito, Tomoyuki

2017-10-16

While cam resection is essential to achieve a good clinical result with respect to femoroacetabular impingement (FAI), it is unclear whether it should also be performed in cases of borderline developmental dysplasia of the hip (DDH) with a cam deformity. The aim of this study was to evaluate improvements in range of motion (ROM) in cases of cam-type FAI and borderline DDH after virtual osteochondroplasty using a computer impingement simulation. Thirty-eight symptomatic hips in 31 patients (11male and 20 female) diagnosed with cam-type FAI or borderline DDH were analyzed. There were divided into a cam-type FAI group (cam-FAI group: 15 hips), borderline DDH without cam group (DDH W/O cam group: 12 hips), and borderline DDH with cam group (DDH W/ cam group: 11 hips). The bony impingement point on the femoral head-neck junction at 90° flexion and maximum internal rotation of the hip joint was identified using ZedHip® software. Virtual osteochondroplasty of the impingement point was then performed in all cases. The maximum flexion angle and maximum internal rotation angle at 90° flexion were measured before and after virtual osteochondroplasty at two resection ranges (i.e., slight and sufficient). The mean improvement in the internal rotation angle in the DDH W/ cam group after slight resection was significantly greater than that in the DDH W/O cam group (P = 0.046). Furthermore, the mean improvement in the internal rotation angle in the DDH W/ cam and cam-FAI groups after sufficient resection was significantly greater than that in the DDH W/O cam group (DDH W/ cam vs DDH W/O cam: P = 0.002, cam-FAI vs DDH W/O cam: P = 0.043). Virtual osteochondroplasty resulted in a significant improvement in internal rotation angle in DDH W/ cam group but not in DDH W/O cam group. Thus, borderline DDH cases with cam deformity may be better to consider performing osteochondroplasty.

SPring-8 BL41XU, a high-flux macromolecular crystallography beamline

PubMed Central

Hasegawa, Kazuya; Shimizu, Nobutaka; Okumura, Hideo; Mizuno, Nobuhiro; Baba, Seiki; Hirata, Kunio; Takeuchi, Tomoyuki; Yamazaki, Hiroshi; Senba, Yasunori; Ohashi, Haruhiko; Yamamoto, Masaki; Kumasaka, Takashi

2013-01-01

SPring-8 BL41XU is a high-flux macromolecular crystallography beamline using an in-vacuum undulator as a light source. The X-rays are monochromated by a liquid-nitrogen-cooling Si double-crystal monochromator, and focused by Kirkpatrick–Baez mirror optics. The focused beam size at the sample is 80 µm (H) × 22 µm (V) with a photon flux of 1.1 × 1013 photons s−1. A pinhole aperture is used to collimate the beam in the range 10–50 µm. This high-flux beam with variable size provides opportunities not only for micro-crystallography but also for data collection effectively making use of crystal volume. The beamline also provides high-energy X-rays covering 20.6–35.4 keV which allows ultra-high-resolution data to be obtained and anomalous diffraction using the K-edge of Xe and I. Upgrade of BL41XU for more rapid and accurate data collection is proceeding. Here, details of BL41XU are given and an outline of the upgrade project is documented. PMID:24121338

The flaring activity of Markarian 421 during April 2000

NASA Astrophysics Data System (ADS)

Fegan, D. J.; VERITAS Collaboration

2001-08-01

Evidence for correlated TeV γ and X-ray flaring of the extreme blazar Mrk421 during April 2000 is presented and discussed. The remarkably persistent TeV flare of April 30th 2000 (40 σ significance), exhibiting structure over almost six hours of continuous observation, is analysed in detail. 1 Extreme BL Lac objects The most extreme members of the Active Galactic Nucleus (AGN) family are BL Lac objects and optically violently variable (OVV) quasars, collectively known as blazars. These objects are dominated by the presence of relativistic jets. For jets fortuitously aligned with an observers line of sight, emission may exhibit dramatic variability over very short time scales, in turn implying remarkably compact emission regions. For blazars, the Spectral Energy Distribution (SED) is dominated by non-thermal continuum emission, extending from radio to TeV gamma rays. The broadband nature of the blazar emission offers unique insights into energetic physical processes at work in a very compact region, close to the base of the jet and near the underlying central engine, most likely a supermassive black hole. BL Lacs are very effectively characterized on the basis of their SED shape. X-ray and radio flux limited surveys apear to display a bimodal distribution of properties, with LBL (Low-energy peaked, or "Red" BL Lacs) having synchrotron peaks in the IR-optical bands, and HBL (High-energy peaked, or "Blue" BL Lacs) in the UV to soft X-ray band. Recent comprehensive surveys such as DXRBS, REX and RGB have extended, by almost two orders of magnitude, the range of observable synchrotron peak frequencies. For blazar class objects, broadband emission confirms that the synchrotron peak may span the entire IR Xray range, thus accounting for the multi-frequency emission properties of this class of object. Mrk421, Mrk501, 1ES2344 and 1H1426 all exhibit broadband emission properties, high

The vertical structure of the boundary layer around compact objects

NASA Astrophysics Data System (ADS)

Hertfelder, Marius; Kley, Wilhelm

2017-09-01

Context. Mass transfer due to Roche lobe overflow leads to the formation of an accretion disk around a weakly magnetized white dwarf (WD) in cataclysmic variables. At the inner edge of the disk, the gas comes upon the surface of the WD and has to get rid of its excess kinetic energy in order to settle down on the more slowly rotating outer stellar layers. This region is known as the boundary layer (BL). Aims: In this work we investigate the vertical structure of the BL, which is still poorly understood. We shall provide details of the basic structure of the two-dimensional (2D) BL and how it depends on parameters such as stellar mass and rotation rate, as well as the mass-accretion rate. We further investigate the destination of the disk material and compare our results with previous one-dimensional (1D) simulations. Methods: We solve the 2D equations of radiation hydrodynamics in a spherical (r-ϑ) geometry using a parallel grid-based code that employs a Riemann solver. The radiation energy is considered in the two-temperature approach with a radiative flux given by the flux-limited diffusion approximation. Results: The BL around a non-rotating WD is characterized by a steep drop in angular velocity over a width of only 1% of the stellar radius, a heavy depletion of mass, and a high temperature ( 500 000 K) as a consequence of the strong shear. Variations in Ω∗,M∗, and Ṁ influence the extent of the changes of the variables in the BL but not the general structure. Depending on Ω∗, the disk material travels up to the poles or is halted at a certain latitude. The extent of mixing with the stellar material also depends on Ω∗. We find that the 1D approximation matches the 2D data well, apart from an underestimated temperature.

The spectral element method (SEM) on variable-resolution grids: evaluating grid sensitivity and resolution-aware numerical viscosity

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

Guba, O.; Taylor, M. A.; Ullrich, P. A.

2014-11-27

We evaluate the performance of the Community Atmosphere Model's (CAM) spectral element method on variable-resolution grids using the shallow-water equations in spherical geometry. We configure the method as it is used in CAM, with dissipation of grid scale variance, implemented using hyperviscosity. Hyperviscosity is highly scale selective and grid independent, but does require a resolution-dependent coefficient. For the spectral element method with variable-resolution grids and highly distorted elements, we obtain the best results if we introduce a tensor-based hyperviscosity with tensor coefficients tied to the eigenvalues of the local element metric tensor. The tensor hyperviscosity is constructed so that, formore » regions of uniform resolution, it matches the traditional constant-coefficient hyperviscosity. With the tensor hyperviscosity, the large-scale solution is almost completely unaffected by the presence of grid refinement. This later point is important for climate applications in which long term climatological averages can be imprinted by stationary inhomogeneities in the truncation error. We also evaluate the robustness of the approach with respect to grid quality by considering unstructured conforming quadrilateral grids generated with a well-known grid-generating toolkit and grids generated by SQuadGen, a new open source alternative which produces lower valence nodes.« less

The spectral element method on variable resolution grids: evaluating grid sensitivity and resolution-aware numerical viscosity

DOE PAGES

Guba, O.; Taylor, M. A.; Ullrich, P. A.; ...

2014-06-25

We evaluate the performance of the Community Atmosphere Model's (CAM) spectral element method on variable resolution grids using the shallow water equations in spherical geometry. We configure the method as it is used in CAM, with dissipation of grid scale variance implemented using hyperviscosity. Hyperviscosity is highly scale selective and grid independent, but does require a resolution dependent coefficient. For the spectral element method with variable resolution grids and highly distorted elements, we obtain the best results if we introduce a tensor-based hyperviscosity with tensor coefficients tied to the eigenvalues of the local element metric tensor. The tensor hyperviscosity ismore » constructed so that for regions of uniform resolution it matches the traditional constant coefficient hyperviscsosity. With the tensor hyperviscosity the large scale solution is almost completely unaffected by the presence of grid refinement. This later point is important for climate applications where long term climatological averages can be imprinted by stationary inhomogeneities in the truncation error. We also evaluate the robustness of the approach with respect to grid quality by considering unstructured conforming quadrilateral grids generated with a well-known grid-generating toolkit and grids generated by SQuadGen, a new open source alternative which produces lower valence nodes.« less

Turbulence and Radiation in Stratocumulus-Topped Marine Boundary Layers: A Case Study from VOCALS-REx

DOE PAGES

Ghate, Virendra P.; Albrecht, Bruce A.; Miller, Mark A.; ...

2014-01-13

Observations made during a 24-h period as part of the Variability of the American Monsoon Systems (VAMOS) Ocean–Cloud–Atmosphere–Land Study Regional Experiment (VOCALS-REx) are analyzed to study the radiation and turbulence associated with the stratocumulus-topped marine boundary layer (BL). The first 14 h exhibited a well-mixed (coupled) BL with an average cloud-top radiative flux divergence of ~130 W m 22; the BL was decoupled during the last 10 h with negligible radiative flux divergence. The averaged radiative cooling very close to the cloud top was -9.04 K h -1 in coupled conditions and -3.85 K h -1 in decoupled conditions. Thismore » is the first study that combined data from a vertically pointing Doppler cloud radar and a Doppler lidar to yield the vertical velocity structure of the entire BL. The averaged vertical velocity variance and updraft mass flux during coupled conditions were higher than those during decoupled conditions at all levels by a factor of 2 or more. The vertical velocity skewness was negative in the entire BL during coupled conditions, whereas it was weakly positive in the lower third of the BL and negative above during decoupled conditions. A formulation of velocity scale is proposed that includes the effect of cloud-top radiative cooling in addition to the surface buoyancy flux. When scaled by the velocity scale, the vertical velocity variance and coherent downdrafts had similar magnitude during the coupled and decoupled conditions. Finally, the coherent updrafts that exhibited a constant profile in the entire BL during both the coupled and decoupled conditions scaled well with the convective velocity scale to a value of ~0.5.« less

Strain and sex differences in anxiety-like and social behaviors in C57BL/6J and BALB/cJ mice.

PubMed

An, Xiao-Lei; Zou, Jun-Xian; Wu, Rui-Yong; Yang, Ying; Tai, Fa-Dao; Zeng, Shuang-Yan; Jia, Rui; Zhang, Xia; Liu, En-Qi; Broders, Hugh

2011-01-01

Mood disorders are more frequent in women than men, however, the majority of research has focused on male rodents as animal models. We used a variety of common behavioral tests to look for differences in anxiety-like and social behaviors between and within C57BL/6J and BALB/cJ mice. Our results show that female C57BL/6J mice exhibited lower levels of anxiety-like behavior and higher levels of activity than female BALB/cJ during the open field and elevated plus maze tests. Principal component analysis generated more factors in the behavioral variables of males than females. In the open field, a sex difference was also found and factor 1 emerged as anxiety in males, and motor activity in females. While C57BL/6J mice were found to have higher levels of social exploration and social contacts, differences were found between the sexes (females were more social) in both strains for this measure and also for anxiety-like behaviors. When interacting with animals of the same sex, levels of sniffing body and huddling in both male and female C57BL/6J mice were higher than those in male and female BALB/cJ mice. However, in the between-sex interactions, male C57BL/6J mice sniffed the stimulus mouse less, and female C57BL/6J mice sniffed the stimulus more compared to BALB/cJ mice. This study provides important behavioral phenotypes and confirms the multidimensional behavioral structure of two widely used mice strains.

Adaptive Methods for Compressible Flow

DTIC Science & Technology

1994-03-01

labor -intensive task of purpose of this work is to demonstrate the generating acceptable surface triangulations, advantages of integrating the CAD/CAM...sintilar results). L 1 (’-1)(2sn~p) boundary error (MUSCL) The flow variables wre then given by .04 .78% M=asOIne/i .02 AM% v= acosO /sintt .01 .0 p

Diversity of Rock Compositions at Gale Crater Observed by ChemCam and APXS on Curiosity, and Comparison to Meteorite and Orbital Observations

NASA Astrophysics Data System (ADS)

Wiens, R. C.; Maurice, S.; Grotzinger, J. P.; Gellert, R.; Mangold, N.; Sautter, V.; Ollila, A.; Dyar, M. D.; Le Mouelic, S.; Ehlmann, B. L.; Clegg, S. M.; Lanza, N.; Cousin, A.; Forni, O.; Gasnault, O.; Lasue, J.; Blaney, D. L.; Newsom, H. E.; Herkenhoff, K. E.; Anderson, R. B.; D'Uston, L.; Bridges, N. T.; Fabre, C.; Meslin, P.; Johnson, J.; Vaniman, D.; Bridges, J.; Dromart, G.; Schmidt, M. E.; Team, M.

2013-12-01

Gale crater was selected as the Curiosity landing site because of the apparent sedimentary spectral signatures seen from orbit. Sedimentary materials on Mars have to this point showed very little expression of major element mobility, so compositions of precursor igneous minerals play a strong role in the compositions of sediments. In addition, pebbles and float rocks on Bradbury Rise (sols 0-50, > 324) appear to be mostly igneous in origin, and are assumed to have been carried down from the crater rim. Overall in the first year on Mars ChemCam obtained >75,000 LIBS spectra on > 2,000 observation points, supported by > 1,000 RMI images, and APXS obtained a significant number of observations. These show surprisingly variable compositions. The mean ChemCam compositions for Bradbury Rise dust-free rocks and pebbles (62 locations) give SiO2 = 56%, FeOT = 16% and show high alkalis consistent with Jake Matijevic (sol ~47) APXS Na2O ~6.6 wt%. ChemCam observations on the conglomerate Link (sol 27) gave Rb > 150 ppm and Sr > 1500 ppm. These compositions imply the presence of abundant alkali feldspars in the material infilling the lower parts of Gale crater. They are generally consistent with the more feldspar-rich SNC meteorites but show a radical departure from larger scale orbital observations, e.g., GRS, raising the question of how widespread these compositions are outside of Gale crater. Sedimentary materials at Yellowknife Bay encompassing the Sheepbed (sols 125-300) and Shaler (sols 121, 311-324) units, potentially including Point Lake (sols 301-310) and Rocknest (sols 57-97), appear to have incorporated varying amounts of igneous source materials. Seven rocks investigated at Rocknest show significant additions of Fe, with mean FeOT = 25% (154 locations), suggesting that FeO was a cementing agent. ChemCam observations at Shaler show varying amounts of alkali feldspar (i.e., related to Bradbury Rise), Fe-rich material (Rocknest-like), and potassium-rich material (related potentially to Bathurst, apparent bedrock observed sols 54-55, located stratigraphically between Bradbury and Rocknest). ChemCam observations in Yellowknife Bay formation rocks identified calcium-sulfate veins with varying amounts of hydration, as suggested by Mastcam multispectral observations. ChemCam also discovered Mg-rich raised ridges as a diagenetic feature occurring in the upper part of the Sheepbed member.

Use of complementary and alternative medicine among patients: classification criteria determine level of use.

PubMed

Kristoffersen, Agnete Egilsdatter; Fønnebø, Vinjar; Norheim, Arne Johan

2008-10-01

Self-reported use of complementary and alternative medicine (CAM) among patients varies widely between studies, possibly because the definition of a CAM user is not comparable. This makes it difficult to compare studies. The aim of this study is to present a six-level model for classifying patients' reported exposure to CAM. Prayer, physical exercise, special diets, over-the-counter products/CAM techniques, and personal visits to a CAM practitioner are successively removed from the model in a reductive fashion. By applying the model to responses given by Norwegian patients with cancer, we found that 72% use CAM if the user was defined to include all types of CAM. This proportion was reduced successively to only 11% in the same patient group when a CAM user was defined as a user visiting a CAM practitioner four or more times. When considering a sample of 10 recently published studies of CAM use among patients with breast cancer, we found 98% use when the CAM user was defined to include all sorts of CAM. This proportion was reduced successively to only 20% when a CAM user was defined as a user of a CAM practitioner. We recommend future surveys of CAM use to report at more than one level and to clarify which intensity level of CAM use the report is based on.

Facultative crassulacean acid metabolism (CAM) plants: powerful tools for unravelling the functional elements of CAM photosynthesis.

PubMed

Winter, Klaus; Holtum, Joseph A M

2014-07-01

Facultative crassulacean acid metabolism (CAM) describes the optional use of CAM photosynthesis, typically under conditions of drought stress, in plants that otherwise employ C3 or C4 photosynthesis. In its cleanest form, the upregulation of CAM is fully reversible upon removal of stress. Reversibility distinguishes facultative CAM from ontogenetically programmed unidirectional C3-to-CAM shifts inherent in constitutive CAM plants. Using mainly measurements of 24h CO2 exchange, defining features of facultative CAM are highlighted in five terrestrial species, Clusia pratensis, Calandrinia polyandra, Mesembryanthemum crystallinum, Portulaca oleracea and Talinum triangulare. For these, we provide detailed chronologies of the shifts between photosynthetic modes and comment on their usefulness as experimental systems. Photosynthetic flexibility is also reviewed in an aquatic CAM plant, Isoetes howellii. Through comparisons of C3 and CAM states in facultative CAM species, many fundamental biochemical principles of the CAM pathway have been uncovered. Facultative CAM species will be of even greater relevance now that new sequencing technologies facilitate the mapping of genomes and tracking of the expression patterns of multiple genes. These technologies and facultative CAM systems, when joined, are expected to contribute in a major way towards our goal of understanding the essence of CAM. © The Author 2014. Published by Oxford University Press on behalf of the Society for Experimental Biology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

A systematic review of the traits and cognitions associated with use of and belief in complementary and alternative medicine (CAM).

PubMed

Galbraith, Niall; Moss, Tim; Galbraith, Victoria; Purewal, Satvinder

2018-08-01

Complementary and alternative medicine (CAM) use is widespread despite the controversy over its effectiveness. Although previous reviews have examined the demographics and attitudes of CAM users, there is no existing review on the traits or cognitions which characterise either CAM users or those who believe in CAM effectiveness. The current systematic review set out to address these gaps in the literature by applying a narrative synthesis. A bibliographic search and manual searches were undertaken and key authors were contacted. Twenty-three papers were selected. The trait openness to experience was positively associated with CAM use but not CAM belief. Absorption and various types of coping were also positively associated with CAM use and belief. No other trait was reliably associated with CAM use or belief. Intuitive thinking and ontological confusions were positively associated with belief in CAM effectiveness; intuitive thinking was also positively associated with CAM use. Studies researching cognitions in CAM use/belief were mostly on non-clinical samples, whilst studies on traits and CAM use/belief were mostly on patients. The quality of studies varied but unrepresentative samples, untested outcome measures and simplistic statistical analyses were the most common flaws. Traits and cognition might be important correlates of CAM use and also of faith in CAM.

Effect of CAD/CAM glass fiber post-core on cement micromorphology and fracture resistance of endodontically treated roots.

PubMed

da Costa, Rogério Goulart; Freire, Andrea; Caregnatto de Morais, Eduardo Christiano; Machado de Souza, Evelise; Correr, Giselle Maria; Rached, Rodrigo Nunes

2017-02-01

To investigate the fracture resistance of weakened roots restored with prefabricated or CAD/CAM-customized posts and cores as well as the thickness of the cement film and the presence of voids in the cement. The roots of 40 human premolars were weakened by removing internal dentin with a diamond bur (2.5 mm in the coronal third and 1.5 mm in the apical third) and restored with prefabricated posts (PPs) or customized posts (CPs) with or without a zirconia crown (n= 10). Posts and crowns were cemented with resin cement. Microtomography was used to determine the thickness of the cement film and whether voids were present. After fatigue testing (1 million cycles, 50 N, 5 Hz, 36.5°C), the specimens underwent compression testing with an oblique load (30°, 1 mm/minute) and fracture strengths were recorded (N). Fracture strength and film thickness were analyzed with ANOVA and the Games-Howell test; the variable presence of voids was analyzed with the Mann-Whitney test (α= 5%). Mean fracture strengths varied between 640.4 and 792.9 N and did not differ significantly between groups. The CP group had a thinner cement film and fewer voids than the PP group. There was a positive, statistically significant correlation (Spearman, R=0.488, P= 0.029) between these variables. CAD/CAM-manufactured glass-fiber posts and cores do not affect the fracture strength of flared root canals or cause catastrophic failure of the root when used with zirconia crowns.

Development of Consistency between Marketing and Planning.

ERIC Educational Resources Information Center

Williford, A. Michael

1986-01-01

Examined descriptive information about marketing, enrollment management, institutional planning and factors affecting them. A factor analysis of statistically appropriate variables identified factors associated with a state of symbiosis between marketing and institutional planning. (Author/BL)

Calcium-dependent stoichiometries of the KCa2.2 (SK) intracellular domain/calmodulin complex in solution

PubMed Central

Halling, D. Brent; Kenrick, Sophia A.; Riggs, Austen F.

2014-01-01

Ca2+ activates SK Ca2+-activated K+ channels through the protein Ca2+ sensor, calmodulin (CaM). To understand how SK channels operate, it is necessary to determine how Ca2+ regulates CaM binding to its target on SK. Tagless, recombinant SK peptide (SKp), was purified for binding studies with CaM at low and high Ca2+ concentrations. Composition gradient multi-angle light scattering accurately measures the molar mass, stoichiometry, and affinity of protein complexes. In 2 mM Ca2+, SKp and CaM bind with three different stoichiometries that depend on the molar ratio of SKp:CaM in solution. These complexes include 28 kD 1SKp/1CaM, 39 kD 2SKp/1CaM, and 44 kD 1SKp/2CaM. A 2SKp/2CaM complex, observed in prior crystallographic studies, is absent. At <5 nM Ca2+, 1SKp/1CaM and 2SKp/1CaM were observed; however, 1SKp/2CaM was absent. Analytical ultracentrifugation was used to characterize the physical properties of the three SKp/CaM stoichiometries. In high Ca2+, the sedimentation coefficient is smaller for a 1SKp:1CaM solution than it is for either 2SKp:1CaM or 1SKp:2CaM. At low Ca2+ and at >100 µM protein concentrations, a molar excess of SKp over CaM causes aggregation. Aggregation is not observed in Ca2+ or with CaM in molar excess. In low Ca2+ both 1SKp:1CaM and 1SKp:2CaM solutions have similar sedimentation coefficients, which is consistent with the absence of a 1SKp/2CaM complex in low Ca2+. These results suggest that complexes with stoichiometries other than 2SKp/2CaM are important in gating. PMID:24420768

Calcium-dependent stoichiometries of the KCa2.2 (SK) intracellular domain/calmodulin complex in solution.

PubMed

Halling, D Brent; Kenrick, Sophia A; Riggs, Austen F; Aldrich, Richard W

2014-02-01

Ca(2+) activates SK Ca(2+)-activated K(+) channels through the protein Ca(2+) sensor, calmodulin (CaM). To understand how SK channels operate, it is necessary to determine how Ca(2+) regulates CaM binding to its target on SK. Tagless, recombinant SK peptide (SKp), was purified for binding studies with CaM at low and high Ca(2+) concentrations. Composition gradient multi-angle light scattering accurately measures the molar mass, stoichiometry, and affinity of protein complexes. In 2 mM Ca(2+), SKp and CaM bind with three different stoichiometries that depend on the molar ratio of SKp:CaM in solution. These complexes include 28 kD 1SKp/1CaM, 39 kD 2SKp/1CaM, and 44 kD 1SKp/2CaM. A 2SKp/2CaM complex, observed in prior crystallographic studies, is absent. At <5 nM Ca(2+), 1SKp/1CaM and 2SKp/1CaM were observed; however, 1SKp/2CaM was absent. Analytical ultracentrifugation was used to characterize the physical properties of the three SKp/CaM stoichiometries. In high Ca(2+), the sedimentation coefficient is smaller for a 1SKp:1CaM solution than it is for either 2SKp:1CaM or 1SKp:2CaM. At low Ca(2+) and at >100 µM protein concentrations, a molar excess of SKp over CaM causes aggregation. Aggregation is not observed in Ca(2+) or with CaM in molar excess. In low Ca(2+) both 1SKp:1CaM and 1SKp:2CaM solutions have similar sedimentation coefficients, which is consistent with the absence of a 1SKp/2CaM complex in low Ca(2+). These results suggest that complexes with stoichiometries other than 2SKp/2CaM are important in gating.

Complementary and alternative medicine (CAM) among Australian hospital-based nurses: knowledge, attitude, personal and professional use, reasons for use, CAM referrals, and socio-demographic predictors of CAM users.

PubMed

Shorofi, Seyed Afshin; Arbon, Paul

2017-05-01

This study was intended to examine CAM among Australian hospital-based nurses, identifying their knowledge, attitude, personal and professional use, reasons for use, CAM referrals, and socio-demographic predictors of CAM users. Nurses holding a qualification in nursing and working in surgical wards were included using a convenience sampling technique. A self-complete questionnaire was developed to achieve the aims of the study. Descriptive and non-parametric statistics were calculated to describe and analyse data. Overall, 95.7% and 49.7% of nurses reported personal and professional use of CAM, respectively. The most popular CAM/CAM domain personally and professionally used by nurses was massage therapy and mind-body therapies. The primary reason for personal use of CAM was "[it] fits into my way of life/philosophy". Furthermore, massage therapists were the most commonly recommended CAM practitioners to patients. Only 15.8% of nurses would always ask patients about use of herbal medicines as part of nursing history taking. Over one-fifth (22.4%) of nurses rated their attitude as having a very positive, and 60.3% rated themselves as having very little or no knowledge of CAM. A positive correlation was also found between knowledge and attitude about CAM. Positive attitude and higher knowledge about CAM were positively correlated to CAM referrals. Several socio-demographic factors predicted personal and professional use of CAM. This study revealed that nurses generally believe not to have sufficient knowledge of CAM but are open to use CAM with patients. Nurses' positive attitude toward and personal use of CAM could be an indication that they are poised for further integration of evidence-based CAM into nursing practice to treat whole person. Copyright © 2017 Elsevier Ltd. All rights reserved.

An integrative review of complementary and alternative medicine use for back pain: a focus on prevalence, reasons for use, influential factors, self-perceived effectiveness, and communication.

PubMed

Murthy, Vijayendra; Sibbritt, David W; Adams, Jon

2015-08-01

Back pain is the most prevalent of musculoskeletal conditions, and back pain sufferers have been identified as high users of complementary and alternative medicine (CAM). Despite lacking evidence, CAM treatments (e.g., acupuncture, chiropractic, and massage) and CAM products (eg, vitamins, supplements, and aromatherapy oils) for back pain care have become widely available internationally, and CAM use by back pain sufferers has become a significant health service issue. However, to date, there has been no integrative review on CAM use for back pain. This study aims to conduct an integrative review on CAM use for back pain focusing on prevalence of use, commonly used CAM, characteristics of users, factors influencing decision making, self-perceived effectiveness, and communication with health-care providers. The study is based on an integrative literature review. A comprehensive search of international literature from 2000 to 2014 in MEDLINE, CINHAL, AMED, DARE, EMBASE, ExceptaMedica, psycINFO, and SCOPUS databases was conducted. The search was limited to peer-reviewed articles published in English language and reporting empirical research findings on CAM use for back pain. The review reveals a considerable variation in prevalences of CAM use for back pain internationally. Acupuncture, chiropractic, osteopathy, and massage therapy are the commonly used CAM treatments besides a range of self-prescribed CAM, and back pain sufferers use CAM alongside conventional medical treatments. Female gender, chronicity of back pain, and previous exposure to CAM are key predictors of CAM use for back pain as highlighted from the reviewed literature. Family, friends, and recommendation by doctors appear to influence decision making on CAM use for back pain. The review reveals that users of CAM for back pain tend to report CAM as beneficial, but there is little knowledge on communication between CAM users with back pain and health-care providers about such use. Existing literature is largely based on the research investigating CAM use for back pain among a range of other health conditions. Further rigorous research is needed to investigate the use of a wider range of CAM treatments, particularly self-prescribed CAM for back pain. The review findings provide insights for health-care providers and policy makers on the range of CAM treatments used by back pain sufferers. Conventional medical and CAM practitioners should be aware of back pain sufferers' decision making regarding a range of CAM treatments and be prepared to communicate with patients on safe and effective CAM treatments for back pain. Copyright © 2015 Elsevier Inc. All rights reserved.

Impact of background on color, transmittance, and fluorescence of leucite based ceramics.

PubMed

Rafael, Caroline Freitas; Güth, Jan-Frederik; Kauling, Ana Elisa Colle; Cesar, Paulo Francisco; Volpato, Claudia Angelo Mazieiro; Liebermann, Anja

2017-07-26

This study evaluated the impact of tooth shade on differences in color (∆E), lightness (∆L), chromaticity coordinates a*/b* (∆a and ∆b), transmittance and the degree of fluorescence of CAD/CAM leucite based ceramic (LBC). Ten disks were fabricated of LBC; Empress CAD, A2, thickness of 1.5 mm and eight disks of resin-nano-ceramic (RNC; Lava Ultimate) in different colors to simulate variations in substrate shade. The associations of LBC disks with different color substrates were analyzed with a spectrophotometer; ∆E, ∆L*, ∆a*, ∆b*, and transmittance were measured and calculated. Fluorescence was evaluated with a fluorescence system (Fluorescence System, Biopdi). All substrate shades influenced the optical properties of LBC, with regard to color, luminosity, coordinate a* and b*, transmittance, and fluorescence (p<0.001). Substrate colors with high saturation (A3.5 and C2) presented highest impact, whereas colors with lowest saturations (BL, B1) showed less impact. Substrate color influenced the optical properties of ceramic restorations.

Cryogenic Cam Butterfly Valve

NASA Technical Reports Server (NTRS)

McCormack, Kenneth J. (Inventor)

2016-01-01

A cryogenic cam butterfly valve has a body that includes an axially extending fluid conduit formed there through. A disc lug is connected to a back side of a valve disc and has a circular bore that receives and is larger than a cam of a cam shaft. The valve disc is rotatable for a quarter turn within the body about a lug axis that is offset from the shaft axis. Actuating the cam shaft in the closing rotational direction first causes the camming side of the cam of the cam shaft to rotate the disc lug and the valve disc a quarter turn from the open position to the closed position. Further actuating causes the camming side of the cam shaft to translate the valve disc into sealed contact with the valve seat. Opening rotational direction of the cam shaft reverses these motions.

Complementary and Alternative Medicine: A Clinical Study in 1,016 Hematology/Oncology Patients.

PubMed

Hierl, Marina; Pfirstinger, Jochen; Andreesen, Reinhard; Holler, Ernst; Mayer, Stephanie; Wolff, Daniel; Vogelhuber, Martin

2017-01-01

Surveys state a widespread use of complementary and alternative medicine (CAM) in patients with malignant diseases. CAM methods might potentially interfere with the metabolization of tumor-specific therapy. However, there is little communication about CAM use in hematology/oncology patients between patients, CAM providers, and oncologists. A self-administered questionnaire was handed out to all patients attending to the hematology/oncology outpatient clinic of Regensburg University Hospital. Subsequently, a chart review of all CAM users was performed. Questionnaires of 1,016 patients were analyzed. Of these patients, 30% used CAM, preferably vitamins and micronutrients. Main information sources for CAM methods were physicians/nonmedical practitioners and friends/relatives. CAM therapies were provided mainly by licensed physicians (29%), followed by nonmedical practitioners (14%) and the patients themselves (13%). Although 62% of the CAM users agreed that the oncologist may know about their CAM therapy, a chart entry about CAM use was found only in 41%. CAM is frequently used by hematology/oncology patients. Systematic communication about CAM is essential to avoid possible drug interactions. © 2017 S. Karger AG, Basel.

CAM practitioners in the Australian health workforce: an underutilized resource

PubMed Central

2012-01-01

Background CAM practitioners are a valuable but underutilizes resource in Australian health care. Despite increasing public support for complementary and alternative medicine (CAM) little is known about the CAM workforce. Apart from the registered professions of chiropractic, osteopathy and Chinese medicine, accurate information about the number of CAM practitioners in the workforce has been difficult to obtain. It appears that many non-registered CAM practitioners, although highly qualified, are not working to their full capacity. Discussion Increasing public endorsement of CAM stands in contrast to the negative attitude toward the CAM workforce by some members of the medical and other health professions and by government policy makers. The marginalisation of the CAM workforce is evident in prejudicial attitudes held by some members of the medical and other health professions and its exclusion from government policy making. Inconsistent educational standards has meant that non-registered CAM practitioners, including highly qualified and competent ones, are frequently overlooked. Legitimising their contribution to the health workforce could alleviate workforce shortages and provide opportunities for redesigned job roles and new multidisciplinary teams. Priorities for better utilisation of the CAM workforce include establishing a guaranteed minimum education standard for more CAM occupation groups through national registration, providing interprofessional education that includes CAM practitioners, developing courses to upgrade CAM practitioners' professional skills in areas of indentified need, and increasing support for CAM research. Summary Marginalisation of the CAM workforce has disadvantaged those qualified and competent CAM practitioners who practise evidence-informed medicine on the basis of many years of university training. Legitimising and expanding the important contribution of CAM practitioners could alleviate projected health workforce shortages, particularly for the prevention and management of chronic health conditions and for health promotion. PMID:23116374

CAM practitioners in the Australian health workforce: an underutilized resource.

PubMed

Grace, Sandra

2012-11-02

CAM practitioners are a valuable but underutilizes resource in Australian health care. Despite increasing public support for complementary and alternative medicine (CAM) little is known about the CAM workforce. Apart from the registered professions of chiropractic, osteopathy and Chinese medicine, accurate information about the number of CAM practitioners in the workforce has been difficult to obtain. It appears that many non-registered CAM practitioners, although highly qualified, are not working to their full capacity. Increasing public endorsement of CAM stands in contrast to the negative attitude toward the CAM workforce by some members of the medical and other health professions and by government policy makers. The marginalisation of the CAM workforce is evident in prejudicial attitudes held by some members of the medical and other health professions and its exclusion from government policy making. Inconsistent educational standards has meant that non-registered CAM practitioners, including highly qualified and competent ones, are frequently overlooked. Legitimising their contribution to the health workforce could alleviate workforce shortages and provide opportunities for redesigned job roles and new multidisciplinary teams. Priorities for better utilisation of the CAM workforce include establishing a guaranteed minimum education standard for more CAM occupation groups through national registration, providing interprofessional education that includes CAM practitioners, developing courses to upgrade CAM practitioners' professional skills in areas of indentified need, and increasing support for CAM research. Marginalisation of the CAM workforce has disadvantaged those qualified and competent CAM practitioners who practise evidence-informed medicine on the basis of many years of university training. Legitimising and expanding the important contribution of CAM practitioners could alleviate projected health workforce shortages, particularly for the prevention and management of chronic health conditions and for health promotion.

The utilisation of Complementary and Alternative Medicine (CAM) among ethnic minorities in South Korea

PubMed Central

2014-01-01

Background Race has been reported to affect the use of complementary and alternative medicine (CAM), but there is very little research on the use of CAM by ethnicity in Korea. This study explores the prevalence of CAM use among ethnic minorities in South Korea. Methods The design is a descriptive and cross-sectional study. A convenience sample of ethnic minorities was recruited from two public healthcare centres in Gyeonggi province. The survey instrument included 37 questions regarding CAM use, factors influencing use of CAM, self-health management, and the socio-demographic profile of study participants. Results Sixty-two percent of study participants reported the use of CAM. Multivitamins (53.3%), acupuncture (48.9%), and traditional Korean herbal medicine (38.9%) were popular CAM modalities in our sample. Other notable CAM modalities included herbal plants, therapeutic massage, and moxibustion therapy. The majority of CAM users (52.2%) received CAM services to treat diseases or as a secondary treatment while receiving conventional care. Having positive perceptions toward the effectiveness of CAM was a major determining factor in CAM use. Conclusions Physicians need to be aware of the fact that many ethnic minorities use CAM therapies. Many CAM users reported that they want doctors to know about their CAM use and have a basic understanding of traditional medicine in their home country. Overcoming language and cultural barriers will help reduce unwanted medical complications. High prevalence of CAM use among ethnic minorities in our study warrants further studies using larger sample population. PMID:24641983

The influence of genetic factors associated with the immunoglobulin heavy chain locus on the development of benign monoclonal gammapathy in ageing IgH-congenic mice.

PubMed Central

van den Akker, T W; de Glopper-van der Veer, E; Radl, J; Benner, R

1988-01-01

The role of genetic factors associated with the immunoglobulin heavy chain locus (Igh) in the development of benign monoclonal gammapathy (BMG), a benign B-cell proliferative disorder, was investigated in six Igh congenic mouse strains during ageing. The strains used had a C57BL or BALB background: C57BL/6, BALB.Igb and CB-20 carrying the C57BL Igh (Ighb allotype), BALB/c and C57BL/6.Iga carrying the BALB/c Igh (Igha allotype) and BAB-14, that is of BALB/c origin with the exception of the constant part of the Igh, which is of C57BL origin. The frequency of homogeneous immunoglobulins (H-Ig), both single and multiple, was the highest in C57BL/6 mice, followed by C57BL/6.Iga. The frequencies of H-Ig in BALB.Igb and CB-20 mice were higher than those of BALB/c and BAB-14, although somewhat lower than in C57BL/6.Iga mice. Multiple H-Ig were found especially in the sera of C57BL/6 mice. Categorization of the monoclonal gammapathies (MG) on the basis of their origin showed a single transient monoclonal B-cell proliferation in 0-8% of the mice of all strains. Persistent, non-progressive MG, presumably BMG, were detected in 64% of C57BL/6, 30% of C57BL/6.Iga, 22% of BALB.Igb, 17% of CB-20, 13% of BAB-14 and 6% of BALB/c mice. Multiple myeloma or Waldenström-like B-cell lymphoma were found to be responsible for 2-4% of the paraproteinemias in all strains. The remaining H-Ig, varying from 11% of the C57BL/6 to 70% of the BAB-14 mice, could not be evaluated in time. The most frequent isotypes of the BMG within C57BL/6 and C57BL/6.Iga were IgG2a and IgG2b, respectively; IgM was the most frequent isotype within the four BALB congenic strains. The immunoglobulin heavy chain allotypes under investigation appeared to be only partly related to the onset, occurrence, multiplicity and persistence of the BMG developing in these Igh congenic C57BL and BALB strains during ageing. The immunoglobulin heavy chain allotypes, however, were not related to the major isotype of the BMG. The results obtained in CB-20 and BALB.Igb on the one hand, and in BAB-14 on the other hand, may suggest a role for the variable part of the Igh in the development of BMG. Since no absolute influence could be ascribed to the Igh, we assume that primarily other genetic sequences regulating proliferative B-cell functions account for the pathogenesis of BMG. PMID:3141270

Variable Valve Actuation

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

Jeffrey Gutterman; A. J. Lasley

2008-08-31

Many approaches exist to enable advanced mode, low temperature combustion systems for diesel engines - such as premixed charge compression ignition (PCCI), Homogeneous Charge Compression Ignition (HCCI) or other HCCI-like combustion modes. The fuel properties and the quantity, distribution and temperature profile of air, fuel and residual fraction in the cylinder can have a marked effect on the heat release rate and combustion phasing. Figure 1 shows that a systems approach is required for HCCI-like combustion. While the exact requirements remain unclear (and will vary depending on fuel, engine size and application), some form of substantially variable valve actuation ismore » a likely element in such a system. Variable valve actuation, for both intake and exhaust valve events, is a potent tool for controlling the parameters that are critical to HCCI-like combustion and expanding its operational range. Additionally, VVA can be used to optimize the combustion process as well as exhaust temperatures and impact the after treatment system requirements and its associated cost. Delphi Corporation has major manufacturing and product development and applied R&D expertise in the valve train area. Historical R&D experience includes the development of fully variable electro-hydraulic valve train on research engines as well as several generations of mechanical VVA for gasoline systems. This experience has enabled us to evaluate various implementations and determine the strengths and weaknesses of each. While a fully variable electro-hydraulic valve train system might be the 'ideal' solution technically for maximum flexibility in the timing and control of the valve events, its complexity, associated costs, and high power consumption make its implementation on low cost high volume applications unlikely. Conversely, a simple mechanical system might be a low cost solution but not deliver the flexibility required for HCCI operation. After modeling more than 200 variations of the mechanism it was determined that the single cam design did not have enough flexibility to satisfy three critical OEM requirements simultaneously, (maximum valve lift variation, intake valve opening timing and valve closing duration), and a new approach would be necessary. After numerous internal design reviews including several with the OEM a dual cam design was developed that had the flexibility to meet all motion requirements. The second cam added complexity to the mechanism however the cost was offset by the deletion of the electric motor required in the previous design. New patent applications including detailed drawings and potential valve motion profiles were generated and alternate two cam designs were proposed and evaluated for function, cost, reliability and durability. Hardware was designed and built and testing of sample hardware was successfully completed on an engine test stand. The mechanism developed during the course of this investigation can be applied by Original Equipment Manufacturers, (OEM), to their advanced diesel engines with the ultimate goal of reducing emissions and improving fuel economy. The objectives are: (1) Develop an optimal, cost effective, variable valve actuation (VVA) system for advanced low temperature diesel combustion processes. (2) Design and model alternative mechanical approaches and down-select for optimum design. (3) Build and demonstrate a mechanism capable of application on running engines.« less

The Double ABCX Model of Family Stress and Adaptation: An Empirical Test by Analysis of Structural Equations with Latent Variables.

ERIC Educational Resources Information Center

Lavee, Yoav; And Others

1985-01-01

Examined relationships among major variables of the Double ABCX model of family stress and adaptation using data on Army families' adaptation to the crisis of relocation overseas. Results support the notion of pile-up of demands. Family system resources and social support are both found to facilitate adaptation. (Author/BL)

Backbone resonance assignments of complexes of human voltage-dependent sodium channel NaV1.2 IQ motif peptide bound to apo calmodulin and to the C-domain fragment of apo calmodulin.

PubMed

Mahling, Ryan; Kilpatrick, Adina M; Shea, Madeline A

2017-10-01

Human voltage-gated sodium channel Na V 1.2 has a single pore-forming α-subunit and two transmembrane β-subunits. Expressed primarily in the brain, Na V 1.2 is critical for initiation and propagation of action potentials. Milliseconds after the pore opens, sodium influx is terminated by inactivation processes mediated by regulatory proteins including calmodulin (CaM). Both calcium-free (apo) CaM and calcium-saturated CaM bind tightly to an IQ motif in the C-terminal tail of the α-subunit. Our thermodynamic studies and solution structure (2KXW) of a C-domain fragment of apo 13 C, 15 N- CaM (CaM C ) bound to an unlabeled peptide with the sequence of rat Na V 1.2 IQ motif showed that apo CaM C (a) was necessary and sufficient for binding, and (b) bound more favorably than calcium-saturated CaM C . However, we could not monitor the Na V 1.2 residues directly, and no structure of full-length CaM (including the N-domain of CaM (CaM N )) was determined. To distinguish contributions of CaM N and CaM C , we used solution NMR spectroscopy to assign the backbone resonances of a complex containing a 13 C, 15 N-labeled peptide with the sequence of human Na V 1.2 IQ motif (Na V 1.2 IQp ) bound to apo 13 C, 15 N-CaM or apo 13 C, 15 N-CaM C . Comparing the assignments of apo CaM in complex with Na V 1.2 IQp to those of free apo CaM showed that residues within CaM C were significantly perturbed, while residues within CaM N were essentially unchanged. The chemical shifts of residues in Na V 1.2 IQp and in the C-domain of CaM were nearly identical regardless of whether CaM N was covalently linked to CaM C . This suggests that CaM N does not influence apo CaM binding to Na V 1.2 IQp .

Application of an online-coupled regional climate model, WRF-CAM5, over East Asia for examination of ice nucleation schemes: Part I. Comprehensive model evaluation and trend analysis for 2006 and 2011

DOE PAGES

Chen, Ying; Zhang, Yang; Fan, Jiwen; ...

2015-08-18

Online-coupled climate and chemistry models are necessary to realistically represent the interactions between climate variables and chemical species and accurately simulate aerosol direct and indirect effects on cloud, precipitation, and radiation. In this Part I of a two-part paper, simulations from the Weather Research and Forecasting model coupled with the physics package of Community Atmosphere Model (WRF-CAM5) are conducted with the default heterogeneous ice nucleation parameterization over East Asia for two full years: 2006 and 2011. A comprehensive model evaluation is performed using satellite and surface observations. The model shows an overall acceptable performance for major meteorological variables at themore » surface and in the boundary layer, as well as column variables (e.g., precipitation, cloud fraction, precipitating water vapor, downward longwave and shortwave radiation). Moderate to large biases exist for cloud condensation nuclei over oceanic areas, cloud variables (e.g., cloud droplet number concentration, cloud liquid and ice water paths, cloud optical depth, longwave and shortwave cloud forcing). These biases indicate a need to improve the model treatments for cloud processes, especially cloud droplets and ice nucleation, as well as to reduce uncertainty in the satellite retrievals. The model simulates well the column abundances of chemical species except for column SO 2 but relatively poor for surface concentrations of several species such as CO, NO 2, SO 2, PM 2.5, and PM 10. Several reasons could contribute to the underestimation of major chemical species in East Asia including underestimations of anthropogenic emissions and natural dust emissions, uncertainties in the spatial and vertical distributions of the anthropogenic emissions, as well as biases in meteorological, radiative, and cloud predictions. Despite moderate to large biases in the chemical predictions, the model performance is generally consistent with or even better than that reported for East Asia with only a few exceptions. The model generally reproduces the observed seasonal variations and the difference between 2006 and 2011 for most variables or chemical species. Overall, these results demonstrate promising skills of WRF-CAM5 for long-term simulations at a regional scale and suggest several areas of potential improvements.« less

Application of an Online-Coupled Regional Climate Model, WRF-CAM5, over East Asia for Examination of Ice Nucleation Schemes: Part I. Comprehensive Model Evaluation and Trend Analysis for 2006 and 2011

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

Chen, Ying; Zhang, Yang; Fan, Jiwen

Online-coupled climate and chemistry models are necessary to realistically represent the interactions between climate variables and chemical species and accurately simulate aerosol direct and indirect effects on cloud, precipitation, and radiation. In this Part I of a two-part paper, simulations from the Weather Research and Forecasting model coupled with the physics package of Community Atmosphere Model (WRF-CAM5) are conducted with the default heterogeneous ice nucleation parameterization over East Asia for two full years: 2006 and 2011. A comprehensive model evaluation is performed using satellite and surface observations. The model shows an overall acceptable performance for major meteorological variables at themore » surface and in the boundary layer, as well as column variables (e.g., precipitation, cloud fraction, precipitating water vapor, downward longwave and shortwave radiation). Moderate to large biases exist for cloud condensation nuclei over oceanic areas, cloud variables (e.g., cloud droplet number concentration, cloud liquid and ice water paths, cloud optical depth, longwave and shortwave cloud forcing). These biases indicate a need to improve the model treatments for cloud processes, especially cloud droplets and ice nucleation, as well as to reduce uncertainty in the satellite retrievals. The model simulates well the column abundances of chemical species except for column SO 2 but relatively poor for surface concentrations of several species such as CO, NO 2, SO 2, PM2.5, and PM10. Several reasons could contribute to the underestimation of major chemical species in East Asia including underestimations of anthropogenic emissions and natural dust emissions, uncertainties in the spatial and vertical distributions of the anthropogenic emissions, as well as biases in meteorological, radiative, and cloud predictions. Despite moderate to large biases in the chemical predictions, the model performance is generally consistent with or even better than that reported for East Asia with only a few exceptions. The model generally reproduces the observed seasonal variations and the difference between 2006 and 2011 for most variables or chemical species. Overall, these results demonstrate promising skills of WRF-CAM5 for long-term simulations at a regional scale and suggest several areas of potential improvements.« less

Application of an online-coupled regional climate model, WRF-CAM5, over East Asia for examination of ice nucleation schemes: Part I. Comprehensive model evaluation and trend analysis for 2006 and 2011

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

Chen, Ying; Zhang, Yang; Fan, Jiwen

Online-coupled climate and chemistry models are necessary to realistically represent the interactions between climate variables and chemical species and accurately simulate aerosol direct and indirect effects on cloud, precipitation, and radiation. In this Part I of a two-part paper, simulations from the Weather Research and Forecasting model coupled with the physics package of Community Atmosphere Model (WRF-CAM5) are conducted with the default heterogeneous ice nucleation parameterization over East Asia for two full years: 2006 and 2011. A comprehensive model evaluation is performed using satellite and surface observations. The model shows an overall acceptable performance for major meteorological variables at themore » surface and in the boundary layer, as well as column variables (e.g., precipitation, cloud fraction, precipitating water vapor, downward longwave and shortwave radiation). Moderate to large biases exist for cloud condensation nuclei over oceanic areas, cloud variables (e.g., cloud droplet number concentration, cloud liquid and ice water paths, cloud optical depth, longwave and shortwave cloud forcing). These biases indicate a need to improve the model treatments for cloud processes, especially cloud droplets and ice nucleation, as well as to reduce uncertainty in the satellite retrievals. The model simulates well the column abundances of chemical species except for column SO 2 but relatively poor for surface concentrations of several species such as CO, NO 2, SO 2, PM 2.5, and PM 10. Several reasons could contribute to the underestimation of major chemical species in East Asia including underestimations of anthropogenic emissions and natural dust emissions, uncertainties in the spatial and vertical distributions of the anthropogenic emissions, as well as biases in meteorological, radiative, and cloud predictions. Despite moderate to large biases in the chemical predictions, the model performance is generally consistent with or even better than that reported for East Asia with only a few exceptions. The model generally reproduces the observed seasonal variations and the difference between 2006 and 2011 for most variables or chemical species. Overall, these results demonstrate promising skills of WRF-CAM5 for long-term simulations at a regional scale and suggest several areas of potential improvements.« less

Seasonal and interannual variability in wetland methane emissions simulated by CLM4Me' and CAM-chem and comparisons to observations of concentrations

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

Meng, L.; Paudel, R.; Hess, P. G. M.

Understanding the temporal and spatial variation of wetland methane emissions is essential to the estimation of the global methane budget. Our goal for this study is three-fold: (i) to evaluate the wetland methane fluxes simulated in two versions of the Community Land Model, the Carbon-Nitrogen (CN; i.e., CLM4.0) and the Biogeochemistry (BGC; i.e., CLM4.5) versions using the methane emission model CLM4Me' so as to determine the sensitivity of the emissions to the underlying carbon model; (ii) to compare the simulated atmospheric methane concentrations to observations, including latitudinal gradients and interannual variability so as to determine the extent to which themore » atmospheric observations constrain the emissions; (iii) to understand the drivers of seasonal and interannual variability in atmospheric methane concentrations. Simulations of the transport and removal of methane use the Community Atmosphere Model with chemistry (CAM-chem) model in conjunction with CLM4Me' methane emissions from both CN and BGC simulations and other methane emission sources from literature. In each case we compare model-simulated atmospheric methane concentration with observations. In addition, we simulate the atmospheric concentrations based on the TransCom wetland and rice paddy emissions derived from a different terrestrial ecosystem model, Vegetation Integrative Simulator for Trace gases (VISIT). Our analysis indicates CN wetland methane emissions are higher in the tropics and lower at high latitudes than emissions from BGC. In CN, methane emissions decrease from 1993 to 2004 while this trend does not appear in the BGC version. In the CN version, methane emission variations follow satellite-derived inundation wetlands closely. However, they are dissimilar in BGC due to its different carbon cycle. CAM-chem simulations with CLM4Me' methane emissions suggest that both prescribed anthropogenic and predicted wetlands methane emissions contribute substantially to seasonal and interannual variability in atmospheric methane concentration. Simulated atmospheric CH 4 concentrations in CAM-chem are highly correlated with observations at most of the 14 measurement stations evaluated with an average correlation between 0.71 and 0.80 depending on the simulation (for the period of 1993–2004 for most stations based on data availability). Our results suggest that different spatial patterns of wetland emissions can have significant impacts on Northern and Southern hemisphere (N–S) atmospheric CH 4 concentration gradients and growth rates. In conclusion, this study suggests that both anthropogenic and wetland emissions have significant contributions to seasonal and interannual variations in atmospheric CH 4 concentrations. However, our analysis also indicates the existence of large uncertainties in terms of spatial patterns and magnitude of global wetland methane budgets, and that substantial uncertainty comes from the carbon model underlying the methane flux modules.« less

Seasonal and interannual variability in wetland methane emissions simulated by CLM4Me' and CAM-chem and comparisons to observations of concentrations

DOE PAGES

Meng, L.; Paudel, R.; Hess, P. G. M.; ...

2015-07-03

Understanding the temporal and spatial variation of wetland methane emissions is essential to the estimation of the global methane budget. Our goal for this study is three-fold: (i) to evaluate the wetland methane fluxes simulated in two versions of the Community Land Model, the Carbon-Nitrogen (CN; i.e., CLM4.0) and the Biogeochemistry (BGC; i.e., CLM4.5) versions using the methane emission model CLM4Me' so as to determine the sensitivity of the emissions to the underlying carbon model; (ii) to compare the simulated atmospheric methane concentrations to observations, including latitudinal gradients and interannual variability so as to determine the extent to which themore » atmospheric observations constrain the emissions; (iii) to understand the drivers of seasonal and interannual variability in atmospheric methane concentrations. Simulations of the transport and removal of methane use the Community Atmosphere Model with chemistry (CAM-chem) model in conjunction with CLM4Me' methane emissions from both CN and BGC simulations and other methane emission sources from literature. In each case we compare model-simulated atmospheric methane concentration with observations. In addition, we simulate the atmospheric concentrations based on the TransCom wetland and rice paddy emissions derived from a different terrestrial ecosystem model, Vegetation Integrative Simulator for Trace gases (VISIT). Our analysis indicates CN wetland methane emissions are higher in the tropics and lower at high latitudes than emissions from BGC. In CN, methane emissions decrease from 1993 to 2004 while this trend does not appear in the BGC version. In the CN version, methane emission variations follow satellite-derived inundation wetlands closely. However, they are dissimilar in BGC due to its different carbon cycle. CAM-chem simulations with CLM4Me' methane emissions suggest that both prescribed anthropogenic and predicted wetlands methane emissions contribute substantially to seasonal and interannual variability in atmospheric methane concentration. Simulated atmospheric CH 4 concentrations in CAM-chem are highly correlated with observations at most of the 14 measurement stations evaluated with an average correlation between 0.71 and 0.80 depending on the simulation (for the period of 1993–2004 for most stations based on data availability). Our results suggest that different spatial patterns of wetland emissions can have significant impacts on Northern and Southern hemisphere (N–S) atmospheric CH 4 concentration gradients and growth rates. In conclusion, this study suggests that both anthropogenic and wetland emissions have significant contributions to seasonal and interannual variations in atmospheric CH 4 concentrations. However, our analysis also indicates the existence of large uncertainties in terms of spatial patterns and magnitude of global wetland methane budgets, and that substantial uncertainty comes from the carbon model underlying the methane flux modules.« less

Allosteric Effects of the Anti-Psychotic Drug Trifluoperazine on the Energetics of Calcium Binding by Calmodulin

PubMed Central

Feldkamp, Michael D.; O'Donnell, Susan E.; Yu, Liping; Shea, Madeline A.

2010-01-01

Trifluoperazine (TFP; Stelazine™) is an antagonist of calmodulin (CaM), an essential regulator of calcium-dependent signal transduction. Reports differ regarding whether, or where, TFP binds to apo CaM. Three crystallographic structures (1CTR, 1A29, 1LIN) show TFP bound to (Ca2+)4-CaM in ratios of 1, 2 or 4 TFP per CaM. In all of these, CaM domains adopt the “open” conformation seen in CaM-kinase complexes having increased calcium affinity. Most reports suggest TFP also increases calcium affinity of CaM. To compare TFP binding to apo CaM and (Ca2+)4-CaM, and explore differential effects on the N- and C-domains of CaM, stoichiometric TFP titrations of CaM were monitored by 15N-HSQC NMR. Two TFP bound to apo CaM, while four bound to (Ca2+)4-CaM. In both cases, the preferred site was in the C-domain. During the titrations, biphasic responses for some resonances suggested inter-site interactions. TFP-binding sites in apo CaM appeared distinct from those in (Ca2+)4-CaM. In equilibrium calcium titrations at defined ratios of TFP:CaM, TFP reduced calcium affinity at most levels tested; this is similar to the effect of many IQ-motifs on CaM. However, at the highest level tested, TFP raised the calcium affinity of the N-domain of CaM. A model of conformational switching is proposed to explain how TFP can exert opposing allosteric effects on calcium affinity by binding to different sites in the “closed”, “semi-open” and “open” domains of CaM. In physiological processes, apo CaM, as well as (Ca2+)4-CaM, needs to be considered a potential target of drug action. PMID:20544963

Modeling biophysical properties of broad-leaved stands in the hyrcanian forests of Iran using fused airborne laser scanner data and ultraCam-D images

NASA Astrophysics Data System (ADS)

Mohammadi, Jahangir; Shataee, Shaban; Namiranian, Manochehr; Næsset, Erik

2017-09-01

Inventories of mixed broad-leaved forests of Iran mainly rely on terrestrial measurements. Due to rapid changes and disturbances and great complexity of the silvicultural systems of these multilayer forests, frequent repetition of conventional ground-based plot surveys is often cost prohibitive. Airborne laser scanning (ALS) and multispectral data offer an alternative or supplement to conventional inventories in the Hyrcanian forests of Iran. In this study, the capability of a combination of ALS and UltraCam-D data to model stand volume, tree density, and basal area using random forest (RF) algorithm was evaluated. Systematic sampling was applied to collect field plot data on a 150 m × 200 m sampling grid within a 1100 ha study area located at 36°38‧- 36°42‧N and 54°24‧-54°25‧E. A total of 308 circular plots (0.1 ha) were measured for calculation of stand volume, tree density, and basal area per hectare. For each plot, a set of variables was extracted from both ALS and multispectral data. The RF algorithm was used for modeling of the biophysical properties using ALS and UltraCam-D data separately and combined. The results showed that combining the ALS data and UltraCam-D images provided a slight increase in prediction accuracy compared to separate modeling. The RMSE as percentage of the mean, the mean difference between observed and predicted values, and standard deviation of the differences using a combination of ALS data and UltraCam-D images in an independent validation at 0.1-ha plot level were 31.7%, 1.1%, and 84 m3 ha-1 for stand volume; 27.2%, 0.86%, and 6.5 m2 ha-1 for basal area, and 35.8%, -4.6%, and 77.9 n ha-1 for tree density, respectively. Based on the results, we conclude that fusion of ALS and UltraCam-D data may be useful for modeling of stand volume, basal area, and tree density and thus gain insights into structural characteristics in the complex Hyrcanian forests.

In vitro Evaluation of the Marginal Fit and Internal Adaptation of Zirconia and Lithium Disilicate Single Crowns: Micro-CT Comparison Between Different Manufacturing Procedures.

PubMed

Riccitiello, Francesco; Amato, Massimo; Leone, Renato; Spagnuolo, Gianrico; Sorrentino, Roberto

2018-01-01

Prosthetic precision can be affected by several variables, such as restorative materials, manufacturing procedures, framework design, cementation techniques and aging. Marginal adaptation is critical for long-term longevity and clinical success of dental restorations. Marginal misfit may lead to cement exposure to oral fluids, resulting in microleakage and cement dissolution. As a consequence, marginal discrepancies enhance percolation of bacteria, food and oral debris, potentially causing secondary caries, endodontic inflammation and periodontal disease. The aim of the present in vitro study was to evaluate the marginal and internal adaptation of zirconia and lithium disilicate single crowns, produced with different manufacturing procedures. Forty-five intact human maxillary premolars were prepared for single crowns by means of standardized preparations. All-ceramic crowns were fabricated with either CAD-CAM or heat-pressing procedures (CAD-CAM zirconia, CAD-CAM lithium disilicate, heat-pressed lithium disilicate) and cemented onto the teeth with a universal resin cement. Non-destructive micro-CT scanning was used to achieve the marginal and internal gaps in the coronal and sagittal planes; then, precision of fit measurements were calculated in a dedicated software and the results were statistically analyzed. The heat-pressed lithium disilicate crowns were significantly less accurate at the prosthetic margins (p<0.05) while they performed better at the occlusal surface ( p <0.05). No significant differences were noticed between CAD-CAM zirconia and lithium disilicate crowns ( p >0.05); nevertheless CAD-CAM zirconia copings presented the best marginal fit among the experimental groups. As to the thickness of the cement layer, reduced amounts of luting agent were noticed at the finishing line, whereas a thicker layer was reported at the occlusal level. Within the limitations of the present in vitro investigation, the following conclusions can be drawn: the recorded marginal gaps were within the clinical acceptability irrespective of both the restorative material and the manufacturing procedures; the CAD-CAM processing techniques for both zirconia and lithium disilicate produced more consistent marginal gaps than the heat-pressing procedures; the tested universal resin cement can be safely used with both restorative materials.

SEVEN-YEAR MULTI-COLOR OPTICAL MONITORING OF BL LACERTAE OBJECT S5 0716+714

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

Dai Yan; Wu Jianghua; Zhu Zonghong

We have monitored the BL Lacertae object S5 0716+714 in five intermediate optical wavebands from 2004 September to 2011 April. Here, we present data that include 8661 measurements representing one of the largest databases obtained for an object in the optical domain. A simple analysis of the data indicates that the object was active most of the time, and intraday variability was frequently observed. In total, the object varied by 2.614 mag in the i band. Strong bluer-when-brighter chromatism was observed on long, intermediate, and short timescales.

The prevalence, patterns of usage and people's attitude towards complementary and alternative medicine (CAM) among the Indian community in Chatsworth, South Africa.

PubMed

Singh, Vimal; Raidoo, Deshandra M; Harries, Catherine S

2004-02-04

The purpose of this study was to determine, among the Indian community of Chatsworth, South Africa, the prevalence and utilisation patterns of complementary and alternative medicine (CAM), attitudes associated with CAM use and communication patterns of CAM users with their primary care doctors. Face-to-face structured interviews were conducted in Chatsworth, a suburb of Durban in which South Africans of Indian origin predominantly reside. Participants were 200 randomly selected adult English-speaking Indian residents. The prevalence of CAM usage for period 2000/2001 was 38.5% (95% confidence interval 31.7% to 45.6%). Spiritual healing and herbal/natural medicines, including vitamins were the most common types of CAM used, accounting for 42.8% and 48.1% respectively of overall CAM usage. People used CAM to treat conditions including diabetes mellitus, headaches, arthritis and joint pains, stress, skin disorders, backaches, hypertension and nasal disorders. Half of the CAM users used allopathic medicines concurrently. The cost of CAM utilization over this 1-year period, incurred by 80.5% of users for the duration of therapy for their most troublesome condition was below R500 (approximately US50 dollars). Age, sex, marital status, religion, level of education and income were shown not to influence the use of CAM. Greater than half (51.9%) of CAM users did so either upon the advice of someone they knew, or after noticing a CAM advertisement in the local press. Seventy-nine percent of CAM users indicated that they had positive outcomes with their treatments. Fifty four percent of CAM users (excluding those using spiritual healing only) failed to inform their doctors that they used CAM. The main reason given by half of this group was that informing their doctors did not seem necessary. The prevalence of CAM in Chatsworth is similar to findings in other parts of the world. Although CAM was used to treat many different ailments, this practice could not be attributed to any particular demographic profile. The majority of CAM users were satisfied with the effects of CAM. Findings support a need for greater integration of allopathic medicine and CAM, as well as improved communication between patients and caregivers regarding CAM usage.

The prevalence, patterns of usage and people's attitude towards complementary and alternative medicine (CAM) among the Indian community in Chatsworth, South Africa

PubMed Central

Singh, Vimal; Raidoo, Deshandra M; Harries, Catherine S

2004-01-01

Background The purpose of this study was to determine, among the Indian community of Chatsworth, South Africa, the prevalence and utilisation patterns of complementary and alternative medicine (CAM), attitudes associated with CAM use and communication patterns of CAM users with their primary care doctors. Methods Face-to-face structured interviews were conducted in Chatsworth, a suburb of Durban in which South Africans of Indian origin predominantly reside. Participants were 200 randomly selected adult English-speaking Indian residents. Results The prevalence of CAM usage for period 2000/2001 was 38.5% (95% confidence interval 31.7% to 45.6%). Spiritual healing and herbal/natural medicines, including vitamins were the most common types of CAM used, accounting for 42.8% and 48.1% respectively of overall CAM usage. People used CAM to treat conditions including diabetes mellitus, headaches, arthritis and joint pains, stress, skin disorders, backaches, hypertension and nasal disorders. Half of the CAM users used allopathic medicines concurrently. The cost of CAM utilization over this 1-year period, incurred by 80.5% of users for the duration of therapy for their most troublesome condition was below R500 (approximately US$50). Age, sex, marital status, religion, level of education and income were shown not to influence the use of CAM. Greater than half (51.9%) of CAM users did so either upon the advice of someone they knew, or after noticing a CAM advertisement in the local press. Seventy-nine percent of CAM users indicated that they had positive outcomes with their treatments. Fifty four percent of CAM users (excluding those using spiritual healing only) failed to inform their doctors that they used CAM. The main reason given by half of this group was that informing their doctors did not seem necessary. Conclusion The prevalence of CAM in Chatsworth is similar to findings in other parts of the world. Although CAM was used to treat many different ailments, this practice could not be attributed to any particular demographic profile. The majority of CAM users were satisfied with the effects of CAM. Findings support a need for greater integration of allopathic medicine and CAM, as well as improved communication between patients and caregivers regarding CAM usage. PMID:15018622

Survey of practices and policies relating to the use of complementary and alternative medicines and therapies in New South Wales cancer services.

PubMed

Raszeja, V M; Jordens, C F C; Kerridge, I H

2013-01-01

To examine policies and practices relating to the provision, prescription and monitoring of complementary and alternative medicine and therapies (CAM) in conventional cancer services in NSW. Self-administered questionnaire sent to directors of all 65 eligible cancer services in NSW in 2009. Forty-three services responded to the survey (response rate 66%). Only six (14%) services reported having formal policies about CAM. Most (n = 33, 77%) expected that patients would be asked about CAM use during their initial assessment. Eight services (19%) provided and/or prescribed CAM for patients, and most of these (n = 7) recorded details of CAM use in patients' records. Only four (9%) services permitted CAM practitioners from the community to attend inpatients, whereas 24 (56%) permitted inpatients to bring in their own CAM. Most of these services (n = 17) required medical approval for the use of CAM. Of the latter, most (n = 13) recorded the use of approved CAM, but only seven recorded use of unapproved CAM and only three refused permission to continue use of unapproved CAM. Most cancer services in NSW recognise potential CAM use by patients and expect medical staff to ask patients about their use of CAM. While few cancer services provided or prescribed CAM, over half permitted inpatients to bring their own CAM into hospital. There was little control over the use of CAM, however, and monitoring was lax. Given the wide usage of CAM by patients with cancer, this lack of control may compromise clinical outcomes, with potentially dangerous consequences. © 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.

Disclosure of complementary and alternative medicine use to health care providers among HIV-infected women.

PubMed

Liu, Chenglong; Yang, Yang; Gange, Stephen J; Weber, Kathleen; Sharp, Gerald B; Wilson, Tracey E; Levine, Alexandra; Robison, Esther; Goparaju, Lakshmi; Gandhi, Monica; Ganhdi, Monica; Merenstein, Dan

2009-11-01

To determine prevalence and predictors of complementary and alternative medicine (CAM) use disclosure to health care providers and whether CAM use disclosure is associated with highly active antiretroviral therapy (HAART) adherence among HIV-infected women, we analyzed longitudinal data collected between October 1994 and March 2002 from HIV-infected CAM-using women enrolled in the Women's Interagency HIV Study. Repeated measures Poisson regression models were constructed to evaluate associations of selected predictors with CAM use disclosure and association between CAM use disclosure and HAART adherence. A total of 1,377 HIV-infected women reported CAM use during study follow-up and contributed a total of 4,689 CAM-using person visits. The overall prevalence of CAM use disclosure to health care providers was 36% across study visits. Women over 45 years old, with a college education, or with health insurance coverage were more likely to disclose their CAM use to health care providers, whereas women identified as non-Hispanic Black or other ethnicities were less likely to communicate their CAM usage. More health care provider visits, more CAM domains used, and higher health care satisfaction scores had significant relationships with increased levels of CAM use disclosure. Restricting analysis to use of herbal or nonherbal medications only, similar results were obtained. Compared to other CAM domains, mind-body practice had the lowest prevalence of CAM use disclosure. Additionally, CAM use disclosure was significantly associated with higher HAART adherence. From this study, we showed that a high percentage of HIV-infected women did not discuss their CAM use with health care providers. Interventions targeted towards both physicians and patients may enhance communication of CAM use, avoid potential adverse events and drug interactions, and enhance HAART adherence.

Disclosure of Complementary and Alternative Medicine Use to Health Care Providers among HIV-Infected Women

PubMed Central

Yang, Yang; Gange, Stephen J.; Weber, Kathleen; Sharp, Gerald B.; Wilson, Tracey E.; Levine, Alexandra; Robison, Esther; Goparaju, Lakshmi; Gandhi, Monica; Merenstein, Dan

2009-01-01

Abstract To determine prevalence and predictors of complementary and alternative medicine (CAM) use disclosure to health care providers and whether CAM use disclosure is associated with highly active antiretroviral therapy (HAART) adherence among HIV-infected women, we analyzed longitudinal data collected between October 1994 and March 2002 from HIV-infected CAM-using women enrolled in the Women's Interagency HIV Study. Repeated measures Poisson regression models were constructed to evaluate associations of selected predictors with CAM use disclosure and association between CAM use disclosure and HAART adherence. A total of 1377 HIV-infected women reported CAM use during study follow-up and contributed a total of 4689 CAM-using person visits. The overall prevalence of CAM use disclosure to health care providers was 36% across study visits. Women over 45 years old, with a college education, or with health insurance coverage were more likely to disclose their CAM use to health care providers, whereas women identified as non-Hispanic Black or other ethnicities were less likely to communicate their CAM usage. More health care provider visits, more CAM domains used, and higher health care satisfaction scores had significant relationships with increased levels of CAM use disclosure. Restricting analysis to use of herbal or nonherbal medications only, similar results were obtained. Compared to other CAM domains, mind–body practice had the lowest prevalence of CAM use disclosure. Additionally, CAM use disclosure was significantly associated with higher HAART adherence. From this study, we showed that a high percentage of HIV-infected women did not discuss their CAM use with health care providers. Interventions targeted towards both physicians and patients may enhance communication of CAM use, avoid potential adverse events and drug interactions, and enhance HAART adherence. PMID:19821723

Complementary and alternative medicine use among paediatric emergency department patients.

PubMed

Taylor, David McDonald; Dhir, Reetika; Craig, Simon S; Lammers, Thalia; Gardiner, Kaya; Hunter, Kirrily; Joffe, Paul; Krieser, David; Babl, Franz E

2015-09-01

To determine the period prevalence and nature of complementary and alternative medicine (CAM) use among paediatric emergency department (ED) patients and the perceptions of CAM among the CAM administrators. A survey was undertaken in four Victorian EDs (January to September 2013). A convenience sample of parents/carers accompanying paediatric patients completed a self-administered questionnaire. The main outcome measures were CAM use and perceptions of CAM. The parents/carers of 883 patients participated. Three hundred eighty-eight (43.9%, 95% confidence interval (CI) 40.6-47.3) and 53 (6.0%, 95% CI 4.6-7.8) patients had taken a CAM within the previous 12 months and on the day of presentation, respectively. There were no gender differences between CAM users and non-users (P = 0.83). The use of CAM was significantly more common among older patients (P < 0.001), those with European ethnicity (P = 0.046) and among those with chronic disease (P < 0.01). Fish oil, garlic, chamomile and acidophilus were the most commonly used CAM. Only 4.4% of CAM use was reported to the ED doctor. There were reports of potentially dangerous CAM use (St John's wort, ginseng). Parents/carers who had administered CAM were more likely to report that CAMs are safe, drug free and could prevent illness (P < 0.01). In addition, a number of this group reported that CAMs are more effective than prescription medicines and safe when taken with prescription medicines. CAM use is common among paediatric ED patients although rarely reported to the ED doctor. Parents/carers who administer CAM have differing perceptions of CAM safety from those who do not. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Classification of CAM use and its correlates in patients with early-stage breast cancer.

PubMed

Saquib, Juliann; Madlensky, Lisa; Kealey, Sheila; Saquib, Nazmus; Natarajan, Loki; Newman, Vicky A; Patterson, Ruth E; Pierce, John P

2011-06-01

Self-reported use of complementary and alternative medicine (CAM) has been shown to increase following a cancer diagnosis, and breast cancer survivors are the heaviest users among cancer survivors. The aim of this study was to determine whether the prevalence estimate of CAM use varied according to classification of CAM. The authors used a comprehensive system to classify CAM users and test differences in demographic, lifestyle, quality of life, and cancer characteristics among them. Participants were 2562 breast cancer survivors participating in the Women's Healthy Eating and Living (WHEL) Study, aged 28 to 74 years. A structured telephone interview assessed CAM use, questioning about specific CAM practices, and whether use was related to cancer. This study examined CAM use in relation to demographics, health behaviors, and quality of life. Approximately 80% of the women used CAM for general purposes but only 50% reported CAM use for cancer purposes. Visual imagery, spiritual healing, and meditation were the most frequently used practices for cancer purposes. CAM use, defined as consulting a CAM practitioner and regular use, was significantly related to younger age, higher education, increased fruit and vegetable intake, and lower body mass index (P < .05). CAM users who had seen a practitioner were also more likely to report poor physical and mental health than non-CAM users (P < .05). CAM use was not associated with changes in physical and mental health between study baseline and 1-year follow-up. This study addressed important differences in the classification of CAM use among breast cancer survivors. Future studies need to further test the potential benefits and risks associated with CAM use.

EpCAM and the biology of hepatic stem/progenitor cells

PubMed Central

Theise, Neil D.; Schmelzer, Eva; Boulter, Luke; Gires, Olivier; van Grunsven, Leo A.

2014-01-01

Epithelial cell adhesion molecule (EpCAM) is a transmembrane glycoprotein, which is frequently and highly expressed on carcinomas, tumor-initiating cells, selected tissue progenitors, and embryonic and adult stem cells. During liver development, EpCAM demonstrates a dynamic expression, since it can be detected in fetal liver, including cells of the parenchyma, whereas mature hepatocytes are devoid of EpCAM. Liver regeneration is associated with a population of EpCAM-positive cells within ductular reactions, which gradually lose the expression of EpCAM along with maturation into hepatocytes. EpCAM can be switched on and off through a wide panel of strategies to fine-tune EpCAM-dependent functional and differentiative traits. EpCAM-associated functions relate to cell–cell adhesion, proliferation, maintenance of a pluripotent state, regulation of differentiation, migration, and invasion. These functions can be conferred by the full-length protein and/or EpCAM-derived fragments, which are generated upon regulated intramembrane proteolysis. Control by EpCAM therefore not only depends on the presence of full-length EpCAM at cellular membranes but also on varying rates of the formation of EpCAM-derived fragments that have their own regulatory properties and on changes in the association of EpCAM with interaction partners. Thus spatiotemporal localization of EpCAM in immature liver progenitors, transit-amplifying cells, and mature liver cells will decisively impact the regulation of EpCAM functions and might be one of the triggers that contributes to the adaptive processes in stem/progenitor cell lineages. This review will summarize EpCAM-related molecular events and how they relate to hepatobiliary differentiation and regeneration. PMID:25477371

Observations of the boundary layer, cloud, and aerosol variability in the southeast Pacific coastal marine stratocumulus during VOCALS-REx

NASA Astrophysics Data System (ADS)

Zheng, X.; Albrecht, B.; Jonsson, H. H.; Khelif, D.; Feingold, G.; Minnis, P.; Ayers, K.; Chuang, P.; Donaher, S.; Rossiter, D.; Ghate, V.; Ruiz-Plancarte, J.; Sun-Mack, S.

2011-05-01

Aircraft observations made off the coast of northern Chile in the Southeastern Pacific (20° S, 72° W; named Point Alpha) from 16 October to 13 November 2008 during the VAMOS Ocean-Cloud-Atmosphere-Land Study-Regional Experiment (VOCALS-REx), combined with meteorological reanalysis, satellite measurements, and radiosonde data, are used to investigate the boundary layer (BL) and aerosol-cloud-drizzle variations in this region. The BL at Point Alpha was typical of a non-drizzling stratocumulus-topped BL on days without predominately synoptic and meso-scale influences. The BL had a depth of 1140 ± 120 m, was well-mixed and capped by a sharp inversion. The wind direction generally switched from southerly within the BL to northerly above the inversion. The cloud liquid water path (LWP) varied between 15 g m-2 and 160 g m-2. From 29 October to 4 November, when a synoptic system affected conditions at Point Alpha, the cloud LWP was higher than on the other days by around 40 g m-2. On 1 and 2 November, a moist layer above the inversion moved over Point Alpha. The total-water specific humidity above the inversion was larger than that within the BL during these days. Entrainment rates (average of 1.5 ± 0.6 mm s-1) calculated from the near cloud-top fluxes and turbulence (vertical velocity variance) in the BL at Point Alpha appeared to be weaker than those in the BL over the open ocean west of Point Alpha and the BL near the coast of the northeast Pacific. The accumulation mode aerosol varied from 250 to 700 cm-3 within the BL, and CCN at 0.2 % supersaturation within the BL ranged between 150 and 550 cm-3. The main aerosol source at Point Alpha was horizontal advection within the BL from south. The average cloud droplet number concentration ranged between 80 and 400 cm-3, which was consistent with the satellite-derived values. The relationship of cloud droplet number concentration and CCN at 0.2 % supersaturation from 18 flights is Nd =4.6 × CCN0.71. While the mean LWP retrieved from GOES was in good agreement with the in situ measurements, the GOES-derived cloud droplet effective radius tended to be larger than that from the aircraft {in situ} observations near cloud top. The aerosol and cloud LWP relationship reveals that during the typical well-mixed BL days the cloud LWP increased with the CCN concentrations. On the other hand, meteorological factors and the decoupling processes have large influences on the cloud LWP variation as well.

Use of complementary and alternative medicine before and after organ removal due to urologic cancer

PubMed Central

Mani, Jens; Juengel, Eva; Arslan, Ilhan; Bartsch, Georg; Filmann, Natalie; Ackermann, Hanns; Nelson, Karen; Haferkamp, Axel; Engl, Tobias; Blaheta, Roman A

2015-01-01

Objective Many patients use complementary and alternative medicine (CAM) as primary treatment or symptom relief for a variety of illnesses. This study was designed to investigate the influence of surgical removal of a tumor-bearing urogenital organ on CAM use. Methods From 2007 to 2011, 350 patients underwent major urological surgery for kidney, prostate, or bladder cancer at the Goethe-University Hospital, Frankfurt, Germany. Data from 172 patients (49%), who returned a questionnaire, were retrospectively evaluated using the hospital information system along with the questionnaire to objectify CAM use 2 years before and after surgery. Results From the 172 patients returning questionnaires, 56 (33%) used CAM before and/or after surgery and 116 (67%) never used CAM. Of the 56 CAM users, 30 (54%) used CAM presurgery and 53 (95%) used CAM postsurgery, indicating a significant change of mind about CAM use. Patients of German nationality used CAM significantly more than patients of other nationalities. Higher educational status (high-school diploma or higher) was a significant factor in favor of CAM use. The most common type of CAM used before/after surgery was an alternative medical system (63/49%), a manipulative and body-based method (50/19%), and a biological-based therapy (37/32%). Information about CAM, either provided by medical professionals or by other sources, was the main reason determining whether patients used CAM or not. Conclusion The number of patients using CAM almost doubled after surgical removal of a cancer-bearing organ. Better awareness and understanding of CAM use by medical professionals could improve patient counseling. PMID:26491269

The welcoming attitude of dermatologists towards complementary and alternative medicine despite their lack of knowledge and training.

PubMed

AlGhamdi, Khalid M; Khurrum, Huma; Asiri, Yousif

2017-09-01

Background / aim: Although complementary and alternative medicine (CAM) use is highly prevalent, there is very limited information on dermatologists' attitudes and knowledge about CAM. In this survey, we aimed to study the knowledge and attitude of dermatologists in Saudi Arabia towards CAM. Furthermore, we assessed dermatologists' intention to receive CAM education and training. Methods and design: We collected data through an online cross-sectional survey sent to email addresses of dermatologists in Saudi Arabia. Questions included socio-demographic data, knowledge and attitudes towards CAM practice. Results: A total of 93 questionnaires were returned from dermatologists in various regions of Saudi Arabia. The mean age was 41.7 ± 10.3 (range, 25-63) years. A total of 67% of dermatologists had welcoming attitudes towards CAM. We did not find any significant relationship between age, gender, experience or any other factor and positive attitudes towards CAM. More than 70% of participants reported an interest in learning about CAM. However, only 9 (9.7%) dermatologists had attended CAM courses. Sixty-one participants (65.6%) were eager to receive CAM-specific education, and 66% of dermatologists acknowledged having previously discussed CAM with their patients. The most important reason that dermatologists did not discuss CAM with their patients was a lack of studies supporting CAM (66.7%) and the belief that doctors' knowledge on CAM is insufficient (58.1%). Conclusion: A greater number of dermatologists have an affirmative attitude towards CAM. The willingness to improve knowledge and training indicates that the CAM field could potentially grow in dermatology.

Frequency of technical complications in fixed implant prosthesis: the effect of prosthesis screw emergence correction by CAD-CAM.

PubMed

Anitua, Eduardo; Flores, Carlos; Piñas, Laura; Alkhraisat, Mohammad

2018-06-05

CAD-CAM technology permits the angular correction of screw emergence into the prosthesis, however there is lack of controlled clinical studies that assess the frequency of technical complications in angled screw channel restorations. This controlled clinical study was designed to assess technical incidences in angled screw channel restorations. Patients having implant prosthesis placed between November, 2014 and December, 2015 were screened. The patients were selected if they received prosthesis with up to 30º correction of the prosthesis screw emergence and had at least one non-angulated prosthesis (screw-retained). All the prostheses were located completely/partially in the posterior region. The frequency of technical complications was the principal variable. A total of 52 patients with a mean age of 62 ± 10 years participated with a total 110 prostheses (55 in the test group and 55 in the control group). A total of 11 technical complications occurred (7 in the test group and 4 in the control group). These differences were not statistically significant. All the prostheses in both groups survived the follow-up. The correction of the screw emergence into the prosthesis has not increased the risk of technical complications in CAD-CAM implant prostheses.

Understanding the signature of rock coatings in laser-induced breakdown spectroscopy data

USGS Publications Warehouse

Lanza, Nina L.; Ollila, Ann M.; Cousin, Agnes; Wiens, Roger C.; Clegg, Samuel M.; Mangold, Nicolas; Bridges, Nathan; Cooper, Daniel; Schmidt, Mariek E.; Berger, Jeffrey; Arvidson, Raymond E.; Melikechi, Noureddine; Newsom, Horton E.; Tokar, Robert; Hardgrove, Craig; Mezzacappa, Alissa; Jackson, Ryan S.; Clark, Benton C.; Forni, Olivier; Maurice, Sylvestre; Nachon, Marion; Anderson, Ryan B.; Blank, Jennifer; Deans, Matthew; Delapp, Dorothea; Léveillé, Richard; McInroy, Rhonda; Martinez, Ronald; Meslin, Pierre-Yves; Pinet, Patrick

2015-01-01

Surface compositional features on rocks such as coatings and weathering rinds provide important information about past aqueous environments and water–rock interactions. The search for these features represents an important aspect of the Curiosity rover mission. With its unique ability to do fine-scale chemical depth profiling, the ChemCam laser-induced breakdown spectroscopy instrument (LIBS) onboard Curiosity can be used to both identify and analyze rock surface alteration features. In this study we analyze a terrestrial manganese-rich rock varnish coating on a basalt rock in the laboratory with the ChemCam engineering model to determine the LIBS signature of a natural rock coating. Results show that there is a systematic decrease in peak heights for elements such as Mn that are abundant in the coating but not the rock. There is significant spatial variation in the relative abundance of coating elements detected by LIBS depending on where on the rock surface sampled; this is due to the variability in thickness and spatial discontinuities in the coating. Similar trends have been identified in some martian rock targets in ChemCam data, suggesting that these rocks may have coatings or weathering rinds on their surfaces.

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

Zarzycki, Colin M.; Thatcher, Diana R.; Jablonowski, Christiane

This paper describes an objective technique for detecting the extratropical transition (ET) of tropical cyclones (TCs) in high-resolution gridded climate data. The algorithm is based on previous observational studies using phase spaces to define the symmetry and vertical thermal structure of cyclones. Storm tracking is automated, allowing for direct analysis of climate data. Tracker performance in the North Atlantic is assessed using 23 years of data from the variable-resolution Community Atmosphere Model (CAM) at two different resolutions (DX 55 km and 28 km), the Climate Forecast System Reanalysis (CFSR, DX 38 km), and the ERA-Interim Reanalysis (ERA-I, DX 80 km).more » The mean spatiotemporal climatologies and seasonal cycles of objectively detected ET in the observationally constrained CFSR and ERA-I are well matched to previous observational studies, demonstrating the capability of the scheme to adequately find events. High resolution CAM reproduces TC and ET statistics that are in general agreement with reanalyses. One notable model bias, however, is significantly longer time between ET onset and ET completion in CAM, particularly for TCs that lose symmetry prior to developing a cold-core structure and becoming extratropical cyclones, demonstrating the capability of this method to expose model biases in simulated cyclones beyond the tropical phase.« less

The systemic theory of living systems and relevance to CAM: the theory (Part III).

PubMed

Olalde Rangel, José A

2005-09-01

Western medical science lacks a solid philosophical and theoretical approach to disease cognition and therapeutics. My first two articles provided a framework for a humane medicine based on Modern Biophysics. Its precepts encompass modern therapeutics and CAM. Modern Biophysics and its concepts are presently missing in medicine, whether orthodox or CAM, albeit they probably provide the long sought explanation that bridges the abyss between East and West. Key points that differentiate Systemic from other systems' approaches are 'Intelligence', 'Energy' and the objective 'to survive'. The General System Theory (GST) took a forward step by proposing a departure from the mechanistic biological concept-of analyzing parts and processes in isolation-and brought us towards an organismic model. GST examines the system's components and results of their interaction. However, GST still does not go far enough. GST assumes 'Self-Organization' as a spontaneous phenomenon, ignoring a causative entity or central controller to all systems: Intelligence. It also neglects 'Survive' as the directional motivation common to any living system, and scarcely assigns 'Energy' its true inherent value. These three parameters, Intelligence, Energy and Survive, are vital variables to be considered, in our human quest, if we are to achieve a unified theory of life.

Pattern and predictors of complementary and alternative medicine (CAM) use among pediatric patients with epilepsy.

PubMed

Doering, Jan H; Reuner, Gitta; Kadish, Navah E; Pietz, Joachim; Schubert-Bast, Susanne

2013-10-01

Parents of pediatric patients with chronic conditions such as epilepsy increasingly opt for complementary and alternative medicine (CAM). However, data on the pattern and reasons of CAM use in childhood epilepsy are scarce. The objectives of this study were as follows: first, to characterize CAM use among pediatric patients with epilepsy by assessing its spectrum, prevalence, costs, and frequency of use; second, to evaluate the influence of CAM use on compliance and satisfaction with conventional care as well as to explore parent-child neurologist communication concerning CAM; and third, to investigate predictors of CAM use. A postal survey was administered to all parents of pediatric outpatients with epilepsy aged 6 to 12, who have received treatment at the neuropediatric outpatient clinic of the University Children's Hospital Heidelberg between 2007 and 2009. One hundred thirty-two of the 297 distributed questionnaires were suitable for inclusion in statistical analysis (44.7%). Forty-nine participants indicated that their children used CAM during the previous year (37.1%). Thirty different types of CAM were used, with homeopathy (55.1%), osteopathy (24.5%), and kinesiology (16.3%) being the most commonly named. A mean of 86€ (0€-500€) and 3h (1 h-30 h) per month was committed to CAM treatment. Only 53% of the users informed their child neurologist of the additional CAM treatment, while 85.6% of all parents wished to discuss CAM options with their child neurologist. Seventy-five percent of users considered the CAM treatment effective. Among the participants most likely to seek CAM treatment are parents whose children show a long duration of epileptic symptoms, parents who make use of CAM treatment themselves, and parents who value a holistic and natural treatment approach. A substantial portion of pediatric patients with epilepsy receive CAM treatment. The high prevalence of use and significant level of financial and time resources spent on CAM indicate the high importance of these treatment options for parents. On the other hand, communication concerning CAM with the child neurologist is largely insufficient despite the wish to speak about CAM. Complementary and alternative medicine users' high compliance with conventional treatment and high perceived effectiveness of CAM support an integrative approach to CAM for pediatric patients with epilepsy. Our study implies that in addition to open parent-child neurologist communication, active inquiry on CAM treatments is necessary to enable informed decision making by parents and to establish the suitability of CAM treatment for the patient. Reliable predictors for CAM use, which allow for improved identification of patients with a high likelihood to receive CAM treatment, are the duration of the illness, use of CAM by the parents themselves, and the desire of the parents to receive a holistic and natural treatment for their child. © 2013.

Geneva mechanism. [including star wheel and driver

NASA Technical Reports Server (NTRS)

Summers, R. H.; Kenney, R. L. (Inventor)

1974-01-01

An improved Geneva mechanism is characterized by a driven star-wheel having a segmented cam-follower surface. Star-wheel driver includes a restraining cam having a segmented cam surface for engaging the cam-follower surface of the star-wheel and antifriction rollers pinned to the restraining cam for engaging the cam-follower surface.

Hip Range of Motion Is Lower in Professional Soccer Players With Hip and Groin Symptoms or Previous Injuries, Independent of Cam Deformities.

PubMed

Tak, Igor; Glasgow, Philip; Langhout, Rob; Weir, Adam; Kerkhoffs, Gino; Agricola, Rintje

2016-03-01

Soccer (football) players often have hip and groin symptoms (HGS), and a previous groin injury is a risk factor for a relapse. Decreased hip range of motion (HROM) has been related to both hip and groin pain and the presence of a cam deformity. How these factors interact is unknown. The first aim was to study whether HGS are associated with HROM. The second aim was to study the association of the presence of a cam deformity with HROM. Additionally, the influence of a cam deformity on the relationship between HGS and HROM was examined. Cross-sectional study; Level of evidence, 3. Seasonal screening data of 2 professional soccer clubs were used. Variables for HGS were current hip or groin pain, the Copenhagen Hip and Groin Outcome Score (HAGOS), and previous hip- and groin-related time-loss injuries (HGTIs). HROM was determined for hip internal rotation (IR), external rotation, and total rotation (TR) in the supine position and for the bent knee fall out (BKFO) test. A cam deformity was defined by an alpha angle >60° on standardized anteroposterior pelvic and frog-leg lateral radiographs. Sixty players (mean [±SD] age, 23.1 ± 4.2 years) were included. All were noninjured at the time of screening. Current hip or groin pain was not associated with HROM. Hips of players in the lowest HAGOS interquartile range (thus most affected by complaints; n = 12) showed less IR (23.9° ± 8.7° vs 28.9° ± 7.8°, respectively; P = .036) and TR (58.2° ± 13.5° vs 65.6° ± 11.8°, respectively; P = .047) than those in the highest interquartile range (n = 29). No such differences were found for BKFO (P = .417). Hips of players with a previous HGTI showed less IR (21.1° ± 6.8° vs 28.3° ± 8.9°, respectively; P < .001) and TR (56.0° ± 8.2° vs 64.5° ± 13.6°, respectively; P < .001) than those without a previous HGTI. This was independent of the presence of a cam deformity. BKFO did not differ between groups (P = .983). Hips with a cam deformity showed less but nonsignificant IR (25.5° ± 10.3° vs 29.0° ± 7.1°, respectively; P = .066) and TR (P = .062) and higher but nonsignificant BKFO values (17.1 cm ± 3.4 cm vs 14.2 cm ± 4.6 cm, respectively; P = .078) than those without a cam deformity. Decreased HROM in professional soccer players is associated with more hip- and groin-related symptoms and with previous injuries, independent of the presence of a cam deformity. © 2015 The Author(s).

Crassulacean acid metabolism and fitness under water deficit stress: if not for carbon gain, what is facultative CAM good for?

PubMed Central

Herrera, Ana

2009-01-01

Background In obligate Crassulacean acid metabolism (CAM), up to 99 % of CO2 assimilation occurs during the night, therefore supporting the hypothesis that CAM is adaptive because it allows CO2 fixation during the part of the day with lower evaporative demand, making life in water-limited environments possible. By comparison, in facultative CAM (inducible CAM, C3-CAM) and CAM-cycling plants drought-induced dark CO2 fixation may only be, with few exceptions, a small proportion of C3 CO2 assimilation in watered plants and occur during a few days. From the viewpoint of survival the adaptive advantages, i.e. increased fitness, of facultative CAM and CAM-cycling are not obvious. Therefore, it is hypothesized that, if it is to increase fitness, CAM must aid in reproduction. Scope An examination of published reports of 23 facultative CAM and CAM-cycling species finds that, in 19 species, drought-induced dark CO2 fixation represents on average 11 % of C3 CO2 assimilation of watered plants. Evidence is discussed on the impact of the operation of CAM in facultative and CAM-cycling plants on their survival – carbon balance, water conservation, water absorption, photo-protection of the photosynthetic apparatus – and reproductive effort. It is concluded that in some species, but not all, facultative and cycling CAM contribute, rather than to increase carbon balance, to increase water-use efficiency, water absorption, prevention of photoinhibition and reproductive output. PMID:18708641

Crassulacean acid metabolism and fitness under water deficit stress: if not for carbon gain, what is facultative CAM good for?

PubMed

Herrera, Ana

2009-02-01

In obligate Crassulacean acid metabolism (CAM), up to 99 % of CO(2) assimilation occurs during the night, therefore supporting the hypothesis that CAM is adaptive because it allows CO(2) fixation during the part of the day with lower evaporative demand, making life in water-limited environments possible. By comparison, in facultative CAM (inducible CAM, C(3)-CAM) and CAM-cycling plants drought-induced dark CO(2) fixation may only be, with few exceptions, a small proportion of C(3) CO(2) assimilation in watered plants and occur during a few days. From the viewpoint of survival the adaptive advantages, i.e. increased fitness, of facultative CAM and CAM-cycling are not obvious. Therefore, it is hypothesized that, if it is to increase fitness, CAM must aid in reproduction. Scope An examination of published reports of 23 facultative CAM and CAM-cycling species finds that, in 19 species, drought-induced dark CO(2) fixation represents on average 11 % of C(3) CO(2) assimilation of watered plants. Evidence is discussed on the impact of the operation of CAM in facultative and CAM-cycling plants on their survival--carbon balance, water conservation, water absorption, photo-protection of the photosynthetic apparatus--and reproductive effort. It is concluded that in some species, but not all, facultative and cycling CAM contribute, rather than to increase carbon balance, to increase water-use efficiency, water absorption, prevention of photoinhibition and reproductive output.

A Prospective, Multicenter Study of Complementary/Alternative Medicine (CAM) Utilization During Definitive Radiation for Breast Cancer

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

Moran, Meena S., E-mail: meena.moran@yale.edu; Department of Radiation Therapy, William W. Backus Hospital, Norwich, Connecticut; Ma Shuangge

Purpose: Although complementary and alternative medicine (CAM) utilization in breast cancer patients is reported to be high, there are few data on CAM practices in breast patients specifically during radiation. This prospective, multi-institutional study was conducted to define CAM utilization in breast cancer during definitive radiation. Materials/Methods: A validated CAM instrument with a self-skin assessment was administered to 360 Stage 0-III breast cancer patients from 5 centers during the last week of radiation. All data were analyzed to detect significant differences between users/nonusers. Results: CAM usage was reported in 54% of the study cohort (n=194/360). Of CAM users, 71% reportedmore » activity-based CAM (eg, Reiki, meditation), 26% topical CAM, and 45% oral CAM. Only 16% received advice/counseling from naturopathic/homeopathic/medical professionals before initiating CAM. CAM use significantly correlated with higher education level (P<.001), inversely correlated with concomitant hormone/radiation therapy use (P=.010), with a trend toward greater use in younger patients (P=.066). On multivariate analysis, level of education (OR: 6.821, 95% CI: 2.307-20.168, P<.001) and hormones/radiation therapy (OR: 0.573, 95% CI: 0.347-0.949, P=.031) independently predicted for CAM use. Significantly lower skin toxicity scores were reported in CAM users vs nonusers, respectively (mild: 34% vs 25%, severe: 17% vs 29%, P=.017). Conclusion: This is the first prospective study to assess CAM practices in breast patients during radiation, with definition of these practices as the first step for future investigation of CAM/radiation interactions. These results should alert radiation oncologists that a large percentage of breast cancer patients use CAM during radiation without disclosure or consideration for potential interactions, and should encourage increased awareness, communication, and documentation of CAM practices in patients undergoing radiation treatment for breast cancer.« less

A method to combine remotely sensed and in situ measurements: Program documentation

NASA Technical Reports Server (NTRS)

Peck, E. L.; Johnson, E. R.; Wong, M. Y.

1984-01-01

All user and programmer information required for using the correlation area method (CAM) program is presented. This program combines measurements of hydrologic variables from all measurement technologies to produce estimated areal mean values. The method accounts for sampling geometries and measurement accuracies and provides a measure of the accuracy of the estimated mean areal value.

Effectiveness Measures for Cross-Sectional Studies: A Comparison of Value-Added Models and Contextualised Attainment Models

ERIC Educational Resources Information Center

Lenkeit, Jenny

2013-01-01

Educational effectiveness research often appeals to "value-added models (VAM)" to gauge the impact of schooling on student learning net of the effect of student background variables. A huge amount of cross-sectional studies do not, however, meet VAM's requirement for longitudinal data. "Contextualised attainment models (CAM)"…

Quality of Life in CAM and Non-CAM Users among Breast Cancer Patients during Chemotherapy in Malaysia

PubMed Central

Chui, Ping Lei; Abdullah, Khatijah Lim; Wong, Li Ping; Taib, Nur Aishah

2015-01-01

Background Complementary and alternative medicine (CAM) use has become increasingly popular among patients with cancer. The purposes of this study were to compare the QOL in CAM users and non-CAM users and to determine whether CAM use influences QOL among breast cancer patients during chemotherapy. Methodology A cross-sectional survey was conducted at two outpatient chemotherapy centers. A total of 546 patients completed the questionnaires on CAM use. QOL was evaluated based on the European Organization for Research and Treatment of Cancer (EORTC) core quality of life (QLQ-C30) and breast cancer-specific quality of life (QLQ-BR23) questionnaires. Results A total of 70.7% of patients were identified as CAM users. There was no significant difference in global health status scores and in all five subscales of the QLQ C30 functional scales between CAM users and non-CAM users. On the QLQ-C30 symptom scales, CAM users (44.96±3.89) had significantly (p = 0.01) higher mean scores for financial difficulties than non-CAM users (36.29±4.81). On the QLQ-BR23 functional scales, CAM users reported significantly higher mean scores for sexual enjoyment (6.01±12.84 vs. 4.64±12.76, p = 0.04) than non-CAM users. On the QLQ-BR23 symptom scales, CAM users reported higher systemic therapy side effects (41.34±2.01 vs. 37.22±2.48, p = 0.04) and breast symptoms (15.76±2.13 vs. 11.08±2.62, p = 0.02) than non-CAM users. Multivariate logistic regression analysis indicated that the use of CAM modality was not significantly associated with higher global health status scores (p = 0.71). Conclusion While the findings indicated that there was no significant difference between users and non-users of CAM in terms of QOL, CAM may be used by health professionals as a surrogate to monitor patients with higher systemic therapy side effects and breast symptoms. Furthermore, given that CAM users reported higher financial burdens (which may have contributed to increased distress), patients should be encouraged to discuss the potential benefits and/or disadvantages of using CAM with their healthcare providers. PMID:26451732

Prayer-for-health and complementary alternative medicine use among Malaysian breast cancer patients during chemotherapy.

PubMed

Chui, Ping Lei; Abdullah, Khatijah Lim; Wong, Li Ping; Taib, Nur Aishah

2014-10-30

The inclusion of prayer-for-health (PFH) in the definition of complementary alternative medicine (CAM) has resulted in higher levels of CAM use. The objective of this study was to assess PFH and CAM use among breast cancer patients undergoing chemotherapy. A cross-sectional study was performed at two chemotherapy providers. Patients were questioned about use of three categories of CAM, mind-body practices (MBPs), natural products (NPs) and traditional medicine (TM). PFH was also examined separately from CAM to better characterise the patterns of CAM and PFH used during chemotherapy. A total of 546 eligible patients participated in the study; 70.7% (n = 386) reported using some form of CAM, and 29.3% (n = 160) were non-CAM users. When PFH was excluded as a CAM, fewer patients reported the use of CAM (66.1%; n = 361). The total number of patients who used MBPs decreased from 342 to 183. The most common CAM use category was NPs (82.8%), followed by MBPs (50.7%), and TM (35.7%). CAM users were more likely to have a tertiary education (OR 2.11, 95% CI 1.15-3.89 vs. primary/lower), have household incomes > RM 3,000 (≈944 USD) per month (OR 2.32, 95% CI 1.40-3.84 vs. ≤RM 3,000 (≈944 USD)), and have advanced cancer (OR 1.75, 95% CI 1.18-2.59 vs. early stage cancer), compared with non-CAM users. The CAM users were less likely to have their chemotherapy on schedule (OR 0.24, 95% CI 0.10-0.58 vs. chemotherapy postponed) than non-CAM users. Most MBPs were perceived to be more helpful by their users, compared with the users of NPs and TM. CAM use was prevalent among breast cancer patients. Excluding PFH from the definition of CAM reduced the prevalence of overall CAM use. Overall, CAM use was associated with higher education levels and household incomes, advanced cancer and lower chemotherapy schedule compliance. Many patients perceived MBP to be beneficial for improving overall well-being during chemotherapy. These findings, while preliminary, clearly indicate the differences in CAM use when PFH is included in, and excluded from, the definition of CAM.

Exposure to bright light modifies HRV responses to mental tasks during nocturnal sleep deprivation.

PubMed

Yokoi, Mari; Aoki, Ken; Shimomura, Yoshihiro; Iwanaga, Koichi; Katsuura, Tetsuo

2006-03-01

This study was intended to determine the effects of continuous bright light exposure on cardiovascular responses, particularly heart rate variability (HRV), at rest and during performance of mental tasks with acute nocturnal sleep deprivation. Eight healthy male subjects stayed awake from 21.00 to 04.30 hours under bright (BL, 2800 lux) or dim (DL, 120 lux) light conditions. During sleep deprivation, mental tasks (Stroop color-word conflict test: CWT) were performed for 15 min each hour. Blood pressure, electrocardiogram, respiratory rate, urinary melatonin concentrations and rectal temperature were measured. During sleep deprivation, BL exposure depressed melatonin secretion in comparison to DL conditions. During sleep deprivation, exposure to BL delayed the decline in heart rate (HR) for 4 h in resting periods. A significant increment of HR induced by each CWT was detected, especially at 03.00 h and later, under DL conditions only. In addition, at 04.00 h, an index of sympathetic activity and sympatho-vagal balance on HRV during CWT increased significantly under DL conditions. In contrast, an index of parasympathetic activity during CWT decreased significantly under DL conditions. However, the indexes of HRV during CWT did not change throughout sleep deprivation under BL conditions. Our results suggest that BL exposure not only delays the nocturnal decrease in HR at rest but also maintains HR and balance of cardiac autonomic modulation to mental tasks during nocturnal sleep deprivation.

Collecting Information About a CAM Practitioner’s Practice: A Preliminary Report of a Self-Interview Methodology

PubMed Central

Elder, William G.; Purdy, Hunter; Bentley, Andrew

2009-01-01

To prepare allopathic providers to advise patients about complementary and alternative medicine (CAM) therapies, the University of Kentucky CAM curriculum integration project has identified and trained CAM practitioners to coteach, precept, and demonstrate their respective practices. This project is interested in integrating CAM practitioners as teachers into this university and has formed a multidisciplinary committee for advice. The committee has recognized the importance of increased understanding of CAM practices to enhance communication within itself and to decide to which CAM practices students should receive exposure. This article reports our attempt to create a CAM practice description, based on questions general to CAM practice and specific to a particular approach. Because there is limited existing systematic research on CAM practice characteristics, these questions may interest researchers conducting qualitative studies, especially those seeking an example of questions to ask CAM practitioners. We also believe this practice description will be of general interest. PMID:19890441

Association of complementary and alternative medicine use with highly active antiretroviral therapy initiation.

PubMed

Merenstein, Daniel; Yang, Yang; Schneider, Michael F; Goparaju, Lakshmi; Weber, Kathleen; Sharma, Anjali; Levine, Alexandra M; Sharp, Gerald B; Gandhi, Monica; Liu, Chenglong

2008-01-01

To assess whether complementary and alternative medicine (CAM) use is associated with the timing of highly active antiretroviral therapy (HAART) initiation among human immunodeficiency virus (HIV)-infected participants of the Women's Interagency HIV Study. Prospective cohort study between January 1996 and March 2002. Differences in the cumulative incidence of HAART initiation were compared between CAM users and non-CAM users using a logrank test. Cox regression model was used to assess associations of CAM exposures with time to HAART initiation. MAIN OUTCOME AND EXPOSURES: Study outcome was time from January 1996 to initiation of HAART. Primary exposure was use of any CAM modality before January 1996, and secondary exposures included the number and type of CAM modalities used (ingestible CAM medication, body practice, or spiritual healing) during the same period. One thousand thirty-four HIV-infected women contributed a total of 4987 person-visits during follow-up. At any time point, the cumulative incidence of HAART initiation among CAM users was higher than that among non-CAM users. After adjustment for potential confounders, those reporting CAM use were 1.34 times (95% confidence interval: 1.09, 1.64) more likely to initiate HAART than non-CAM users. Female CAM users initiated HAART regimens earlier than non-CAM users. Initiation of HAART is an important clinical marker, but more research is needed to elucidate the role specific CAM modalities play in HIV disease progression.

Consequences of systematic model drift in DYNAMO MJO hindcasts with SP-CAM and CAM5

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

Hannah, Walter M.; Maloney, Eric D.; Pritchard, Michael S.

Hindcast simulations of MJO events during the dynamics of the MJO (DYNAMO) field campaign are conducted with two models, one with conventional parameterization (CAM5) and a comparable model that utilizes superparameterization (SP–CAM). SP–CAM is shown to produce a qualitatively better reproduction of the fluctuations of precipitation and low–level zonal wind associated with the first two DYNAMO MJO events compared to CAM5. Interestingly, skill metrics using the real–time multivariate MJO index (RMM) suggest the opposite conclusion that CAM5 has more skill than SP–CAM. This inconsistency can be explained by a systematic increase of RMM amplitude with lead time, which results frommore » a drift of the large–scale wind field in SP–CAM that projects strongly onto the RMM index. CAM5 hindcasts exhibit a contraction of the moisture distribution, in which extreme wet and dry conditions become less frequent with lead time. SP–CAM hindcasts better reproduce the observed moisture distribution, but also have stronger drift patterns of moisture budget terms, such as an increase in drying by meridional advection in SP–CAM. This advection tendency in SP–CAM appears to be associated with enhanced off–equatorial synoptic eddy activity with lead time. In conclusion, systematic drift moisture tendencies in SP–CAM are of similar magnitude to intraseasonal moisture tendencies, and therefore are important for understanding MJO prediction skill.« less

Complementary and conventional medicine: a concept map

PubMed Central

Baldwin, Carol M; Kroesen, Kendall; Trochim, William M; Bell, Iris R

2004-01-01

Background Despite the substantive literature from survey research that has accumulated on complementary and alternative medicine (CAM) in the United States and elsewhere, very little research has been done to assess conceptual domains that CAM and conventional providers would emphasize in CAM survey studies. The objective of this study is to describe and interpret the results of concept mapping with conventional and CAM practitioners from a variety of backgrounds on the topic of CAM. Methods Concept mapping, including free sorts, ratings, and multidimensional scaling was used to organize conceptual domains relevant to CAM into a visual "cluster map." The panel consisted of CAM providers, conventional providers, and university faculty, and was convened to help formulate conceptual domains to guide the development of a CAM survey for use with United States military veterans. Results Eight conceptual clusters were identified: 1) Self-assessment, Self-care, and Quality of Life; 2) Health Status, Health Behaviors; 3) Self-assessment of Health; 4) Practical/Economic/ Environmental Concerns; 5) Needs Assessment; 6) CAM vs. Conventional Medicine; 7) Knowledge of CAM; and 8) Experience with CAM. The clusters suggest panelists saw interactions between CAM and conventional medicine as a critical component of the current medical landscape. Conclusions Concept mapping provided insight into how CAM and conventional providers view the domain of health care, and was shown to be a useful tool in the formulation of CAM-related conceptual domains. PMID:15018623

Complementary alternative medicine for children with autism: a physician survey.

PubMed

Golnik, Allison E; Ireland, Marjorie

2009-07-01

Previous studies suggest over half of children with autism are using complementary alternative medicine (CAM). In this study, physicians responded (n = 539, 19% response rate) to a survey regarding CAM use in children with autism. Physicians encouraged multi-vitamins (49%), essential fatty acids (25%), melatonin (25%) and probiotics (19%) and discouraged withholding immunizations (76%), chelation (61%), anti-infectives (57%), delaying immunizations (55%) and secretin (43%). Physicians encouraging CAM were more likely to desire CAM training, inquire about CAM use, be female, be younger, and report greater autism visits, autism education and CAM knowledge. Physicians were more likely to desire CAM training, inquire about CAM and view CAM as a challenge for children with autism compared to children with other neurodevelopmental and chronic/complex conditions.

Combining Airborne and Lidar Measurements for Attribution of Aerosol Layers

NASA Astrophysics Data System (ADS)

Nikandrova, A.; Väänänen, R.; Tabakova, K.; Kerminen, V. M.; O'Connor, E.

2016-12-01

The aim of this work was to identify discrete aerosol layers and diagnose their origin, investigate the strength of mixing within the free-troposphere and with the boundary layer (BL), and understand the impact that mixing has on local and long-range transport of aerosol. For these purposes we combined airborne in-situ aerosol measurements with data obtained by a High Spectral Resolution Lidar (HSRL). The HSRL was deployed in Hyytiälä, Southern Finland, from January to September 2014 as a part of the US DoE ARM (Atmospheric Radiation Measurement) Mobile Facility during the BAECC (Biogenic Aerosols - Effects on Cloud and Climate) Campaign. Two airborne campaigns took place in April and August 2014 during the BAECC campaign. The vertical profile of backscatter coefficient from the HSRL was used to diagnose the location and depth of significant aerosol layers in the atmosphere. Frequently, in addition to the BL, one or two tropospheric layers were identified. In-situ measurements of the aerosol size distribution in these layers were obtained from a Scanning Mobility Particle Sizer (SMPS) and Optical Particle Sizer (OPS), that were installed on board the aircraft; these measurements were combined to cover sizes ranging from 10 nm to 10 µm. As expected, the highest number concentration of aerosol particles at all size ranges was found predominantly in the BL. Many upper layers had size distributions with a similar shape to that in the BL but with overall lower concentrations attributed to dilution of particles into a large volume of air. Hence, these layers were likely of very similar origin to the air in the BL and presumably were the result of lofted residual layers. Intervening layers however, could contain markedly different distribution shapes, which could be attributed to both different air mass origins, and different ambient relative humidity. Potential for mixing between two discreet elevated layers was often seen as a thin interface layer, which exhibited a combination of properties from both layers. Strong turbulent mixing ensured lower variability in the size distribution in the BL on short timescales, with more variability seen in the free troposphere. 96-hour back trajectories from multiple altitudes were used to diagnose the air mass origin of each discrete layer.

Abnormal placental development and early embryonic lethality in EpCAM-null mice.

PubMed

Nagao, Keisuke; Zhu, Jianjian; Heneghan, Mallorie B; Hanson, Jeffrey C; Morasso, Maria I; Tessarollo, Lino; Mackem, Susan; Udey, Mark C

2009-12-31

EpCAM (CD326) is encoded by the tacstd1 gene and expressed by a variety of normal and malignant epithelial cells and some leukocytes. Results of previous in vitro experiments suggested that EpCAM is an intercellular adhesion molecule. EpCAM has been extensively studied as a potential tumor marker and immunotherapy target, and more recent studies suggest that EpCAM expression may be characteristic of cancer stem cells. To gain insights into EpCAM function in vivo, we generated EpCAM -/- mice utilizing an embryonic stem cell line with a tacstd1 allele that had been disrupted. Gene trapping resulted in a protein comprised of the N-terminus of EpCAM encoded by 2 exons of the tacstd1 gene fused in frame to betageo. EpCAM +/- mice were viable and fertile and exhibited no obvious abnormalities. Examination of EpCAM +/- embryos revealed that betageo was expressed in several epithelial structures including developing ears (otocysts), eyes, branchial arches, gut, apical ectodermal ridges, lungs, pancreas, hair follicles and others. All EpCAM -/- mice died in utero by E12.5, and were small, developmentally delayed, and displayed prominent placental abnormalities. In developing placentas, EpCAM was expressed throughout the labyrinthine layer and by spongiotrophoblasts as well. Placentas of EpCAM -/- embryos were compact, with thin labyrinthine layers lacking prominent vascularity. Parietal trophoblast giant cells were also dramatically reduced in EpCAM -/- placentas. EpCAM was required for differentiation or survival of parietal trophoblast giant cells, normal development of the placental labyrinth and establishment of a competent maternal-fetal circulation. The findings in EpCAM-reporter mice suggest involvement of this molecule in development of vital organs including the gut, kidneys, pancreas, lungs, eyes, and limbs.

Use of complementary and alternative medicine (CAM) in autism spectrum disorder (ASD): comparison of Chinese and western culture (Part A).

PubMed

Wong, V C N

2009-03-01

A cross-sectional survey of the use of CAM by children was undertaken in the Duchess of Kent Children's Hospital in Hong Kong (March-December 2006). A questionnaire survey concerning the use of CAM was administered to chief caretakers (only the mothers) who accompanied children with neurodevelopmental disabilities followed up in our Neurodevelopmental paediatrics clinics. Four hundred and thirty agreed for interview of which 98 (22.8%) had Autism Spectrum Disorder (ASD). CAM was used in 40.8% for ASD and 21.4% of non-ASD (p < 0.001). We describe the profile of use of CAM in ASD in this part A paper. The three most common type of CAM use was Acupuncture (47.5%), Sensory Integration (42.5%), and Chinese Medicine (30%). About 76.9% of interviewees expected CAM to augment conventional treatment. Although 47.5% used both conventional western medicine and CAM, only 22.4% disclosed the use of CAM to Doctors. The following factors were significantly related to CAM use: father's job and mother's religion. Our frequency of CAM used in children with ASD was lower in Canada (52%) and USA (74%, 92%). The main CAM use in western culture was biological-based therapy whereas acupuncture was the most common CAM used in our locality.

Integrating CAM into nursing curricula: CAM camp as an educational intervention.

PubMed

Cornman, B Jane; Carr, Catherine A; Heitkemper, Margaret M

2006-05-01

In 2002, the University of Washington School of Nursing (SON) partnered with Bastyr University on a five-year plan to offer a four-week intensive "CAM Camp" (CAMp) for SON faculty members and medical students from across the country. The four-week educational program introduced attendees to various complementary and alternative medicine (CAM) modalities through didactic and experiential learning. To enhance complementary and alternative medicine content in a SON curriculum and to increase SON faculty knowledge and understanding about (1) the range of CAM therapies, (2) the theoretic and cultural backgrounds of these therapies, and (3) their potential contributions to the health of diverse populations. A descriptive pretest, posttest design was used to compare pre-CAMp CAM knowledge and CAM course content with post-CAMp knowledge levels of faculty and course CAM content. On post-CAMp surveys, familiarity with CAM modalities was rated with mixed results as compared with positive reports on the qualitative interviews. Interview results were more positive about CAM in general and were less specific about individual CAM topics. Statistically significant increases in competences were evident in each of 13 competencies rated with four competencies at P < .01. The number of required and elective courses containing CAM content increased as did the CAM content in continuing education conferences offered by the SON.

Valve actuator for internal combustion engine

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

Uchida, T.

1987-06-16

A valve actuating mechanism is described for an overhead valve and overhead cam type internal combustion engine in which the camshaft is positioned above and between the valve and a cam follower seat member in a cylinder head of the engine. The cam follower seat member is threadedly mounted in the cylinder head and has a semi-spherical recess facing upwardly. A cam follower has an adjustable bolt threadedly received in one end of the cam follower. The adjustable bolt has a spherical fulcrum engaging the semispherical recess of the seat member. The cam follower also has a downwardly facing meansmore » on the other end for engaging the valve and an upwardly facing slipper face for sliding engagement with a cam on the camshaft. The cam is adapted to rotate across the slipper face in the direction of the valve. The slipper face has a surface shape for engaging the cam at the start of valve-lifting movement of the cam follower at a point through which a line tangent to the slipper face is substantially parallel to a line through contact points between the cam follower. The seat member and valve for minimizing the lateral forces are imposed on the cam follower by the cam at the start of the valve-lifting movement.« less

Evaluation of complementary-alternative medicine (CAM) questionnaire development for Indonesian clinical psychologists: A pilot study.

PubMed

Liem, Andrian; Newcombe, Peter A; Pohlman, Annie

2017-08-01

This study aimed to evaluate questionnaire development to measure the knowledge of Complementary-Alternative Medicine (CAM), attitudes towards CAM, CAM experiences, and CAM educational needs of clinical psychologists in Indonesia. A 26-item questionnaire was developed through an extensive literature search. Data was obtained from provisional psychologists from the Master of Professional Clinical Psychology programs at two established public universities in urban areas of Indonesia. To validate the questionnaire, panel reviews by executive members of the Indonesian Clinical Psychology Association (ICPA), experts in health psychology, and experts in public health and CAM provided their professional judgements. The self-reporting questionnaire consisted of four scales including: knowledge of CAM (6 items), attitudes towards CAM (10 items), CAM experiences (4 items), and CAM educational needs (6 items). All scales, except CAM Experiences, were assessed on a 7-point Likert scale. Sixty provisional psychologists were eligible to complete the questionnaire with a response rate of 73% (N=44). The results showed that the CAM questionnaire was reliable (Cronbach's coefficient alpha range=0.62-0.96; item-total correlation range=0.14-0.92) and demonstrated content validity. Following further psychometric evaluation, the CAM questionnaire may provide the evidence-based information to inform the education and practice of Indonesian clinical psychologists. Copyright © 2017 Elsevier Ltd. All rights reserved.

Attitudes towards complementary and alternative medicine among medical and psychology students.

PubMed

Ditte, Darja; Schulz, Wolfgang; Ernst, Gundula; Schmid-Ott, Gerhard

2011-03-01

The use of complementary and alternative medicine (CAM) is increasing in Europe as well as in the USA, but CAM courses are infrequently integrated into medical curricula. In Europe, but also especially in the USA and in Canada, the attitudes of medical students and health science professionals in various disciplines towards CAM have been the subject of investigation. Most studies report positive attitudes. The main aim of this study was to compare the attitudes towards CAM of medical and psychology students in Germany. An additional set of questions concerned how CAM utilisation and emotional and physical condition affect CAM-related attitudes. Two hundred thirty-three medical students and 55 psychology students were questioned concerning their attitudes towards CAM using the Questionnaire on Attitudes Towards Complementary Medical Treatment (QACAM). Both medical students and psychology students were sceptical about the diagnostic and the therapeutic proficiency of doctors and practitioners of CAM. Students' attitudes towards CAM correlated neither with their experiences as CAM patients nor with their emotional and physical condition. It can be assumed that German medical and psychology students will be reluctant to use or recommend CAM in their professional careers. Further studies should examine more closely the correlation between attitudes towards CAM and the students' worldview as well as their existing knowledge of the effectiveness of CAM.

Fusion and Compatibility of Camphor and Octane Plasmids in Pseudomonas

PubMed Central

Chou, George I. N.; Katz, Dvorah; Gunsalus, I. C.

1974-01-01

The octane (OCT) plasmid in Pseudomonas putida derived from the ω-hydroxylase-carrying strain of Coon and coworkers is transferable to the camphor (CAM) plasmid-bearing strain by conjugation or by transduction. While the majority of the Cam +Oct+ exconjugants segregate Cam+ or Oct+ cells, exconjugants with stable Cam +Oct+ phenotype (CAM-OCT) can be detected at a low frequency. The transductants are all of the CAM-OCT phenotype. In the stable Cam +Oct+ strains, the OCT plasmid resembles the CAM plasmid with respect to curing by mitomycin C, transfer in conjugation, and reaction to ts (temperature-sensitive) mutation specifically affecting CAM plasmid replication. Therefore, it is suggested that certain regions of homology exist between the CAM and OCT plasmids that enable them to recombine to form a single plasmid, and to overcome the incompatibility barrier that prevents their coexisting. PMID:4527812

Concentration of clarithromycin and 14-R-hydroxy-clarithromycin in plasma of patients with Mycobacterium avium complex infection, before and after the addition of rifampicin.

PubMed

Yamamoto, F; Harada, S; Mitsuyama, T; Harada, Y; Kitahara, Y; Yoshida, M; Nakanishi, Y

2004-02-01

Clarithromycin (CAM) and rifampicin (RFP) have both been recognized to be effective antibiotic agents against Mycobacterium avium complex (MAC) infection. Rifamycin derivatives including RFP and rifabutin modulate the CAM metabolism by inducing the hepatic cytochrome p-450 3A4. To clarify the effect of RFP on the CAM metabolism, we measured the plasma concentration of CAM and 14-R-hydroxyclarithromycin (M-5), the major metabolite of CAM, in 9 patients suffering from MAC infection before and after the addition of RFP. After the addition of RFP, the mean plasma concentration of CAM significantly decreased, while that of M-5 did not. In addition, the amount of CAM + M-5 concentration also significantly decreased. As M-5 is less effective against MAC infection than CAM, more attention should thus be paid to the plasma CAM concentration in patients administered CAM and RFP concomitantly.

Personality Mechanisms of Alcohol-Related Violence.

ERIC Educational Resources Information Center

Holcomb, William R.; Adams, Nicholas A.

1985-01-01

Personality variables involved in alcohol-related violence were studied by comparing Minnesota Multiphasic Personality Inventory (MMPI) scores of four different groups (N=259). Results are given for violent versus nonviolent groups and intoxicated versus sober men who commit murder. (Author/BL)

Some Psychological Benefits of Gardening

ERIC Educational Resources Information Center

Kaplan, Rachel

1973-01-01

Psychological benefits derived from gardening, a leisure activity intimately involved with the natural environment, are examined. Three areas of benefits (tangible outcomes, primary gardening experiences, and sustained interest) were identified and related to the kind of garden, attitudinal, and role variables. (BL)

Heart rate variability and psychometric responses to overload and tapering in collegiate sprint-swimmers.

PubMed

Flatt, Andrew A; Hornikel, Bjoern; Esco, Michael R

2017-06-01

The purpose of this study was to evaluate cardiac-parasympathetic and psychometric responses to competition preparation in collegiate sprint-swimmers. Additionally, we aimed to determine the relationship between average vagal activity and its daily fluctuation during each training phase. Observational. Ten Division-1 collegiate sprint-swimmers performed heart rate variability recordings (i.e., log transformed root mean square of successive RR intervals, lnRMSSD) and completed a brief wellness questionnaire with a smartphone application daily after waking. Mean values for psychometrics and lnRMSSD (lnRMSSD mean ) as well as the coefficient of variation (lnRMSSD cv ) were calculated from 1 week of baseline (BL) followed by 2 weeks of overload (OL) and 2 weeks of tapering (TP) leading up to a championship competition. Competition preparation resulted in improved race times (p<0.01). Moderate decreases in lnRMSSD mean , and Large to Very Large increases in lnRMSSD cv , perceived fatigue and soreness were observed during the OL and returned to BL levels or peaked during TP (p<0.05). Inverse correlations between lnRMSSD mean and lnRMSSD cv were Very Large at BL and OL (p<0.05) but only Moderate at TP (p>0.05). OL training is associated with a reduction and greater daily fluctuation in vagal activity compared with BL, concurrent with decrements in perceived fatigue and muscle soreness. These effects are reversed during TP where these values returned to baseline or peaked leading into successful competition. The strong inverse relationship between average vagal activity and its daily fluctuation weakened during TP. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Incidence and time trends of childhood lymphomas: findings from 14 Southern and Eastern European cancer registries and the Surveillance, Epidemiology and End Results, USA.

PubMed

Georgakis, Marios K; Karalexi, Maria A; Agius, Domenic; Antunes, Luis; Bastos, Joana; Coza, Daniela; Demetriou, Anna; Dimitrova, Nadya; Eser, Sultan; Florea, Margareta; Ryzhov, Anton; Sekerija, Mario; Žagar, Tina; Zborovskaya, Anna; Zivkovic, Snezana; Bouka, Evdoxia; Kanavidis, Prodromos; Dana, Helen; Hatzipantelis, Emmanuel; Kourti, Maria; Moschovi, Maria; Polychronopoulou, Sophia; Stiakaki, Eftichia; Kantzanou, Μaria; Pourtsidis, Apostolos; Petridou, Eleni Th

2016-11-01

To describe epidemiologic patterns of childhood (0-14 years) lymphomas in the Southern and Eastern European (SEE) region in comparison with the Surveillance, Epidemiology and End Results (SEER), USA, and explore tentative discrepancies. Childhood lymphomas were retrieved from 14 SEE registries (n = 4,702) and SEER (n = 4,416), diagnosed during 1990-2014; incidence rates were estimated and time trends were evaluated. Overall age-adjusted incidence rate was higher in SEE (16.9/10 6 ) compared to SEER (13.6/10 6 ), because of a higher incidence of Hodgkin (HL, 7.5/10 6 vs. 5.1/10 6 ) and Burkitt lymphoma (BL, 3.1 vs. 2.3/10 6 ), whereas the incidence of non-Hodgkin lymphoma (NHL) was overall identical (5.9/10 6 vs. 5.8/10 6 ), albeit variable among SEE. Incidence increased with age, except for BL which peaked at 4 years; HL in SEE also showed an early male-specific peak at 4 years. The male preponderance was more pronounced for BL and attenuated with increasing age for HL. Increasing trends were noted in SEER for total lymphomas and NHL, and was marginal for HL, as contrasted to the decreasing HL and NHL trends generally observed in SEE registries, with the exception of increasing HL incidence in Portugal; of note, BL incidence trend followed a male-specific increasing trend in SEE. Registry-based data reveal variable patterns and time trends of childhood lymphomas in SEE and SEER during the last decades, possibly reflecting diverse levels of socioeconomic development of the populations in the respective areas; optimization of registration process may allow further exploration of molecular characteristics of disease subtypes.

SELECTION OF BURST-LIKE TRANSIENTS AND STOCHASTIC VARIABLES USING MULTI-BAND IMAGE DIFFERENCING IN THE PAN-STARRS1 MEDIUM-DEEP SURVEY

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

Kumar, S.; Gezari, S.; Heinis, S.

2015-03-20

We present a novel method for the light-curve characterization of Pan-STARRS1 Medium Deep Survey (PS1 MDS) extragalactic sources into stochastic variables (SVs) and burst-like (BL) transients, using multi-band image-differencing time-series data. We select detections in difference images associated with galaxy hosts using a star/galaxy catalog extracted from the deep PS1 MDS stacked images, and adopt a maximum a posteriori formulation to model their difference-flux time-series in four Pan-STARRS1 photometric bands g {sub P1}, r {sub P1}, i {sub P1}, and z {sub P1}. We use three deterministic light-curve models to fit BL transients; a Gaussian, a Gamma distribution, and anmore » analytic supernova (SN) model, and one stochastic light-curve model, the Ornstein-Uhlenbeck process, in order to fit variability that is characteristic of active galactic nuclei (AGNs). We assess the quality of fit of the models band-wise and source-wise, using their estimated leave-out-one cross-validation likelihoods and corrected Akaike information criteria. We then apply a K-means clustering algorithm on these statistics, to determine the source classification in each band. The final source classification is derived as a combination of the individual filter classifications, resulting in two measures of classification quality, from the averages across the photometric filters of (1) the classifications determined from the closest K-means cluster centers, and (2) the square distances from the clustering centers in the K-means clustering spaces. For a verification set of AGNs and SNe, we show that SV and BL occupy distinct regions in the plane constituted by these measures. We use our clustering method to characterize 4361 extragalactic image difference detected sources, in the first 2.5 yr of the PS1 MDS, into 1529 BL, and 2262 SV, with a purity of 95.00% for AGNs, and 90.97% for SN based on our verification sets. We combine our light-curve classifications with their nuclear or off-nuclear host galaxy offsets, to define a robust photometric sample of 1233 AGNs and 812 SNe. With these two samples, we characterize their variability and host galaxy properties, and identify simple photometric priors that would enable their real-time identification in future wide-field synoptic surveys.« less

The use of complementary and alternative medicine among people living with diabetes in Sydney.

PubMed

Manya, Kiran; Champion, Bernard; Dunning, Trisha

2012-01-12

Complementary and alternative medicine (CAM) is common in patients with chronic disease such as diabetes mellitus. The primary objective of the study was to determine the overall prevalence and type of CAM use in individuals with diabetes mellitus (DM) in Western Sydney and to compare the prevalence and factors associated with CAM use with the literature. A multicenter cross-sectional study was undertaken using a self-completed questionnaire distributed to patients with DM attending a public hospital and specialist endocrinology clinics in the region. The type of DM and pattern of CAM utilisation were analyzed. Sixty nine people responded to the questionnaire: age range of 18-75 years during a twelve week collection period. Overall, 32 respondents with diabetes were using some form of CAM, resulting in a utilisation rate of 46.3%. Twenty of the 32 CAM users used CAM specifically to treat their diabetes accounting for 28.9% of the respondent sample population. Multivitamins (40%), cinnamon, Co-enzyme q10 and prayer were the most frequently used CAM modalities. There was no significant difference between males and females, age range, income or diabetes complications between CAM and non-CAM users. (p values each > 0.05) The factor most significantly associated with CAM usage was being born overseas (p = 0.044). Almost half the respondents (46.3%) used CAM: 28% used CAM specifically to treat their diabetes. Individuals born overseas were significantly more likely to use CAM than those born in Australia. Other factors such as age, gender, wealth and duration of living with diabetes were not associated with higher rate of CAM usage.

Complementary and alternative medicine use in radiotherapy: what are patients using?

PubMed

Gillett, John; Ientile, Clare; Hiscock, Joanne; Plank, Ashley; Martin, Jarad M

2012-11-01

Complementary and alternative medicine (CAM) use by patients could interact in unpredictable ways with conventional therapies. This trial was designed to study the prevalence, types, and clinical implications of CAM use in patients with cancer who are receiving radiotherapy. A validated questionnaire was given to consenting outpatients in this ethics-approved study. Questions specified types of CAM used, clinician knowledge, reason for use, perceived effectiveness, safety, and cost. Of the 101 assessable questionnaires, 38 patients (38%) of the total patient group used CAM, with vitamins (53%), antioxidants (29%), spiritual/meditation practices (29%), and herbs (18%) being the most commonly used. The intention of CAM use was to improve quality of life in 69% of patients and for either hope of cure or to assist other forms of treatment in 26%. The majority of patients (58%) were using CAM prior to their diagnosis of cancer, with 40% starting at diagnosis or during conventional treatment. Patients spent up to $300/month on CAM use. Patients using CAM were significantly more likely to also receive chemotherapy versus non-CAM users (45% versus 24%, p=0.045). Significantly fewer CAM users expected cure from conventional therapy, compared to non-CAM users (50% versus 75%, p=0.016). More CAM users expected conventional therapy to prolong life (58% versus 32%, p<0.001). Only 40% discussed CAM use with their oncologists. CAM is commonly used by patients with cancer. CAMs, particularly antioxidants, are being taken which could negate the underlying free-radical tumorcidal effects of radiotherapy. Oncologists need to have greater awareness of this use and of its potential adverse consequences.

Calcium-Dependent Energetics of Calmodulin Domain Interactions with Regulatory Regions of the Ryanodine Receptor Type 1 (RyR1)

PubMed Central

Newman, Rhonda A.; Sorensen, Brenda R.; Kilpatrick, Adina M.; Shea, Madeline A.

2014-01-01

Calmodulin (CaM) plays a vital role in calcium homeostasis by allosterically modulating intracellular calcium channels including the homo-tetrameric human Ryanodine Receptor Type 1 (hRyR1). Apo (calcium-free) CaM activates hRyR1 while calcium-saturated CaM inhibits it. Two CaM-binding regions (residues 1975–1999 and 3614–3643) identified in each RyR1 monomer were proposed to allow CaM to bridge adjacent RyR1 subunits. We explored the distinct roles of CaM domains by using fluorescence anisotropy to determine the affinity of CaM1–148 (full-length), CaM1–80 (N-domain) and CaM76–148 (C-domain) for peptides encompassing hRyR1 residues 1975–1999 or 3614–3643. Both CaM1–148 and CaM76–148 associated in a calcium-independent manner with similar affinities for hRyR1(3614–3643)p while CaM1–80 required calcium and bound ~250-fold more weakly. Association of CaM1–148, CaM1–80 and CaM76–148 with hRyR1(1975–1999)p was much less favorable than with hRyR1(3614–3643)p; differences between the two CaM domains were smaller. Equilibrium calcium titrations monitored by steady-state fluorescence demonstrated that both hRyR1 peptides increased the calcium-binding affinity of both CaM domains. These thermodynamic properties support a prior model in which the CaM C-domain associates with RyR1(3614–3643) at low levels of calcium, positioning CaM to rapidly respond to calcium efflux. However, the affinity of the N-domain of CaM for hRyR1(1975–1999)p is insufficient to explain a model in which CaM bridges adjacent RyR1 subunits within the tetramer. This indicates that other protein factors or properties of the tertiary or quaternary structure of hRyR1 contribute to the energetics of CaM-mediated regulation. PMID:25145833

Use of Complementary and Alternative Medicine Among Dermatology Outpatients: Results From a National Survey.

PubMed

AlGhamdi, Khalid M; Khurrum, Huma; Al-Natour, Sahar H; Alghamdi, Waleed; Mubki, Thamer; Alzolibani, Abdulatif; Hafez, Dhafer Mohammed Y; AlDraibi, Mohammed

2015-01-01

Little is known about the prevalence and practice of complementary and alternative medicine (CAM) among dermatology patients in the Arab world. The aim of this study was to determine knowledge and attitudes about CAM, prevalence of its use, reasons for its use, and types of CAM used in dermatology patients in Saudi Arabia. This was a national survey of various regions of Saudi Arabia. In this cross-sectional study, dermatology outpatients were interviewed using a questionnaire. Sociodemographic characteristics, acceptability, utilization pattern, and reasons for CAM use were elicited. Dermatology life quality index (DLQI) was obtained. Overall, 1901 patients returned complete questionnaires out of 2500 distributed (76% response rate). Of these, 808 (40%) were CAM users, and the majority were woman (55.1%), with a mean age of 31.6±12 years. Most were literate (71.2%) and just over half were married (51.9%). Patients with acute skin diseases were found to be more likely to use CAM (P=.027). The mean DLQI score was higher (worse quality of life) among CAM users than among nonusers (P=.002). The results showed that 315 of 801 (40%) and 250 of 601 (30%) CAM users agreed that CAM methods are safer and more effective than modern medicine, respectively, and 83% will continue to use CAM in future. The most commonly used CAM modalities were vitamins, prayers, natural products, and herbs. Responses indicated that 379 of 803 (47.2%) CAM users did not consult their doctor before using CAM, and 219 of 743 (30%) did not obtain sufficient answers regarding CAM use from their dermatologists. There is a significant use of CAM among dermatology outpatients in Saudi Arabia. In view of the common belief that CAM has fewer side effects than conventional medicine, dermatologists need to increase their awareness of CAM. © The Author(s) 2015.

The Synaptic Cell Adhesion Molecule, SynCAM1, Mediates Astrocyte-to-Astrocyte and Astrocyte-to-GnRH Neuron Adhesiveness in the Mouse Hypothalamus

PubMed Central

Sandau, Ursula S.; Mungenast, Alison E.; McCarthy, Jack; Biederer, Thomas; Corfas, Gabriel

2011-01-01

We previously identified synaptic cell adhesion molecule 1 (SynCAM1) as a component of a genetic network involved in the hypothalamic control of female puberty. Although it is well established that SynCAM1 is a synaptic adhesion molecule, its contribution to hypothalamic function is unknown. Here we show that, in addition to the expected neuronal localization illustrated by its presence in GnRH neurons, SynCAM1 is expressed in hypothalamic astrocytes. Cell adhesion assays indicated that SynCAM is recognized by both GnRH neurons and astrocytes as an adhesive partner and promotes cell-cell adhesiveness via homophilic, extracellular domain-mediated interactions. Alternative splicing of the SynCAM1 primary mRNA transcript yields four mRNAs encoding membrane-spanning SynCAM1 isoforms. Variants 1 and 4 are predicted to be both N and O glycosylated. Hypothalamic astrocytes and GnRH-producing GT1-7 cells express mainly isoform 4 mRNA, and sequential N- and O-deglycosylation of proteins extracted from these cells yields progressively smaller SynCAM1 species, indicating that isoform 4 is the predominant SynCAM1 variant expressed in astrocytes and GT1-7 cells. Neither cell type expresses the products of two other SynCAM genes (SynCAM2 and SynCAM3), suggesting that SynCAM-mediated astrocyte-astrocyte and astrocyte-GnRH neuron adhesiveness is mostly mediated by SynCAM1 homophilic interactions. When erbB4 receptor function is disrupted in astrocytes, via transgenic expression of a dominant-negative erbB4 receptor form, SynCAM1-mediated adhesiveness is severely compromised. Conversely, SynCAM1 adhesive behavior is rapidly, but transiently, enhanced in astrocytes by ligand-dependent activation of erbB4 receptors, suggesting that erbB4-mediated events affecting SynCAM1 function contribute to regulate astrocyte adhesive communication. PMID:21486931

Features of complementary and alternative medicine use by patients with coronary artery disease in Beijing: a cross-sectional study

PubMed Central

2013-01-01

Background Complementary and alternative medicine (CAM) is commonly used in China for the management of coronary artery disease (CAD). However, few studies have been conducted to investigate the prevalence, perceived effectiveness, types, and reasons of CAM use in patients diagnosed with CAD. Methods A cross-sectional study design was adopted. Questionnaires were distributed at the outpatient cardiac clinics of four tertiary-level teaching general hospitals in Beijing. Quantitative data were analyzed using Student’s t-test. Categorical data were analyzed using chi-square test. Logistic regression was employed to explore factors associated with the use of CAM as well as CAM use features in Chinese medicine (CM) hospitals when significant differences were found upon comparisons. Results From May to July, 2009, a total of 600 questionnaires were distributed, and 546 patients with a diagnosis of CAD responded with valid values and were included in the present study. CAM was used by 69.1% of the patients with CAD; the majority (75.9%) of these CAM users believes that CAM is effective. “Few side effects” (49.6%) was the main reason of CAM use; whereas “doubt of effect” (61.5%) was the main reason for non-use. Patent herbal medicine (90.7%) was the most commonly used CAM type. Compared with non-CAM users, CAM users tended to be older (p < 0.01), have a longer disease duration (p = 0.02) and better current health status. In addition, CAM users had significant lower odds for emergency admission and hospitalization within the past one year. Patients with CAD from CM and WM hospitals differ in CAM use frequency, types, perceived effectiveness, as well as reasons for CAM use or non-CAM use. Conclusion The present study suggested a group of significant factors which could influence the use of CAM in patients with CAD. CAM use patterns differ in patients from CM and WM hospitals. PMID:24160843

The role of complementary and alternative medicine (CAM) in Germany - a focus group study of GPs.

PubMed

Joos, Stefanie; Musselmann, Berthold; Miksch, Antje; Rosemann, Thomas; Szecsenyi, Joachim

2008-06-12

There has been a marked increase in the use of complementary and alternative medicine (CAM) in recent years worldwide. In Germany, apart from 'Heilpraktiker' (= state-licensed, non-medical CAM practitioners), some general practitioners (GPs) provide CAM in their practices. This paper aims to explore the attitudes of GPs about the role of CAM in Germany, in relation to the healthcare system, quality of care, medical education and research. Furthermore, experiences of GPs integrating CAM in their daily practice were explored. Using a qualitative methodological approach 3 focus groups with a convenience sample of 17 GPs were conducted. The discussions were transcribed verbatim and analysed using qualitative content analysis. The majority of the participating GPs had integrated one or more CAM therapies into their every-day practice. Four key themes were identified based on the topics covered in the focus groups: the role of CAM within the German healthcare system, quality of care, education and research. Within the theme 'role of CAM within the healthcare system' there were five categories: integration of CAM, CAM in the Statutory Health Insurance, modernisation of the Statutory Health Insurance Act, individual healthcare services and 'Heilpraktiker'. Regarding quality of care there were two broad groups of GPs: those who thought patients would benefit from standardizing CAM and those who feared that quality control would interfere with the individual approach of CAM. The main issues identified relating to research and education were the need for the development of alternative research strategies and the low quality of existing CAM education respectively. The majority of the participating GPs considered CAM as a reasonable complementary approach within primary care. The study increased our understanding of GPs attitudes about the role of CAM within the German healthcare system and the use of 'Heilpraktiker' as a competing CAM-provider. It seems to be a need for increased funding for research, better education and remuneration by the Statutory Health Insurance in order to improve access to 'Integrative medicine' in Germany.

Inflammatory bowel disease professionals’ attitudes to and experiences of complementary and alternative medicine

PubMed Central

2013-01-01

Background Complementary and alternative medicine (CAM) use in patients with IBD is on the increase. Patients report they use CAM when their condition is unresponsive to conventional medication or when they suffer from side-effects, negative stress and disease-related concerns. CAM use may improve patients’ well-being but it can also lead to side-effects and interactions with conventional medications. Research on attitudes to and experiences of CAM among healthcare professionals working with IBD patients is not well studied. Studies in this area could lead to enhanced awareness of and improved communication about CAM between care staff and IBD patients. The aim of this study was to explore IBD professionals’ attitudes to and experience of CAM. Methods Sixteen physicians and nurses, 26–70 years old, who had worked with IBD patients for 1–42 years, were recruited. Semi-structured qualitative interviews were conducted. Qualitative content analysis was performed. Results Participants stated patients used CAM to improve their well-being generally and there conditions specifically. Participants had a positive attitude towards CAM and respected their patients’ decision to use it, but reported a lack of CAM knowledge. They required education about CAM to be able to meet patients’ needs and provide adequate information. The result of this study indicates that there is a need for CAM education to be implemented in nursing and medical school. Conclusions All participants had experience of IBD patients who had used CAM in an attempt to achieve improvement and well-being. Attitudes to CAM were mainly positive, although a problematic aspect was lack of knowledge and evidence in relation to CAM. Implementing CAM education in nursing and medical school will allow healthcare professionals to gain an understanding of therapies widely used by patients with IBD. In clinical practice, using a standard questionnaire regarding CAM use allow healthcare professionals to better understand their patients’ wishes and current CAM use. PMID:24325595

OPTICAL SPECTROSCOPY OF SDSS J004054.65-0915268: THREE POSSIBLE SCENARIOS FOR THE CLASSIFICATION. A z ∼ 5 BL LACERTAE, A BLUE FSRQ, OR A WEAK EMISSION LINE QUASAR

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

Landoni, M.; Zanutta, A.; Bianco, A.

2016-02-15

The haunt of high-redshift BL Lacerate objects is day by day more compelling to firmly understand their intrinsic nature and evolution. SDSS J004054.65-0915268 is, at the moment, one of the most distant BL Lac candidates, at z ∼ 5. We present a new optical-near-IR spectrum obtained with ALFOSC-NOT with a new, custom designed dispersive grating aimed to detect broad emission lines that could disprove this classification. In the obtained spectra, we do not detect any emission features and we provide an upper limit to the luminosity of the C iv broad emission line. Therefore, the nature of the object is then discussed,more » building the overall spectral energy distribution (SED) and fitting it with three different models. Our fits, based on SED modeling with different possible scenarios, cannot rule out the possibility that this source is indeed a BL Lac object, though the absence of optical variability and the lack of strong radio flux seem to suggest that the observed optical emission originates from a thermalized accretion disk.« less

Optical Spectroscopy of SDSS J004054.65-0915268: Three Possible Scenarios for the Classification. A z ˜ 5 BL Lacertae, a Blue FSRQ, or a Weak Emission Line Quasar

NASA Astrophysics Data System (ADS)

Landoni, M.; Zanutta, A.; Bianco, A.; Tavecchio, F.; Bonnoli, G.; Ghisellini, G.

2016-02-01

The haunt of high-redshift BL Lacerate objects is day by day more compelling to firmly understand their intrinsic nature and evolution. SDSS J004054.65-0915268 is, at the moment, one of the most distant BL Lac candidates, at z ˜ 5. We present a new optical-near-IR spectrum obtained with ALFOSC-NOT with a new, custom designed dispersive grating aimed to detect broad emission lines that could disprove this classification. In the obtained spectra, we do not detect any emission features and we provide an upper limit to the luminosity of the C IV broad emission line. Therefore, the nature of the object is then discussed, building the overall spectral energy distribution (SED) and fitting it with three different models. Our fits, based on SED modeling with different possible scenarios, cannot rule out the possibility that this source is indeed a BL Lac object, though the absence of optical variability and the lack of strong radio flux seem to suggest that the observed optical emission originates from a thermalized accretion disk.

Taiwanese adult cancer patients' reports of using complementary therapies.

PubMed

Lu, Jui-Hua; Tsay, Shiow-Luan; Sung, Su-Ching

2010-01-01

More information is needed by cancer clinicians regarding cancer patients' use of complementary and alternative medicine (CAM). In this qualitative study, in-depth interviews were used to obtain the reports of adult cancer patients regarding their use of CAM. Seven cancer patients (4 women, 3 men) who reported using CAM were recruited by snowball sampling. Content analysis was used to examine the interview transcriptions. Five themes and multiple categories were identified related to CAM use: (1) facing the challenges of cancer (I can't be defeated, need to cooperate with conventional medical treatment, rebuilding my confidence), (2) handling the physical and psychological distress of CAM use (extra loading due to the therapy, uncertainty and fear about the efficacy of CAM, being understood and supported, feeling guilty about being sick, (3) lifestyle disruption (altering social life, changing family living style), (4) having reasons for seeking other therapies (finding a way to cure the disease, boosting my immunity, improving my overall health status, and prolonging life and searching for peace of mind), and (5) unresolved practical concerns about CAM (finding an easy and effective way to practice CAM, needing CAM to be integrated into mainstream health care, and where to get the related information). Adult Taiwanese cancer patients who use CAM do experience burdens secondary to CAM use and prefer that oncology specialists be more informed about CAM. Oncology specialists who know where adult cancer patients could obtain helpful information about CAM would help to decrease the burdens that patients who use CAM experience.

ASSOCIATION OF COMPLEMENTARY AND ALTERNATIVE MEDICINE USE WITH HIGHLY ACTIVE ANTIRETROVIRAL THERAPY INITIATION

PubMed Central

Merenstein, Daniel; Yang, Yang; Schneider, Michael F.; Goparaju, Lakshmi; Weber, Kathleen; Sharma, Anjali; Levine, Alexandra M.; Sharp, Gerald B.; Gandhi, Monica; Liu, Chenglong

2009-01-01

Objective To assess whether complementary and alternative medicine (CAM) use is associated with the timing of highly active antiretroviral therapy (HAART) initiation among human immunodeficiency virus (HIV)–infected participants of the Women’s Interagency HIV Study. Study Methods Prospective cohort study between January 1996 and March 2002. Differences in the cumulative incidence of HAART initiation were compared between CAM users and non–CAM users using a logrank test. Cox regression model was used to assess associations of CAM exposures with time to HAART initiation. Main Outcome and Exposures Study outcome was time from January 1996 to initiation of HAART. Primary exposure was use of any CAM modality before January 1996, and secondary exposures included the number and type of CAM modalities used (ingestible CAM medication, body practice, or spiritual healing) during the same period. Results One thousand thirty-four HIV-infected women contributed a total of 4987 person-visits during follow-up. At any time point, the cumulative incidence of HAART initiation among CAM users was higher than that among non–CAM users. After adjustment for potential confounders, those reporting CAM use were 1.34 times (95% confidence interval: 1.09, 1.64) more likely to initiate HAART than non–CAM users. Conclusion Female CAM users initiated HAART regimens earlier than non–CAM users. Initiation of HAART is an important clinical marker, but more research is needed to elucidate the role specific CAM modalities play in HIV disease progression. PMID:18780580

Optical Aptamer Probes of Fluorescent Imaging to Rapid Monitoring of Circulating Tumor Cell

PubMed Central

Hwang, Ji Yeon; Kim, Sang Tae; Han, Ho-Seong; Kim, Kyunggon; Han, Jin Soo

2016-01-01

Fluorescence detecting of exogenous EpCAM (epithelial cell adhesion molecule) or muc1 (mucin1) expression correlated to cancer metastasis using nanoparticles provides pivotal information on CTC (circulating tumor cell) occurrence in a noninvasive tool. In this study, we study a new skill to detect extracellular EpCAM/muc1 using quantum dot-based aptamer beacon (QD-EpCAM/muc1 ALB (aptamer linker beacon). The QD-EpCAM/muc1 ALB was designed using QDs (quantum dots) and probe. The EpCAM/muc1-targeting aptamer contains a Ep-CAM/muc1 binding sequence and BHQ1 (black hole quencher 1) or BHQ2 (black hole quencher2). In the absence of target EpCAM/muc1, the QD-EpCAM/muc1 ALB forms a partial duplex loop-like aptamer beacon and remained in quenched state because the BHQ1/2 quenches the fluorescence signal-on of the QD-EpCAM/muc1 ALB. The binding of EpCAM/muc1 of CTC to the EpCAM/muc1 binding aptamer sequence of the EpCAM/muc1-targeting oligonucleotide triggered the dissociation of the BHQ1/2 quencher and subsequent signal-on of a green/red fluorescence signal. Furthermore, acute inflammation was stimulated by trigger such as caerulein in vivo, which resulted in increased fluorescent signal of the cy5.5-EpCAM/muc1 ALB during cancer metastasis due to exogenous expression of EpCAM/muc1 in Panc02-implanted mouse model. PMID:27886058

Attitudes Toward Combining Psychological, Mind-Body Therapies and Nutritional Approaches for the Enhancement of Mood.

PubMed

Lores, Taryn Jade; Henke, Miriam; Chur-Hansen, Anna

2016-01-01

Context • Interest has been rising in the use of complementary and alternative medicine (CAM) for the promotion of health and treatment of disease. To date, the majority of CAM research has focused on exploring the demographic characteristics, attitudes, and motivations of CAM users and on the efficacy of different therapies and products. Less is known with respect to the psychological characteristics of people who use CAM. Previous research has not investigated the usefulness of integrating mind-body therapies with natural products in a combined mood intervention. Objective • The study intended to investigate attitudes toward a proposed new approach to the treatment of mood, one that integrates psychological mind-body therapies and natural nutritional products. Design • Participants completed an online survey covering demographics, personality traits, locus of control, use of CAM, attitudes toward the proposed psychonutritional approach, and mood. Setting • This study was conducted at the University of Adelaide School of Psychology (Adelaide, SA, Australia). Participants • Participants were 333 members of the Australian general public, who were recruited online via the social-media platform Facebook. The majority were women (83.2%), aged between 18 and 81 y. Outcome Measures • Measures included the Multidimensional Health Locus of Control Scale Form B, the Ten-Item Personality Inventory, and the Depression, Anxiety and Stress Scale. Results • Participants were positive about the proposed approach and were likely to try it to enhance their moods. The likeliness of use of the combined approach was significantly higher in the female participants and was associated with higher levels of the personality trait openness and an internal health locus of control, after controlling for all other variables. Conclusions • Interest exists for an intervention for mood that incorporates both psychological and nutritional approaches. Further research into the development of targeted treatment programs for mood is warranted.

What should students learn about complementary and alternative medicine?

PubMed

Gaster, Barak; Unterborn, John N; Scott, Richard B; Schneeweiss, Ronald

2007-10-01

With thousands of complementary and alternative medicine (CAM) treatments currently being used in the United States today, it is challenging to design a concise body of CAM content which will fit into already overly full curricula for health care students. The purpose of this article is to outline key principles which 15 National Center for Complementary and Alternative Medicine-funded education programs found useful when developing CAM course-work and selecting CAM content. Three key guiding principles are discussed: teach foundational CAM competencies to give students a framework for learning about CAM; choose specific content on the basis of evidence, demographics and condition (what conditions are most appropriate for CAM therapies?); and finally, provide students with skills for future learning, including where to find reliable information about CAM and how to search the scientific literature and assess the results of CAM research. Most of the programs developed evidence-based guides to help students find reliable CAM resources. The cumulative experiences of the 15 programs have been compiled, and an annotated table outlining the most highly recommended resources about CAM is presented.

Complementary and alternative health care in Israel

PubMed Central

2012-01-01

The paper explores the patterns of coexistence of alternative/complementary health care (CAM) and conventional medicine in Israel in the cultural, political, and social contexts of the society. The data are drawn from over ten years of sociological research on CAM in Israel, which included observation, survey research, and over one hundred in-depth interviews with a variety of CAM practitioners - many with bio-medical credentials - and with policy makers in the major medical institutions. The analysis considers the reasons for CAM use, number of practitioners, the frequency of CAM use and some of its correlates, and how CAM is regulated. The structure of the relationship between the conventional health care system and CAM is discussed in the public sector, which provides two-thirds of CAM services, and in the private sector, which provides about one-third. The history of the development of these structures and some of the dilemmas of their operation are discussed. A number of policy issues are considered against this background: regulation and licensing, CAM in primary care, reimbursement for CAM treatment, and the inclusion of CAM in education and training for the health professions. PMID:22913721

Is prayer CAM?

PubMed

Tippens, Kim; Marsman, Kevin; Zwickey, Heather

2009-04-01

Alternative medicine researchers and policy makers have classified prayer as a mind-body intervention, and thus, a modality of complementary and alternative medicine (CAM). As such, numerous epidemiological surveys of CAM utilization-which have included prayer-depict increasing CAM use, particularly in specific racial and ethnic groups. This paper discusses the implications of conflating prayer and CAM, especially regarding the definitions of both concepts and the resulting statistics of CAM utilization.

Prevalence and determinants of complementary and alternative medicine use among infertile patients in Lebanon: a cross sectional study

PubMed Central

2012-01-01

Background Complementary and alternative medicine (CAM) is widely used for the treatment of infertility. While the Middle East and North Africa region has been shown to house one of the fastest growing markets of CAM products in the world, research describing the use of CAM therapies among Middle-Eastern infertile patients is minimal. The aim of this study is to examine the prevalence, characteristics and determinants of CAM use among infertile patients in Lebanon. Methods A cross sectional survey design was used to carry out face-to-face interviews with 213 consecutive patients attending the Assisted Reproductive Unit at a major academic medical center in Beirut. The questionnaire comprised three sections: socio-demographic and lifestyle characteristics, infertility-related aspects and information on CAM use. The main outcome measure was the use of CAM modalities for infertility treatment. Determinants of CAM use were assessed through the logistic regression method. Results Overall, 41% of interviewed patients reported using a CAM modality at least once for their infertility. There was a differential by gender in the most commonly used CAM therapies; where males mostly used functional foods (e.g. honey & nuts) (82.9%) while females mostly relied on spiritual healing/prayer (56.5%). Factors associated with CAM use were higher household income (OR: 0.305, 95% CI: 0.132–0.703) and sex, with females using less CAM than males (OR: 0.12, 95% CI: 0.051–0.278). The older patients were diagnosed with infertility, the lower the odds of CAM use (p for trend <0.05). Almost half of the participants (48%) were advised on CAM use by their friends, and only 13% reported CAM use to their physician. Conclusions The considerably high use of CAM modalities among Lebanese infertile patients, added to a poor CAM use disclosure to physicians, underscore the need to integrate CAM into the education and training of health professionals, as well as enhance infertile patients' awareness on safe use of CAM products. PMID:22901284

Complementary and alternative medicine use by visitors to rural Japanese family medicine clinics: results from the international complementary and alternative medicine survey.

PubMed

Shumer, Gregory; Warber, Sara; Motohara, Satoko; Yajima, Ayaka; Plegue, Melissa; Bialko, Matthew; Iida, Tomoko; Sano, Kiyoshi; Amenomori, Masaki; Tsuda, Tsukasa; Fetters, Michael D

2014-09-25

There is growing interest in the use of complementary and alternative medicine (CAM) throughout the world, however previous research done in Japan has focused primarily on CAM use in major cities. The purpose of this study was to develop and distribute a Japanese version of the International Complementary and Alternative Medicine Questionnaire (I-CAM-Q) to assess the use of CAM among people who visit rural Japanese family medicine clinics. Using a Japanese version of the International Complementary and Alternative Medicine Questionnaire (I-CAM-Q), a cross-sectional survey was conducted in three rural family medicine clinics. All patients and those accompanying patients who met inclusion criteria were eligible to participate. Data were entered into SPSS Statistics and analyzed for use by age, gender, and location. Of the 519 respondents who participated in the project, 415 participants reported CAM use in the past 12 months (80.0%). When prayer is excluded, the prevalence of CAM use drops to 77.3% in the past year, or 403 respondents. The most common forms of CAM used by respondents were pain relief pads (n = 170, 32.8%), herbal medicines/supplements (n = 167, 32.2%), and massage by self or family (n = 166, 32.0%). Female respondents, individuals with higher levels of education, and those with poorer overall health status were more likely to use CAM than respondents without these characteristics. Only 22.8% of CAM therapies used were reported to physicians by survey participants. These data indicate that CAM use in rural Japan is common. The results are consistent with previous studies that show that Japanese individuals are more interested in forms of CAM such as pain relief pads and massage, than in mind-body forms of CAM like relaxation and meditation. Due to the high utilization of certain CAM practices, and given that most CAM users do not disclose their CAM use to their doctors, we conclude that physicians in rural Japan would benefit by asking about CAM use during patient interviews, and by familiarizing themselves with the potential benefits and risks of commonly used CAM modalities.

A roadmap for research on crassulacean acid metabolism (CAM) to enhance sustainable food and bioenergy production in a hotter, drier world.

PubMed

Yang, Xiaohan; Cushman, John C; Borland, Anne M; Edwards, Erika J; Wullschleger, Stan D; Tuskan, Gerald A; Owen, Nick A; Griffiths, Howard; Smith, J Andrew C; De Paoli, Henrique C; Weston, David J; Cottingham, Robert; Hartwell, James; Davis, Sarah C; Silvera, Katia; Ming, Ray; Schlauch, Karen; Abraham, Paul; Stewart, J Ryan; Guo, Hao-Bo; Albion, Rebecca; Ha, Jungmin; Lim, Sung Don; Wone, Bernard W M; Yim, Won Cheol; Garcia, Travis; Mayer, Jesse A; Petereit, Juli; Nair, Sujithkumar S; Casey, Erin; Hettich, Robert L; Ceusters, Johan; Ranjan, Priya; Palla, Kaitlin J; Yin, Hengfu; Reyes-García, Casandra; Andrade, José Luis; Freschi, Luciano; Beltrán, Juan D; Dever, Louisa V; Boxall, Susanna F; Waller, Jade; Davies, Jack; Bupphada, Phaitun; Kadu, Nirja; Winter, Klaus; Sage, Rowan F; Aguilar, Cristobal N; Schmutz, Jeremy; Jenkins, Jerry; Holtum, Joseph A M

2015-08-01

Crassulacean acid metabolism (CAM) is a specialized mode of photosynthesis that features nocturnal CO2 uptake, facilitates increased water-use efficiency (WUE), and enables CAM plants to inhabit water-limited environments such as semi-arid deserts or seasonally dry forests. Human population growth and global climate change now present challenges for agricultural production systems to increase food, feed, forage, fiber, and fuel production. One approach to meet these challenges is to increase reliance on CAM crops, such as Agave and Opuntia, for biomass production on semi-arid, abandoned, marginal, or degraded agricultural lands. Major research efforts are now underway to assess the productivity of CAM crop species and to harness the WUE of CAM by engineering this pathway into existing food, feed, and bioenergy crops. An improved understanding of CAM has potential for high returns on research investment. To exploit the potential of CAM crops and CAM bioengineering, it will be necessary to elucidate the evolution, genomic features, and regulatory mechanisms of CAM. Field trials and predictive models will be required to assess the productivity of CAM crops, while new synthetic biology approaches need to be developed for CAM engineering. Infrastructure will be needed for CAM model systems, field trials, mutant collections, and data management. © 2015 ORNL/UT-Battelle New Phytologist © 2015 New Phytologist Trust.

Socioeconomic Factors and Women's Use of Complementary and Alternative Medicine in Four Racial/Ethnic Groups

PubMed Central

Chao, Maria T.; Wade, Christine M.

2014-01-01

Objective Higher socioeconomic status (SES) is associated with using complementary and alternative medicine (CAM) in national surveys. Less is known about how socioeconomic factors affect CAM use in US subpopulations. We examined whether the relationship between SES and CAM use differs by racial/ethnic groups. Methods Using national survey data, we assessed education and income effects on women's CAM use in four racial/ethnic groups (Whites, Blacks, Mexican Americans, and Chinese Americans), controlling for age, health status, and geographic region. CAM use was defined as using any of 11 domains in the prior year. Results Adjusted effects of SES on CAM use were similar among Mexican American and non-Hispanic White women—education had a distinct gradient effect, with each increasing level of education significantly more likely to use CAM; household income ≥$60,000 was associated with CAM use compared to income <$20,000. For Chinese American women, socioeconomic factors were not associated with CAM use when controlling for confounders. Although income was not associated with CAM use among African American women, college graduates were three times more likely to use CAM than those with less than a high school education, adjusting for confounders. Conclusion SES effects on CAM use are not uniform across racial/ethnic populations. Other factors, such as culture and social networks, may interact with SES to influence CAM use in minority populations. PMID:18447102

Oncologists' experiences of discussing complementary and alternative treatment options with their cancer patients. A qualitative analysis.

PubMed

Corina, Güthlin; Christine, Holmberg; Klein, Gudrun

2016-09-01

The rising use of complementary and alternative medicine (CAM) means oncologists are increasingly asked by patients to discuss CAM treatment options. However, no formal training or established standards are available on the subject. The aim of this paper was to investigate real-world discussions of CAM treatments. In particular, we wanted to learn about the values, norms and defining features that characterise oncologist-patient discussions on CAM. Semi-standardised interviews with 17 oncologists were analysed using interpretation pattern analysis combined with thematic analysis. Advice on CAM is seen by oncologists as an important service they provide to their patients, even though their knowledge of the subject is often limited. Many interviewees mentioned an apparent lack of scientific proof, especially when their aim was to warn patients against the use of CAM. Discussions on CAM tend to reflect the idea that CAM belongs 'to another world', and judging by the interviews with oncologists, this notion appears to be shared by patients and oncologists alike. Oncologists require reliable information on CAM and would profit from training in the communication of CAM treatment options to patients. Knowing scientific data on CAM would also lower barriers stemming from the view that CAM belongs 'to another world'. Under- and postgraduate education programmes should include training on how to respond to requests addressing possible CAM options.

Inter-annual Tropospheric Aerosol Variability in Late Twentieth Century and its Impact on Tropical Atlantic and West African Climate by Direct and Semi-direct Effects

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

Evans, Katherine J; Hack, James J; Truesdale, John

A new high-resolution (0.9more » $$^{\\circ}$$x1.25$$^{\\circ}$$ in the horizontal) global tropospheric aerosol dataset with monthly resolution is generated using the finite-volume configuration of Community Atmosphere Model (CAM4) coupled to a bulk aerosol model and forced with recent estimates of surface emissions for the latter part of twentieth century. The surface emissions dataset is constructed from Coupled Model Inter-comparison Project (CMIP5) decadal-resolution surface emissions dataset to include REanalysis of TROpospheric chemical composition (RETRO) wildfire monthly emissions dataset. Experiments forced with the new tropospheric aerosol dataset and conducted using the spectral configuration of CAM4 with a T85 truncation (1.4$$^{\\circ}$$x1.4$$^{\\circ}$$) with prescribed twentieth century observed sea surface temperature, sea-ice and greenhouse gases reveal that variations in tropospheric aerosol levels can induce significant regional climate variability on the inter-annual timescales. Regression analyses over tropical Atlantic and Africa reveal that increasing dust aerosols can cool the North African landmass and shift convection southwards from West Africa into the Gulf of Guinea in the spring season in the simulations. Further, we find that increasing carbonaceous aerosols emanating from the southwestern African savannas can cool the region significantly and increase the marine stratocumulus cloud cover over the southeast tropical Atlantic ocean by aerosol-induced diabatic heating of the free troposphere above the low clouds. Experiments conducted with CAM4 coupled to a slab ocean model suggest that present day aerosols can shift the ITCZ southwards over the tropical Atlantic and can reduce the ocean mixed layer temperature beneath the increased marine stratocumulus clouds in the southeastern tropical Atlantic.« less

The impact of EpCAM expression on response to chemotherapy and clinical outcomes in patients with epithelial ovarian cancer.

PubMed

Tayama, Shingo; Motohara, Takeshi; Narantuya, Dashdemberel; Li, Chenyan; Fujimoto, Koichi; Sakaguchi, Isao; Tashiro, Hironori; Saya, Hideyuki; Nagano, Osamu; Katabuchi, Hidetaka

2017-07-04

Epithelial ovarian cancer is a highly lethal malignancy; moreover, overcoming chemoresistance is the major challenging in treating ovarian cancer patients. The cancer stem cell (CSC) hypothesis considers CSCs to be the main culprits in driving tumor initiation, metastasis, and resistance to conventional therapy. Although growing evidence suggest that CSCs are responsible for chemoresistance, the contribution of CSC marker EpCAM to resistance to chemotherapy remains unresolved.Here we have demonstrated that ovarian cancers containing high levels of EpCAM have a significantly much lower probability of achieving overall responsive rates after first-line chemotherapy. In addition, multivariate analysis revealed that EpCAM expression is an independent risk factor for chemoresistance, indicating that EpCAM expression is a predictive biomarker of chemotherapeutic response. Consistent with these clinical observations, in vitro assays, we found that the subpopulation of EpCAM-positive ovarian cancer cells shows a significantly higher viability compared with EpCAM-negative cells in response to cisplatin treatment by preventing chemotherapy-induced apoptosis, which is regulated by EpCAM-Bcl-2 axis. Furthermore, in an in vivo mouse model, platinum agents preferentially eliminated EpCAM-negative cells in comparison with EpCAM-positive cells, suggesting that the remaining subpopulation of EpCAM-positive cells contributes to tumor recurrence after chemotherapy. Finally, we also found that an increased expression of EpCAM is associated with poor prognosis in ovarian cancer patients.Our findings highlight the clinical significance of EpCAM in the resistance to chemotherapy and provide a rationale for EpCAM-targeted therapy to improve chemoresistance. Targeting EpCAM should be a promising approach to effectively extirpate the CSCs as the putative root of ovarian cancer.

Different CAD/CAM-processing routes for zirconia restorations: influence on fitting accuracy.

PubMed

Kohorst, Philipp; Junghanns, Janet; Dittmer, Marc P; Borchers, Lothar; Stiesch, Meike

2011-08-01

The aim of the present in vitro study was to evaluate the influence of different processing routes on the fitting accuracy of four-unit zirconia fixed dental prostheses (FDPs) fabricated by computer-aided design/computer-aided manufacturing (CAD/CAM). Three groups of zirconia frameworks with ten specimens each were fabricated. Frameworks of one group (CerconCAM) were produced by means of a laboratory CAM-only system. The other frameworks were made with different CAD/CAM systems; on the one hand by in-laboratory production (CerconCAD/CAM) and on the other hand by centralized production in a milling center (Compartis) after forwarding geometrical data. Frameworks were then veneered with the recommended ceramics, and marginal accuracy was determined using a replica technique. Horizontal marginal discrepancy, vertical marginal discrepancy, absolute marginal discrepancy, and marginal gap were evaluated. Statistical analyses were performed by one-way analysis of variance (ANOVA), with the level of significance chosen at 0.05. Mean horizontal discrepancies ranged between 22 μm (CerconCAM) and 58 μm (Compartis), vertical discrepancies ranged between 63 μm (CerconCAD/CAM) and 162 μm (CerconCAM), and absolute marginal discrepancies ranged between 94 μm (CerconCAD/CAM) and 181 μm (CerconCAM). The marginal gap varied between 72 μm (CerconCAD/CAM) and 112 μm (CerconCAM, Compartis). Statistical analysis revealed that, with all measurements, the marginal accuracy of the zirconia FDPs was significantly influenced by the processing route used (p < 0.05). Within the limitations of this study, all restorations showed a clinically acceptable marginal accuracy; however, the results suggest that the CAD/CAM systems are more precise than the CAM-only system for the manufacture of four-unit FDPs.

Attitudes, Knowledge, Use, and Recommendation of Complementary and Alternative Medicine by Health Professionals in Western Mexico.

PubMed

Brambila-Tapia, Aniel Jessica Leticia; Rios-Gonzalez, Blanca Estela; Lopez-Barragan, Liliana; Saldaña-Cruz, Ana Miriam; Rodriguez-Vazquez, Katya

2016-01-01

The use of complementary and alternative medicine (CAM) has increased in many countries, and this has altered the knowledge, attitudes, and treatment recommendations of health professionals in regard to CAM. Considering Mexican health professionals׳ lack of knowledge of CAM, in this report we surveyed 100 biomedical researchers and Ph.D. students and 107 specialized physicians and residents of a medical specialty in Guadalajara, México (Western Mexico) with a questionnaire to address their attitudes, knowledge, use, and recommendation of CAM. We observed that significantly more researchers had ever used CAM than physicians (83% vs. 69.2%, P = .023) and that only 36.4% of physicians had ever recommended CAM. Female researchers tended to have ever used CAM more than male researchers, but CAM use did not differ between genders in the physician group or by age in either group. Homeopathy, herbal medicine, and massage therapy were the most commonly used CAMs in both the groups. Physicians more frequently recommended homeopathy, massage therapy, and yoga to their patients than other forms of CAM, and physicians had the highest perception of safety and had taken the most courses in homeopathy. All CAMs were perceived to have high efficacy (>60%) in both the groups. The attitude questionnaire reported favorable attitudes toward CAM in both the groups. We observed a high rate of Mexican health professionals that had ever used CAM, and they had mainly used homeopathy, massage therapy, and herbal medicine. However, the recommendation rate of CAM by Mexican physicians was significantly lower than that in other countries, which is probably due to the lack of CAM training in most Mexican medical schools. Copyright © 2016 Elsevier Inc. All rights reserved.

EpCAM expression in primary tumour tissues and metastases: an immunohistochemical analysis.

PubMed

Spizzo, Gilbert; Fong, Dominic; Wurm, Martin; Ensinger, Christian; Obrist, Peter; Hofer, Carina; Mazzoleni, Guido; Gastl, Guenther; Went, Philip

2011-05-01

Epithelial cell adhesion molecule (EpCAM) is a cell surface protein with oncogenic features that is expressed on healthy human epithelia and corresponding malignant tumours. EpCAM expression frequently correlates with more aggressive tumour behaviour and new EpCAM-specific therapeutic agents have recently been approved for clinical use in patients with cancer. However, no consensus exists on how and when to evaluate EpCAM expression in patients with cancer. EpCAM expression was assessed by a well-established immunohistochemical staining protocol in 2291 primary tumour tissues and in 108 metastases using the EpCAM-specific antibody clone VU1D9. A total immunostaining score was calculated as the product of a proportion score and an intensity score. Four expression subgroups (no, weak, moderate and intense) were defined. As described previously, the term 'EpCAM overexpression' was reserved for tissues showing a total immunostaining score >4. EpCAM was highly expressed in most tumours of gastrointestinal origin and in some carcinomas of the genitourinary tract. However, hepatocellular carcinomas, clear cell renal cell cancer, urothelial cancer and squamous cell cancers were frequently EpCAM negative. EpCAM expression in breast cancer depended on the histological subtype; lobular histology usually showed no or weak expression. Most metastases were EpCAM positive and they frequently reflected the expression phenotype of the primary tumour. EpCAM expression was detected on adenocarcinomas of various primary sites. If EpCAM-specific antibodies are intended to be used in patients with cancer, we recommend prior immunohistochemical evaluation of EpCAM expression, particularly in patients with renal cell cancer, hepatocellular carcinoma, urothelial carcinoma, breast cancer and squamous cell carcinomas.

The use of complementary and alternative medicine among people living with diabetes in Sydney

PubMed Central

2012-01-01

Background Complementary and alternative medicine (CAM) is common in patients with chronic disease such as diabetes mellitus. The primary objective of the study was to determine the overall prevalence and type of CAM use in individuals with diabetes mellitus (DM) in Western Sydney and to compare the prevalence and factors associated with CAM use with the literature. Methods A multicenter cross-sectional study was undertaken using a self-completed questionnaire distributed to patients with DM attending a public hospital and specialist endocrinology clinics in the region. The type of DM and pattern of CAM utilisation were analyzed. Results Sixty nine people responded to the questionnaire: age range of 18-75 years during a twelve week collection period. Overall, 32 respondents with diabetes were using some form of CAM, resulting in a utilisation rate of 46.3%. Twenty of the 32 CAM users used CAM specifically to treat their diabetes accounting for 28.9% of the respondent sample population. Multivitamins (40%), cinnamon, Co-enzyme q10 and prayer were the most frequently used CAM modalities. There was no significant difference between males and females, age range, income or diabetes complications between CAM and non-CAM users. (p values each > 0.05) The factor most significantly associated with CAM usage was being born overseas (p = 0.044). Conclusions Almost half the respondents (46.3%) used CAM: 28% used CAM specifically to treat their diabetes. Individuals born overseas were significantly more likely to use CAM than those born in Australia. Other factors such as age, gender, wealth and duration of living with diabetes were not associated with higher rate of CAM usage. PMID:22240113

College Access Marketing

ERIC Educational Resources Information Center

Tremblay, Christopher W.

2011-01-01

College Access Marketing (CAM) is a relatively new phenomenon that seeks to positively influence the college-going rate. This report defines CAM, describes CAM examples, and discusses how CAM seeks to counter barriers to college. It explores four main elements of CAM: information, marketing, advocacy, and social mobilization. Further, it…

Complementary and alternative medicine in pulmonology.

PubMed

Mark, John D; Chung, Youngran

2015-06-01

To provide a comprehensive review of complementary and alternative medicine (CAM) therapies for the treatment of pulmonary disorders in children. The use of complementary medicine (CAM) is commonly used by both children and adults with breathing problems, and especially in chronic pulmonary disorders such as asthma and cystic fibrosis. Many clinics and hospitals now offer CAM, even though most of the conventionally trained health practitioners have little knowledge or education regarding CAM therapies. Research in CAM that demonstrates overall benefit is lacking, especially in children. Often parents do not report CAM use to their child's healthcare provider and this could compromise their overall quality of care. Although many research studies evaluating CAM therapies have methodological flaws, data exist to support CAM therapies in treating children with pulmonary disorders. This review examines the latest evidence of CAM use and effectiveness in children with pulmonary disorders. Physicians should be aware of the many CAM therapy options and the research surrounding them in order to provide their patients with the most current and accurate information available.

Pattern and frequency of use of complementary and alternative medicine among patients with epilepsy in the midwestern United States.

PubMed

Liow, Kore; Ablah, Elizabeth; Nguyen, John C; Sadler, Toni; Wolfe, Deborah; Tran, Ky-Dieu; Guo, Lisa; Hoang, Tina

2007-06-01

Complementary and alternative medicine (CAM) is recognized to be commonly used by patients, yet there have been few studies regarding the scope of CAM use by patients with epilepsy. This study assessed usage and perceptions of CAM by patients with epilepsy in the midwest of the United States. A 25-item survey was administered to adult patients with epilepsy, and data were collected from 228 patients. The survey collected demographics, specific CAM usage, adverse effects of CAM therapy, and perceptions of the effectiveness of CAM. Thirty-nine percent reported using CAM; 25% reported using CAM specifically for their epilepsy. Prayer/spirituality was the most commonly used form of CAM (46%), followed by "mega" vitamins (25%), chiropractic care (24%), and stress management (16%). CAM use is common among midwestern patients with epilepsy, although the pattern of use may be slightly different than in other regions of the United States and elsewhere.

Is Prayer CAM?

PubMed Central

Marsman, Kevin; Zwickey, Heather

2009-01-01

Abstract Background Alternative medicine researchers and policy makers have classified prayer as a mind–body intervention, and thus, a modality of complementary and alternative medicine (CAM). As such, numerous epidemiological surveys of CAM utilization—which have included prayer—depict increasing CAM use, particularly in specific racial and ethnic groups. Objectives This paper discusses the implications of conflating prayer and CAM, especially regarding the definitions of both concepts and the resulting statistics of CAM utilization. PMID:19388867

L1-CAM in cancerous tissues.

PubMed

Gavert, Nancy; Ben-Shmuel, Amir; Raveh, Shani; Ben-Ze'ev, Avri

2008-11-01

L1-cell adhesion molecule (L1-CAM) is a cell adhesion receptor of the immunoglobulin superfamily, known for its roles in nerve cell function. While originally believed to be present only in brain cells, in recent years L1-CAM has been detected in other tissues, and in a variety of cancer cells, including some common types of human cancer. We review the prevalence of L1-CAM in human cancer, the possible mechanisms involved in L1-CAM-mediated tumorigenesis, and cancer therapies based upon L1-CAM antibody treatment. In colon cancer cells, the L1-CAM gene was identified as a target of the Wnt/beta-catenin-TCF signaling pathway, and L1-CAM was exclusively detected at the invasive front of colon and ovarian cancer tissue. The expression of L1-CAM in normal and cancer cells enhanced tumorigenesis and conferred metastasis in colon cancer cells. Antibodies against the L1-CAM ectodomain severely inhibited the proliferation of a variety of cancer cells in culture and reduced tumor burden when injected into mice harboring cancer cells expressing L1-CAM. These results, in addition to the presence of L1-CAM on the cell surface and its restricted distribution in normal tissues, make it an ideal target for tumor therapy.

Perception, attitude and usage of complementary and alternative medicine among doctors and patients in a tertiary care hospital in India.

PubMed

Roy, Vandana; Gupta, Monica; Ghosh, Raktim Kumar

2015-01-01

Complementary and alternative medicine (CAM) has been practiced in India for thousands of years. The aim of this study was to determine the extent of use, perception and attitude of doctors and patients utilizing the same healthcare facility. This study was conducted among 200 doctors working at a tertiary care teaching Hospital, India and 403 patients attending the same, to determine the extent of usage, attitude and perception toward CAM. The use of CAM was more among doctors (58%) when compared with the patients (28%). Among doctors, those who had utilized CAM themselves, recommended CAM as a therapy to their patients (52%) and enquired about its use from patients (37%) to a greater extent. CAM was used concomitantly with allopathic medicine by 60% patients. Very few patients (7%) were asked by their doctors about CAM use, and only 19% patients voluntarily informed their doctors about the CAM they were using. Most patients who used CAM felt it to be more effective, safer, less costly and easily available in comparison to allopathic medicines. CAM is used commonly by both doctors and patients. There is a lack of communication between doctors and patients regarding CAM, which may be improved by sensitization of doctors and inclusion of CAM in the medical curriculum.

Molecular cloning and expression of the calmodulin gene from guinea pig hearts.

PubMed

Feng, Rui; Liu, Yan; Sun, Xuefei; Wang, Yan; Hu, Huiyuan; Guo, Feng; Zhao, Jinsheng; Hao, Liying

2015-06-01

The aim of the present study was to isolate and characterize a complementary DNA (cDNA) clone encoding the calmodulin (CaM; GenBank accession no. FJ012165) gene from guinea pig hearts. The CaM gene was amplified from cDNA collected from guinea pig hearts and inserted into a pGEM®-T Easy vector. Subsequently, CaM nucleotide and protein sequence similarity analysis was conducted between guinea pigs and other species. In addition, reverse transcription-polymerase chain reaction (RT-PCR) was performed to investigate the CaM 3 expression patterns in different guinea pig tissues. Sequence analysis revealed that the CaM gene isolated from the guinea pig heart had ∼90% sequence identity with the CaM 3 genes in humans, mice and rats. Furthermore, the deduced peptide sequences of CaM 3 in the guinea pig showed 100% homology to the CaM proteins from other species. In addition, the RT-PCR results indicated that CaM 3 was widely and differentially expressed in guinea pigs. In conclusion, the current study provided valuable information with regard to the cloning and expression of CaM 3 in guinea pig hearts. These findings may be helpful for understanding the function of CaM3 and the possible role of CaM3 in cardiovascular diseases.

Trick or treat? Australian newspaper portrayal of complementary and alternative medicine for the treatment of cancer.

PubMed

Mercurio, Reegan; Eliott, Jaklin Ardath

2011-01-01

Many cancer patients within developed nations cite the media as informing their decisions to use complementary and alternative medicine (CAM). The present study describes (1) Australian newspaper coverage of CAM use for cancer between 1998 and 2007; (2) trends in reporting frequency and characteristics; and (3) how the Australian press framed stories on CAM use for cancer. This study is a content analysis featuring quantitative and qualitative techniques, the latter guided by 'media framing', of targeted newspaper articles. One hundred nineteen articles focused on CAM use for the treatment of cancer were identified. Quantitative analysis found that biologically based CAMs were most frequently described and breast cancer most mentioned. Two thirds of all articles described CAM use in the context of a cure, with approximately half of these opposing this reason for use. Potential benefits of CAM were discussed more frequently than potential risks, and information on costs and how to access CAM were uncommon. Recommendations included advice to use complementary, not alternative therapies, yet advice to discuss CAM with a medical doctor was rare. Qualitative analysis found six CAM cancer-related frames, four in support of CAM use for cancer treatment. The dominant frame constructed CAM as legitimate tools to assist biomedicine (even to cure), with others depicting CAM as normal and necessary or as addressing limitations of biomedicine. Negative frames depicted CAM as questionable and risky practices and the industry/practitioners as possessing malevolent intent. These findings have implications for biomedical practitioners attempting to determine, respect and assist patient choices about their treatment.

The shed ectodomain of Nr-CAM stimulates cell proliferation and motility, and confers cell transformation.

PubMed

Conacci-Sorrell, Maralice; Kaplan, Anna; Raveh, Shani; Gavert, Nancy; Sakurai, Takeshi; Ben-Ze'ev, Avri

2005-12-15

Nr-CAM, a cell-cell adhesion molecule of the immunoglobulin-like cell adhesion molecule family, known for its function in neuronal outgrowth and guidance, was recently identified as a target gene of beta-catenin signaling in human melanoma and colon carcinoma cells and tissue. Retrovirally mediated transduction of Nr-CAM into fibroblasts induces cell motility and tumorigenesis. We investigated the mechanisms by which Nr-CAM can confer properties related to tumor cell behavior and found that Nr-CAM expression in NIH3T3 cells protects cells from apoptosis in the absence of serum by constitutively activating the extracellular signal-regulated kinase and AKT signaling pathways. We detected a metalloprotease-mediated shedding of Nr-CAM into the culture medium of cells transfected with Nr-CAM, and of endogenous Nr-CAM in B16 melanoma cells. Conditioned medium and purified Nr-CAM-Fc fusion protein both enhanced cell motility, proliferation, and extracellular signal-regulated kinase and AKT activation. Moreover, Nr-CAM was found in complex with alpha4beta1 integrins in melanoma cells, indicating that it can mediate, in addition to homophilic cell-cell adhesion, heterophilic adhesion with extracellular matrix receptors. Suppression of Nr-CAM levels by small interfering RNA in B16 melanoma inhibited the adhesive and tumorigenic capacities of these cells. Stable expression of the Nr-CAM ectodomain in NIH3T3 cells conferred cell transformation and tumorigenesis in mice, suggesting that the metalloprotease-mediated shedding of Nr-CAM is a principal route for promoting oncogenesis by Nr-CAM.

The use of complementary and alternative medicines by patients with peripheral neuropathy.

PubMed

Brunelli, Brian; Gorson, Kenneth C

2004-03-15

Complementary and alternative medicine (CAM) therapies have become increasingly popular and are used regularly by patients with chronic neurological disorders. The prevalence and characteristics of CAM use by patients with peripheral neuropathy is unknown. We performed a prospective, questionnaire-based study to determine the prevalence and patterns of use of CAM therapies in 180 consecutive outpatients with peripheral neuropathy. The use of CAM was reported by 77 patients (43%) with neuropathy. The most frequent were megavitamins (35%), magnets (30%), acupuncture (30%), herbal remedies (22%), and chiropractic manipulation (21%); 37 (48%) tried more than one form of alternative treatment. Seventeen respondents (27%) thought their neuropathy symptoms improved with these approaches. Those who used CAM were slightly younger (mean age 62 vs. 65 years, p = 0.05) and more often college educated (39% vs. 24%, p = 0.03) compared to CAM nonusers. They also more often reported burning neuropathic pain (62% vs. 44%, p = 0.01). Patients with diabetic neuropathy used CAM more frequently than others (p = 0.03). The most common reason for using CAM was inadequate pain control (32%). Almost half of patients did not consult a physician before starting CAM. We conclude that there is a high prevalence of CAM use in our patients with neuropathy, and one-quarter reported that their symptoms improved. CAM users were better educated than nonusers, but most did not discuss CAM treatments with their physician. Neuropathic pain was substantially more common in CAM users, and lack of pain control was the most common reason for CAM use.

The role of complementary and alternative medicine (CAM) routines and rituals in men with cancer and their significant others (SOs): a qualitative investigation.

PubMed

Klafke, Nadja; Eliott, Jaklin A; Olver, Ian N; Wittert, Gary A

2014-05-01

Complementary and alternative medicine (CAM) is frequently used in cancer patients, often with contribution of the significant others (SOs), but without consultation of healthcare professionals. This research explored how cancer patients integrate and maintain CAM use in their everyday life, and how SOs are involved in it. In this qualitative study, male participants were selected from a preceding Australian survey on CAM use in men with cancer (94 % response rate and 86 % consent rate for follow-up interview). Semistructured interviews were conducted with 26 men and 24 SOs until data saturation was reached. Interview transcripts were coded and analyzed thematically, thereby paying close attention to participants' language in use. A major theme associated with high CAM use was "CAM routines and rituals," as it was identified that men with cancer practiced CAM as (1) functional routines, (2) meaningful rituals, and (3) mental/spiritual routines or/and rituals. Regular CAM use was associated with intrapersonal and interpersonal benefits: CAM routines provided men with certainty and control, and CAM rituals functioned for cancer patients and their SOs as a means to create meaning, thereby working to counter fear and uncertainty consequent upon a diagnosis of cancer. SOs contributed most to men's uptake and maintenance of dietary-based CAM in ritualistic form resulting in interpersonal bonding and enhanced closeness. CAM routines and rituals constitute key elements in cancer patients' regular and satisfied CAM use, and they promote familial strengthening. Clinicians and physicians can convey these benefits to patient consultations, further promoting the safe and effective use of CAM.

Modeled hydraulic redistribution in tree-grass, CAM-grass, and tree-CAM associations: the implications of crassulacean acid metabolism (CAM).

PubMed

Yu, Kailiang; Foster, Adrianna

2016-04-01

Past studies have largely focused on hydraulic redistribution (HR) in trees, shrubs, and grasses, and recognized its role in interspecies interactions. HR in plants that conduct crassulacean acid metabolism (CAM), however, remains poorly investigated, as does the effect of HR on transpiration in different vegetation associations (i.e., tree-grass, CAM-grass, and tree-CAM associations). We have developed a mechanistic model to investigate the net direction and magnitude of HR at the patch scale for tree-grass, CAM-grass, and tree-CAM associations at the growing season to yearly timescale. The modeling results show that deep-rooted CAM plants in CAM-grass associations could perform hydraulic lift at a higher rate than trees in tree-grass associations in a relatively wet environment, as explained by a significant increase in grass transpiration rate in the shallow soil layer, balancing a lower transpiration rate by CAM plants. By comparison, trees in tree-CAM associations may perform hydraulic descent at a higher rate than those in tree-grass associations in a dry environment. Model simulations also show that hydraulic lift increases the transpiration of shallow-rooted plants, while hydraulic descent increases that of deep-rooted plants. CAM plants transpire during the night and thus perform HR during the day. Based on these model simulations, we suggest that the ability of CAM plants to perform HR at a higher rate may have different effects on the surrounding plant community than those of plants with C3 or C4 photosynthetic pathways (i.e., diurnal transpiration).

Older adults' use of complementary and alternative medicine for mental health: findings from the 2002 National Health Interview Survey.

PubMed

Grzywacz, Joseph G; Suerken, Cynthia K; Quandt, Sara A; Bell, Ronny A; Lang, Wei; Arcury, Thomas A

2006-06-01

To compare complementary and alternative medicine (CAM) use among adults 65 and older with and without self-reported anxiety or depression, and to investigate the prevalence and predictors of CAM use for treatment by persons with anxiety or depression. Cross-sectional survey. Computer-assisted interviews conducted in participants' homes. Subjects included 5827 adults aged 65 and older who participated in the 2002 National Health Interview Survey including the Alternative Health Supplement. None. Overall use of CAM, use of four categories of CAM, and use of 20 CAM modalities. CAM use for treatment of any health condition, and CAM use to treat mental health. Eighty-one and seven tenths percent (81.7%) of older adults with self-reported anxiety or depression who used CAM in the past year, whereas 64.6% of older adults without these conditions used CAM. Differences in CAM use were driven by elevated use of spiritual practices, relaxation techniques, and use of nonvitamin, nonmineral natural products by patients with symptoms of mental conditions. Fewer than 20% of CAM users with self-reported anxiety or depression used CAM for their mental health. Few personal and health-related factors predicted CAM use for treatment among older adults with self-reported anxiety or depression. Older adults with self-reported anxiety or depression were more likely to use spiritual practices, relaxation techniques, and nonvitamin, nonmineral natural products than elders in good mental health. However, for the majority of older adults with self-reported anxiety or depression, CAM was used for purposes other than treating mental health.

Boundary Layer Remote Sensing with Combined Active and Passive Techniques: GPS Radio Occultation and High-Resolution Stereo Imaging (WindCam) Small Satellite Concept

NASA Technical Reports Server (NTRS)

Mannucci, A.J.; Wu, D.L.; Teixeira, J.; Ao, C.O.; Xie, F.; Diner, D.J.; Wood, R.; Turk, Joe

2012-01-01

Objective: significant progress in understanding low-cloud boundary layer processes. This is the Single largest uncertainty in climate projections. Radio occultation has unique features suited to boundary layer remote sensing (1) Cloud penetrating (2) Very high vertical resolution (approximately 50m-100m) (3) Sensitivity to thermodynamic variables

Exploring the symbiotic pangenome of the nitrogen-fixing bacterium Sinorhizobium meliloti

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

Galardini, Marco; Mengoni, Alessio; Brilli, Matteo

Background: Sinorhizobium meliloti is a model system for the studies of symbiotic nitrogen fixation. An extensive polymorphism at the genetic and phenotypic level is present in natural populations of this species, especially in relation with symbiotic promotion of plant growth. AK83 and BL225C are two nodule-isolated strains with diverse symbiotic phenotypes; BL225C is more efficient in promoting growth of the Medicago sativa plants than strain AK83. In order to investigate the genetic determinants of the phenotypic diversification of S. meliloti strains AK83 and BL225C, we sequenced the complete genomes for these two strains. Results: With sizes of 7.14 Mbp andmore » 6.97 Mbp, respectively, the genomes of AK83 and BL225C are larger than the laboratory strain Rm1021. The core genome of Rm1021, AK83, BL225C strains included 5124 orthologous groups, while the accessory genome was composed by 2700 orthologous groups. While Rm1021 and BL225C have only three replicons (Chromosome, pSymA and pSymB), AK83 has also two plasmids, 260 and 70 Kbp long. We found 65 interesting orthologous groups of genes that were present only in the accessory genome, consequently responsible for phenotypic diversity and putatively involved in plant-bacterium interaction. Notably, the symbiosis inefficient AK83 lacked several genes required for microaerophilic growth inside nodules, while several genes for accessory functions related to competition, plant invasion and bacteroid tropism were identified only in AK83 and BL225C strains. Presence and extent of polymorphism in regulons of transcription factors involved in symbiotic interaction were also analyzed. Our results indicate that regulons are flexible, with a large number of accessory genes, suggesting that regulons polymorphism could also be a key determinant in the variability of symbiotic performances among the analyzed strains.« less

Corticosterone facilitates extinction of fear memory in BALB/c mice but strengthens cue related fear in C57BL/6 mice.

PubMed

Brinks, V; de Kloet, E R; Oitzl, M S

2009-04-01

Corticosterone, the naturally occurring glucocorticoid of rodents is secreted in response to stressors and is known for its facilitating and detrimental effects on emotional learning and memory. The large variability in the action of corticosterone on processing of emotional memories is postulated to depend on genetic background and the spatio-temporal domain in which the hormone operates. To address this hypothesis, mice of two strains with distinct corticosterone secretory patterns and behavioural phenotype (BALB/c and C57BL/6J) were treated with corticosterone (250 microg/kg, i.p.), either 5 min before or directly after acquisition in a fear conditioning task. As the paradigm allowed assessing in one experimental procedure both context- and cue-related fear behaviour, we were able to detect generalization and specificity of fear. BALB/c showed generalized strong fear memory, while C57BL/6J mice discriminated between freezing during context- and cue episodes. Corticosterone had opposite effects on fear memory depending on the strain and time of injection. Corticosterone after acquisition did not affect C57BL/6J mice, but destabilized consolidation and facilitated extinction in BALB/c. Corticosterone 5 min before acquisition strengthened stress-associated signals: BALB/c no longer showed lower fear memory, while C57BL/6J mice displayed increased fear memory and impaired extinction in cue episodes. We propose that corticosterone-induced facilitation of fear memory in C57BL/6J mice can be used to study the development of fear memories, corticosterone administration in BALB/c mice presents a model to examine treatment. We conclude that genetic background and time of corticosterone action are modifiers of fear memory with interesting translational implications for anxiety-related diseases.

An evidence-based review of commonly used dietary supplements.

PubMed

Laird, John

2015-07-01

Use of complementary and alternative medicine (CAM) is increasing in the United States. Physician assistants need to know about the efficacy of CAM therapies if they practice integrative medicine (which combines CAM and traditional therapies), recommend a CAM therapy occasionally as part of their treatment plan, refer patients to CAM providers, or have patients who self-select CAM therapies. This article describes integrative medicine and reviews the most commonly used dietary supplements.

Integrating Complementary and Alternative Medicine Education Into the Pharmacy Curriculum

PubMed Central

Wallis, Marianne

2008-01-01

Objectives To evaluate the effectiveness of an integrated approach to the teaching of evidence-based complementary and alternative medicine (CAM) in a pharmacy curriculum. Design Evidence-based CAM education was integrated throughout the third, fourth, and fifth years of the pharmacy curriculum. Specifically, an introductory module focusing on CAM familiarization was added in the third year and integrated, evidence-based teaching related to CAM was incorporated into clinical topics through lectures and clinical case studies in the fourth and fifth years. Assessment Students' self-assessed and actual CAM knowledge increased, as did their use of evidence-based CAM resources. However, only 30% of the fourth-year students felt they had learned enough about CAM. Students preferred having CAM teaching integrated into the curriculum beginning in the first year rather than waiting until later in their education. Conclusion CAM education integrated over several years of study increases students' knowledge and application. PMID:19002274

Complementary and Alternative Medicine (CAM) use by Malaysian oncology patients.

PubMed

Farooqui, Maryam; Hassali, Mohamed Azmi; Abdul Shatar, Aishah Knight; Shafie, Asrul Akmal; Seang, Tan Boon; Farooqui, Muhammad Aslam

2012-05-01

The current study sought to evaluate Malaysian oncology patients' decision making about the use of Complementary and Alternative Medicine (CAM) for the management of their care. Patients were interviewed across three major Malaysian ethnic groups, Malay, Chinese and Indian. Thematic content analysis identified four central themes: Conceptualizing CAM, the decision making process; rationale given for selecting or rejecting CAM and barriers to CAM use. Participants generally used the term 'traditional medicine', referred to locally as 'ubat kampung', meaning medicine derived from 'local traditions'. Mixed reactions were shown concerning the effectiveness of CAM to cure cancer and the slow progression of CAM results and treatment costs were cited as major barriers to CAM use. Concerns regarding safety and efficacy of CAM in ameliorating cancer as well as potential interactions with conventional therapies highlighted the importance of patients' knowledge about cancer treatments. Copyright © 2011 Elsevier Ltd. All rights reserved.

L1-CAM and N-CAM: From Adhesion Proteins to Pharmacological Targets.

PubMed

Colombo, Federico; Meldolesi, Jacopo

2015-11-01

L1 cell adhesion molecule (L1-CAM) and neural cell adhesion molecule (N-CAM), key members of the immunoglobulin-like CAM (Ig-CAM) family, were first recognized to play critical roles in surface interactions of neurons, by binding with each other and with extracellular matrix (ECM) proteins. Subsequently, adhesion was recognized to include signaling due to both activation of β-integrin, with the generation of intracellular cascades, and integration with the surface cytoskeleton. The importance of the two Ig-CAMs was revealed by their activation of the tyrosine kinase receptors of fibroblast growth factor (FGF), epidermal growth factor (EGF), and nerve growth factor (NGF). Based on these complex signaling properties, L1-CAM and N-CAM have become of great potential pharmacological interest in neurons and cancers. Treatment of neurodegenerative disorders and cognitive deficits of neurons is aimed to increase the cell Ig-CAM tone, possibly provided by synthetic/mimetic peptides. In cancer cells, where Ig-CAMs are often overexpressed, the proteins are employed for prognosis. The approaches to therapy are based on protein downregulation, antibodies, and adoptive immunotherapy. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Arrhythmogenic Calmodulin Mutation D129G Dysregulates Cell Growth, Calmodulin-dependent Kinase II Activity, and Cardiac Function in Zebrafish*

PubMed Central

Zacharias, Triantafyllos; Kulej, Katarzyna; Wang, Kevin; Torggler, Raffaela; la Cour, Jonas M.

2016-01-01

Calmodulin (CaM) is a Ca2+ binding protein modulating multiple targets, several of which are associated with cardiac pathophysiology. Recently, CaM mutations were linked to heart arrhythmia. CaM is crucial for cell growth and viability, yet the effect of the arrhythmogenic CaM mutations on cell viability, as well as heart rhythm, remains unknown, and only a few targets with relevance for heart physiology have been analyzed for their response to mutant CaM. We show that the arrhythmia-associated CaM mutants support growth and viability of DT40 cells in the absence of WT CaM except for the long QT syndrome mutant CaM D129G. Of the six CaM mutants tested (N53I, F89L, D95V, N97S, D129G, and F141L), three showed a decreased activation of Ca2+/CaM-dependent kinase II, most prominently the D129G CaM mutation, which was incapable of stimulating Thr286 autophosphorylation. Furthermore, the CaM D129G mutation led to bradycardia in zebrafish and an arrhythmic phenotype in a subset of the analyzed zebrafish. PMID:27815504

[Complementary and alternative medicine in primary care in Switzerland].

PubMed

Déglon-Fischer, Agnès; Barth, Jürgen; Ausfeld-Hafter, Brigitte

2009-08-01

This study investigated the current supply of complementary and alternative medicine (CAM) in Swiss primary care. Information was collected on physicians' qualifications in CAM, frequency of patients' demand for CAM, physicians' supply and temporal resources for CAM as well as physicians' referrals to CAM. 750 (500 German-speaking and 250 French-speaking) randomly selected Swiss female and male primary care physicians were asked to complete a questionnaire (response rate 50.4%). Sociodemographic data on professional training, place of residence, and sex were used to calculate a weighting factor to correct the responders' data in the analysis accordingly. 14.2% of the physicians were qualified in at least one CAM discipline. Around 30% (95% confidence interval 25.4-34.6%) of the physicians were asked for CAM by their patients more than once a week. Homeopathy and phytotherapy were the most frequently offered therapies, followed by traditional Chinese medicine (TCM)/acupuncture. 62.5% (57.6-67.4%) of the physicians refer their patients to CAM. Most patients were referred to TCM/acupuncture. Of the 37.2% (32.6-42.4%) of the physicians who do not refer their patients to CAM, around 40% (35.1-44.9%) offer it themselves. About three quarters of the physicians offer CAM themselves or refer their patients to CAM treatments. CAM is very important in primary medical care in Switzerland. Clear regulations for CAM are required in order to ensure a high quality in care. Copyright 2009 S. Karger AG, Basel.

Complementary and alternative medicine use in patients with hematological cancers in Malaysia.

PubMed

Gan, G G; Leong, Y C; Bee, P C; Chin, E; Teh, A K H

2015-08-01

Complementary and alternative medicine (CAM) is often used by cancer patients, but not many studies had been published on the prevalence of CAM use in patients with hematological cancers. This study aims to determine the prevalence of CAM and type of CAM used in this group of patients in a multiracial and multicultural country. This is a cross-sectional survey carried out in two hospitals in Malaysia. Patients with underlying hematological cancers were asked to complete the questionnaires on CAM and the Hospital Anxiety and Depression Scale. A total of 245 patients participated. The prevalence of CAM use was 70.2 %. The most common types of CAM used are biological-based therapies (90.2 %) and mind-body interventions (42 %). Vitamin and diet supplements (68.6 %) and folk/herb remedies (58 %) are the most common biological-based therapies used. There is no significant association of CAM use with age, gender, education level, and household income. Female patients are more likely to use more than one CAM therapies. The most common reason reported for CAM use was to boost immunity (57 %) and cure (24 %). Majority of patients (65 %) felt CAM was effective, and 60 % did not inform their physicians regarding CAM usage. In view of the high prevalence of CAM use in patients with hematological cancers, it is important that the physicians play an active role in seeking information from patients and to monitor possible drug-vitamin-herbal interactions.

Use of Complementary and Alternative Medicine (CAM) as Part of the Oncological Treatment: Survey about Patients' Attitude towards CAM in a University-Based Oncology Center in Germany.

PubMed

Kessel, Kerstin A; Lettner, Sabrina; Kessel, Carmen; Bier, Henning; Biedermann, Tilo; Friess, Helmut; Herrschbach, Peter; Gschwend, Jürgen E; Meyer, Bernhard; Peschel, Christian; Schmid, Roland; Schwaiger, Markus; Wolff, Klaus-Dietrich; Combs, Stephanie E

2016-01-01

To understand if and which patients would be open-minded to Complementary and Alternative Medicine (CAM) use parallel to their oncological treatment. Moreover, we sought to determine which methods are most accepted and which are the primary motivators to use CAM. We developed and anonymously conducted a questionnaire for patients in the oncology center (TU Munich). Questions focus on different CAM methods, previous experiences, and willingness to apply or use CAM when offered in a university-based setting. A total of 171 of 376 patients (37.4% women, 62.0% men, 0.6% unknown) participated. This corresponds to a return rate of 45%. Median age was 64 years (17-87 years). Of all participants, 15.2% used CAM during their oncological therapy; 32.7% have used it in the past. The majority (81.9%) was not using CAM during therapy; 55.5% have not used CAM in the past respectively. The analysis revealed a significant correlation between education and CAM use during therapy (r = 0.18; p = 0.02), and CAM use in the past (r = 0.17; p = 0.04). Of all patients using CAM during therapy, favored methods were food supplements (42.3%), vitamins/minerals (42.3%), massage (34.6%). Motivations are especially the reduction of side effect and stress, the positive effect of certain CAM-treatments on the immune system and tumor therapy. Results showed no difference between women and men. Most patients not having had any experience with CAM complain about the deficiency of information by their treating oncologist (31.4%) as well as missing treatment possibilities (54.3%). Since many patients believe in study results demonstrating the efficacy of CAM, it stresses our task to develop innovative study protocols to investigate the outcomes of certain CAM on symptom reduction or other endpoints. Thus, prospective trials and innovative evidence-based treatment concepts to include CAM into high-end oncology is what patients demand and what a modern oncology center should offer.

The Mars NetLander panoramic camera

NASA Astrophysics Data System (ADS)

Jaumann, Ralf; Langevin, Yves; Hauber, Ernst; Oberst, Jürgen; Grothues, Hans-Georg; Hoffmann, Harald; Soufflot, Alain; Bertaux, Jean-Loup; Dimarellis, Emmanuel; Mottola, Stefano; Bibring, Jean-Pierre; Neukum, Gerhard; Albertz, Jörg; Masson, Philippe; Pinet, Patrick; Lamy, Philippe; Formisano, Vittorio

2000-10-01

The panoramic camera (PanCam) imaging experiment is designed to obtain high-resolution multispectral stereoscopic panoramic images from each of the four Mars NetLander 2005 sites. The main scientific objectives to be addressed by the PanCam experiment are (1) to locate the landing sites and support the NetLander network sciences, (2) to geologically investigate and map the landing sites, and (3) to study the properties of the atmosphere and of variable phenomena. To place in situ measurements at a landing site into a proper regional context, it is necessary to determine the lander orientation on ground and to exactly locate the position of the landing site with respect to the available cartographic database. This is not possible by tracking alone due to the lack of on-ground orientation and the so-called map-tie problem. Images as provided by the PanCam allow to determine accurate tilt and north directions for each lander and to identify the lander locations based on landmarks, which can also be recognized in appropriate orbiter imagery. With this information, it will be further possible to improve the Mars-wide geodetic control point network and the resulting geometric precision of global map products. The major geoscientific objectives of the PanCam lander images are the recognition of surface features like ripples, ridges and troughs, and the identification and characterization of different rock and surface units based on their morphology, distribution, spectral characteristics, and physical properties. The analysis of the PanCam imagery will finally result in the generation of precise map products for each of the landing sites. So far comparative geologic studies of the Martian surface are restricted to the timely separated Mars Pathfinder and the two Viking Lander Missions. Further lander missions are in preparation (Beagle-2, Mars Surveyor 03). NetLander provides the unique opportunity to nearly double the number of accessible landing site data by providing simultaneous and long-term observations at four different surface locations which becomes especially important for studies of variable surface features as well as properties and phenomena of the atmosphere. Major changes on the surface that can be detected by PanCam are caused by eolian activities and condensation processes, which directly reflect variations in the prevailing near-surface wind regime and the diurnal and seasonal volatile and dust cycles. Atmospheric studies will concentrate on the detection of clouds, measurements of the aerosol contents and the water vapor absorption at 936 nm. In order to meet these objectives, the proposed PanCam instrument is a highly miniaturized, dedicated stereo and multispectral imaging device. The camera consists of two identical camera cubes, which are arranged in a common housing at a fixed stereo base length of 11 cm. Each camera cube is equipped with a CCD frame transfer detector with 1024×1024 active pixels and optics with a focal length of 13 mm yielding a field-of-view of 53°×53° and an instantaneous filed of view of 1.1 mrad. A filter swivel with six positions provides different color band passes in the wavelength range of 400-950 nm. The camera head is mounted on top of a deployable scissors boom and can be rotated by 360° to obtain a full panorama, which is already covered by eight images. The boom raises the camera head to a final altitude of 90 cm above the surface. Most camera activities will take place within the first week and the first month of the mission. During the remainder of the mission, the camera will operate with a reduced data rate to monitor time-dependent variations on a daily basis. PanCam is a joint German/French project with contributions from DLR, Institute of Space Sensor Technology and Planetary Exploration, Berlin, Institut d'Astrophysique Spatiale, CNRS, Orsay, and Service d'Aéronomie, CNRS, Verrières-le-Buisson.

The path to CAM6: coupled simulations with CAM5.4 and CAM5.5

NASA Astrophysics Data System (ADS)

Bogenschutz, Peter A.; Gettelman, Andrew; Hannay, Cecile; Larson, Vincent E.; Neale, Richard B.; Craig, Cheryl; Chen, Chih-Chieh

2018-01-01

This paper documents coupled simulations of two developmental versions of the Community Atmosphere Model (CAM) towards CAM6. The configuration called CAM5.4 introduces new microphysics, aerosol, and ice nucleation changes, among others to CAM. The CAM5.5 configuration represents a more radical departure, as it uses an assumed probability density function (PDF)-based unified cloud parameterization to replace the turbulence, shallow convection, and warm cloud macrophysics in CAM. This assumed PDF method has been widely used in the last decade in atmosphere-only climate simulations but has never been documented in coupled mode. Here, we compare the simulated coupled climates of CAM5.4 and CAM5.5 and compare them to the control coupled simulation produced by CAM5.3. We find that CAM5.5 has lower cloud forcing biases when compared to the control simulations. Improvements are also seen in the simulated amplitude of the Niño-3.4 index, an improved representation of the diurnal cycle of precipitation, subtropical surface wind stresses, and double Intertropical Convergence Zone biases. Degradations are seen in Amazon precipitation as well as slightly colder sea surface temperatures and thinner Arctic sea ice. Simulation of the 20th century results in a credible simulation that ends slightly colder than the control coupled simulation. The authors find this is due to aerosol indirect effects that are slightly stronger in the new version of the model and propose a solution to ameliorate this. Overall, in these early coupled simulations, CAM5.5 produces a credible climate that is appropriate for science applications and is ready for integration into the National Center for Atmospheric Research's (NCAR's) next-generation climate model.

Complementary and Alternative Medicine Use and Symptom Burden in Women Undergoing Chemotherapy for Breast Cancer in Malaysia.

PubMed

Chui, Ping Lei; Abdullah, Khatijah Lim; Wong, Li Ping; Taib, Nur Aishah

Complementary and alternative medicine (CAM) is commonly used for cancer- and chemotherapy-related symptoms. Nurses are likely to encounter many CAM users in their practice. The aims of this study were to assess CAM use and examine the symptom burden of CAM and non-CAM users among patients with breast cancer who are undergoing chemotherapy. A CAM use questionnaire and the Side-Effect Burden Scale were administered to 546 patients. Complementary and alternative medicine use was categorized as mind-body practices (MBPs), natural products (NPs), or traditional medicine (TM). We identified 386 CAM users (70.7%) in this study. The CAM users reported a higher marginal mean total symptom burden score (40.39 ± 2.6) than non-CAM users (36.93 ± 3.21), although this difference was not statistically significant (P = .09). Triple-modality (MBP-NP-TM) CAM users had a significantly higher marginal mean total symptom burden score (47.44 ± 4.12) than single-modality (MBP) users (34.09 ± 4.43). The risk of having a high total symptom burden score was 12.9-fold higher among the MBP-NP-TM users than among the MBP users. Complementary and alternative medicine use is common among Malaysian patients who are undergoing chemotherapy for breast cancer. However, CAM and non-CAM users reported similar symptom burdens, although single-modality use of MBP is likely associated with a lower symptom burden. Nurses should keep abreast of current developments and trends in CAM use. Understanding CAM use and the related symptom burden will allow nurses to initiate open discussion and guide their patients in seeking additional information or referrals for a particular therapy.

Medical student attitudes towards complementary and alternative medicine (CAM) in medical education: a critical review.

PubMed

Joyce, Paul; Wardle, Jon; Zaslawski, Chris

2016-12-01

Background This paper aims to remedy a gap in the knowledge by presenting the first critical review of the literature on major themes relating to medical students perceptions and attitudes towards the exponentially growing field of complementary and alternative medicine (CAM). MethodsAfter a comprehensive database search of the literature, 21 papers were chosen as suitable for the review. The results from these papers were tabled and discussed. ResultsThe results indicated that medical students lacked knowledge of CAM and are generally positive towards CAM education (especially in the preclinical years, if it provided evidence of efficacy and post-placement). Medical students thought that CAM should generally be incorporated into the medical curriculum mainly so they can confidently undertake referral to CAM practitioners. Being able to communicate with future patients about their CAM use was a major motivation for medical students to learn about CAM and a factor for medical student support of further incorporation of CAM content in the medical curricula. Educational exposure to CAM in many forms and in many papers was shown to significantly affect medical student attitudes to CAM. This may be reflective of the fact that, outside direct CAM training, there may be limited accessible opportunities for medical students and if integration is to occur, educational exposure is most important. ConclusionsThe rise of CAM as a social and clinical phenomenon necessitates consideration of further inclusion of these topics in the medical curriculum, if future physicians are to be able to fully discharge their role as care providers in an increasingly medically pluralistic world. However, the inclusion of CAM needs to be done in an objective and critical manner, which is relevant to the learner.

Complementary and alternative medicine in breast cancer patients.

PubMed

Nahleh, Zeina; Tabbara, Imad A

2003-09-01

Complementary and Alternative Medicine (CAM) is becoming increasingly popular among cancer patients, in particular those with breast cancer. It represents one of the fastest growing treatment modalities in the United States. Therefore, knowledge of CAM therapies is becoming necessary for physicians and other health care providers. CAM encompasses a wide range of modalities including special diet and nutrition, mind-body approaches, and traditional Chinese medicine. We reviewed the biomedical literature on CAM use in breast cancer patients, using Medline search from 1975 until 2002. In addition, consensus reports and books on CAM and breast cancer were included in the review. We evaluated the prevalence of CAM use in breast cancer patients, the reasons cited for its use, the different available modalities, and the reported outcomes. Use of CAM in breast cancer patients ranges between 48% and 70% in the United States. The most commonly used CAM modalities include dietary supplements, mind-body approaches, and acupuncture. The reasons cited for using CAM were to boost the immune system, improve the quality of life, prevent recurrence of cancer, provide control over life, and treat breast cancer and the side effects of treatment. Several studies reported favorable results including improved survival, better pain control, reduced anxiety, improvement in coping strategies and significant efficacy in treating nausea and vomiting. Other less well-organized trials have reported either no benefit or negative effect of CAM and potential toxicity of some commercial products. CAM is a growing field in health care and particularly among breast cancer patients. Knowledge of CAM by physicians, especially oncologists, is necessary. Oncologists should be willing to discuss the role of CAM with their patients and encourage patients to participate in well-organized research about CAM.

Nitric Oxide Mediates the Hormonal Control of Crassulacean Acid Metabolism Expression in Young Pineapple Plants1[W][OA

PubMed Central

Freschi, Luciano; Rodrigues, Maria Aurineide; Domingues, Douglas Silva; Purgatto, Eduardo; Van Sluys, Marie-Anne; Magalhaes, Jose Ronaldo; Kaiser, Werner M.; Mercier, Helenice

2010-01-01

Genotypic, developmental, and environmental factors converge to determine the degree of Crassulacean acid metabolism (CAM) expression. To characterize the signaling events controlling CAM expression in young pineapple (Ananas comosus) plants, this photosynthetic pathway was modulated through manipulations in water availability. Rapid, intense, and completely reversible up-regulation in CAM expression was triggered by water deficit, as indicated by the rise in nocturnal malate accumulation and in the expression and activity of important CAM enzymes. During both up- and down-regulation of CAM, the degree of CAM expression was positively and negatively correlated with the endogenous levels of abscisic acid (ABA) and cytokinins, respectively. When exogenously applied, ABA stimulated and cytokinins repressed the expression of CAM. However, inhibition of water deficit-induced ABA accumulation did not block the up-regulation of CAM, suggesting that a parallel, non-ABA-dependent signaling route was also operating. Moreover, strong evidence revealed that nitric oxide (NO) may fulfill an important role during CAM signaling. Up-regulation of CAM was clearly observed in NO-treated plants, and a conspicuous temporal and spatial correlation was also evident between NO production and CAM expression. Removal of NO from the tissues either by adding NO scavenger or by inhibiting NO production significantly impaired ABA-induced up-regulation of CAM, indicating that NO likely acts as a key downstream component in the ABA-dependent signaling pathway. Finally, tungstate or glutamine inhibition of the NO-generating enzyme nitrate reductase completely blocked NO production during ABA-induced up-regulation of CAM, characterizing this enzyme as responsible for NO synthesis during CAM signaling in pineapple plants. PMID:20147491

Calcium triggers reversal of calmodulin on nested anti-parallel sites in the IQ motif of the neuronal voltage-dependent sodium channel NaV1.2.

PubMed

Hovey, Liam; Fowler, C Andrew; Mahling, Ryan; Lin, Zesen; Miller, Mark Stephen; Marx, Dagan C; Yoder, Jesse B; Kim, Elaine H; Tefft, Kristin M; Waite, Brett C; Feldkamp, Michael D; Yu, Liping; Shea, Madeline A

2017-05-01

Several members of the voltage-gated sodium channel family are regulated by calmodulin (CaM) and ionic calcium. The neuronal voltage-gated sodium channel Na V 1.2 contains binding sites for both apo (calcium-depleted) and calcium-saturated CaM. We have determined equilibrium dissociation constants for rat Na V 1.2 IQ motif [IQRAYRRYLLK] binding to apo CaM (~3nM) and (Ca 2+ ) 4 -CaM (~85nM), showing that apo CaM binding is favored by 30-fold. For both apo and (Ca 2+ ) 4 -CaM, NMR demonstrated that Na V 1.2 IQ motif peptide (Na V 1.2 IQp ) exclusively made contacts with C-domain residues of CaM (CaM C ). To understand how calcium triggers conformational change at the CaM-IQ interface, we determined a solution structure (2M5E.pdb) of (Ca 2+ ) 2 -CaM C bound to Na V 1.2 IQp . The polarity of (Ca 2+ ) 2 -CaM C relative to the IQ motif was opposite to that seen in apo CaM C -Na v 1.2 IQp (2KXW), revealing that CaM C recognizes nested, anti-parallel sites in Na v 1.2 IQp . Reversal of CaM may require transient release from the IQ motif during calcium binding, and facilitate a re-orientation of CaM N allowing interactions with non-IQ Na V 1.2 residues or auxiliary regulatory proteins interacting in the vicinity of the IQ motif. Copyright © 2017 Elsevier B.V. All rights reserved.

Integrative medicine or infiltrative pseudoscience?

PubMed

Li, Ben; Forbes, Thomas L; Byrne, John

2018-01-02

Evidence-based medicine, first described in 1992, offers a clear, systematic, and scientific approach to the practice of medicine. Recently, the non-evidence-based practice of complementary and alternative medicine (CAM) has been increasing in the United States and around the world, particularly at medical institutions known for providing rigorous evidence-based care. The use of CAM may cause harm to patients through interactions with evidence-based medications or if patients choose to forego evidence-based care. CAM may also put financial strain on patients as most CAM expenditures are paid out-of-pocket. Despite these drawbacks, patients continue to use CAM due to media promotion of CAM therapies, dissatisfaction with conventional healthcare, and a desire for more holistic care. Given the increasing demand for CAM, many medical institutions now offer CAM services. Recently, there has been controversy surrounding the leaders of several CAM centres based at a highly respected academic medical institution, as they publicly expressed anti-vaccination views. These controversies demonstrate the non-evidence-based philosophies that run deep within CAM that are contrary to the evidence-based care that academic medical institutions should provide. Although there are financial incentives for institutions to provide CAM, it is important to recognize that this legitimizes CAM and may cause harm to patients. The poor regulation of CAM allows for the continued distribution of products and services that have not been rigorously tested for safety and efficacy. Governments in Australia and England have successfully improved regulation of CAM and can serve as a model to other countries. Copyright © 2017 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Occurrence and co-occurrence of types of complementary and alternative medicine use by age, gender, ethnicity, and education among adults in the United States: the 2002 National Health Interview Survey (NHIS).

PubMed

Neiberg, Rebecca H; Aickin, Mikel; Grzywacz, Joseph G; Lang, Wei; Quandt, Sara A; Bell, Ronny A; Arcury, Thomas A

2011-04-01

There are widespread assumptions that a large proportion of American adults use a variety of complementary and alternative medicine (CAM) therapies. The goal of this study is to explore the clustering or linkages among CAM categories in the general population. Linkset analysis and data from the 2002 National Health Interview Survey (NHIS) were used to address two specific aims. First, the dominant linkages of CAM categories used by the same individual were delineated, and population estimates were generated of the percentage of American adults using different linksets of CAM categories. Second, it was determined whether dominant linkages of CAM modalities differ by age, gender, ethnicity, and education. Linkset analysis, a method of estimating co-occurrence beyond chance, was used on data from the 2002 NHIS (N = 29,862) to identify possible sets of CAM use. Most adults use CAM therapies from a single category. Approximately 20% of adults combined two CAM categories, with the combination of mind-body therapies and biologically based therapies estimated to be most common. Only 5% of adults use therapies representing three or more CAM categories. Combining therapies across multiple CAM categories was more common among those 46-64, women, whites, and those with a college education. The results of this study allow researchers to refine descriptions of CAM use in the adult population. Most adults do not use a wide assortment of CAM; most use therapies within a single CAM category. Sets of CAM use were found to differ by age, gender, ethnicity, and education in ways consistent with previous research.

Women's reasons for complementary and alternative medicine use: racial/ethnic differences.

PubMed

Chao, Maria T; Wade, Christine; Kronenberg, Fredi; Kalmuss, Debra; Cushman, Linda F

2006-10-01

Although racial/ethnic differences in the prevalence of complementary and alternative medicine (CAM) utilization have been documented, differences in the reasons for using CAM have not been empirically assessed. In an increasingly diverse society, understanding differences in rates of and reasons for CAM use could elucidate cultural and social factors of health behaviors and inform health care improvements. The current study examines reasons for CAM use among women in four racial/ethnic groups. A national telephone survey of 3172 women aged 18 years and older was conducted in four languages. Respondents were asked about their use of remedies or treatments not typically prescribed by a medical doctor. This study focuses on those women who used CAM in the previous year and their reasons for using CAM. Non-Hispanic white women were most likely to cite personal beliefs for CAM use. Cost of conventional medicine was most prevalent among Mexican-American women CAM users. Physician referral, family and friends, and media sources were all equally likely to lead to CAM use in non-Hispanic white women. In contrast, informal networks of family and friends were the most important social influences of CAM use among African-, Mexican-, and Chinese-American women. Racial/ethnic differences in reasons for CAM use highlight cultural and social factors that are important to consider in public evaluation of the risks and benefits of CAM remedies and treatments.

Prevalence and Correlates of Complementary and Alternative Medicine Use among Patients with Lung Cancer: A Cross-Sectional Study in Beirut, Lebanon

PubMed Central

Anouti, Bilal; Haibe, Yolla

2017-01-01

Patients with lung cancer are increasingly seeking complementary and alternative medicine (CAM) to improve their physiological and psychological well-being. This study aimed to assess CAM use among lung cancer patients in Lebanon. Using a cross-sectional design, 150 lung cancer patients attending the Basile Cancer Institute at the American University of Beirut Medical Center were interviewed. Participants completed a questionnaire addressing sociodemographic characteristics, lung cancer condition, and use of CAM. The main outcome of interest was “use of any CAM therapy since diagnosis.” Prevalence of CAM use was 41%. The most commonly used CAM modality among study participants was “dietary supplements/special foods.” Results of the multiple logistic regression analyses showed that CAM use was positively associated with Lebanese nationality and paying for treatment out of pocket and was negatively associated with unemployment and having other chronic diseases. About 10% of patients used CAM on an alternative base, 58% did not disclose CAM use to their physician, and only 2% cited health professionals as influencing their choice of CAM. This study revealed a prevalent CAM use among lung cancer patients in Lebanon, with a marginal role for physicians in guiding this use. Promoting an open-communication and a patient-centered approach regarding CAM use is warranted. PMID:28912824

Complementary and alternative medicine in the undergraduate medical curriculum: a survey of Korean medical schools.

PubMed

Kim, Do Yeun; Park, Wan Beom; Kang, Hee Cheol; Kim, Mi Jung; Park, Kyu-Hyun; Min, Byung-Il; Suh, Duk-Joon; Lee, Hye Won; Jung, Seung Pil; Chun, Mison; Lee, Soon Nam

2012-09-01

The current status of complementary and alternative medicine (CAM) education in Korean medical schools is still largely unknown, despite a growing need for a CAM component in medical education. The prevalence, scope, and diversity of CAM courses in Korean medical school education were evaluated. Participants included academic or curriculum deans and faculty at each of the 41 Korean medical schools. A mail survey was conducted from 2007 to 2010. Replies were received from all 41 schools. CAM was officially taught at 35 schools (85.4%), and 32 schools (91.4%) provided academic credit for CAM courses. The most common courses were introduction to CAM or integrative medicine (88.6%), traditional Korean medicine (57.1%), homeopathy and naturopathy (31.4%), and acupuncture (28.6%). Educational formats included lectures by professors and lectures and/or demonstrations by practitioners. The value order of core competencies was attitude (40/41), knowledge (32/41), and skill (6/41). Reasons for not initiating a CAM curriculum were a non-evidence-based approach in assessing the efficacy of CAM, insufficiently reliable reference resources, and insufficient time to educate students in CAM. This survey reveals heterogeneity in the content, format, and requirements among CAM courses at Korean medical schools. Korean medical school students should be instructed in CAM with a more consistent educational approach to help patients who participate in or demand CAM.

Expression of L1-CAM and ADAM10 in human colon cancer cells induces metastasis.

PubMed

Gavert, Nancy; Sheffer, Michal; Raveh, Shani; Spaderna, Simone; Shtutman, Michael; Brabletz, Thomas; Barany, Francis; Paty, Phillip; Notterman, Daniel; Domany, Eytan; Ben-Ze'ev, Avri

2007-08-15

L1-CAM, a neuronal cell adhesion receptor, is also expressed in a variety of cancer cells. Recent studies identified L1-CAM as a target gene of beta-catenin-T-cell factor (TCF) signaling expressed at the invasive front of human colon cancer tissue. We found that L1-CAM expression in colon cancer cells lacking L1-CAM confers metastatic capacity, and mice injected in their spleen with such cells form liver metastases. We identified ADAM10, a metalloproteinase that cleaves the L1-CAM extracellular domain, as a novel target gene of beta-catenin-TCF signaling. ADAM10 overexpression in colon cancer cells displaying endogenous L1-CAM enhanced L1-CAM cleavage and induced liver metastasis, and ADAM10 also enhanced metastasis in colon cancer cells stably transfected with L1-CAM. DNA microarray analysis of genes induced by L1-CAM in colon cancer cells identified a cluster of genes also elevated in a large set of human colon carcinoma tissue samples. Expression of these genes in normal colon epithelium was low. These results indicate that there is a gene program induced by L1-CAM in colon cancer cells that is also present in colorectal cancer tissue and suggest that L1-CAM can serve as target for colon cancer therapy.

Women's Reasons for Complementary and Alternative Medicine Use: Racial/Ethnic Differences

PubMed Central

CHAO, MARIA T.; WADE, CHRISTINE; KRONENBERG, FREDI; KALMUSS, DEBRA; CUSHMAN, LINDA F.

2009-01-01

Objectives Although racial/ethnic differences in the prevalence of complementary and alternative medicine (CAM) utilization have been documented, differences in the reasons for using CAM have not been empirically assessed. In an increasingly diverse society, understanding differences in rates of and reasons for CAM use could elucidate cultural and social factors of health behaviors and inform health care improvements. The current study examines reasons for CAM use among women in four racial/ethnic groups. Design A national telephone survey of 3172 women aged 18 years and older was conducted in four languages. Respondents were asked about their use of remedies or treatments not typically prescribed by a medical doctor. This study focuses on those women who used CAM in the previous year and their reasons for using CAM. Results Non-Hispanic white women were most likely to cite personal beliefs for CAM use. Cost of conventional medicine was most prevalent among Mexican-American women CAM users. Physician referral, family and friends, and media sources were all equally likely to lead to CAM use in non-Hispanic white women. In contrast, informal networks of family and friends were the most important social influences of CAM use among African-, Mexican-, and Chinese-American women. Conclusions Racial/ethnic differences in reasons for CAM use highlight cultural and social factors that are important to consider in public evaluation of the risks and benefits of CAM remedies and treatments. PMID:17034277

Complementary and alternative medicine use by Canadian university students.

PubMed

Teper, Amy M; Tsai, Ellen

2008-01-01

Studies investigating Complementary and Alternative Medicine (CAM) prevalence are outdated and are generalized across different demographic groups due to their national scope. Determining trends among specific populations is necessary to gain insight into the growing popularity of CAM. To determine the prevalence and factors associated with CAM use among Canadian university undergraduate students and to determine student views regarding CAM research, education and policy-making decisions. Two arbitrarily selected undergraduate student classes at Queen's University were surveyed for this cross-sectional descriptive study. Information was provided by 128 respondents via questionnaire (75% response rate) on key demographics, CAM use and satisfaction with mainstream Canadian healthcare. Upon completion of the survey, voluntary participation was requested for the interview portion resulting in 7 semi-structured qualitative interviews. Of the 128 participants, 90 (70%) claimed to be users of at least one CAM modality. Female gender was strongly associated with CAM use (p<0.001). Other characteristics that may be correlated include being enrolled in a health-related academic program, being dissatisfied with certain aspects of the healthcare system and having parents who use CAM. The majority of respondents desired more research and education on CAM and more collaboration between the two healthcare streams. Canadian university undergraduate students are active CAM users and interest in CAM is high among this population. Further investigation is required to ensure that students are using CAM safely and appropriately.

Web Conversations About Complementary and Alternative Medicines and Cancer: Content and Sentiment Analysis

PubMed Central

Truccolo, Ivana; Antonini, Marialuisa; Rinaldi, Fabio; Omero, Paolo; Ferrarin, Emanuela; De Paoli, Paolo; Tasso, Carlo

2016-01-01

Background The use of complementary and alternative medicine (CAM) among cancer patients is widespread and mostly self-administrated. Today, one of the most relevant topics is the nondisclosure of CAM use to doctors. This general lack of communication exposes patients to dangerous behaviors and to less reliable information channels, such as the Web. The Italian context scarcely differs from this trend. Today, we are able to mine and analyze systematically the unstructured information available in the Web, to get an insight of people’s opinions, beliefs, and rumors concerning health topics. Objective Our aim was to analyze Italian Web conversations about CAM, identifying the most relevant Web sources, therapies, and diseases and measure the related sentiment. Methods Data have been collected using the Web Intelligence tool ifMONITOR. The workflow consisted of 6 phases: (1) eligibility criteria definition for the ifMONITOR search profile; (2) creation of a CAM terminology database; (3) generic Web search and automatic filtering, the results have been manually revised to refine the search profile, and stored in the ifMONITOR database; (4) automatic classification using the CAM database terms; (5) selection of the final sample and manual sentiment analysis using a 1-5 score range; (6) manual indexing of the Web sources and CAM therapies type retrieved. Descriptive univariate statistics were computed for each item: absolute frequency, percentage, central tendency (mean sentiment score [MSS]), and variability (standard variation σ). Results Overall, 212 Web sources, 423 Web documents, and 868 opinions have been retrieved. The overall sentiment measured tends to a good score (3.6 of 5). Quite a high polarization in the opinions of the conversation partaking emerged from standard variation analysis (σ≥1). In total, 126 of 212 (59.4%) Web sources retrieved were nonhealth-related. Facebook (89; 21%) and Yahoo Answers (41; 9.7%) were the most relevant. In total, 94 CAM therapies have been retrieved. Most belong to the “biologically based therapies or nutrition” category: 339 of 868 opinions (39.1%), showing an MSS of 3.9 (σ=0.83). Within nutrition, “diets” collected 154 opinions (18.4%) with an MSS of 3.8 (σ=0.87); “food as CAM” overall collected 112 opinions (12.8%) with a MSS of 4 (σ=0.68). Excluding diets and food, the most discussed CAM therapy is the controversial Italian “Di Bella multitherapy” with 102 opinions (11.8%) with an MSS of 3.4 (σ=1.21). Breast cancer was the most mentioned disease: 81 opinions of 868. Conclusions Conversations about CAM and cancer are ubiquitous. There is a great concern about the biologically based therapies, perceived as harmless and useful, under-rating all risks related to dangerous interactions or malnutrition. Our results can be useful to doctors to be aware of the implications of these beliefs for the clinical practice. Web conversation exploitation could be a strategy to gain insights of people’s perspective for other controversial topics. PMID:27311444

Multi-epoch intranight optical monitoring of eight radio-quiet BL Lac candidates

NASA Astrophysics Data System (ADS)

Kumar, P.; Gopal-Krishna; Stalin, C. S.; Chand, H.; Srianand, R.; Petitjean, P.

2017-10-01

For a new sample of eight weak-line quasars (WLQs) we report a sensitive search in 20 intranight monitoring sessions, for blazar-like optical flux variations on hour-like and longer time-scale (day/month/year-like). The sample consists exclusively of the WLQs that are not radio-loud and either have been classified as 'radio-weak probable BL Lac candidates' and/or are known to have exhibited at least one episode of large, blazar-like optical variability. Whereas only a hint of intranight variability is seen for two of these WLQs, J104833.5+620305.0 (z = 0.219) and J133219.6+622715.9 (z = 3.15), statistically significant internight variability at a few per cent level is detected for three of the sources, including the radio-intermediate WLQ J133219.6+622715.9 (z = 3.15) and the well-known bona fide radio-quiet WLQs J121221.5+534128.0 (z = 3.10) and WLQ J153259.9-003944.1 (z = 4.62). In the rest frame, this variability is intraday and in the far-ultraviolet band. On the time-scale of a decade, we find for three of the WLQs large brightness changes, amounting to 1.655 ± 0.009, 0.163 ± 0.010 and 0.144 ± 0.018 mag, for J104833.5+620305.0, J123743.1+630144.9 and J232428.4+144324.4, respectively. Whereas the latter two are confirmed radio-quiet WLQs, the extragalactic nature of J104833.5+620305.0 remains to be well established, thanks to the absence of any feature(s) in its available optical spectra. This study forms a part of our ongoing campaign of intranight optical monitoring of radio-quiet WLQs, in order to improve the understanding of this enigmatic class of active galactic nuclei and to look among them for a possible tiny, elusive population of radio-quiet BL Lacs.

Self-latching eccentric cam for dual stroke compressor or pump

DOEpatents

Sisk, Francis J.

1985-01-01

For a dual capacity refrigerant compressor of the type which has an eccentric cam rotatable on a crankpin between two opposite positions which changes the total eccentricity of the crankpin and cam so as to obtain two different stroke lengths, the rotation of the cam on the crankpin being effected by a reversal of motor operation, the cam moves through an angle of about 270.degree. around the crankpin so that a centrifugal force torque tending to hold the cam in place is available at least in the reduced stroke length position of the cam, and by providing lightening cavities and eccentric weightings, the center of mass 74 of the cam can be shifted to obtain the centrifugal torque in the proper direction at both the maximum and reduced stroke positions.

Self-latching eccentric cam for dual stroke compressor or pump

DOEpatents

Sisk, F.J.

1985-01-22

For a dual capacity refrigerant compressor of the type which has an eccentric cam rotatable on a crankpin between two opposite positions which changes the total eccentricity of the crankpin and cam so as to obtain two different stroke lengths, the rotation of the cam on the crankpin being effected by a reversal of motor operation, the cam moves through an angle of about 270[degree] around the crankpin so that a centrifugal force torque tending to hold the cam in place is available at least in the reduced stroke length position of the cam, and by providing lightening cavities and eccentric weightings, the center of mass of the cam can be shifted to obtain the centrifugal torque in the proper direction at both the maximum and reduced stroke positions. 7 figs.

High prevalence but limited evidence in complementary and alternative medicine: guidelines for future research

PubMed Central

2014-01-01

The use of complementary and alternative Medicine (CAM) has increased over the past two decades in Europe. Nonetheless, research investigating the evidence to support its use remains limited. The CAMbrella project funded by the European Commission aimed to develop a strategic research agenda starting by systematically evaluating the state of CAM in the EU. CAMbrella involved 9 work packages covering issues such as the definition of CAM; its legal status, provision and use in the EU; and a synthesis of international research perspectives. Based on the work package reports, we developed a strategic and methodologically robust research roadmap based on expert workshops, a systematic Delphi-based process and a final consensus conference. The CAMbrella project suggests six core areas for research to examine the potential contribution of CAM to the health care challenges faced by the EU. These areas include evaluating the prevalence of CAM use in Europe; the EU cititzens’ needs and attitudes regarding CAM; the safety of CAM; the comparative effectiveness of CAM; the effects of meaning and context on CAM outcomes; and different models for integrating CAM into existing health care systems. CAM research should use methods generally accepted in the evaluation of health services, including comparative effectiveness studies and mixed-methods designs. A research strategy is urgently needed, ideally led by a European CAM coordinating research office dedicated to fostering systematic communication between EU governments, the public, charitable and industry funders, researchers and other stakeholders. A European Centre for CAM should also be established to monitor and further a coordinated research strategy with sufficient funds to commission and promote high quality, independent research focusing on the public’s health needs and pan-European collaboration. There is a disparity between highly prevalent use of CAM in Europe and solid knowledge about it. A strategic approach on CAM research should be established to investigate the identified gaps of knowledge and to address upcoming health care challenges. PMID:24499316

Use of complementary and alternative medicine (CAM) by parents in their children and adolescents with epilepsy - Prevelance, predictors and parents' assessment.

PubMed

Hartmann, Nicole; Neininger, Martina P; Bernhard, Matthias K; Syrbe, Steffen; Nickel, Petra; Merkenschlager, Andreas; Kiess, Wieland; Bertsche, Thilo; Bertsche, Astrid

2016-01-01

The use of complementary and alternative medicine (CAM) is popular. Parents of children suffering from epilepsy may also consider administering CAM to their children. Systematic data about frequency of and motivations for CAM use, however, are scarce. In a university hospital's neuropaediatric department parents of patients aged 0-18 years suffering from epilepsy were consecutively invited to take part in a structured interview during 4 months in 2014. Of the invited parents, 164/165 (99%) agreed to participate. From those, 21/164 (13%) stated that they used CAM in their child. The highest independent predictive value of CAM use was the occurrence of adverse drug events (ADE) of anticonvulsants as judged by parents. Patients affected by ADE had a 5.6 higher chance of receiving CAM compared to patients without ADE. Most commonly used were homeopathy (14/21, 67%) and osteopathy (12/21, 57%). The internet was the most frequently used source of information (14/21, 67%). Of the parents, 10/21 (48%) described positive effects of CAM on seizure frequency, 12/21 (57%) on general condition of their child, and 20/21 (95%) wished to continue CAM for epilepsy therapy. From the non-users of CAM, 91/143 (66%) expressed the desire to learn more about CAM for epilepsy therapy. Our study was performed in a university hospital in a large urban city in Eastern Germany. CAM user rates can differ in other parts of Germany and Europe, in other institutions and for chronic diseases other than epilepsy. The main reason for CAM use was the occurrence of ADE of anticonvulsants. More than half of the parents saw a benefit of CAM for their children. Almost all parents wished to continue CAM use, even those who did not see concrete positive effects. Copyright © 2015 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Orexin signaling via the orexin 1 receptor mediates operant responding for food reinforcement.

PubMed

Sharf, Ruth; Sarhan, Maysa; Brayton, Catherine E; Guarnieri, Douglas J; Taylor, Jane R; DiLeone, Ralph J

2010-04-15

Orexin (hypocretin) signaling is implicated in drug addiction and reward, but its role in feeding and food-motivated behavior remains unclear. We investigated orexin's contribution to food-reinforced instrumental responding using an orexin 1 receptor (Ox1r) antagonist, orexin -/- (OKO) and littermate wildtype (WT) mice, and RNAi-mediated knockdown of orexin. C57BL/6J (n = 76) and OKO (n = 39) mice were trained to nose poke for food under a variable ratio schedule of reinforcement. After responding stabilized, a progressive ratio schedule was initiated to evaluate motivation to obtain food reinforcement. Blockade of Ox1r in C57BL/6J mice impaired performance under both the variable ratio and progressive ratio schedules of reinforcement, indicating impaired motivational processes. In contrast, OKO mice initially demonstrated a delay in acquisition but eventually achieved levels of responding similar to those observed in WT animals. Moreover, OKO mice did not differ from WT mice under a progressive ratio schedule, indicating delayed learning processes but no motivational impairments. Considering the differences between pharmacologic blockade of Ox1r and the OKO mice, animals with RNAi mediated knockdown of orexin were then generated and analyzed to eliminate possible developmental effects of missing orexin. Orexin gene knockdown in the lateral hypothalamus in C57BL/6J mice resulted in blunted performance under both the variable ratio and progressive ratio schedules, resembling data obtained following Ox1r antagonism. The behavior seen in OKO mice likely reflects developmental compensation often seen in mutant animals. These data suggest that activation of the Ox1r is a necessary component of food-reinforced responding, motivation, or both in normal mice. Copyright 2010 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Simultaneous assessment of autonomic function and anxiety-related behavior in BALB/c and C57BL/6 mice.

PubMed

Depino, Amaicha Mara; Gross, Cornelius

2007-02-27

In humans, anxiety is accompanied by changes in autonomic nervous system function, including increased heart rate, body temperature, and blood pressure, and decreased heart rate variability. In rodents, anxiety is inferred by examining anxiety-related behavioral responses such as avoidance and freezing, and more infrequently by assessing autonomic responses to anxiogenic stimuli. However, few studies have simultaneously measured behavioral and autonomic responses to aversive stimuli in rodents and it remains unclear whether autonomic measures are reliable correlates of anxiety-related behavior in these animal models. Here we recorded for the first time heart rate and body temperature in freely moving BALB/c and C57BL/6 mice during exposure to an unfamiliar environment. Our data show that upon exposure to a novel open field, BALB/c mice showed increased anxiety-related behavior, reduced heart rate and higher heart rate variability (HRV) when compared with C57BL/6 mice. Regression analysis revealed a significant correlation between both heart rate and long-term HRV measures and locomotor activity and time spent in the center of the open field, but no correlation between body temperature and any behavioral variables. In the free exploration test, in which animals were allowed direct access to a novel environment from a familiar environment without experimenter handling, significant correlations were found only between heart rate and total locomotor activity, but not time spent in the unfamiliar chamber despite increased anxiety-related behavior in BALB/c mice. These findings demonstrate that increased anxiety-related behavior in BALB/c mice is not associated with specific changes in heart rate, HRV, or body temperature.

Perspectives of Oncology Nurses on Complementary and Alternative Medicine in Turkey: A Cross-Sectional Survey.

PubMed

Gok Metin, Zehra; Izgu, Nur; Karadas, Canan; Arikan Donmez, Ayse

In Turkey, between 22.1% and 84.1% of patients with cancer use complementary and alternative medicine (CAM). However, few CAM-related studies have focused on the perspective of oncology nurses. This study aimed to determine the knowledge, attitudes, and practices of Turkish oncology nurses regarding CAM. A descriptive cross-sectional survey of 127 participants was conducted in Ankara, Turkey. A semistructured questionnaire including characteristics, knowledge, attitudes, and practices of oncology nurses toward CAM was administered to participants. We found that more than half of nurses (54.0%) surveyed had no information on CAM modalities. Most oncology nurses (81.1%) used audiovisual media sources to obtain CAM information. Many nurses (81.3%) reported not using any CAM in cancer care, and only 26.8% recommended CAM to patients. Most nurses used CAM to accelerate wound healing (19.7%) and to manage symptoms, including constipation and diarrhea (8.8%) and anxiety (7.9%). Music (52.8%), massage (49.6%), and exercise (48.8%) were stated to be beneficial. Important barriers to use CAM for patients with cancer involved a lack of knowledge (60.6%); needing physician approval to apply any CAM methods to patients (52.1%); legal and institutional issues (47.2%); and limited educational, training, or certificate programs (44.1%). There is a need for increased knowledge about CAM by oncology nurses, considering their vital role in symptom management of patients with cancer. This can be achieved through solving legal and institutional problems, structured and comprehensive education/training programs, and the integration of CAM therapy into cancer care guidelines.

Preventive Screening of Women Who Use Complementary and Alternative Medicine Providers

PubMed Central

Tyree, Patrick T.; Lafferty, William E.

2009-01-01

Abstract Background Many women use complementary and alternative medicine (CAM). Although CAM use has been associated with reductions in conventionally recommended pediatric preventive care (e.g., vaccination), little is known about associations between CAM use and receipt of recommended preventive screening in women. Methods Using Washington State insurance data from 2000 to 2003, the authors generated clustered logistic regression models, examining associations between provider-based CAM use and receipt of screening tests for Chlamydia trachomatis, breast cancer, and cervical cancer: (1) contrasting women who used CAM providers only (alternative use) and women who used both conventional and CAM providers (complementary use) with women who used conventional care only and (2) testing associations between screening and use of four specific CAM provider types—naturopathic physicians, chiropractors, massage therapists, and acupuncturists. Results Both alternative and complementary use was associated with reduced Chlamydia screening. Cancer screening increased with complementary use but decreased with alternative use of CAM. Use of naturopathy was associated with decreased mammography, whereas all four CAM therapies were positively associated with Papanicolaou testing. Conclusions When used in conjunction with conventional care, use of provider-based CAM may signal high interest in various types of health-promoting behavior, including cancer screening. Negative associations between CAM and Chlamydia screening and between naturopathy and mammography require additional study. Interventions with CAM providers and their patients, aimed at improving rates of conventionally recommended screening, might encourage greater focus on preventive care, an important task when CAM providers serve as women's only contact with the healthcare system. PMID:19630554

Perception of cancer patients of their disease, self-efficacy and locus of control and usage of complementary and alternative medicine.

PubMed

Ebel, Marie-Desirée; Rudolph, Ivonne; Keinki, Christian; Hoppe, Andrea; Muecke, Ralph; Micke, Oliver; Muenstedt, Karsten; Huebner, Jutta

2015-08-01

A high percentage of cancer patients use complementary and alternative medicine (CAM). The aim of our study was to learn more about the association of CAM usage, information needs, perceived impact of disease, locus of control and self-efficacy of cancer patients. We asked patients attending a series of lectures on CAM using a standardized questionnaire which integrated questions on information needs, CAM and validated short questionnaires on self-efficacy, perception of the disease and locus of control of reinforcement. One hundred and eighty-five patients answered the questionnaire, from whom 45 % used CAM. Sixty percentage disclosed using CAM to the general practitioner and 57 % to the oncologist. Physicians and nurses, print media and the Internet are the most important source of information on CAM (used by 20-25 % each). Impact on neither daily life, perceived personal control nor coherence was associated with CAM usage, disclosure to physicians or sources of information. There also was no association between CAM usage and self-efficacy. In contrast, there was a significant association between CAM user rate and a high external locus of control. While CAM usage is agreed upon by many physicians due to the idea that it helps patients to become active and feel more in control of the disease, our data are in favor of the contrary. A strong perception of external locus of control seems to be a driver of CAM usage. Physicians should be aware of this association when counseling on CAM.

The Use of Complementary and Alternative Medicine among Lebanese Adults: Results from a National Survey

PubMed Central

Naja, F.; Alameddine, M.; Itani, L.; Shoaib, H.; Hariri, D.; Talhouk, S.

2015-01-01

Objective. To examine the prevalence and correlates of Complementary and Alternative Medicine (CAM) use in Lebanon. Methods. A cross-sectional survey was conducted through face to face interviews on a nationally representative sample of 1,475 Lebanese adults. The survey questionnaire explored the sociodemographic and health related characteristics as well as the types and modes of CAM use. The main outcome in this study was the use of CAM during the last 12 months. Results. Prevalence of CAM use was 29.87% with “folk herbs” being the most commonly used (75%). Two out of five CAM users indicated using it as alternative to conventional therapies and only 28.4% of users disclosed the use of CAM to their physician. CAM use was significantly associated with higher income, presence of a chronic disease, and lack of access to needed health care. Lower odds of CAM use were observed among older adults and those with a higher education level. Conclusions. This study revealed a high prevalence of CAM use in Lebanon. Health policy and decision makers need to facilitate proper regulation and integration of CAM into mainstream medicine and educate health care providers and the public alike on the safe and effective use of CAM therapies. PMID:26106436

Negotiating complementary and alternative medicine use in primary care visits with older patients

PubMed Central

Koenig, Christopher J.; Ho, Evelyn Y.; Yadegar, Vivien; Tarn, Derjung M.

2013-01-01

Objective To empirically investigate the ways in which patients and providers discuss Complementary and Alternative Medicine (CAM) treatment in primary care visits. Methods Audio recordings from visits between 256 adult patients aged 50 years and older and 28 primary care physicians were transcribed and analyzed using discourse analysis, an empirical sociolinguistic methodology focusing on how language is used to negotiate meaning. Results Discussion about CAM occurred 128 times in 82 of 256 visits (32.0%). The most frequently discussed CAM modalities were non-vitamin, non-mineral supplements and massage. Three physician–patient interactions were analyzed turn-by-turn to demonstrate negotiations about CAM use. Patients raised CAM discussions to seek physician expertise about treatments, and physicians adopted a range of responses along a continuum that included encouragement, neutrality, and discouragement. Despite differential knowledge about CAM treatments, physicians helped patients assess the risks and benefits of CAM treatments and made recommendations based on patient preferences for treatment. Conclusion Regardless of a physician's stance or knowledge about CAM, she or he can help patients negotiate CAM treatment decisions. Practice implications Providers do not have to possess extensive knowledge about specific CAM treatments to have meaningful discussions with patients and to give patients a framework for evaluating CAM treatment use. PMID:22483672

Complementary and alternative medicine use among adults in Enugu, Nigeria.

PubMed

Onyiapat, Jane-Lovena E; Okoronkwo, Ijeoma L; Ogbonnaya, Ngozi P

2011-03-04

Attention and interest in the use of Complementary and Alternative Medicine (CAM) has been reawakened globally. Evidence from studies carried out in different parts of the world has established that CAM use is very common and varies among populations. This study investigated the use of CAM among adults in Enugu urban, irrespective of their health status. It provided information on the prevalence of CAM use, forms of CAM remedies used and reasons for utilizing them The study areas were three local government areas in Enugu urban of Enugu State. Cross-sectional survey using questionnaires were administered to randomly selected households. All consenting participants were used for the study 732 participants (37.2% males and 62.8% females) were used for the study. Ages ranged from 18 - 65 years. 620 (84.7%) of the adult population have used CAM ranging from one single type to twenty different types while 112 (15.3%) have not used any form of CAM. The most commonly used CAM product was the biological products, followed by prayer/faith healing. Major reasons for using CAM include their natural state and also for health promotion and maintenance. There is need for adequate policy formulation and regulation to ensure safety and efficacy of CAM products. Measures to ensure rational use of CAM should be instituted.

Temporal and spatial transcriptomic and microRNA dynamics of CAM photosynthesis in pineapple.

PubMed

Wai, Ching M; VanBuren, Robert; Zhang, Jisen; Huang, Lixian; Miao, Wenjing; Edger, Patrick P; Yim, Won C; Priest, Henry D; Meyers, Blake C; Mockler, Todd; Smith, J Andrew C; Cushman, John C; Ming, Ray

2017-10-01

The altered carbon assimilation pathway of crassulacean acid metabolism (CAM) photosynthesis results in an up to 80% higher water-use efficiency than C 3 photosynthesis in plants making it a potentially useful pathway for engineering crop plants with improved drought tolerance. Here we surveyed detailed temporal (diel time course) and spatial (across a leaf gradient) gene and microRNA (miRNA) expression patterns in the obligate CAM plant pineapple [Ananas comosus (L.) Merr.]. The high-resolution transcriptome atlas allowed us to distinguish between CAM-related and non-CAM gene copies. A differential gene co-expression network across green and white leaf diel datasets identified genes with circadian oscillation, CAM-related functions, and source-sink relations. Gene co-expression clusters containing CAM pathway genes are enriched with clock-associated cis-elements, suggesting circadian regulation of CAM. About 20% of pineapple microRNAs have diel expression patterns, with several that target key CAM-related genes. Expression and physiology data provide a model for CAM-specific carbohydrate flux and long-distance hexose transport. Together these resources provide a list of candidate genes for targeted engineering of CAM into C 3 photosynthesis crop species. © 2017 The Authors The Plant Journal © 2017 John Wiley & Sons Ltd.

Negotiating complementary and alternative medicine use in primary care visits with older patients.

PubMed

Koenig, Christopher J; Ho, Evelyn Y; Yadegar, Vivien; Tarn, Derjung M

2012-12-01

To empirically investigate the ways in which patients and providers discuss Complementary and Alternative Medicine (CAM) treatment in primary care visits. Audio recordings from visits between 256 adult patients aged 50 years and older and 28 primary care physicians were transcribed and analyzed using discourse analysis, an empirical sociolinguistic methodology focusing on how language is used to negotiate meaning. Discussion about CAM occurred 128 times in 82 of 256 visits (32.0%). The most frequently discussed CAM modalities were non-vitamin, non-mineral supplements and massage. Three physician-patient interactions were analyzed turn-by-turn to demonstrate negotiations about CAM use. Patients raised CAM discussions to seek physician expertise about treatments, and physicians adopted a range of responses along a continuum that included encouragement, neutrality, and discouragement. Despite differential knowledge about CAM treatments, physicians helped patients assess the risks and benefits of CAM treatments and made recommendations based on patient preferences for treatment. Regardless of a physician's stance or knowledge about CAM, she or he can help patients negotiate CAM treatment decisions. Providers do not have to possess extensive knowledge about specific CAM treatments to have meaningful discussions with patients and to give patients a framework for evaluating CAM treatment use. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Complementary and alternative medicine (CAM) use in an Italian cohort of pediatric headache patients: the tip of the iceberg.

PubMed

Dalla Libera, D; Colombo, B; Pavan, G; Comi, G

2014-05-01

The use of complementary alternative medicine (CAM) in paediatric populations is considerably increased, especially for pain and chronic conditions, as demonstrated by epidemiological surveys both in Europe and in the USA. In our study, CAM was used in 76 % patients of a cohort of 124 children affected by headache (age 4-16 years; 67 % female; 70 % migraine without aura, 12 % migraine with aura, 18 % tensive headache according to IHS criteria) consecutively recruited at a Pediatric Headache University Center. CAM was used as preventive treatment in 80 % cases. The main reasons for seeking CAM were: the wish of avoiding chronic use of drugs with their related side effects, the desire of an integrated approach, the reported inefficacy of conventional medicine, and a more suitable children disposition to CAM than to pharmacological compound. Female gender, younger age, migraine without aura, parents' higher educational status, maternal use of CAM and other associated chronic conditions, correlated with CAM use (p < 0.05). 73 % patients chose CAM also to treat other diseases (i.e. allergies, colitis, asthma, insomnia, muscle-scheletric disorders and dysmenorrhoea). The most assumed CAM were: herbal remedies (64 %) such as Valeriana, Ginkgo biloba, Boswellia serrata, Vitex agnus-castus, passion flower, Linden tree; vitamins/minerals supplements (40 %) with magnesium, 5-Hydroxytryptophan, vitamin B6 or B12, Multivitamin compounds; Homeopathy (47 %) with Silicea, Ignatia Amara, Pulsatilla, Aconitum, Nux Vomica, Calcarea phosphorica; physical treatment (45 %) such as Ayurvedic massage, shiatsu, osteopathy; yoga (33 %); acupuncture (11 %). CAM-often integrated with conventional care-was auto-prescribed in 30 % of the cases, suggested by non-physician in 22 %, by the General Practitioner in 24 % and by paediatrician in 24 %. Both general practitioners and neurologists were mostly unaware of their patients' CAM use. In conclusion, neurologists should inquire for CAM use and be prepared to learn about CAM therapies or to directly interact with CAM trained experts, in order to coordinate an integrative approach to health, as especially required in paediatric headache patients and their parents. Further studies are required to investigate safety and efficacy of CAM in pediatric headache, as a possible side-medicine to conventional pharmacological approach.

The use of complementary and alternative medicine by patients with cancer: a cross-sectional survey in Saudi Arabia.

PubMed

Abuelgasim, Khadega A; Alsharhan, Yousef; Alenzi, Tariq; Alhazzani, Abdulaziz; Ali, Yosra Z; Jazieh, Abdul Rahman

2018-03-12

A significant proportion of cancer patients use complementary and alternative medicine (CAM) along with conventional therapies (CT), whereas a smaller proportion delay or defer CT in favor of CAM. Previous studies exploring CAM use among cancer patients in the Middle East region have shown discrepant results. This study investigates the prevalence and pattern of CAM use by Saudi cancer patients. It also discusses the possible benefits and harm related to CAM use by cancer patients, and it explores the beliefs patients hold and their transparency with health care providers regarding their CAM use. A cross-sectional study was conducted in oncology wards and outpatient clinics by using face-to-face interviews with the participants. A total of 156 patients with a median age of 50 years (18-84) participated in the study. The prevalence of CAM use was 69.9%; the most prominent types of CAM were those of a religious nature, such as supplication (95.4%), Quran recitation (88.1%), consuming Zamzam water (84.4%), and water upon which the Quran has been read (63.3%). Drinking camel milk was reported by 24.1% of CAM users, whereas camel urine was consumed by 15.7%. A variety of reasons were given for CAM use: 75% reported that they were using CAM to treat cancer, enhance mood (18.3%),control pain (11.9%), enhance the immune system (11%),increase physical fitness (6.4%), and improve appetite (4.6%). Thirty percent of CAM users had discussed the issue with their doctors; only 7.7% had done so with their nurses. The use of CAM, including camel products, is highly prevalent among cancer patients in the Middle East, but these patients do not necessarily divulge their CAM use to their treating physicians and nurses. Although CAM use can be beneficial, some can be very harmful, especially for cancer patients. Association is known between camel products and brucellosis and Middle East respiratory syndrome coronavirus (MERS-CoV). Both can lead to tremendous morbidity in immune-compromised patients. Doctor-patient communication regarding CAM use is of paramount importance in cancer care.

Complementary and alternative medicine use amongst Malaysian orthopaedic oncology patients.

PubMed

Dhanoa, Amreeta; Yong, Tze Lek; Yeap, Stephanie Jin Leng; Lee, Isaac Shi Zhung; Singh, Vivek Ajit

2014-10-17

Although studies have shown that a large proportion of cancer patients use CAM, no study on CAM use amongst orthopaedic oncology patients has been published. Therefore, this study aims to determine the prevalence, characteristics and factors associated with CAM use amongst orthopaedic oncology patients. All consecutive consenting patients/parents who presented at the Orthopaedic Oncology Clinic, University Malaya Medical Centre (1st January to 31st December 2013) were interviewed using a structured questionnaire. Overall, one hundred sixty-eight of the 274 patients recruited (61.3%) had used CAM at some time during their current illness. The prevalence of CAM used was 68% (123/181) for patients with malignant tumours and 48.4% (45/93) for patients with benign tumours. The most popular CAMs were biological-based therapies (90.5%), followed by mind-body techniques (40.5%). The most frequently used biological therapies were mega/multivitamins (31%), snakehead (Chana striatus) (28%) and sea cucumber (Stichopus horrens) (18%); whereas prayers (31%) and holy water (13%) dominated the mind-body category. Common reasons for CAM use were to improve physical well-being (60.1%), try out everything that would help (59.5%) and to enhance wound-healing (39.3%). Independent predictors for CAM use in multivariate analysis were paediatric patients [OR 2.46; 95% CI 0.99-6.06; p = 0.05], malignant tumours [OR 1.90; 95% CI 1.12-3.25; p = 0.018] and patients who underwent surgery [OR 2.06; 95% CI 1.15-3.69; p = 0.015]. Majority patients started taking CAMs following suggestions from family members (53%) and friends (49%). Sixty-six percent of patients felt they actually benefitted from CAM and 83.3% were satisfied/very satisfied. Only 5 patients reported side-effects. Majority of CAM users planned to continue CAM use or recommend it to others. However, only 31.5% of patients disclosed their CAM usage to their doctors. This survey revealed a high prevalence of CAM usage amongst orthopaedic oncology patients, with majority patients expressing satisfaction towards CAM. Oncologists should proactively ask patients about CAM to prevent potential adverse effects, as most patients do not share this information with them.

Analysis of Microvariable Activity of BL Lacertae

NASA Astrophysics Data System (ADS)

Sadun, Alberto C.; Asadi-Zeydabadi, Masoud; Hindman, Lauren; Moody, J. Ward

2018-06-01

BL Lac is a low-frequency peaked blazar (LBL) which emits synchrotron radiation at near-IR and optical wavelengths. Therefore optical observations are helpful in, among other things, studying the acceleration and cooling timescales of the electrons in the relativistic jets. We have made very high cadence observations of BL Lac over a number of nights with the Remote Observatory for Variable Object Research (ROVOR). Each night shows secular drift as well as a number of microvariable events lasting only a few minutes each. These data were then processed, compiled, and analyzed in order to examine the underlying mechanism that resulted in such activity. A geometric model is introduced that has worked well in the past on other similar sources.Our relativistic jet model consists of a slowly varying beamed source that already appears bright because it lies nearly to our line of sight. From this, individual relativistic components are ejected a few degrees relative to the aforementioned beaming angle. This is what we believe is responsible for the microvariability emission.

The Systemic Theory of Living Systems and Relevance to CAM: the Theory (Part III)

PubMed Central

2005-01-01

Western medical science lacks a solid philosophical and theoretical approach to disease cognition and therapeutics. My first two articles provided a framework for a humane medicine based on Modern Biophysics. Its precepts encompass modern therapeutics and CAM. Modern Biophysics and its concepts are presently missing in medicine, whether orthodox or CAM, albeit they probably provide the long sought explanation that bridges the abyss between East and West. Key points that differentiate Systemic from other systems' approaches are ‘Intelligence’, ‘Energy’ and the objective ‘to survive’. The General System Theory (GST) took a forward step by proposing a departure from the mechanistic biological concept—of analyzing parts and processes in isolation—and brought us towards an organismic model. GST examines the system's components and results of their interaction. However, GST still does not go far enough. GST assumes ‘Self-Organization’ as a spontaneous phenomenon, ignoring a causative entity or central controller to all systems: Intelligence. It also neglects ‘Survive’ as the directional motivation common to any living system, and scarcely assigns ‘Energy’ its true inherent value. These three parameters, Intelligence, Energy and Survive, are vital variables to be considered, in our human quest, if we are to achieve a unified theory of life. PMID:16136205

Asiago eclipsing binaries program IV. SZ Camelopardalis, a β Cephei pulsator in a quadruple, eclipsing system

NASA Astrophysics Data System (ADS)

Tamajo, E.; Munari, U.; Siviero, A.; Tomasella, L.; Dallaporta, S.

2012-03-01

We present a spectroscopic and photometric analysis of the multiple system and early-type eclipsing binary SZ Cam (O9 IV + B0.5 V), which consists of an eclipsing SB2 pair of orbital period P = 2.7 days in a long orbit (~55 yrs) around a non-eclipsing SB1 pair of orbital period P = 2.8 days. We have reconstructed the spectra of the individual components of SZ Cam from the observed composite spectra using the technique of spectral disentangling. We used them together with extensive and accurate BVIC CCD photometry to obtain an orbital solution. Our photometry revealed the presence of a β Cep variable in the SZ Cam hierarchical system, probably located within the non-eclipsing SB1 pair. The pulsation period is (0.33265 ± 0.00005) days and the observed total amplitude in the B band is (0.0105 ± 0.0005) mag. NLTE analysis of the disentangled spectra provided atmospheric parameters for all three components, consistent with those derived from orbital solution. Full Table 3 is only available at the CDS via anonymous ftp to cdsarc.u-strasbg.fr (130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/539/A139

Objective tropical cyclone extratropical transition detection in high-resolution reanalysis and climate model data

DOE PAGES

Zarzycki, Colin M.; Thatcher, Diana R.; Jablonowski, Christiane

2017-01-22

This paper describes an objective technique for detecting the extratropical transition (ET) of tropical cyclones (TCs) in high-resolution gridded climate data. The algorithm is based on previous observational studies using phase spaces to define the symmetry and vertical thermal structure of cyclones. Storm tracking is automated, allowing for direct analysis of climate data. Tracker performance in the North Atlantic is assessed using 23 years of data from the variable-resolution Community Atmosphere Model (CAM) at two different resolutions (DX 55 km and 28 km), the Climate Forecast System Reanalysis (CFSR, DX 38 km), and the ERA-Interim Reanalysis (ERA-I, DX 80 km).more » The mean spatiotemporal climatologies and seasonal cycles of objectively detected ET in the observationally constrained CFSR and ERA-I are well matched to previous observational studies, demonstrating the capability of the scheme to adequately find events. High resolution CAM reproduces TC and ET statistics that are in general agreement with reanalyses. One notable model bias, however, is significantly longer time between ET onset and ET completion in CAM, particularly for TCs that lose symmetry prior to developing a cold-core structure and becoming extratropical cyclones, demonstrating the capability of this method to expose model biases in simulated cyclones beyond the tropical phase.« less

Development and classification of an operational definition of complementary and alternative medicine for the Cochrane Collaboration

PubMed Central

Wieland, L. Susan; Manheimer, Eric; Berman, Brian M.

2011-01-01

Over the past decade the Cochrane Collaboration has been an increasingly important source of information on complementary and alternative medicine (CAM) therapies. From 2007 to 2008 the Cochrane CAM Field developed a topics list that allowed us to categorize all 396 Cochrane reviews related to CAM (as of The Cochrane Library, Issue 4, 2009). This topics list is an advance in making Cochrane reviews on CAM topics accessible to the public. In this paper, we discuss challenges in developing the topics list, including developing an operational definition of CAM, deciding which reviews should be included within the CAM Field’s scope, developing the structured list of CAM Field-specific topics, and determining where in the topics list the reviews should be placed. Although aspects of our operational definition of CAM are open to revision, a standardized definition provides us with an objective, reproducible and systematic method for defining and classifying CAM therapies. PMID:21717826

Use and interest in complementary and alternative medicine among college students seeking healthcare at a university campus student health center.

PubMed

Nguyen, Jannett; Liu, Michael A; Patel, Rohini J; Tahara, Keli; Nguyen, Annie L

2016-08-01

There is growing data on complementary and alternative medicine (CAM) preferences among college students. While several studies have focused on undergraduate students, there is limited data on graduate students. Cross sectional analysis of undergraduate and graduate students seeking medical care at the University of California Irvine's Student Health Center (SHC). The survey assessed previous CAM use and preferences for future CAM use and education. The majority (67.0%) had used CAM within the last year, 27.0% would use CAM for their current health condition, and 51.9% would consider CAM for their current health condition if they were more knowledgeable. Most respondents desired more CAM education and indicated that they would try CAM modalities if covered under insurance. Most college students requested more knowledge to assist in their decisions to use CAM. These findings provide insight for health centers on the preferences of college student patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

Attitudes, Patterns of Recommendation, and Communication of Pediatric Providers About Complementary and Alternative Medicine in a Large Metropolitan Children’s Hospital

PubMed Central

Kundu, Anjana; Tassone, Rosalie F.; Jimenez, Nathalia; Seidel, Kristy; Valentine, Jessica K.; Pagel, Paul S.

2014-01-01

The authors conducted an Email survey of their medical staff to explore the attitudes, patterns of recommendation, and communication of pediatric providers about complementary and alternative medicine (CAM) in a large metropolitan children’s hospital. Two thirds of the respondents reported awareness about their patients’ CAM therapy use (65%) and recommended CAM therapy to their patients (67%). Providers who reported personal use of CAM (71%) were more likely to recommend CAM to their patients compared with those who do not (76% vs 45%; P < .05). One half of pediatric providers reported occasional consultation with their patient’s CAM provider, but bidirectional communication was rare (4%). Specific changes in care based on a CAM provider’s recommendations were also unusual (4%). Despite the positive attitudes about and willingness to recommend CAM by pediatric providers, communication between these clinicians and CAM providers may be less than ideal. PMID:21127080

Complementary and Alternative Medicine Use in Infertility: Cultural and Religious Influences in a Multicultural Canadian Setting

PubMed Central

Read, Suzanne C.; Carrier, Marie-Eve; Whitley, Rob; Gold, Ian; Tulandi, Togas

2014-01-01

Abstract Objectives: To explore the use of complementary and alternative medicine (CAM) for infertility in a multicultural healthcare setting and to compare Western and non-Western infertility patients' reasons for using CAM and the meanings they attribute to CAM use. Design: Qualitative semi-structured interviews using thematic analysis. Settings/location: Two infertility clinics in Montreal, Quebec, Canada. Participants: An ethnoculturally varied sample of 32 heterosexual infertile couples. Results: CAM used included lifestyle changes (e.g., changing diet, exercise), alternative medicine (e.g., acupuncture, herbal medicines), and religious methods (e.g., prayers, religious talismans). Patients expressed three attitudes toward CAM: desperate hope, casual optimism, and amused skepticism. Participants' CAM use was consistent with cultural traditions of health and fertility: Westerners relied primarily on biomedicine and used CAM mainly for relaxation, whereas non-Westerners' CAM use was often influenced by culture-specific knowledge of health, illness and fertility. Conclusions: Understanding patients' CAM use may help clinicians provide culturally sensitive, patient-centered care. PMID:25127071

Effect of gel formation on the dissolution behavior of clarithromycin tablets.

PubMed

Inukai, Koki; Takiyama, Kei; Noguchi, Shuji; Iwao, Yasunori; Itai, Shigeru

2017-04-15

Clarithromycin (CAM) is a macrolide antibiotic that is widely used at clinical sites. We found that release of CAM is suppressed when tablets of CAM were exposed to an external solvent containing carboxylate buffers such as citrate. The suppressed release of CAM can be attributed to the formation of gels on the tablet surfaces, which inhibits penetration of the solvent into the tablet and thus disintegration of the tablets. Delayed disintegration of the tablets was also observed for commercial tablets. This suggests that taking CAM and carboxylates at the same time might be avoided. The crystal structure of CAM citrate reveals that molecular chains of CAM are cross-linked by hydrogen bond between citrate groups in the crystal. The crystal structure indicates that cross-linked CAM chains of the three-dimensional mesh structure might also be formed in high concentration CAM solutions in the presence of carboxylates, resulting in gel formation. Copyright © 2017 Elsevier B.V. All rights reserved.

Prevalence and correlates of complementary and alternative medicine use among diabetic patients in Beirut, Lebanon: a cross-sectional study

PubMed Central

2014-01-01

Background Patients with Type 2 Diabetes Mellitus (T2DM) are increasingly using complementary and alternative medicine (CAM) therapies due to difficulty in adhering to the therapeutic regimens and lifestyle changes necessary for disease management. Little is known about the prevalence and mode of CAM use among patients with T2DM in Lebanon. Objective To assess the prevalence and modes of CAM use among patients with T2DM residing in Beirut, Lebanon. Methods A cross-sectional survey of T2DM patients was conducted on patients recruited from two major referral centers in Beirut- a public hospital and a private academic medical center. In a face-to-face interview, participants completed a questionnaire comprised of three sections: socio-demographic, diabetes characteristics and types and modes of CAM use. Descriptive statistics, univariate and multivariate logistic regression analyses were utilized to assess the prevalence and correlates of CAM use, as well as whether the use was complementary or alternative to mainstream medicine. The main outcome in this study, CAM use, was defined as using CAM at least once since diagnosis with T2DM. Results A total of 333 T2DM patients completed the survey (response rate: 94.6%). Prevalence of CAM use since diagnosis with the disease was 38%. After adjustment, CAM use was significantly associated with a “married” status, a longer duration of T2DM, the presence of disease complications, and a positive family history of the disease. Folk foods and herbs were the most commonly used CAM followed by natural health products. One in five patients used CAM as alternative to conventional treatment. Only 7% of CAM users disclosed the CAM use to their treating physician. Health care practitioners were the least cited (7%) as influencing the choice of CAM among users. Conclusion The use of CAM therapies among T2DM patients in Lebanon is prevalent. Decision makers and care providers must fully understand the potential risks and benefits of CAM therapies to appropriately advise their patients. Attention must be dedicated to educating T2DM patients on the importance of disclosing CAM use to their physicians especially patients with a family history of diabetes, and those who have had the disease for a long time. PMID:24906634

Prevalence, patterns, and perceived value of complementary and alternative medicine among cancer patients: a cross-sectional, descriptive study.

PubMed

Bahall, Mandreker

2017-06-30

Sophisticated conventional medicine (CM) has brought significant advances to cancer prevention, detection, and treatment. However, many cancer patients still turn to complementary and alternative medicine (CAM) treatment. This study explored the prevalence, patterns, and perceived value of CAM among cancer patients. This quantitative descriptive study was conducted between March 1, 2015, and July 31, 2015, among a cross-sectional, convenience sample of patients from the Oncology Department of San Fernando General Hospital in Trinidad and Tobago. Face-to-face interviews were conducted at the oncology clinic and treatment suite after obtaining informed consent. Data analysis included descriptive analysis, chi-square tests, and binary logistic regression analysis. The prevalence of CAM use among a sample of 350 cancer patients was 39.1% (39.6% for breast cancer, 44.4% for prostate cancer, 37% for ovarian cancer, and 38.7% for colon cancer patients). Herbs were the most common type of CAM used (93.4%), followed by spiritual therapy (73.7%). CAM use was more prevalent among females (68.6%), Indo-Trinidadians (63.5%), and patients aged 41-50 years (37.2%). The majority (70%-80%) rated CAM efficacy on perceived value. CAM was used mainly because of a desire to try anything that might help (67.6%), followed by it being congruent with the patients' beliefs (59.1%). Patients knew about CAM mainly through friends (69.3%) and family (69.3%). Most patients were generally satisfied (93.6%) and considered CAM helpful (89.8%), but the majority never informed their health care provider of CAM use (78.8%). Patients reported the simultaneous use of more than one type of CAM, without considering or knowing of possible side-effects. The perceived value of CAM included empowerment, control, cure, and improved quality of life. CAM use was associated with age, but no predictors of CAM use could be identified. Medicinal herbs and spiritual therapy are commonly used among cancer patients because of perceived benefits and satisfaction. CAM use is more prevalent among females, Indo-Trinidadians, and patients aged 41-50 years old. There are no useful predictors of CAM use. More than one type of CAM is commonly used simultaneously without disclosure to health care providers.

Short timescale photometric and polarimetric behavior of two BL Lacertae type objects

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

Covino, S.; Baglio, M. C.; Foschini, L.

Context. Blazars are astrophysical sources whose emission is dominated by non-thermal processes, typically interpreted as synchrotron and inverse Compton emission. Although the general picture is rather robust and consistent with observations, many aspects are still unexplored. Aims. Polarimetric monitoring can offer a wealth of information about the physical processes in blazars. Models with largely different physical ingredients can often provide almost indistinguishable predictions for the total flux, but usually are characterized by markedly different polarization properties. We explore, with a pilot study, the possibility to derive structural information about the emitting regions of blazars by means of a joint analysismore » of rapid variability of the total and polarized flux at optical wavelengths. Methods. Short timescale (from tens of seconds to a couple of minutes) optical linear polarimetry and photometry for two blazars, BL Lacertae and PKS 1424+240, was carried out with the PAOLO polarimeter at the 3.6 m Telescopio Nazionale Galileo. Several hours of almost continuous observations were obtained for both sources. Results. Our intense monitoring allowed us to draw strongly different scenarios for BL Lacertae and PKS 1424+240, with the former characterized by intense variability on time-scales from hours to a few minutes and the latter practically constant in total flux. Essentially the same behavior is observed for the polarized flux and the position angle. The variability time-scales turned out to be as short as a few minutes, although involving only a few percent variation of the flux. The polarization variability time-scale is generally consistent with the total flux variability. Total and polarized flux appear to be essentially uncorrelated. However, even during our relatively short monitoring, different regimes can be singled out. Conclusions. No simple scenario is able to satisfactorily model the very rich phenomenology exhibited in our data. As a result, detailed numerical simulations show that the emitting region should be characterized by some symmetry, and the inclusion of turbulence for the magnetic field may constitute the missing ingredient for a more complete interpretation of the data.« less

Short timescale photometric and polarimetric behavior of two BL Lacertae type objects

DOE PAGES

Covino, S.; Baglio, M. C.; Foschini, L.; ...

2015-06-05

Context. Blazars are astrophysical sources whose emission is dominated by non-thermal processes, typically interpreted as synchrotron and inverse Compton emission. Although the general picture is rather robust and consistent with observations, many aspects are still unexplored. Aims. Polarimetric monitoring can offer a wealth of information about the physical processes in blazars. Models with largely different physical ingredients can often provide almost indistinguishable predictions for the total flux, but usually are characterized by markedly different polarization properties. We explore, with a pilot study, the possibility to derive structural information about the emitting regions of blazars by means of a joint analysismore » of rapid variability of the total and polarized flux at optical wavelengths. Methods. Short timescale (from tens of seconds to a couple of minutes) optical linear polarimetry and photometry for two blazars, BL Lacertae and PKS 1424+240, was carried out with the PAOLO polarimeter at the 3.6 m Telescopio Nazionale Galileo. Several hours of almost continuous observations were obtained for both sources. Results. Our intense monitoring allowed us to draw strongly different scenarios for BL Lacertae and PKS 1424+240, with the former characterized by intense variability on time-scales from hours to a few minutes and the latter practically constant in total flux. Essentially the same behavior is observed for the polarized flux and the position angle. The variability time-scales turned out to be as short as a few minutes, although involving only a few percent variation of the flux. The polarization variability time-scale is generally consistent with the total flux variability. Total and polarized flux appear to be essentially uncorrelated. However, even during our relatively short monitoring, different regimes can be singled out. Conclusions. No simple scenario is able to satisfactorily model the very rich phenomenology exhibited in our data. As a result, detailed numerical simulations show that the emitting region should be characterized by some symmetry, and the inclusion of turbulence for the magnetic field may constitute the missing ingredient for a more complete interpretation of the data.« less

Knowledge of, Attitudes Toward, and Experience of Complementary and Alternative Medicine in Western Medicine– and Oriental Medicine–Trained Physicians in Korea

PubMed Central

Lee, Sang-Il; Khang, Young-Ho; Lee, Moo-Song; Kang, Weechang

2002-01-01

Objectives. We compared knowledge of, attitudes toward, and experience with complementary and alternative medicine (CAM) among Western medicine–trained doctors (WMDs) and Oriental medicine–trained doctors (OMDs). Methods. In Korea, 502 WMDs and 500 OMDs were interviewed with a structured questionnaire. Results. OMDs held more favorable attitudes toward CAM than did WMDs. OMDs possessed a deeper understanding of and greater experience with CAM. OMDs more readily endorsed health beliefs congruent with CAM. Conclusions. In the future, CAM can be more readily used by OMDs than by WMDs. Because evidence for the effectiveness of CAM remains sparse, more research is needed for the prudent use of CAM in Korea. An education and training system for potential CAM providers remains to be developed. PMID:12453822

Perspectives of complementary and alternative medicine (CAM) practitioners in the support and treatment of infertility.

PubMed

O'Reilly, Erin; Sevigny, Marika; Sabarre, Kelley-Anne; Phillips, Karen P

2014-10-14

Infertility patients are increasingly using complementary and alternative medicine (CAM) to supplement or replace conventional fertility treatments. The objective of this study was to determine the roles of CAM practitioners in the support and treatment of infertility. Ten semi-structured interviews were conducted in Ottawa, Canada in 2011 with CAM practitioners who specialized in naturopathy, acupuncture, traditional Chinese medicine, hypnotherapy and integrated medicine. CAM practitioners played an active role in both treatment and support of infertility, using a holistic, interdisciplinary and individualized approach. CAM practitioners recognized biological but also environmental and psychosomatic determinants of infertility. Participants were receptive to working with physicians, however little collaboration was described. Integrated infertility patient care through both collaboration with CAM practitioners and incorporation of CAM's holistic, individualized and interdisciplinary approaches would greatly benefit infertility patients.

Complementary and Alternative Medicine Use and Adherence to Asthma Medications among Latino and Non-Latino White Families

PubMed Central

McQuaid, Elizabeth L.; Fedele, David A.; Adams, Sue K.; Koinis-Mitchell, Daphne; Mitchell, Jessica; Kopel, Sheryl J.; Seifer, Ronald; Jandasek, Barbara; Fritz, Gregory K.; Canino, Glorisa

2013-01-01

Objective The current study sought to evaluate patterns of complementary and alternative medicine (CAM) use in a sample of Latino and Non-Latino white (NLW) children with asthma, to determine whether parental beliefs about conventional medications and barriers to obtaining these medications were related to CAM use, and to assess whether CAM use was associated with decreased adherence to controller medications. Methods Participants included 574 families of children with asthma from Non-Latino White, Puerto Rican, and Dominican backgrounds from RI and from Island Puerto Rico. All parents completed a brief checklist of barriers to medication use and an assessment of CAM approaches. A subsample of 259 families had controller medication use monitored objectively for approximately one month by MDILog (fluticasone propionate), TrackCap (montelukast), or dosage counter (fluticasone/salmeterol combination). Results Prevalence of CAM use was high among Latino families. Perceived barriers to obtaining medication were related to increased CAM use in Puerto Rican families from RI. Elevated medication concerns were positively associated with CAM use among NLW and Island PR families. CAM use was positively related to objective adherence within NLW families, and unrelated in other groups. Conclusions CAM use is common among Latino families with asthma. Among some families, CAM use may be initiated as a way to cope with barriers to obtaining medication or when parents have concerns about conventional medications. Families who report CAM use do not appear to be substituting CAM for conventional asthma medication. PMID:24602583

Family Medicine Residency Program Directors Attitudes and Knowledge of Family Medicine CAM Competencies

PubMed Central

Gardiner, Paula; Filippelli, Amanda C.; Lebensohn, Patricia; Bonakdar, Robert

2013-01-01

Context Little is known about the incorporation of integrative medicine (IM) and complementary and alternative medicine (CAM) into family medicine residency programs. Objective The Society for Teachers of Family Medicine (STFM) approved a set of CAM/IM competencies for family medicine residencies. We hope to evaluate with an online survey tool, whether residency programs are implementing such competencies into their curriculum. We also hope to assess the knowledge and attitudes of Residency Directors (RDs) on the CAM/IM competencies. Design A survey was distributed by the CAFM (Council of Academic Family Medicine) Educational Research Alliance to RDs via email. The survey was distributed to 431 RDs. Of those who received it, 212 responded for a response rate of 49.1%. Questions assessed the knowledge and attitudes of CAM/IM competencies and incorporation of CAM/IM into residency curriculum. Results Forty-five percent of RDs were aware of the competencies. In term of RD attitudes, 58% reported that CAM/IM is an important component of residents' curriculum yet, 60% report not having specific learning objectives for CAM/IM in their residency curriculum. Among all programs, barriers to CAM/IM implementation included: time in residents' schedules (77%); faculty training (75%); access to CAM experts (43%); lack of reimbursement (43%), and financial resources (29%). Conclusions While many RDs are aware of the STFM CAM/IM competencies and acknowledge their role in residence education, there are many barriers preventing residencies to implementing the STFM CAM/IM competencies. PMID:24021471

Family medicine residency program directors attitudes and knowledge of family medicine CAM competencies.

PubMed

Gardiner, Paula; Filippelli, Amanda C; Lebensohn, Patricia; Bonakdar, Robert

2013-01-01

Little is known about the incorporation of integrative medicine (IM) and complementary and alternative medicine (CAM) into family medicine residency programs. The Society for Teachers of Family Medicine (STFM) approved a set of CAM/IM competencies for family medicine residencies. We hope to evaluate whether residency programs are implementing such competencies into their curriculum using an online survey tool. We also hope to assess the knowledge and attitudes of Residency Directors (RDs) on the CAM/IM competencies. A survey was distributed by the Council of Academic Family Medicine (CAFM) Educational Research Alliance to RDs via e-mail. The survey was distributed to 431 RDs. Of those who received it, 212 responded, giving a response rate of 49.1%. Questions assessed the knowledge and attitudes of CAM/IM competencies and incorporation of CAM/IM into the residency curriculum. Forty-five percent of RDs were aware of the competencies. In terms of RD attitudes, 58% reported that CAM/IM is an important component of residents' curriculum; yet, 60% report not having specific learning objectives for CAM/IM in their residency curriculum. Among all programs, barriers to CAM/IM implementation included time in residents' schedules (77%); faculty training (75%); access to CAM experts (43%); lack of reimbursement (43%); and financial resources (29%). While many RDs are aware of the STFM CAM/IM competencies and acknowledge their role in residence education, there are many barriers that prevent residencies from implementing the STFM CAM/IM competencies. © 2013 Elsevier Inc. All rights reserved.

Comparative study of RetCamRetCam II vs. binocular ophthalmoscopy in a screening program for retinopathy of prematurity.

PubMed

Tejada-Palacios, P; Zarratea, L; Moral, M; de la Cruz-Bértolo, J

2015-08-01

To determine the performance of RetCam vs. binocular ophthalmoscopy (BIO) in a screening program for retinopathy of prematurity (ROP). Observational comparative study with prospective data collection. Examinations with RetCam (n=169) were performed on 83 infants included in a screening program for ROP and stored for analysis at a later stage. An experienced ophthalmologist examined the ocular fundus with binocular indirect ophthalmoscopy (BIO). The RetCam images were assessed for the presence of ROP, zone, grade, and presence of plus disease. RetCam and BIO data were compared by visually to estimate sensitivity, specificity, positive (VPP) and negative (VPN) predictive values. ROP disease was detected in 108 eyes with BIO, and in 74 with RetCam. Out of 306 eyes examined with RetCam, false negative results were found in 34 eyes, with no false positives. Sensitivity of RetCam exam vs. BIO was 0.68, and specificity was 0.99. Positive predictive value was 0.93 and negative predictive value was 0.85. All 34 ROP cases not detected with RetCam were in zone III or outer zone II. They were all mild and regressed spontaneously. No threshold ROP was missed with RetCam. Binocular indirect ophthalmoscopy is the reference method for the diagnosis of ROP. RetCam may be used as an alternative for ROP screening. Copyright © 2010 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

Attitudes of members of the German Society for Palliative Medicine toward complementary and alternative medicine for cancer patients.

PubMed

Conrad, A C; Muenstedt, K; Micke, O; Prott, F J; Muecke, R; Huebner, J

2014-07-01

A high proportion of cancer patients use complementary and alternative medicine (CAM). In oncology, risks of CAM are side effects and interactions. Our aim was to conduct a survey on professionals in palliative care regarding attitudes toward CAM. An internet-based survey with a standardized questionnaire was sent to all members of the German Society for Palliative Care. The questionnaire collected data on attitude toward CAM and experiences. Six hundred and ninety questionnaires (19 %) were returned (49 % physicians, 35 % nurses, 3 % psychologists). Acceptance of CAM is high (92 % for complementary and 54 % for alternative medicine). Most participants had already been asked on CAM by patients (95 %) and relatives (89 %). Forty-four percent already had used complementary methods and 5 % alternative methods. Only 21 % think themselves adequately informed. Seventy-four percent would use complementary methods in a patient with advanced tumor, and 62 % would use alternative therapy in patients if there was no other therapy. Even from those who are skeptical 45 % would treat a patient with alternative methods. In order to inform patients on CAM and to further patients' autonomy, evidence on benefits and harms of CAM must be provided. As awareness of risks from CAM is low and critical appraisal especially of alternative medicine missing, but interest on information on CAM is high, experts should provide evidence-based recommendations for CAM in palliative care to members of different professions. This could be done by a curriculum focusing on the most often used CAM methods.

Multiwavelength Observations of Markarian 421 During a TeV/X-Ray Flare

NASA Technical Reports Server (NTRS)

Bertsch, D. L.; Bruhweiler, F.; Macomb, D. J.; Cheng, K.-P.; Carter-Lewis, D. A.; Akerlof, C. W.; Aller, H. D.; Aller, M. F.; Buckley, J. H.; Cawley, M. F.

1995-01-01

A TeV flare from the BL Lac object Mrk 421 was detected in May of 1994 by the Whipple Observatory air Cherenkov experiment during which the flux above 250 GeV increased by nearly an order of magnitude over a 2-day period. Contemporaneous observations by ASCA showed the X-ray flux to be in a very high state. We present these results, combined with the first ever simultaneous or nearly simultaneous observations at GeV gamma-ray, UV, IR, mm, and radio energies for this nearest BL Lac object. While the GeV gamma-ray flux increased slightly, there is little evidence for variability comparable to that seen at TeV and X-ray energies. Other wavelengths show even less variability. This provides important constraints on the emission mechanisms at work. We present the multiwavelength spectrum of this gamma-ray blazar for both quiescent and flaring states and discuss the data in terms of current models of blazar emission.

Laser Transformation Hardening of Firing Zone Cutout Cams.

DTIC Science & Technology

1981-06-01

bath nitriding to case harden firing zone cutout cams for the Mk 10 Guided Missile Launcher System (GMLS). These cams, machined of 4340 steel ...salt bath nitriding to case harden firing zone cutout cams for the Mk 10 Guided Missile Launcher System (GMLS). These cams, machined of 4340 steel ...Patterns ........ ................ 8 9 Laser Beam Step Pattern ...... .................. .. 10 10 Hardness Profile, 4340 Steel

Physician and patient attitudes towards complementary and alternative medicine in obstetrics and gynecology

PubMed Central

Furlow, Mandi L; Patel, Divya A; Sen, Ananda; Liu, J Rebecca

2008-01-01

Background In the U.S., complementary and alternative medicine (CAM) use is most prevalent among reproductive age, educated women. We sought to determine general attitudes and approaches to CAM among obstetric and gynecology patients and physicians. Methods Obstetrician-gynecologist members of the American Medical Association in the state of Michigan and obstetric-gynecology patients at the University of Michigan were surveyed. Physician and patient attitudes and practices regarding CAM were characterized. Results Surveys were obtained from 401 physicians and 483 patients. Physicians appeared to have a more positive attitude towards CAM as compared to patients, and most reported routinely endorsing, providing or referring patients for at least one CAM modality. The most commonly used CAM interventions by patients were divergent from those rated highest among physicians, and most patients did not consult with a health care provider prior to starting CAM. Conclusion Although obstetrics/gynecology physicians and patients have a positive attitude towards CAM, physician and patients' view of the most effective CAM therapies were incongruent. Obstetrician/gynecologists should routinely ask their patients about their use of CAM with the goal of providing responsible, evidence-based advice to optimize patient care. PMID:18582380

AUTONOMOUS AND NONAUTONOMOUS REGULATION OF WNT-MEDIATED NEURONAL POLARITY BY THE C. ELEGANS ROR KINASE CAM-1

PubMed Central

Chien, Shih-Chieh Jason; Gurling, Mark; Kim, Changsung; Craft, Teresa; Forrester, Wayne; Garriga, Gian

2015-01-01

Wnts are a conserved family of secreted glycoproteins that regulate various developmental processes in metazoans. Three of the five C. elegans Wnts, CWN-1, CWN-2 and EGL-20, and the sole Wnt receptor of the Ror kinase family, CAM-1, are known to regulate the anterior polarization of the mechanosensory neuron ALM. Here we show that CAM-1 and the Frizzled receptor MOM-5 act in parallel pathways to control ALM polarity. We also show that CAM-1 has two functions in this process: an autonomous signaling function that promotes anterior polarization and a nonautonomous Wnt-antagonistic function that inhibits anterior polarization. These antagonistic activities can account for the weak ALM phenotypes displayed by cam-1 mutants. Our observations suggest that CAM-1 could function as a Wnt receptor in many developmental processes, but the analysis of cam-1 mutants may fail to reveal CAM-1’s role as a receptor in these processes because of its Wnt-antagonistic activity. In this model, loss of CAM-1 results in increased levels of Wnts that act through other Wnt receptors, masking CAM-1’s autonomous role as a Wnt receptor. PMID:25917219

Integration of complementary and alternative medicine information and advice in chronic disease management guidelines.

PubMed

Team, Victoria; Canaway, Rachel; Manderson, Lenore

2011-01-01

The growing evidence on the benefits and risks of complementary and alternative medicine (CAM) and its high rate of use (69% of Australians) - particularly for chronic or recurrent conditions - means increasing attention on CAM. However, few people disclose CAM use to their GP, and health professionals tend to inadequately discuss CAM-related issues with their patients, partly due to insufficient knowledge. As clinical and non-clinical chronic condition management guidelines are a means to educate primary health care practitioners, we undertook a content analysis of guidelines relevant to two common chronic conditions - cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) - to assess their provision of CAM-related information. Ten current Australian guidelines were reviewed, revealing scant CAM content. When available, the CAM-relevant information was brief, in some cases unclear, inconclusive and lacking in direction to the GP or health care provider. Although we focus on CVD and T2DM, we argue the value of all chronic condition management guidelines integrating relevant evidence-informed information and advice on CAM risks, benefits and referrals, to increase GP awareness and knowledge of appropriate CAM therapies, and potentially to facilitate doctor-client discussion about CAM.

Prevalence and parental perceptions of complementary and alternative medicine use by children with cancer in a multi-ethnic Southeast Asian population.

PubMed

Hamidah, Alias; Rustam, Zainudin A; Tamil, Azmi M; Zarina, Latiff A; Zulkifli, Zakaria S; Jamal, Rahman

2009-01-01

The purpose of the current study was to determine the prevalence of use of complementary and alternative medicine (CAM) by children with cancer and to compare the characteristics of CAM users and CAM nonusers. A cross-sectional study was performed at a pediatric oncology center in Kuala Lumpur, Malaysia. The parents of 97 children with cancer were interviewed using a structured questionnaire. Overall, 84.5% of the respondents had used CAM, and most of them believed that CAM provided a boost to the immune system, and used CAM with the intention to complement conventional treatment. The most frequently used CAM was water therapy (78%), followed by spirulina (33%), vitamin C (27%), multivitamin (23%), visit to traditional healers (22%), sea cucumber (Stichopus horrens) (15%), and Chinese traditional medicine (12%). The Malay (n = 67) were using more often (93%) CAM than non-Malay (n = 30, use 67%, P = 0.001). CAM use is common among Malaysian children with cancer. Understanding the sociocultural dimension of patients' health beliefs is important to a successful treatment, and pediatric oncologists should ask for the use of CAM.

Differential expression and functional analysis of three calmodulin isoforms in germinating pea (Pisum sativum L.) seeds.

PubMed

Duval, Frédéric D; Renard, Michelle; Jaquinod, Michel; Biou, Valérie; Montrichard, Françoise; Macherel, David

2002-11-01

Implication of the ubiquitous, highly conserved, Ca2+ sensor calmodulin (CaM) in pea seed germination has been investigated. Mass spectrometry analysis of purified CaM revealed the coexistence in seeds of three protein isoforms, diverging from each other by single amino acid substitution in the N-terminal alpha-helix. CaM was shown to be encoded by a small multigenic family, and full-length cDNAs of the three isoforms (PsCaM1, 2 and 3) were isolated to allow the design of specific primers in more divergent 5' and 3' untranslated regions. Expression studies, performed by semiquantitative RT-PCR, demonstrated differential expression patterns of the three transcripts during germination. PsCaM1 and 2 were detected at different levels in dry axes and cotyledons, and they accumulated during imbibition and prior to radicle protrusion. In contrast, PsCaM3 appeared only upon radicle protrusion, then gradually increased in both tissues. To characterise the biochemical properties of the CaM isoforms, functional analyses were conducted in vitro using recombinant Strep-tagged proteins (CaM1-ST, CaM2-ST and CaM3-ST) expressed in Escherichia coli. Gel mobility shift assays revealed that CaM1-ST exhibited a stoichiometric binding of a synthetic amphiphilic CaM kinase II peptide while CaM2-ST and CaM3-ST affinities for the same peptide were reduced. Affinity differences were also observed for CaM isoform binding to Trp-3, an idealised helical CaM-binding peptide. However, the three proteins activated in the same way the CaM-dependent pea NAD kinase. Finally, the significance of the single substitutions upon CaM interaction with its targets is discussed in a structural context.

The use of complementary and alternative medicines during breastfeeding: results from the Herbal supplements in Breastfeeding InvesTigation (HaBIT).

PubMed

Bettiol, Alessandra; Lombardi, Niccolò; Marconi, Ettore; Crescioli, Giada; Bonaiuti, Roberto; Maggini, Valentina; Gallo, Eugenia; Mugelli, Alessandro; Firenzuoli, Fabio; Ravaldi, Claudia; Vannacci, Alfredo

2018-05-16

Use of complementary and alternative medicines (CAMs) during breastfeeding is commonly increasing, mainly due to their presumed higher safety compared to conventional medications. Indeed, CAMs can cause serious adverse effects, and high-quality evidence supporting their use during lactation is limited. In Italy, specific investigations on the attitude of lactating women towards CAMs are lacking. The Herbal supplements in Breastfeeding InvesTigation (HaBIT) aimed to explore the attitudes and knowledge on CAMs among lactating women. A web-based survey was conducted over a six-year period among lactating women resident in Tuscany (Italy). Data on lactating behavior, CAMs use during pregnancy or breastfeeding, and women knowledge about CAMs' efficacy and safety were collected. 388 lactating women answered the questionnaire; the majority of them were primiparae with high education level. Two-hundred and four women declared to have been CAMs users during breastfeeding. Moreover, the 61 and 48% of subjects reported CAMs use also before and during pregnancy. A significant proportion of subjects were unable to correctly identify the type of CAMs they were using. The 73% of women were convinced that CAMs had higher or comparable safety than conventional medications; nevertheless, 65% of women admitted to have no scientific information about the potential risks of CAMs, and 14 CAMs users reported to have experienced side effects. These results claim the necessity that healthcare providers amplify their role to increase nursing women' awareness about CAMs. Further research is needed to support the evidence base of non-pharmaceutical approaches for symptom control during breastfeeding. This article is protected by copyright. All rights reserved.

Insights into molecular interactions between CaM and its inhibitors from molecular dynamics simulations and experimental data.

PubMed

González-Andrade, Martin; Rodríguez-Sotres, Rogelio; Madariaga-Mazón, Abraham; Rivera-Chávez, José; Mata, Rachel; Sosa-Peinado, Alejandro; Del Pozo-Yauner, Luis; Arias-Olguín, Imilla I

2016-01-01

In order to contribute to the structural basis for rational design of calmodulin (CaM) inhibitors, we analyzed the interaction of CaM with 14 classic antagonists and two compounds that do not affect CaM, using docking and molecular dynamics (MD) simulations, and the data were compared to available experimental data. The Ca(2+)-CaM-Ligands complexes were simulated 20 ns, with CaM starting in the "open" and "closed" conformations. The analysis of the MD simulations provided insight into the conformational changes undergone by CaM during its interaction with these ligands. These simulations were used to predict the binding free energies (ΔG) from contributions ΔH and ΔS, giving useful information about CaM ligand binding thermodynamics. The ΔG predicted for the CaM's inhibitors correlated well with available experimental data as the r(2) obtained was 0.76 and 0.82 for the group of xanthones. Additionally, valuable information is presented here: I) CaM has two preferred ligand binding sites in the open conformation known as site 1 and 4, II) CaM can bind ligands of diverse structural nature, III) the flexibility of CaM is reduced by the union of its ligands, leading to a reduction in the Ca(2+)-CaM entropy, IV) enthalpy dominates the molecular recognition process in the system Ca(2+)-CaM-Ligand, and V) the ligands making more extensive contact with the protein have higher affinity for Ca(2+)-CaM. Despite their limitations, docking and MD simulations in combination with experimental data continue to be excellent tools for research in pharmacology, toward a rational design of new drugs.

Gender Differences in the Use of Complementary and Alternative Medicine and Their Association With Moderate Mental Distress in U.S. Adults With Migraines/Severe Headaches.

PubMed

Rhee, Taeho Greg; Harris, Ila M

2017-01-01

We examined whether the prevalence of complementary and alternative medicine (CAM) use varies by gender, and assessed the interaction of gender and CAM use on moderate mental distress (MMD) in U.S. adults with migraines/severe headaches. We used data from the 2012 National Health Interview Survey, which represents non-institutionalized U.S. adults with migraines/severe headaches (n = 4645 unweighted). Using a cross-sectional design with survey sampling techniques, we conducted descriptive analyses for prevalence of CAM use by gender. Multivariate logistic regression analyses were run to investigate potential roles of migraines/severe headaches and CAM use on MMD by gender. The overall prevalence of past year CAM use was 44.4%. Women consistently used CAM more frequently than men (P = .004). The most commonly used CAM types included herbal supplements (22.2%), massage (14.2%), and chiropractic/osteopathic (13.9%). After controlling for covariates, the odds of MDD were increased by the presence of migraines/severe headaches (P < .001) and the use of any CAM (P < .001). The interaction effect of migraines/severe headaches and CAM use decreased the odds of MMD by 27% in women (P < .05), but not in men. Women used CAM more frequently than men among adults with migraines/severe headaches in the United States. In addition, the interaction of gender and CAM use exists; the CAM use was associated with decreased odds of MMD among women only, suggesting that women with migraines/severe headaches may have benefited from CAM for their mental distress. Future research is needed to explore why such patterns vary by gender. © 2016 American Headache Society.

Calmodulin in complex with the first IQ motif of myosin-5a functions as an intact calcium sensor

PubMed Central

Shen, Mei; Zhang, Ning; Zheng, Sanduo; Zhang, Wen-Bo; Zhang, Hai-Man; Lu, Zekuan; Su, Qian Peter; Sun, Yujie; Li, Xiang-dong

2016-01-01

The motor function of vertebrate myosin-5a is inhibited by its tail in a Ca2+-dependent manner. We previously demonstrated that the calmodulin (CaM) bound to the first isoleucine-glutamine (IQ) motif (IQ1) of myosin-5a is responsible for the Ca2+-dependent regulation of myosin-5a. We have solved the crystal structure of a truncated myosin-5a containing the motor domain and IQ1 (MD-IQ1) complexed with Ca2+-bound CaM (Ca2+-CaM) at 2.5-Å resolution. Compared with the structure of the MD-IQ1 complexed with essential light chain (an equivalent of apo-CaM), MD-IQ1/Ca2+-CaM displays large conformational differences in IQ1/CaM and little difference in the motor domain. In the MD-IQ1/Ca2+-CaM structure, the N-lobe and the C-lobe of Ca2+-CaM adopt an open conformation and grip the C-terminal and the N-terminal portions of the IQ1, respectively. Remarkably, the interlobe linker of CaM in IQ1/Ca2+-CaM is in a position opposite that in IQ1/apo-CaM, suggesting that CaM flip-flops relative to the IQ1 during the Ca2+ transition. We demonstrated that CaM continuously associates with the IQ1 during the Ca2+ transition and that the binding of CaM to IQ1 increases Ca2+ affinity and substantially changes the kinetics of the Ca2+ transition, suggesting that the IQ1/CaM complex functions as an intact Ca2+ sensor responding to distinct calcium signals. PMID:27647889

Solution Structure of Calmodulin Bound to the Binding Domain of the HIV-1 Matrix Protein*

PubMed Central

Vlach, Jiri; Samal, Alexandra B.; Saad, Jamil S.

2014-01-01

Subcellular distribution of calmodulin (CaM) in human immunodeficiency virus type-1 (HIV-1)-infected cells is distinct from that observed in uninfected cells. CaM co-localizes and interacts with the HIV-1 Gag protein in the cytosol of infected cells. Although it has been shown that binding of Gag to CaM is mediated by the matrix (MA) domain, the structural details of this interaction are not known. We have recently shown that binding of CaM to MA induces a conformational change that triggers myristate exposure, and that the CaM-binding domain of MA is confined to a region spanning residues 8–43 (MA-(8–43)). Here, we present the NMR structure of CaM bound to MA-(8–43). Our data revealed that MA-(8–43), which contains a novel CaM-binding motif, binds to CaM in an antiparallel mode with the N-terminal helix (α1) anchored to the CaM C-terminal lobe, and the C-terminal helix (α2) of MA-(8–43) bound to the N-terminal lobe of CaM. The CaM protein preserves a semiextended conformation. Binding of MA-(8–43) to CaM is mediated by numerous hydrophobic interactions and stabilized by favorable electrostatic contacts. Our structural data are consistent with the findings that CaM induces unfolding of the MA protein to have access to helices α1 and α2. It is noteworthy that several MA residues involved in CaM binding have been previously implicated in membrane binding, envelope incorporation, and particle production. The present findings may ultimately help in identification of the functional role of CaM in HIV-1 replication. PMID:24500712

USE OF COMPLEMENTARY AND ALTERNATIVE MEDICINE IN GEORGIA.

PubMed

Nadareishvili, I; Lunze, K; Tabagari, N; Beraia, A; Pkhakadze, G

2017-11-01

In Georgia, like in most countries globally, people commonly resort to complementary and alternative medicine (CAM). However, not much is known about CAM practices there. The aim of the study was to document common practices of CAM in Georgia and related patient attitudes. We collected data from peoples who commonly use CAM at 20 service provision centers in Georgia using cluster sampling from 300 patients. We admininstered a cross-sectional survey and conducted descriptive statistical analyses. People in Georgia use CAM either for prevention to improve general health (33%) or to treat chronic conditions (36%), spending about 25 Euros per month out of pocket. Most (77%) get their knowledge about CAM from family or friends , less than half (44%) from books or media, and 11% from medical providers. A close person's advice or experience was the most common rationale given for CAM use (54%). In our sample, 17% either don't trust or are unsatisfied with conventional medicine, 29% found CAM treatment "very effective" and 61% "quite/partially" effective; only 5% not effective. Conventional treatment was stopped in half of the cases. 35% of respondents informed their physicians of their CAM use, while about half did not. Public mistrust towards conventional medicine, CAM user high satisfaction, relatively low cost of such services in Georgia - are the factors letting us to suggest that CAM use will further increase. Frequent self taking decisions made by patients to stop physician prescribed treatment, not informing physicians on CAM use, as well as other factors put patients health at risk. Further research and capacity building in practice, education and other related aspects are needed to establish evidence-based regulation and standards for CAM in Georgia that ensure informed decision making and patient safety.

Overexpression of HepaCAM inhibits cell viability and motility through suppressing nucleus translocation of androgen receptor and ERK signaling in prostate cancer.

PubMed

Song, Xuedong; Wang, Yin; Du, Hongfei; Fan, Yanru; Yang, Xue; Wang, Xiaorong; Wu, Xiaohou; Luo, Chunli

2014-07-01

HepaCAM is suppressed in a variety of human cancers, and involved in cell adhesion, growth, migration, invasion, and survival. However, the expression and function of HepaCAM in prostate cancer are still unknown. HepaCAM expression has been detected by RT-PCR, Western blotting and immunohistochemistry staining in prostate cell lines RWPE-1, LNCap, DU145, PC3, and in 75 human prostate tissue specimens, respectively. Meanwhile, the cell proliferation ability was detected by WST-8 assay. The role of HepaCAM in prostate cancer cell migration and invasion was examined by wound healing and transwell assay. And flow cytometry was used to observe the apoptosis of prostate cancer cells. Then we detected changes of Androgen Receptor translocation and ERK signaling using immunofluorescence staining and western blot after overexpression of HepaCAM. The HepaCAM expression was significantly down-regulated in prostate cancer tissues and undetected in prostate cancer cells. However, the low HepaCAM expression was not statistically associated with clinicopathological characteristics of prostate cancer. Overexpression of HepaCAM in prostate cancer cells decreased the cell proliferation, migration and invasion, and induced the cell apoptosis. Meanwhile, HepaCAM prevented the androgen receptor translocation from the cytoplasm to the nucleus and down-regulated the MAPK/ERK signaling. Our results suggested that HepaCAM acted as a tumor suppressor in prostate cancer. HepaCAM inhibited cell viability and motility which might be through suppressing the nuclear translocation of Androgen Receptor and down-regulating the ERK signaling. Therefore, it was indicated that HepaCAM may be a potential therapeutic target for prostate cancer. © 2014 Wiley Periodicals, Inc.

Complementary alternative medicine use among patients with dengue fever in the hospital setting: a cross-sectional study in Malaysia.

PubMed

Ching, SiewMooi; Ramachandran, Vasudevan; Gew, Lai Teck; Lim, Sazlyna Mohd Sazlly; Sulaiman, Wan Aliaa Wan; Foo, Yoke Loong; Zakaria, Zainul Amiruddin; Samsudin, Nurul Huda; Lau, Paul Chih Ming Chih; Veettil, Sajesh K; Hoo, Fankee

2016-01-29

In Malaysia, the number of reported cases of dengue fever demonstrates an increasing trend. Since dengue fever has no vaccine or antiviral treatment available, it has become a burden. Complementary and alternative medicine (CAM) has become one of the good alternatives to treat the patients with dengue fever. There is limited study on the use of CAM among patients with dengue fever, particularly in hospital settings. This study aims to determine the prevalence, types, reasons, expenditure, and resource of information on CAM use among patients with dengue fever. This is a descriptive, cross-sectional study of 306 patients with dengue fever, which was carried out at the dengue clinic of three hospitals. Data were analysed using IBM SPSS Statistics version 21.0 and logistic regression analysis was used to determine the factors associated with CAM use. The prevalence of CAM use was 85.3% among patients with dengue fever. The most popular CAMs were isotonic drinks (85.8%), crab soup (46.7%) and papaya leaf extract (22.2%). The most common reason for CAM use was a good impression of CAM from other CAM users (33.3%). The main resource of information on CAM use among patients with dengue fever was family (54.8%). In multiple logistic regression analysis, dengue fever patients with a tertiary level are more likely to use CAM 5.8 (95% confidence interval (CI 1.62-20.45) and 3.8 (95% CI 1.12-12.93) times than secondary level and primary and below respectively. CAM was commonly used by patients with dengue fever. The predictor of CAM use was a higher level of education.

Calmodulin in complex with the first IQ motif of myosin-5a functions as an intact calcium sensor.

PubMed

Shen, Mei; Zhang, Ning; Zheng, Sanduo; Zhang, Wen-Bo; Zhang, Hai-Man; Lu, Zekuan; Su, Qian Peter; Sun, Yujie; Ye, Keqiong; Li, Xiang-Dong

2016-10-04

The motor function of vertebrate myosin-5a is inhibited by its tail in a Ca 2+ -dependent manner. We previously demonstrated that the calmodulin (CaM) bound to the first isoleucine-glutamine (IQ) motif (IQ1) of myosin-5a is responsible for the Ca 2+ -dependent regulation of myosin-5a. We have solved the crystal structure of a truncated myosin-5a containing the motor domain and IQ1 (MD-IQ1) complexed with Ca 2+ -bound CaM (Ca 2+ -CaM) at 2.5-Å resolution. Compared with the structure of the MD-IQ1 complexed with essential light chain (an equivalent of apo-CaM), MD-IQ1/Ca 2+ -CaM displays large conformational differences in IQ1/CaM and little difference in the motor domain. In the MD-IQ1/Ca 2+ -CaM structure, the N-lobe and the C-lobe of Ca 2+ -CaM adopt an open conformation and grip the C-terminal and the N-terminal portions of the IQ1, respectively. Remarkably, the interlobe linker of CaM in IQ1/Ca 2+ -CaM is in a position opposite that in IQ1/apo-CaM, suggesting that CaM flip-flops relative to the IQ1 during the Ca 2+ transition. We demonstrated that CaM continuously associates with the IQ1 during the Ca 2+ transition and that the binding of CaM to IQ1 increases Ca 2+ affinity and substantially changes the kinetics of the Ca 2+ transition, suggesting that the IQ1/CaM complex functions as an intact Ca 2+ sensor responding to distinct calcium signals.

The use of complementary and alternative medicine in adults with depressive disorders. A critical integrative review.

PubMed

Solomon, Daniela; Adams, Jon

2015-07-01

Depression has been identified as one of the most frequent indications for CAM use and is a strong predictor of CAM use. The present article provides a critical review of CAM use for depressive disorders including bipolar depression by addressing prevalence of CAM use and CAM users׳ characteristics, motivation, decision-making and communication with healthcare providers. A comprehensive search of 2003-2014 international literature in the Medline, CINAHL, AMED, and SCOPUS databases was conducted. The search was confined to peer-reviewed articles published in English with abstracts and reporting new empirical research findings regarding CAM use and depressive disorders. A considerable level of CAM use was observed among both general and clinical populations of people suffering from depressive disorders, many of whom use CAM concurrently with their conventional medicine. In particular, high rates of CAM use were found among those with bipolar disorder, an illness known to cause substantial impairments in health-related quality of life. Concomitant prescription medication use ranged from 0.52% to as high as 100%. Study design such as the inclusion of bipolar and depression in the same diagnostic category hamper the differentiation and attribution of CAM usage for symptoms. Findings of our review show that enduring impairments in function and persistence of symptoms (as reflected by increased CAM use proportional to severity of illness and comorbidity) are the impetus for sufferers of depressive illness to seek out CAM. The psychosocial factors associated with CAM use in depressive illnesses and severe mental illness are yet to be established. Subsequent research amongst those with depressive disorders would be informative in clarifying the range of motivations associated with mental illness. Copyright © 2015 Elsevier B.V. All rights reserved.

Observational Evaluation of Simulated Land-Atmosphere Coupling on the U.S. Southern Great Plains

NASA Astrophysics Data System (ADS)

Phillips, T. J.; Klein, S. A.

2014-12-01

In a recent study of observed features of land-atmosphere coupling (LAC) at the ARM Southern Great Plains (ARM SGP) site in northern Oklahoma (Phillips and Klein, 2014 Journal of Geophysical Research), we identified statistically significant interactions between 1997-2008 summertime daily averages of soil moisture (at 10 cm depth) and a number of surface atmospheric variables, such as surface evaporation, relative humidity, and temperature. Here we will report on an evaluation of similar features of LAC simulated by version 5 of the global Community Atmosphere Model (CAM5), coupled to its native CLM4 land model, and downscaled to the vicinity of the ARM SGP site. In these case studies, the CAM5 was initialized from a 6-hourly atmospheric reanalysis for each day of the years 2008 and 2009 (where the CLM4 land state was equilibrated to the atmospheric model state), thus permitting a close comparison of the modeled and observed summer daily average features of the LAC in these years. Correlation coefficients R and "sensitivity indices" I (a measure of the comparative change of an atmospheric variable for a one-standard-deviation change in soil moisture) provided quantitative measures of the respective coupling strengths. Such a comparison of observed versus modeled LAC is complicated by differences in atmospheric forcings of the land; for example, the CAM5's summertime precipitation is too scant, and thus the model's upper soil layer often is drier than observed. The modeled daily average covariations of soil moisture with lower atmospheric variables also display less coherence (lower R values), but sometimes greater "sensitivity" (higher I values) than are observed at the ARM SGP site. Since the observational estimate of LAC may itself be sensitive to soil moisture measurement biases, we also will report on a planned investigation of the dependence of LAC on several alternative choices of soil moisture data sets local to the ARM SGP site. AcknowledgmentsThis work was funded by the U.S. Department of Energy Office of Science and was performed at the Lawrence Livermore National Laboratory under Contract DE-AC52-07NA27344.

Problems and programming for analysis of IUE high resolution data for variability

NASA Technical Reports Server (NTRS)

Grady, C. A.

1981-01-01

Observations of variability in stellar winds provide an important probe of their dynamics. It is crucial however to know that any variability seen in a data set can be clearly attributed to the star and not to instrumental or data processing effects. In the course of analysis of IUE high resolution data of alpha Cam and other O, B and Wolf-Rayet stars several effects were found which cause spurious variability or spurious spectral features in our data. Programming was developed to partially compensate for these effects using the Interactive Data language (IDL) on the LASP PDP 11/34. Use of an interactive language such as IDL is particularly suited to analysis of variability data as it permits use of efficient programs coupled with the judgement of the scientist at each stage of processing.

Use of complementary and alternative medicine during pregnancy and the postpartum period: an analysis of the National Health Interview Survey.

PubMed

Birdee, Gurjeet S; Kemper, Kathi J; Rothman, Russell; Gardiner, Paula

2014-10-01

Complementary and alternative medicine (CAM) is commonly used among women, but few national data exist regarding CAM use during pregnancy or the postnatal period. Data from the 2007 National Health Interview Survey were analyzed for women ages between the ages of 18 and 49 years who were pregnant or had children less than 1 year old. CAM use was identified based on standard definitions of CAM from the National Institutes of Health's National Center for Complementary and Alternative Medicine. CAM use among women who were pregnant or with a child less than 1 year was compared with the other similarly aged female responders. CAM use was examined among these women stratified by sociodemographics, health conditions, and conventional medicine use through bivariable and multivariable logistic regression models. Among pregnant and postpartum women from the ages of 19 to 49 years in the United States, 37% of pregnant women and 28% of postpartum women reported using CAM in the last 12 months compared with 40% of nonpregnant/non-postpartum women. Mind-body practices were the most common CAM modality reported, with one out of four women reporting use. Biological therapies, excluding vitamins and minerals, during the postpartum period were used by only 8% of women. Using multivariable regression modeling, we report no significant difference in CAM use among pregnant compared with non-pregnant women (adjusted odds ratio [AOR], 0.88; [95% confidence interval 0.65-1.20]), but lower CAM use among postpartum women compared with non-pregnant women (AOR 0.67; [0.52-0.88]), while adjusting for sociodemographics. CAM use among pregnancy similar to women who are not pregnant, while postpartum CAM use decreases. Further evaluation of CAM therapies among pregnant and postpartum women is necessary to determine the costs and benefits of integrative CAM therapies in conventional care.

Use of complementary and alternative medicine for children: a parents' perspective.

PubMed

Gad, Ashry; Al-Faris, Eiad; Al-Rowais, Noura; Al-Rukban, Mohamed

2013-10-01

The present study aims to detect the frequency and types of complementary and alternative medicine (CAM) therapies used for children and to explore parental motivating factors for using CAM for their children in Riyadh, Saudi Arabia. This is a cross-sectional study that involved 462 families selected through a multistage cluster-sampling technique covering Riyadh region, Saudi Arabia. The sample was selected from 40 clusters, distributed proportionally according to the size of the population in the catchment area of primary health care centres (PHCCs). A structured questionnaire that contains items fulfilling the research objectives was used to collect data by research assistants. The study included 926 parents, comprising 351 fathers and 575 mothers; 37.3% of them reported the use of CAM for their children including reciting the Quran, honey and Ferula asafoetida (26.1%, 21.5% and 18.8%, respectively). CAM was used six times higher for children of parents using CAM for themselves than children of parents who did not use CAM themselves (odds ratio (OR)=6.03, 3.9-9.37). Multivariate logistic regression showed that parental use of CAM (OR=3.0, 2.2-4.0), keeping CAM remedies at home (OR=2.3, 1.8-3.1), perceived success of CAM in practice (OR=1.8, 1.3-2.4) and preference of use of natural materials (OR=1.7, 1.2-2.5) were independent predictors of use of CAM for children. In this study, around one-third of the parents used CAM for their children. Quran (Muslims' holy book) was the most common CAM type used for children. Parents' use of CAM for themselves is the most important predictor of its use for children. An in-depth study to investigate CAM use for specific diseases in children is recommended. Copyright © 2013 Elsevier Ltd. All rights reserved.

3D-CAM: Derivation and Validation of a 3-Minute Diagnostic Interview for CAM-defined Delirium

PubMed Central

Marcantonio, Edward R.; Ngo, Long H.; O’Connor, Margaret; Jones, Richard N.; Crane, Paul K.; Metzger, Eran D.; Inouye, Sharon K.

2015-01-01

Background Delirium is common, morbid, and costly, yet remains often unrecognized in most clinical settings. The Confusion Assessment Method (CAM) is the most widely used diagnostic algorithm, and operationalizing its features would represent a substantial advance for clinical care. Objective To derive the 3D-CAM, a new 3-minute diagnostic assessment for CAM-defined delirium, and to validate it against a clinical reference standard. Design Diagnostic test study Setting 4 general medicine units in an academic medical center Participants 201 inpatients aged ≥ 75 years old Measurements We identified 20 items that best operationalized the 4 CAM diagnostic features to create the 3D-CAM. For prospective validation, 3D-CAM assessments were administered by trained research assistants. Independently, clinicians performed an extensive assessment that included patient interviews, family interviews, and review of the medical record. These data were considered by an expert panel to determine the presence or absence of delirium and dementia (reference standard). We compared the 3D-CAM delirium determination to the reference standard in all patients and in subgroups with and without dementia. Results The 201 participants in the prospective validation study had mean age (SD) of 84 (5.5) years, and 27% had dementia. The expert panel identified delirium in 21%. Median administration time for 3D-CAM was 3 minutes (inter-quartile range: 2–5 minutes). The sensitivity [95% CI] of 3D-CAM was 95% [84%, 99%] and the specificity was 94% [90%, 97%]. The 3D-CAM performed well in patients both with dementia (sensitivity=96% [82%, 100%], specificity=86% [67%, 96%]) and without dementia (sensitivity=93% [66%, 100%], specificity=96% [91%,99%]). Limitations Limited to single center, cross-sectional, and medicine patients only Conclusion The 3D-CAM operationalizes the CAM algorithm using a 3-minute structured assessment with high sensitivity and specificity relative to a reference standard and could be an important tool for improving recognition of delirium. PMID:25329203

Complementary and alternative medicines use among pediatric patients with epilepsy in a multiethnic community.

PubMed

Chen, Chunliang; Chong, Ying Jie; Hie, Szu Liang; Sultana, Rehena; Lee, Sze Huay Dorothy; Chan, Wei Shih Derrick; Chan, Sui Yung; Cheong, Han Hui

2016-07-01

Prior studies highlighted that patients on chronic medications who used complementary and alternative medicines (CAMs) did not share this information with their healthcare providers. Furthermore, there might be potential adverse interactions between CAMs and antiepileptic drug (AED) therapy. However, there are no studies that investigate the effect of religion or race on CAM use in a multiethnic community. Therefore, we aimed to investigate CAM usage among pediatric patients with epilepsy (PPE) and identify predictors of CAM usage in our multiethnic setting. This was a cross-sectional study where caregivers of recruited at an outpatient epilepsy clinic between September 2013 and July 2014 completed a self-administered survey. Those who declined participation, lacked understanding of English or Mandarin, or missed the clinic appointments were excluded. Those caring for more than one patient participated only once. Of the 195 surveys collected, 178 were used for analysis. The PPE used an average of 1.50 AEDs (range: 0-4). Forty-nine (27.5%) caregivers reported giving CAMs to their PPE. Commonly used CAMs were multivitamins (44.4%), traditional herbs (42.2%), and acupuncture (17.4%). Multivitamins were mostly given by Christian/Catholic caregivers while Buddhist caregivers mostly gave traditional herbs or acupuncture. The majority of the CAM users were Chinese. Univariate analysis showed that caregivers with secondary school (high school) education were 3.52 times more likely to use CAMs compared to those with primary school (elementary school) education. While some caregivers gave CAMs to their PPE, they had various misconceptions and did not discuss the usage with their healthcare providers. We propose that the predictors identified in this study can help to identify potential CAM users. Healthcare providers should routinely probe about the usage of CAMs by PPE, and thereafter, the suitability of CAM use could be evaluated. The caregivers will benefit from open discussion with healthcare professionals on the safe use of AEDs with or without CAMs. Copyright © 2016 Elsevier Inc. All rights reserved.

The CUPCIG (CAM-Use in Primary Care in Germany) Study:Part I-Pain. Study Protocol of a Pilot-trial to Assess Feasibility, Acceptability and Perceived Effectiveness of CAM in Pain Disorders in Primary Care.

PubMed

Schencking, Martin; Sönnichsen, Andreas; Bassüner, Susanne; Redaelli, Marcus

2015-01-01

There is limited valid data available on CAM procedures for chronic joint and neuropathic pain in primary care in Germany. Indiviual CAM qualifications of the general practitioners (GPs) and the potential of cost reduction through CAM treatment are almost unknown. The aim of this pilot trial preceding the main study is to examine the survey mode, to estimate the response rate by GPs with or without an additional qualification for CAM, and to identify the status quo in therapeutic approaches for chronic pain disorders in primary care. This is a cross-sectional study with an ex post facto design among German GPs consisting of 2 parts: In a first step, a pilot trial precedes the main study targeting 200 GPs with and 200 GPs without additional qualification in CAM in a selected region. The results of the CUPCIG study comprise the distribution of pain types treated in primary care practices, the GPs' attitude toward complementary pain therapy, pharmacological or CAM treatment, the estimate of cost reduction through CAM treatment of pain, the application of diverse CAM procedures, and biographical data. The CUPCIG study serves to compile pain therapy approaches in primary care in Germany with respect to the individual CAM expertise of the GPs. © 2015 S. Karger GmbH, Freiburg.

Complementary and alternative medicine use by pediatric specialty outpatients.

PubMed

Adams, Denise; Dagenais, Simon; Clifford, Tammy; Baydala, Lola; King, W James; Hervas-Malo, Marilou; Moher, David; Vohra, Sunita

2013-02-01

Complementary and alternative medicine (CAM) use is high among children and youth with chronic illnesses. The objective of this study was to assess the prevalence and patterns of CAM use in 10 subspecialty clinics in Canada and to compare CAM use between 2 geographically diverse locations. This survey was carried out at 1 Children's Hospital in western Canada (Edmonton) and 1 Children's Hospital in central Canada (Ottawa). Questionnaires were completed by parents in either French or English. Although demographic characteristics of the 2 populations were similar, CAM use at the western hospital was 71% (n = 704) compared with 42% (n = 222) at the central hospital (P < .0001). Most respondents agreed or strongly agreed that they feel comfortable discussing CAM in their clinic. The most common CAM products currently used were multivitamins/minerals, herbal products, and homeopathic remedies. The most common CAM practices currently used were massage, chiropractic, relaxation, and aromatherapy. Eighty adverse effects were reported, and 55 (68.8%) of these were self-assessed as minor. Results of this study indicate that CAM use is high among pediatric specialty clinic outpatients and is much greater in the western than in the central hospital. Most respondents felt that their CAM use was helpful with few or no harms associated. Many patients, using CAM alongside their conventional medicines, are still not discussing their CAM use with their physicians and are increasing the likelihood for potential interactions and preventable harms.

National survey of China's oncologists' knowledge, attitudes, and clinical practice patterns on complementary and alternative medicine.

PubMed

Yang, Geliang; Lee, Richard; Zhang, Huiqing; Gu, Wei; Yang, Peiying; Ling, Changquan

2017-02-21

It is common for cancer patients to use complementary and alternative medicine (CAM). This study was designed to explore China's oncologists' knowledge, attitudes and clinical practices regarding CAM use by their patients. An online survey was conducted of China's oncologists. Among 11,270 participants who completed the online survey, 6,007 (53.3%) were identified as oncologists. Most were men (75.2%), with a mean age of 33.4 (standard deviation: 6.5) years. The 6,007 oncologists discussed with 36.5% of their patients about CAM. Most of them (75.6%) did not want to initiate discussions due to lack of knowledge on CAM. Oncologists estimated that 40.0% of their patients used CAM treatments. Oncologists reported that 28.7% of their patients underwent anticancer therapy with the concurrent use of CAM. Four out of five of the responding oncologists self-reported inadequate knowledge and only 22.0% reported receiving professional education on CAM. Nearly half (44.9%) of the oncologists believed CAM treatment was effective for symptoms and treatment of cancer. Physician factors associated with initiating discussions with patients about CAM use included sex, age (≥ 33 years), medical license for traditional Chinese medicine, enough knowledge and professional education experience. China's oncologists infrequently discussed with their patients about CAM due to lack of knowledge. Most of the oncologists did not encourage CAM use.

Use of complementary and alternative medicine among midlife Arab women living in Qatar.

PubMed

Gerber, L M; Mamtani, R; Chiu, Y-L; Bener, A; Murphy, M; Cheema, S; Verjee, M

2014-10-12

The prevalence of use of complementary and alternative medicine (CAM) is widespread and is growing worldwide. This cross-sectional study in Qatar examined the use of CAM and its correlates among Arab women in their midlife years. Women aged 40-60 years (n = 814) were recruited at primary care centres in Qatar and completed a specially designed, pre-tested questionnaire. Overall, 38.2% of midlife women in Qatar had used CAM in the previous 12 months. Nutritional remedies and herbal remedies were the most commonly used CAM therapies, followed by physical methods. Qatari nationality and higher level of education were independently associated with CAM use. Menopause transition status was not independently associated with use of CAM. The prevalence of CAM use by women in Qatar was high, consistent with other reports worldwide. It is essential to educate and inform patients and health-care providers about the benefits and limitations associated with CAM.

Complementary and alternative medicine - representations in popular magazines.

PubMed

Dunne, Alexandra; Phillips, Christine

2010-09-01

More than half the patients who use complementary and alternative medicine (CAM) in Australia do not discuss it with their doctors. Many consumers use popular media, especially women's magazines, to learn about CAM. To explore representations of CAM in popular Australian women's magazines. Content analysis of three Australian magazines: Australian Women's Weekly, Dolly and New Idea published from January to June 2008. Of 220 references to CAM (4-17 references per issue), most were to biologically based practices, particularly 'functional foods', which enhance health. Most representations of CAM were positive (81.3% positive, 16.4% neutral, 2.3% negative). Explanations of modes of action of CAM tended to be biological but relatively superficial. Australian magazines cast CAM as safe therapy which enhances patient engagement in healthcare, and works in ways analogous to orthodox medical treatments. General practitioners can use discussions with their patients about CAM to encourage health promoting practices.

Hopelessness and complementary therapy use in patients with ovarian cancer.

PubMed

Gross, Anne H; Cromwell, Jerry; Fonteyn, Marsha; Matulonis, Ursula A; Hayman, Laura L

2013-01-01

Hopelessness negatively affects ovarian cancer patients' quality of life (QOL). Research validating the effects of complementary and alternative medicine (CAM) use on QOL and hope is scarce, even though QOL and hope are reasons that patients cite for using CAM therapy. Clinicians need effective, evidence-based interventions to improve QOL and reduce hopelessness. The objectives of this study were to examine factors influencing hopelessness in patients with newly diagnosed disease, long-term survivors, and patients experiencing ovarian cancer recurrence and to examine the effects of CAM on hopelessness in the same population. Surveys of ovarian cancer patients (N = 219) undergoing treatment at a comprehensive cancer center in the United States were analyzed. Descriptive, correlation, and multivariate analyses described variables and demonstrated the effects of sociodemographics, disease state, psychological distress, QOL, CAM use, and faith on hopelessness. Patients ages 65 years or older (-0.95, P = .03), with strong faith (-0.28, P = .00), and good QOL (0.11, P = .00) directly reduced hopelessness scores (mean, 3.37). Massage therapy substantially reduced hopelessness scores (-1.07, P = .02); holding age constant, employed patients were twice as likely to use massage (odds ratio, 2.09; P = .04). Patients who had newly diagnosed and recurrent ovarian cancer were more hopeless because of greater distress from symptoms and adverse effects of treatment. Patients who used massage therapy were significantly less hopeless, as were those with strong faith and well-controlled disease symptoms and treatment for adverse effects. Support of spiritual needs and symptom management are important interventions to prevent and/or reduce hopelessness, especially for patients with newly diagnosed and recurrent ovarian cancer. Further research testing the positive effect of massage interventions on hopelessness is needed.

An Analysis of News Media Coverage of Complementary and Alternative Medicine

PubMed Central

Bonevski, Billie; Wilson, Amanda; Henry, David A.

2008-01-01

Background To examine the accuracy and adequacy of lay media news stories about complementary and alternative medicines and therapies. Methodology/Principal Findings A descriptive analysis of news stories about complementary and alternative medicine (CAM) in the Australian media using a national medical news monitoring website, mediadoctor.org.au. Each story was rated against 10 criteria by two individuals. Consensus scores of 222 news articles reporting therapeutic claims about complementary medicines posted on mediadoctor.org.au between 1 January 2004 and 1 September 2007 were calculated. The overall rating score for 222 CAM articles was 50% (95% CI 47% to 53%). There was a statistically significant (F = 3.68, p = 0.006) difference in cumulative mean scores according to type of therapy: biologically based practices (54%, 95% CI 50% to 58%); manipulative body based practices (46%, 95% CI 39% to 54%), whole medical systems (45%, 95% CI 32% to 58%), mind body medicine (41%, 95% CI 31% to 50%) and energy medicine (33%, 95% CI 11% to 55%). There was a statistically significant difference in cumulative mean scores (F = 3.72, p = 0.0001) according to the clinical outcome of interest with stories about cancer treatments (62%, 95% CI 54% to 70%) scoring highest and stories about treatments for children's behavioural and mental health concerns scoring lowest (31%, 95% CI 19% to 43%). Significant differences were also found in scores between media outlets. Conclusions/Significance There is substantial variability in news reporting practices about CAM. Overall, although they may be improving, the scores remain generally low. It appears that much of the information the public receives about CAM is inaccurate or incomplete. PMID:18545688

Tetraspecific scFv construct provides NK cell mediated ADCC and self-sustaining stimuli via insertion of IL-15 as a cross-linker

PubMed Central

Schmohl, Joerg U.; Felices, Martin; Todhunter, Deborah; Taras, Elizabeth; Miller, Jeffrey S.; Vallera, Daniel A.

2016-01-01

Background The design of a highly effective anti-cancer immune-engager would include targeting of highly drug refractory cancer stem cells (CSC). The design would promote effective antibody-dependent cell-mediated cytotoxicity (ADCC) and simultaneously promote costimulation to expand and self-sustain the effector NK cell population. Based on our bispecific NK cell engager platform we constructed a tetraspecific killer engager (TetraKE) comprising single-chain variable fragments (scFvs) binding FcγRIII (CD16) on NK cells, EpCAM on carcinoma cells and CD133 on cancer stem cells in order to promote ADCC. Furthermore, an Interleukin (IL)-15-crosslinker enhanced NK cell related proliferation resulting in a highly active drug termed 1615EpCAM133. Results Proliferation assays showed TetraKE promoted proliferation and enhanced NK cell survival. Drug-target binding, NK cell related degranulation, and IFN-γ production was specific for both tumor related antigens in EpCAM and CD133 bearing cancer cell lines. The TetraKE showed higher killing activity and superior dose dependent degranulation. Cytokine profiling showed a moderately enhanced IFN-γ production, enhanced GM-CSF production, but no evidence of induction of excessive cytokine release. Methods Assembly and synthesis of hybrid genes encoding the TetraKE were performed using DNA shuffling and ligation. The TetraKE was tested for efficacy, specificity, proliferation, survival, and cytokine production using carcinoma cell lines and functional assays measuring NK cell activity. Conclusion 1615EpCAM133 combines improved induction of ADCC with enhanced proliferation, limited cytokine response, and prolonged survival and proliferation of NK cells. By linking scFv-related targeting of carcinoma and CSCs with a sustaining IL-15 signal, our new construct shows great promise to target cancer and CSCs. PMID:27650544

Understanding the relationship between vegetation phenology and productivity across key dryland ecosystem types through the integration of PhenoCam, satellite, and eddy covariance data

NASA Astrophysics Data System (ADS)

Yan, D.; Scott, R. L.; Moore, D. J.; Biederman, J. A.; Smith, W. K.

2017-12-01

Land surface phenology (LSP) - defined as remotely sensed seasonal variations in vegetation greenness - is intrinsically linked to seasonal carbon uptake, and is thus commonly used as a proxy for vegetation productivity (gross primary productivity; GPP). Yet, the relationship between LSP and GPP remains uncertain, particularly for understudied dryland ecosystems characterized by relatively large spatial and temporal variability. Here, we explored the relationship between LSP and the phenology of GPP for three dominant dryland ecosystem types, and we evaluated how these relationships change as a function of spatial and temporal scale. We focused on three long-term dryland eddy covariance flux tower sites: Walnut Gulch Lucky Hills Shrubland (WHS), Walnut Gulch Kendall Grassland (WKG), and Santa Rita Mesquite (SRM). We analyzed daily canopy-level, 16-day 30m, and 8-day 500m time series of greenness indices from PhenoCam, Landsat 7 ETM+/Landsat 8 OLI, and MODIS, respectively. We first quantified the impact of spatial scale by temporally resampling canopy-level PhenoCam, 30m Landsat, and 500m MODIS to 16-day intervals and then comparing against flux tower GPP estimates. We next quantified the impact of temporal scale by spatially resampling daily PhenoCam, 16-day Landsat, and 8-day MODIS to 500m time series and then comparing against flux tower GPP estimates. We find evidence of critical periods of decoupling between LSP and the phenology of GPP that vary according to the spatial and temporal scale, and as a function of ecosystem type. Our results provide key insight into dryland LSP and GPP dynamics that can be used in future efforts to improve ecosystem process models and satellite-based vegetation productivity algorithms.

Search for Pulsating Stars in the Open Cluster NGC 1502

NASA Astrophysics Data System (ADS)

Stęślicki, M.

2006-04-01

We present results of a variability search in the field of the young open cluster NGC 1502. We confirm that a beta Cephei suspect WEBDA 26 is indeed pulsating with a period of 0.09612 d and semi-amplitude of about 3 mmag in V. A new VI light curve of the bright eclipsing binary and cluster member SZ Cam was obtained. In addition, we found two new variable stars. One is an interesting eclipsing binary showing total eclipses, which can be used to derive the distance to the cluster once radial velocities of the components will be obtained.

A revised and updated catalog of quasi-stellar objects

NASA Technical Reports Server (NTRS)

Hewitt, A.; Burbidge, G.

1993-01-01

The paper contains a catalog of all known quasi-stellar objects (QSOs) with measured emission redshifts, and BL Lac objects, complete to 1992 December 31. The catalog contains 7315 objects, nearly all QSOs including about 90 BL Lac objects. The catalog and references contain extensive information on names, positions, magnitudes, colors, emission-line redshifts, absorption, variability, polarization, and X-ray, radio, and infrared data. A key in the form of subsidiary tables enables the reader to relate the name of a given object to its coordinate name, which is used throughout the compilation. Plots of the Hubble diagram, the apparent magnitude distribution, the emission redshift distribution, and the distribution of the QSOs on the sky are also given.

[A research roadmap for complementary and alternative medicine - what we need to know by 2020].

PubMed

Fischer, Felix; Lewith, George; Witt, Claudia M; Linde, Klaus; von Ammon, Klaus; Cardini, Francesco; Falkenberg, Torkel; Fønnebø, Vinjar; Johannessen, Helle; Reiter, Bettina; Uehleke, Bernhard; Weidenhammer, Wolfgang; Brinkhaus, Benno

2014-01-01

The CAMbrella coordination action was funded within the Framework Programme 7. Its aim is to provide a research roadmap for clinical and epidemiological research for complementary and alternative medicine (CAM) that is appropriate for the health needs of European citizens and acceptable to their national research institutes and healthcare providers in both public and private sectors. One major issue in the European research agenda is the demographic change and its impact on health care. Our vision for 2020 is that there is an evidence base that enables European citizens to make informed decisions about CAM, both positive and negative. This roadmap proposes a strategic research agenda for the field of CAM designed to address future European health care challenges. This roadmap is based on the results of CAMbrella’s several work packages, literature reviews and expert discussions including a consensus meeting. We first conducted a systematic literature review on key issues in clinical and epidemiological research in CAM to identify the general concepts, methods and the strengths and weaknesses of current CAM research. These findings were discussed in a workshop (Castellaro, Italy, September 7–9th 2011) with international CAM experts and strategic and methodological recommendations were defined in order to improve the rigor and relevance of CAM research. These recommendations provide the basis for the research roadmap, which was subsequently discussed in a consensus conference (Järna, Sweden, May 9–11th 2012) with all CAMbrella members and the CAMbrella advisory board. The roadmap was revised after this discussion in CAMbrella Work Package (WP) 7 and finally approved by CAMbrella’s scientific steering committee on September 26th 2012. Our main findings show that CAM is very heterogenous in terms of definitions and legal regulations between the European countries. In addition, citizens’ needs and attitudes towards CAM as well as the use and provision of CAM differ significantly between countries. In terms of research methodology, there was consensus that CAM researchers should make use of all the commonly accepted scientific research methods and employ those with utmost diligence combined in a mixed methods framework. We propose 6 core areas of research that should be investigated to achieve a robust knowledge base and to allow stakeholders to make informed decisions. These are: Research into the prevalence of CAM in Europe: Reviews show that we do not know enough about the circumstances in which CAM is used by Europeans. To enable a common European strategic approach, a clear picture of current use is of the utmost importance. Research into differences regarding citizens’ attitudes and needs towards CAM: Citizens are the driver for CAM utilization. Their needs and views on CAM are a key priority, and their interests must be investigated and addressed in future CAM research. Research into safety of CAM: Safety is a key issue for European citizens. CAM is considered safe, but reliable data is scarce although urgently needed in order to assess the risk and cost-benefit ratio of CAM. Research into the comparative effectiveness of CAM: Everybody needs to know in what situation CAM is a reasonable choice. Therefore, we recommend a clear emphasis on concurrent evaluation of the overall effectiveness of CAM as an additional or alternative treatment strategy in real-world settings. Research into effects of context and meaning: The impact of effects of context and meaning on the outcome of CAM treatments must be investigated; it is likely that they are significant. Research into different models of CAM health care integration: There are different models of CAM being integrated into conventional medicine throughout Europe, each with their respective strengths and limitations. These models should be described and concurrently evaluated; innovative models of CAM provision in health care systems should be one focus for CAM research. We also propose a methodological framework for CAM research. We consider that a framework of mixed methodological approaches is likely to yield the most useful information. In this model, all available research strategies including comparative effectiveness research utilising quantitative and qualitative methods should be considered to enable us to secure the greatest density of knowledge possible. Stakeholders, such as citizens, patients and providers, should be involved in every stage of developing the specific and relevant research questions, study design and the assurance of real-world relevance for the research. Furthermore, structural and sufficient financial support for research into CAM is needed to strengthen CAM research capacity if we wish to understand why it remains so popular within the EU. In order to consider employing CAM as part of the solution to the health care, health creation and self-care challenges we face by 2020, it is vital to obtain a robust picture of CAM use and reliable information about its cost, safety and effectiveness in real-world settings. We need to consider the availability, accessibility and affordability of CAM. We need to engage in research excellence and utilise comparative effectiveness approaches and mixed methods to obtain this data. Our recommendations are both strategic and methodological. They are presented for the consideration of researchers and funders while being designed to answer the important and implicit questions posed by EU citizens currently using CAM in apparently increasing numbers. We propose that the EU actively supports an EU-wide strategic approach that facilitates the development of CAM research. This could be achieved in the first instance through funding a European CAM coordinating research office dedicated to foster systematic communication between EU governments, public, charitable and industry funders as well as researchers, citizens and other stakeholders. The aim of this office would be to coordinate research strategy developments and research funding opportunities, as well as to document and disseminate international research activities in this field. With the aim to develop sustainability as second step, a European Centre for CAM should be established that takes over the monitoring and further development of a coordinated research strategy for CAM, as well as it should have funds that can be awarded to foster high quality and robust independent research with a focus on citizens health needs and pan-European collaboration. We wish to establish a solid funding for CAM research to adequately inform health care and health creation decision-making throughout the EU. This centre would ensure that our vision of a common, strategic and scientifically rigorous approach to CAM research becomes our legacy and Europe’s reality. We are confident that our recommendations will serve these essential goals for EU citizens.

Marginal adaptation and CAD-CAM technology: A systematic review of restorative material and fabrication techniques.

PubMed

Papadiochou, Sofia; Pissiotis, Argirios L

2018-04-01

The comparative assessment of computer-aided design and computer-aided manufacturing (CAD-CAM) technology and other fabrication techniques pertaining to marginal adaptation should be documented. Limited evidence exists on the effect of restorative material on the performance of a CAD-CAM system relative to marginal adaptation. The purpose of this systematic review was to investigate whether the marginal adaptation of CAD-CAM single crowns, fixed dental prostheses, and implant-retained fixed dental prostheses or their infrastructures differs from that obtained by other fabrication techniques using a similar restorative material and whether it depends on the type of restorative material. An electronic search of English-language literature published between January 1, 2000, and June 30, 2016, was conducted of the Medline/PubMed database. Of the 55 included comparative studies, 28 compared CAD-CAM technology with conventional fabrication techniques, 12 contrasted CAD-CAM technology and copy milling, 4 compared CAD-CAM milling with direct metal laser sintering (DMLS), and 22 investigated the performance of a CAD-CAM system regarding marginal adaptation in restorations/infrastructures produced with different restorative materials. Most of the CAD-CAM restorations/infrastructures were within the clinically acceptable marginal discrepancy (MD) range. The performance of a CAD-CAM system relative to marginal adaptation is influenced by the restorative material. Compared with CAD-CAM, most of the heat-pressed lithium disilicate crowns displayed equal or smaller MD values. Slip-casting crowns exhibited similar or better marginal accuracy than those fabricated with CAD-CAM. Cobalt-chromium and titanium implant infrastructures produced using a CAD-CAM system elicited smaller MD values than zirconia. The majority of cobalt-chromium restorations/infrastructures produced by DMLS displayed better marginal accuracy than those fabricated with the casting technique. Compared with copy milling, the majority of zirconia restorations/infrastructures produced by CAD-CAM milling exhibited better marginal adaptation. No clear conclusions can be drawn about the superiority of CAD-CAM milling over the casting technique and DMLS regarding marginal adaptation. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Attitudes and perceptions of Australian pharmacy students towards Complementary and Alternative Medicine – a pilot study

PubMed Central

Tiralongo, Evelin; Wallis, Marianne

2008-01-01

Background With the increased usage of CAM worldwide comes the demand for its integration into health professional education. However, the incorporation of CAM into health professional curricula is handled quite differently by different institutions and countries. Furthermore, the evaluation of CAM curricula is complicated because students' ability to learn about CAM may be influenced by factors such as student's prior knowledge and motivation, together with the perceptions and attitudes of clinical preceptors. The study aimed to describe the attitudes, perceptions and beliefs of second, third and fourth year pharmacy students towards complementary and alternative medicine (CAM) and to explore factors that might affect attitudes such as learning, preceptors and placements. Methods Pharmacy students from a University in South East Queensland, Australia participated in the study. The study consisted of a cross-sectional survey (n = 110) and semi-structured interviews (n = 9). Results The overall response rate for the survey was 75%, namely 50% (36/72) for second year, 77.3% (34/44) for third year and 97.6% (40/41) for fourth year students. Overall, 95.5% of pharmacy students believe that pharmacists should be able to advise patients about CAM and most (93.7%) have used CAM prior to course enrolment. Students' attitudes to CAM are influenced by the use of CAM by family, friends and self, CAM training, lecturers and to a lesser degree by preceptors. The majority of pharmacy students (89.2%) perceive education about CAM as a core and integral part of their professional degree and favour it over an additional postgraduate degree. However, they see a greater need for education in complementary medicines (such as herbal medicines, vitamins and minerals) than for education in complementary therapies (such as acupuncture, meditation and bio-magnetism). Knowledge and educational input rationalised rather than marginalised students' attitudes towards CAM. Conclusion Pharmacy students perceive education about CAM as a core and integral part of their professional degree. Students' attitudes towards CAM can be influenced by learning, lecturers, preceptors and practice experience. The content and focus of CAM education has to be further investigated and tailored to meet the professional needs of our future health professionals. PMID:18221569

Use of Complementary and Alternative Medicine among People with Multiple Sclerosis in the Nordic Countries

PubMed Central

Skovgaard, L.; Nicolajsen, P. H.; Pedersen, E.; Kant, M.; Fredrikson, S.; Verhoef, M.; Meyrowitsch, D. W.

2012-01-01

Aims. The aim of the study was to describe and compare (1) the types and prevalence of complementary and alternative medicine (CAM) treatments used among individuals with multiple sclerosis (MS) in the Nordic countries; (2) the types of conventional treatments besides disease-modifying medicine for MS that were used in combination with CAM treatments; (3) the types of symptoms/health issues addressed by use of CAM treatments. Methods. An internet-based questionnaire was used to collect data from 6455 members of the five Nordic MS societies. The response rates varied from 50.9% in Norway to 61.5% in Iceland. Results. A large range of CAM treatments were reported to be in use in all five Nordic countries. Supplements of vitamins and minerals, supplements of oils, special diet, acupuncture, and herbal medicine were among the CAM treatment modalities most commonly used. The prevalence of the overall use of CAM treatments within the last twelve months varied from 46.0% in Sweden to 58.9% in Iceland. CAM treatments were most often used in combination with conventional treatments. The conventional treatments that were most often combined with CAM treatment were prescription medication, physical therapy, and over-the-counter (OTC) medications. The proportion of CAM users who reported exclusive use of CAM (defined as use of no conventional treatments besides disease-modifying medicine for MS) varied from 9.5% in Finland to 18.4% in Norway. In all five Nordic countries, CAM treatments were most commonly used for nonspecific/preventative purposes such as strengthening the body in general, improving the body's muscle strength, and improving well-being. CAM treatments were less often used for the purpose of improving specific symptoms such as body pain, problems with balance, and fatigue/lack of energy. Conclusions. A large range of CAM treatments were used by individuals with MS in all Nordic countries. The most commonly reported rationale for CAM treatment use focused on improving the general state of health. The overall pattern of CAM treatment use was similar across the five countries. PMID:23304461

Attitudes of Arab and Jewish patients toward integration of complementary medicine in primary care clinics in Israel: a cross-cultural study.

PubMed

Ben-Arye, Eran; Karkabi, Khaled; Karkabi, Sonia; Keshet, Yael; Haddad, Maria; Frenkel, Moshe

2009-01-01

The purpose of this cross-cultural study was to evaluate patient perspectives on complementary and alternative medicine (CAM) integration within primary care clinics. It is one of the first multiethnic studies to explore patients' perspectives on the best model for integrating CAM into the conventional care setting. We developed a 13-item questionnaire that addresses issues of CAM use, expectations from the primary care physicians concerning CAM, and attitudes toward CAM integration within a patient's primary care clinic. We constructed the questionnaire with cross-cultural sensitivity concerning the core concepts of CAM and traditional medicine in both the Arab and Jewish communities in northern Israel. Data for statistical analysis were obtained from 3840 patients attending seven primary care clinics. Of the 3713 respondents who were willing to identify their religion, 2184 defined themselves as Muslims, Christians, or Druze and 1529 as Jews. Respondents in the two groups were equally distributed by sex but differed significantly by age, education, self-rated religiosity, and self-reported chronic diseases in their medical background. Respondents in the two groups reported comparable overall CAM use during the previous year, but the Arab respondents reported more use of herbs and traditional medicine. Respondents in both groups stated that their primary expectation from a family physician concerning CAM was to refer them appropriately and safely to a CAM practitioner. Respondents in both groups greatly supported a theoretical scenario of CAM integration into primary medical care. However, Arab respondents were more supportive of the option that non-physician CAM practitioners would provide CAM rather than physicians.

Complementary and Alternative Medicine Use in Pediatric Hematology/Oncology Patients at the University of Mississippi Medical Center.

PubMed

Sanchez, Hanny C; Karlson, Cynthia W; Hsu, Johann H; Ostrenga, Andrew; Gordon, Catherine

2015-11-01

To examine the prevalence and modalities of complementary and alternative medicine (CAM) use in children with cancer and sickle cell disease; the reasons for use of CAM; and the use of CAM before, during, and after treatment in children with cancer. This single-center, observational study administered caregivers a written questionnaire regarding the use of CAM therapies. A total of 101 caregivers completed questionnaires. Including prayer, total CAM use in oncology and sickle cell disease was 64% and 63%, respectively. Non-prayer CAM use was 30% in oncology and 23% in sickle cell disease. Of respondents who reported using any CAM, the three most commonly used types were prayer (62.3% oncology; 60.0% sickle cell disease), vitamins/minerals (14.8% oncology; 10.0% sickle cell disease), and massage (9.8% oncology; 7.5% sickle cell disease). The primary reasons for using CAM were to provide hope, to improve quality of life, and to lessen adverse effects. In oncology patients, CAM use tended to increase during treatment compared with before and after treatment. The reported prevalence of non-prayer CAM use was lower (23%-30%) in this sample than has been reported in national samples or other geographic regions of the United States. Nonetheless, participants reported many positive reasons for using CAM, including to gain hope, improve quality of life, and control pain. Thus, CAM use appears to be an important aspect of medical care for many pediatric hematology/oncology families and should be a consideration when providers are discussing treatment and quality of care with families.

Patterns of utilization of complementary and alternative medicine in 2 pediatric gastroenterology clinics.

PubMed

Adams, Denise; Schiffgen, Miriam; Kundu, Anjana; Dagenais, Simon; Clifford, Tammy; Baydala, Lola; King, W James; Vohra, Sunita

2014-09-01

The aim of the present study was to assess the prevalence and patterns of complementary and alternative medicine (CAM) use among pediatric patients with gastrointestinal (GI) disorders at academic clinics in Canada. The survey was carried out at 2 hospital-based gastroenterology clinics: the Stollery Children's Hospital in Edmonton and the Children's Hospital of Eastern Ontario (CHEO) in Ottawa. CAM use at the Stollery was 83% compared with 36% at CHEO (P < 0.001). The most common reason for not using CAM was lack of knowledge about it. Most respondents felt comfortable discussing CAM in their clinic and wanted more information on CAM. The most common CAM products being taken were multivitamins (91%), calcium (35%), vitamin C (32%), probiotics (14%), and fish oil/omega-3 fatty acids (13%). The most common CAM practices being used were massage (43%), chiropractic (27%), faith healing (25%), and relaxation (18%). Most respondents believed that CAM was helpful, and most of the 23 reported adverse effects were minor. Seven were reported as moderate, and 3 were reported as severe. Many (42%) patients used CAM at the same time as prescription medicines, and of these patients, concurrent use was discussed with their physician (76%) or pharmacist (52%). CAM use is high among pediatric patients with GI disorders and is much greater among those in Edmonton than in Ottawa. Most respondents reported their CAM use as helpful, with little or no associated harm. Many patients fail to disclose their concurrent use of CAM and conventional medicines to their doctors, increasing the likelihood of interactions.

Complementary and alternative medicine use and adherence to asthma medications among Latino and non-Latino white families.

PubMed

McQuaid, Elizabeth L; Fedele, David A; Adams, Sue K; Koinis-Mitchell, Daphne; Mitchell, Jessica; Kopel, Sheryl J; Seifer, Ronald; Jandasek, Barbara; Fritz, Gregory K; Canino, Glorisa

2014-01-01

The current study sought to evaluate patterns of complementary and alternative medicine (CAM) use in a sample of Latino and non-Latino white (NLW) children with asthma to determine whether parental beliefs about conventional medications and barriers to obtaining these medications were related to CAM use and to assess whether CAM use was associated with decreased adherence to controller medications. Participants included 574 families of children with asthma from NLW, Puerto Rican (PR), and Dominican backgrounds from Rhode Island (RI) and from Island PR. All parents completed a brief checklist of barriers to medication use and an assessment of CAM approaches. A subsample of 259 families had controller medication use monitored objectively for approximately 1 month by MDILog (fluticasone propionate), TrackCap (montelukast), or dosage counter (fluticasone/salmeterol combination). Prevalence of CAM use was high among Latino families. Perceived barriers to obtaining medication were related to increased CAM use in PR families from RI. Elevated medication concerns were positively associated with CAM use among NLW and Island PR families. CAM use was positively related to objective adherence within NLW families, and unrelated in other groups. CAM use is common among Latino families with asthma. Among some families, CAM use may be initiated as a way to cope with barriers to obtaining medication or when parents have concerns about conventional medications. Families who report CAM use do not appear to be substituting CAM for conventional asthma medication. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Doctor communication quality and Friends' attitudes influence complementary medicine use in inflammatory bowel disease.

PubMed

Mountifield, Réme; Andrews, Jane M; Mikocka-Walus, Antonina; Bampton, Peter

2015-03-28

To examine the frequency of regular complementary and alternative therapy (CAM) use in three Australian cohorts of contrasting care setting and geography, and identify independent attitudinal and psychological predictors of CAM use across all cohorts. A cross sectional questionnaire was administered to inflammatory bowel disease (IBD) patients in 3 separate cohorts which differed by geographical region and care setting. Demographics and frequency of regular CAM use were assessed, along with attitudes towards IBD medication and psychological parameters such as anxiety, depression, personality traits and quality of life (QOL), and compared across cohorts. Independent attitudinal and psychological predictors of CAM use were determined using binary logistic regression analysis. In 473 respondents (mean age 50.3 years, 60.2% female) regular CAM use was reported by 45.4%, and did not vary between cohorts. Only 54.1% of users disclosed CAM use to their doctor. Independent predictors of CAM use which confirm those reported previously were: covert conventional medication dose reduction (P < 0.001), seeking psychological treatment (P < 0.001), adverse effects of conventional medication (P = 0.043), and higher QOL (P < 0.001). Newly identified predictors were CAM use by family or friends (P < 0.001), dissatisfaction with patient-doctor communication (P < 0.001), and lower depression scores (P < 0.001). In addition to previously identified predictors of CAM use, these data show that physician attention to communication and the patient-doctor relationship is important as these factors influence CAM use. Patient reluctance to discuss CAM with physicians may promote greater reliance on social contacts to influence CAM decisions.

Assessment of Perception, Experience, and Information-seeking Behavior of the Public of Ras Al-Khaimah, United Arab Emirates, Toward Usage and Safety of Complementary and Alternative Medicine.

PubMed

Sridhar, Sathvik Belagodu; Shariff, Atiqulla; Al Halabi, Nour; Sarmini, Rand; Harb, Lubab Arkan

2017-01-01

This study was conducted to identify the different types of complementary and alternative medicine (CAM) used, reasons for the use of CAM, and the perceptions, experience, and information seeking-behavior toward usage and safety of CAM by the general public of Ras Al-Khaimah, UAE. This was a prospective cross-sectional study. A validated, self-administered, or interviewer-assisted survey questionnaire was used to collect the data. Data from 403 respondents satisfying inclusion criteria were collected and were analyzed using the Statistical Package for the Social Sciences version 24.0. A majority of the respondents (218 [54.1%]) were females. The most commonly (210 [52.1%]) used CAM among the study respondents was herbal medicine. A total of 91 (22.6%) of the survey respondents mentioned that they receive conventional medications along with their CAM. Majority (213 [52.9%]) of the survey respondents opted for CAM to prevent illness. Good number (208 [51.6%]) of the survey respondents mentioned that CAM usage was beneficial in improving their health condition, and they (216 [53.6%]) do believe it as safe and effective. However, a small group (26 [6%]) of respondents reported side effects or complications with the use of CAM. Widespread use of CAM for different medical problems was evident in our study. Although majority of the CAM users believe it as safe and effective, CAM usage should be discussed with the health-care providers to understand the safety issues involved in the use of majority of CAM.

Integration of Complementary and Alternative Medicine into Family Practices in Germany: Results of a National Survey

PubMed Central

Joos, Stefanie; Musselmann, Berthold; Szecsenyi, Joachim

2011-01-01

More than two-thirds of patients in Germany use complementary and alternative medicine (CAM) provided either by physicians or non-medical practitioners (“Heilpraktiker”). There is little information about the number of family physicians (FPs) providing CAM. Given the widespread public interest in the use of CAM, this study aimed to ascertain the use of and attitude toward CAM among FPs in Germany. A postal questionnaire developed based on qualitatively derived data was sent to 3000 randomly selected FPs in Germany. A reminder letter including a postcard (containing a single question about CAM use in practice and reasons for non-particpation in the survey) was sent to all FPs who had not returned the questionnaire. Of the 3000 FPs, 1027 (34%) returned the questionnaire and 444 (15%) returned the postcard. Altogether, 886 of the 1471 responding FPs (60%) reported using CAM in their practice. A positive attitude toward CAM was indicated by 503 FPs (55%), a rather negative attitude by 127 FPs (14%). Chirotherapy, relaxation and neural therapy were rated as most beneficial CAM therapies by FPs, whereas neural therapy, phytotherapy and acupuncture were the most commonly used therapies in German family practices. This survey clearly demonstrates that CAM is highly valued by many FPs and is already making a substantial contribution to first-contact primary care in Germany. Therefore, education and research about CAM should be increased. Furthermore, with the provision of CAM by FPs, the role of non-medical CAM practitioners within the German healthcare system is to be questioned. PMID:19293252

Discrepant Views of Korean Medical Oncologists and Cancer Patients on Complementary and Alternative Medicine

PubMed Central

Kim, Bong-Seog; Lee, Kyung Hee; Lee, Myung Ah; Hong, Young Seon; Shin, Sang Won; Lee, Soon Nam

2008-01-01

Purpose This study was designed to evaluate the communication gap between Korean medical oncologists and cancer patients on complementary and alternative medicine (CAM). Materials and Methods Cross sectional studies utilized the responses of 59 medical oncologists and 211 patients. To understand the communication gap, perceived reasons and nondisclosure of CAM use, reactions of physicians to disclosure, and expectations for CAM were analyzed. Data were compared with use of the chi-squared test. Results Both medical oncologists and patients were in accord that CAM use would privde the patients with a feeling of hope. The medical oncologists believed more often than patients to attribute CAM use for control over medical care decisions, for the treatment of an incurable disease or as a nontoxic approach (p<0.05). Regarding reasons for nondisclosure, medical oncologists were more likely to think that physicians would not understand the use of CAM, discontinue treatment or disapprove of the use of CAM (p<0.0001). Patients attributed nondisclosure mainly to the lack of questioning about CAM. Medical oncologists were more likely to warn of the risks with CAM use and less likely to encourage the use of CAM than perceived by patients (p=0.01). Patients expected that CAM could cure disease, extend survival, relieve symptoms and improve the immune system or quality of life more often than medical oncologists (p<0.05). Conclusion Given the discrepant views of medical oncologists and patients on the use of CAM, medical oncologists should be aware of the discrepancies and attempt to resolve any differences. PMID:19688054

Use of complementary and alternative medicine in Europe: Health-related and sociodemographic determinants.

PubMed

Kemppainen, Laura M; Kemppainen, Teemu T; Reippainen, Jutta A; Salmenniemi, Suvi T; Vuolanto, Pia H

2018-06-01

The aim of this research was to study health-related and sociodemographic determinants of the use of different complementary and alternative medicine (CAM) treatments in Europe and differences in CAM use in various European countries. The study was based on a design-based logistic regression analysis of the European Social Survey (ESS), Round 7. We distinguished four CAM modalities: manual therapies, alternative medicinal systems, traditional Asian medical systems and mind-body therapies. In total, 25.9% of the general population had used CAM during the last 12 months. Typically, only one CAM treatment had been used, and it was used more often as complementary rather than alternative treatment. The use of CAM varied greatly by country, from 10% in Hungary to almost 40% in Germany. Compared to those in good health, the use of CAM was two to fourfold greater among those with health problems. The health profiles of users of different CAM modalities varied. For example, back or neck pain was associated with all types of CAM, whereas depression was associated only with the use of mind-body therapies. Individuals with difficult to diagnose health conditions were more inclined to utilize CAM, and CAM use was more common among women and those with a higher education. Lower income was associated with the use of mind-body therapies, whereas the other three CAM modalities were associated with higher income. Help-seeking differed according to the health problem, something that should be acknowledged by clinical professionals to ensure safe care. The findings also point towards possible socioeconomic inequalities in health service use.

Doctor communication quality and Friends' attitudes influence complementary medicine use in inflammatory bowel disease

PubMed Central

Mountifield, Réme; Andrews, Jane M; Mikocka-Walus, Antonina; Bampton, Peter

2015-01-01

AIM: To examine the frequency of regular complementary and alternative therapy (CAM) use in three Australian cohorts of contrasting care setting and geography, and identify independent attitudinal and psychological predictors of CAM use across all cohorts. METHODS: A cross sectional questionnaire was administered to inflammatory bowel disease (IBD) patients in 3 separate cohorts which differed by geographical region and care setting. Demographics and frequency of regular CAM use were assessed, along with attitudes towards IBD medication and psychological parameters such as anxiety, depression, personality traits and quality of life (QOL), and compared across cohorts. Independent attitudinal and psychological predictors of CAM use were determined using binary logistic regression analysis. RESULTS: In 473 respondents (mean age 50.3 years, 60.2% female) regular CAM use was reported by 45.4%, and did not vary between cohorts. Only 54.1% of users disclosed CAM use to their doctor. Independent predictors of CAM use which confirm those reported previously were: covert conventional medication dose reduction (P < 0.001), seeking psychological treatment (P < 0.001), adverse effects of conventional medication (P = 0.043), and higher QOL (P < 0.001). Newly identified predictors were CAM use by family or friends (P < 0.001), dissatisfaction with patient-doctor communication (P < 0.001), and lower depression scores (P < 0.001). CONCLUSION: In addition to previously identified predictors of CAM use, these data show that physician attention to communication and the patient-doctor relationship is important as these factors influence CAM use. Patient reluctance to discuss CAM with physicians may promote greater reliance on social contacts to influence CAM decisions. PMID:25834335

Therapeutic uses of the WebCam in child psychiatry.

PubMed

Chlebowski, Susan; Fremont, Wanda

2011-01-01

The authors provide examples for the use of the WebCam as a therapeutic tool in child psychiatry, discussing cases to demonstrate the application of the WebCam, which is most often used in psychiatry training programs during resident supervision and for case presentations. Six cases illustrate the use of the WebCam in individual and family therapy. The WebCam, used during individual sessions, can facilitate the development of prosocial skills. Comparing individual WebCam video sessions can help to evaluate the effectiveness of medication and progress in therapy. The WebCam has proven to be useful in psycho-education, facilitating communication, and treating children and families. The applications of this technology may include cognitive-behavioral therapy, dialectical-behavioral, and group therapy.

PreCam Survey Work at ANL

Science.gov Websites

- Astrophysics - DES - PreCam PreCam Work at ANL The Argonne/HEP Dark Energy Survey (DES) group, working on the Dark Energy Camera (DECam), built a mini-DECam camera called PreCam. This camera has provided valuable

Complementary and Alternative Medicine Use for HIV Management in the State of Florida: Medical Monitoring Project

PubMed Central

Okafor, Chukwuemeka N.; Harman, Jeffrey S.; Canidate, Shantrel S.; Cook, Christa L.; Cook, Robert L.

2016-01-01

Abstract Objective: The aims of this study were to describe complementary and alternative medicine (CAM) use and to assess the relationships between CAM use and antiretroviral therapy (ART) adherence and human immunodeficiency virus (HIV) RNA viral load suppression among a sample of persons living with HIV (PLWH) engaged in care in the state of Florida. Design: The Florida Medical Monitoring Project (n = 803) collected repeated cross-sectional data for surveillance of clinical outcomes among PLWH from 2009 to 2010. Past-year CAM use specifically for the management of HIV was measured via self-report. Logistic regression models were conducted to assess the effect of CAM use on ART adherence and viral load suppression, controlling for demographic and clinical factors using backwards stepwise deletion of factors with a p-value of >0.25. Results: CAM use was reported in 53.3% (n = 428). In bivariate analysis, CAM use was the highest among those 40–49 years of age (61%; p < 0.05), males (56%; p < 0.01), whites (61%; p = 0.001), and those educated beyond high school (59%; p < 0.05). Among those using CAM, 63% and 37% reported one and two or more CAM modalities, respectively. CAM modalities included biologically based therapies (89%), mind–body medicine/manipulative body-based therapies (30%), spiritual healing (23%), energy therapies (6%), and whole medical systems (6%). In multivariable analyses, any CAM use and number of CAM methods used were not associated with ART adherence. Any CAM use was not associated with detectable viral load (adjusted odds ratio [aOR] 0.81; 95% confidence interval [CI] 0.58–1.12; p = 0.20). Those using two or more methods had significantly decreased risk for detectable viral load (aOR 0.60; 95% CI 0.39–0.92; p < 0.02). Conclusions: CAM use was not associated with negative effects on ART adherence. CAM users were less likely to have detectable viral load compared with non-users. Future research should focus on CAM use among PLWH not engaged in HIV care and the longitudinal patterns of CAM use and possible effects of long-term health outcomes. PMID:27631385

Adult vaccination coverage levels among users of complementary/alternative medicine - results from the 2002 National Health Interview Survey (NHIS).

PubMed

Stokley, Shannon; Cullen, Karen A; Kennedy, Allison; Bardenheier, Barbara H

2008-02-22

While many Complementary/Alternative Medicine (CAM) practitioners do not object to immunization, some discourage or even actively oppose vaccination among their patients. However, previous studies in this area have focused on childhood immunizations, and it is unknown whether and to what extent CAM practitioners may influence the vaccination behavior of their adult patients. The purpose of this study was to describe vaccination coverage levels of adults aged > or = 18 years according to their CAM use status and determine if there is an association between CAM use and adult vaccination coverage. Data from the 2002 National Health Interview Survey, limited to 30,617 adults that provided at least one valid answer to the CAM supplement, were analyzed. Receipt of influenza vaccine during the past 12 months, pneumococcal vaccine (ever), and > or = 1 dose of hepatitis B vaccine was self-reported. Coverage levels for each vaccine by CAM use status were determined for adults who were considered high priority for vaccination because of the presence of a high risk condition and for non-priority adults. Multivariable analyses were conducted to evaluate the association between CAM users and vaccination status, adjusting for demographic and healthcare utilization characteristics. Overall, 36% were recent CAM users. Among priority adults, adjusted vaccination coverage levels were significantly different between recent and non-CAM users for influenza (44% vs 38%; p-value < 0.001) and pneumococcal (40% vs 33%; p-value < 0.001) vaccines but were not significantly different for hepatitis B (60% vs 56%; p-value = 0.36). Among non-priority adults, recent CAM users had significantly higher unadjusted and adjusted vaccination coverage levels compared to non-CAM users for all three vaccines (p-values < 0.001). Vaccination coverage levels among recent CAM users were found to be higher than non-CAM users. Because CAM use has been increasing over time in the U.S., it is important to continue monitoring CAM use and its possible influence on receipt of immunizations among adults. Since adult vaccination coverage levels remain below Healthy People 2010 goals, it may be beneficial to work with CAM practitioners to promote adult vaccines as preventive services in keeping with their commitment to maintaining good health.

Multi-year application of WRF-CAM5 over East Asia-Part II: Interannual variability, trend analysis, and aerosol indirect effects

NASA Astrophysics Data System (ADS)

Zhang, Yang; Wang, Kai; He, Jian

2017-09-01

Following a comprehensive evaluation of WRF-CAM5 in Part I, Part II describes analyses of interannual variability, multi-year variation trends, and the direct, indirect, and total effects of anthropogenic aerosols. The interannual variations of chemical column and surface concentrations, and ozone (O3)/particulate matter (PM) indicators are strongly correlated to anthropogenic emission changes. Despite model biases, the model captures well the observed interannual variations of temperature at 2-m, cloud fraction, shortwave cloud forcing, downwelling shortwave radiation, cloud droplet number concentration, column O3, and column formaldehyde (HCHO) for the whole domain. While the model reproduces the volatile organic compound (VOC)-limited regimes of O3 chemistry at sites in Hong Kong, Taiwan, Japan, South Korea, and from the Acid Deposition Monitoring Network in East Asia (EANET) and the degree of sulfate neutralization at the EANET sites, it has limited capability in capturing the interannual variations of the ratio of O3 and nitrogen dioxide (O3/NO2) and PM chemical regime indicators, due to uncertainties in the emissions of precursors for O3 and secondary PM, the model assumption for ammonium bisulfate (NH4HSO4) as well as lack of gas/particle partitioning of total ammonia and total nitrate. While the variation trends in multi-year periods in aerosol optical depth and column concentrations of carbon monoxide, sulfur dioxide, and NO2 are mainly caused by anthropogenic emissions, those of major meteorological and cloud variables partly reflect feedbacks of chemistry to meteorological variables. The impacts of anthropogenic aerosol indirect effects either dominate or play an important role in the aerosol total effects for most cloud and chemical predictions, whereas anthropogenic aerosol direct effects influence most meteorological and radiation variables. The direct, indirect, and total effects of anthropogenic aerosols exhibit a strong interannual variability in 2001, 2006, and 2011.

The subjectively perceived quality of postgraduate medical training in integrative medicine within the public healthcare systems of Germany and Switzerland: the example of anthroposophic hospitals

PubMed Central

2014-01-01

Background Integrative medicine (IM) integrates evidence-based Complementary and Alternative Medicine (CAM) with conventional medicine (CON). Medical schools offer basic CAM electives but in postgraduate medical training (PGMT) little has been done for the integration of CAM. An exception to this is anthroposophic medicine (AM), a western form of CAM based on CON, offering an individualized holistic IM approach. AM hospitals are part of the public healthcare systems in Germany and Switzerland and train AM in PGMT. We performed the first quality evaluation of the subjectively perceived quality of this PGMT. Methods An anonymous full survey of all 214 trainers (TR) and 240 trainees (TE) in all 15 AM hospitals in Germany and Switzerland, using the ETHZ questionnaire for annual national PGMT assessments in Switzerland (CH) and Germany (D), complemented by a module for AM. Data analysis included Cronbach’s alpha to assess internal consistency questionnaire scales, 2-tailed Pearson correlation of specific quality dimensions of PGMT and department size, 2-tailed Wilcoxon Matched-Pair test for dependent variables and 2-tailed Mann–Whitney U-test for independent variables to calculate group differences. The level of significance was set at p < 0.05. Results Return rates were: D: TE 89/215 (41.39%), TR 78/184 (42.39%); CH: TE 19/25 (76%), TR 22/30 (73.33%). Cronbach’s alpha values for TE scales were >0.8 or >0.9, and >0.7 to >0.5 for TR scales. Swiss hospitals surpassed German ones significantly in Global Satisfaction with AM (TR and TE); Clinical Competency training in CON (TE) and AM (TE, TR), Error Management, Culture of Decision Making, Evidence-based Medicine, and Clinical Competency in internal medicine CON and AM (TE). When the comparison was restricted to departments of comparable size, differences remained significant for Clinical Competencies in AM (TE, TR), and Culture of Decision Making (TE). CON received better grades than AM in Global Satisfaction and Clinical Competency. Quality of PGMT depended on department size, working conditions and structural training features. Conclusion The lower quality of PGMT in German hospitals can be attributed to larger departments, more difficult working conditions, and less favorable structural features for PGMT in AM, possibly also in relation to increased financial pressure. PMID:24934998

The subjectively perceived quality of postgraduate medical training in integrative medicine within the public healthcare systems of Germany and Switzerland: the example of anthroposophic hospitals.

PubMed

Heusser, Peter; Eberhard, Sabine; Berger, Bettina; Weinzirl, Johannes; Orlow, Pascale

2014-06-16

Integrative medicine (IM) integrates evidence-based Complementary and Alternative Medicine (CAM) with conventional medicine (CON). Medical schools offer basic CAM electives but in postgraduate medical training (PGMT) little has been done for the integration of CAM. An exception to this is anthroposophic medicine (AM), a western form of CAM based on CON, offering an individualized holistic IM approach. AM hospitals are part of the public healthcare systems in Germany and Switzerland and train AM in PGMT. We performed the first quality evaluation of the subjectively perceived quality of this PGMT. An anonymous full survey of all 214 trainers (TR) and 240 trainees (TE) in all 15 AM hospitals in Germany and Switzerland, using the ETHZ questionnaire for annual national PGMT assessments in Switzerland (CH) and Germany (D), complemented by a module for AM. Data analysis included Cronbach's alpha to assess internal consistency questionnaire scales, 2-tailed Pearson correlation of specific quality dimensions of PGMT and department size, 2-tailed Wilcoxon Matched-Pair test for dependent variables and 2-tailed Mann-Whitney U-test for independent variables to calculate group differences. The level of significance was set at p < 0.05. Return rates were: D: TE 89/215 (41.39%), TR 78/184 (42.39%); CH: TE 19/25 (76%), TR 22/30 (73.33%). Cronbach's alpha values for TE scales were >0.8 or >0.9, and >0.7 to >0.5 for TR scales. Swiss hospitals surpassed German ones significantly in Global Satisfaction with AM (TR and TE); Clinical Competency training in CON (TE) and AM (TE, TR), Error Management, Culture of Decision Making, Evidence-based Medicine, and Clinical Competency in internal medicine CON and AM (TE). When the comparison was restricted to departments of comparable size, differences remained significant for Clinical Competencies in AM (TE, TR), and Culture of Decision Making (TE). CON received better grades than AM in Global Satisfaction and Clinical Competency. Quality of PGMT depended on department size, working conditions and structural training features. The lower quality of PGMT in German hospitals can be attributed to larger departments, more difficult working conditions, and less favorable structural features for PGMT in AM, possibly also in relation to increased financial pressure.

Video image analysis as a potential grading system for Uruguayan beef carcasses.

PubMed

Vote, D J; Bowling, M B; Cunha, B C N; Belk, K E; Tatum, J D; Montossi, F; Smith, G C

2009-07-01

A study was conducted in 2 phases to evaluate the effectiveness of 1) the VIAscan Beef Carcass System (BCSys; hot carcass system) and the CVS BeefCam (chilled carcass system), used independently or in combination, to predict Uruguayan beef carcass fabrication yields; and 2) the CVS BeefCam to segregate Uruguayan beef carcasses into groups that differ in the Warner-Bratzler shear force (WBSF) values of their LM steaks. The results from the meat yield phase of the present study indicated that the prediction of saleable meat yield percentages from Uruguayan beef carcasses by use of the BCSys or CVS BeefCam is similar to, or slightly better than, the use of USDA yield grade calculated to the nearest 0.1 and was much more effective than prediction based on Uruguay National Institute of Meat (INAC) grades. A further improvement in fabrication yield prediction could be obtained by use of a dual-component video image analysis (VIA) system. Whichever method of VIA prediction of fabrication yield is used, a single predicted value of fabrication yield for every carcass removes an impediment to the implementation of a value-based pricing system. Additionally, a VIA method of predicting carcass yield has the advantage over the current INAC classification system in that estimates would be produced by an instrument rather than by packing plant personnel, which would appeal to cattle producers. Results from the tenderness phase of the study indicated that the CVS BeefCam output variable for marbling was not (P > 0.05) able to segregate steer and heifer carcasses into groups that differed in WBSF values. In addition, the results of segregating steer and heifer carcasses according to muscle color output variables indicate that muscle maturity and skeletal maturity were useful for segregating carcasses according to differences in WBSF values of their steaks (P > 0.05). Use of VIA to predict beef carcass fabrication yields could improve accuracy and reduce subjectivity in comparison with use of current INAC grades. Use of VIA to sort carcasses according to muscle color would allow for the marketing of more consistent beef products with respect to tenderness. This would help facilitate the initiation of a value-based marketing system for the Uruguayan beef industry.

Radio and γ -Ray Variability in the BL Lac PKS 0219−164: Detection of Quasi-periodic Oscillations in the Radio Light Curve

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

Bhatta, Gopal, E-mail: gopalbhatta716@gmail.com; Mt. Suhora Observatory, Pedagogical University, ul. Podchorazych 2, 30-084 Kraków

In this work, we explore the long-term variability properties of the blazar PKS 0219−164 in the radio and the γ -ray regime, utilizing the OVRO 15 GHz and the Fermi /LAT observations from the period 2008–2017. We found that γ -ray emission is more variable than the radio emission implying that γ -ray emission possibly originated in more compact regions while the radio emission represented continuum emission from the large-scale jets. Also, in the γ -ray, the source exhibited spectral variability, characterized by the softer-when-brighter trend, a less frequently observed feature in the high-energy emission by BL Lacs. In radio,more » using Lomb–Scargle periodogram and weighted wavelet z -transform, we detected a strong signal of quasi-periodic oscillation (QPO) with a periodicity of 270 ± 26 days with possible harmonics of 550 ± 42 and 1150 ± 157 day periods. At a time when detections of QPOs in blazars are still under debate, the observed QPO with high statistical significance (∼97%–99% global significance over underlying red-noise processes) and persistent over nearly 10 oscillations could make one of the strongest cases for the detection of QPOs in blazar light curves. We discuss various blazar models that might lead to the γ -ray and radio variability, QPO, and the achromatic behavior seen in the high-energy emission from the source.« less

Content-addressable memory based enforcement of configurable policies

DOEpatents

Berg, Michael J

2014-05-06

A monitoring device for monitoring transactions on a bus includes content-addressable memory ("CAM") and a response policy unit. The CAM includes an input coupled to receive a bus transaction tag based on bus traffic on the bus. The CAM stores data tags associated with rules of a security policy to compare the bus transaction tag to the data tags. The CAM generates an output signal indicating whether one or more matches occurred. The response policy unit is coupled to the CAM to receive the output signal from the CAM and to execute a policy action in response to the output signal.

A web-based course on complementary medicine for medical students and residents improves knowledge and changes attitudes.

PubMed

Cook, David A; Gelula, Mark H; Lee, Mark C; Bauer, Brent A; Dupras, Denise M; Schwartz, Alan

2007-01-01

There is a growing need to educate physicians about complementary and alternative medicine (CAM). Few introductory courses in CAM have been described. To develop and evaluate an introductory course in CAM for medical students and residents. We conducted a controlled study evaluating a case-based, Web-based course in CAM, making comparison to no intervention. Participants were 123 internal medicine residents, family medicine residents, and 3rd- and 4th-year medical students at academic residency programs in internal medicine and family medicine and two U.S. medical schools. Outcomes included knowledge of CAM, attitudes toward CAM, and course evaluation information. Eighty-nine learners completed the course. Test scores among a subset of these (n = 57) were higher (M +/- SD = 78.7 +/- 10.1) than scores (50.9 +/- 8.5, p < .001) among a no-intervention control group (n = 34), and remained higher (64.9 +/- 11.4) 3 months later. After the course participants felt more comfortable discussing CAM with patients, recognized a greater role for CAM, and knew better where to find information on CAM (ps < .001 compared to baseline). Course ratings were high, although 26% of learners desired greater feedback. This brief course in CAM improved knowledge, changed attitudes, and was well received.

Use of complementary and alternative medicines among women with gestational trophoblastic diseases: a survey at the Philippine General Hospital.

PubMed

Cagayan, M Stephanie Fay S; Oras, Celestrell May W

2010-01-01

To determine the prevalence of complementary and alternative medicine (CAM) use among women with gestational trophoblastic disease (GTD) at the University of the Philippines-Philippine General Hospital (UP-PGH). A survey on the use of CAM among women (N = 52) with GTD managed at the UP-PGH Gestational Trophoblastic Disease Center from June to August 2009 was done. The mean age of the participants was 32.3 years, and there were no significant differences in the proportion of CAM users as to educational attainment, diagnosis and treatment type received. Among the participants 96% used CAM, most commonly mental healing/prayer, fruit juices/vegetable diet, banaba/taheebo tea and multivitamins. Reasons for CAM use included safety, improvement of immune system, stress reduction and hope for their condition. Benefits included enhanced quality of life, stress reduction, immune system improvement and a healthier lifestyle. No untoward effect of CAM use was reported. Thirty-six percent of the participants disclosed CAM use to their physician. About 56% percent of the physicians were in favor of the CAM used. The main sources of information on CAM were relatives and friends. To better address patients' needs, physicians should routinely ask patients about their use of CAM and be able to discuss these therapies with them.

Bidirectional modulation of endogenous EpCAM expression to unravel its function in ovarian cancer

PubMed Central

van der Gun, B T F; Huisman, C; Stolzenburg, S; Kazemier, H G; Ruiters, M H J; Blancafort, P; Rots, M G

2013-01-01

Background: The epithelial cell adhesion molecule (EpCAM) is overexpressed on most carcinomas. Dependent on the tumour type, its overexpression is either associated with improved or worse patient survival. For ovarian cancer, however, the role of EpCAM remains unclear. Methods: Cell survival of ovarian cancer cell lines was studied after induction or repression of endogenous EpCAM expression using siRNA/cDNA or artificial transcription factors (ATF) consisting of engineered zinc-fingers fused to either a transcriptional activator or repressor domain. Results: Two ATFs were selected as the most potent down- and upregulator, showing at least a two-fold alteration of EpCAM protein expression compared with control. Downregulation of EpCAM expression resulted in growth inhibition in breast cancer, but showed no effect on cell growth in ovarian cancer. Induction or further upregulation of EpCAM expression decreased ovarian cancer cell survival. Conclusion: The bidirectional ATF-based approach is uniquely suited to study cell-type-specific biological effects of EpCAM expression. Using this approach, the oncogenic function of EpCAM in breast cancer was confirmed. Despite its value as a diagnostic marker and for immunotherapy, EpCAM does not seem to represent a therapeutic target for gene expression silencing in ovarian cancer. PMID:23403823

Vct system having closed loop control employing spool valve actuated by a stepper motor

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

Quin, S.B. Jr.; Siemon, E.C.

1993-06-15

An internal combustion engine is described comprising: a crankshaft, the crankshaft being rotable about an axis; a cam shaft, the cam shaft being rotatable about a second axis, the second axis being parallel to the axis, the cam shaft being subject to torque reversals during the rotation thereof; a vane, the vane having at least one lobe, the vane being attached to the cam shaft, being rotatable with the cam shaft and being non-oscillatable with respect to the cam shaft; a housing, the housing being rotatable with the cam shaft and being oscillatable with respect to the cam shaft, themore » housing having at least one recess, the recess receiving the lobe, the lobe being oscillatable within the recess; rotary movement transmitting means for transmitting rotary movement from the crankshaft to the housing; actuating means for varying the position of the housing relative to the cam shaft in reaction to torque reversals in the cam shaft, the actuating means comprising a stepper motor, a lead screw and a proportional spool valve, the position of the spool valve being controlled by the position of the lead screw driven by the stepper motor, the actuating means also delivering hydraulic fluid to the vane; and processing means for controlling the position of the actuating means.« less

Range of Hip Joint Motion Is Correlated With MRI-Verified Cam Deformity in Adolescent Elite Skiers

PubMed Central

Agnvall, Cecilia; Swärd Aminoff, Anna; Todd, Carl; Jonasson, Pall; Thoreson, Olof; Swärd, Leif; Karlsson, Jon; Baranto, Adad

2017-01-01

Background: Radiologically verified cam-type femoroacetabular impingement (FAI) has been shown to correlate with reduced internal rotation, reduced passive hip flexion, and a positive anterior impingement test. Purpose: To validate how a clinical examination of the hip joint correlates with magnetic resonance imaging (MRI)–verified cam deformity in adolescents. Study Design: Cross-sectional study; Level of evidence, 3. Methods: The sample group consisted of 102 adolescents with the mean age 17.7 ± 1.4 years. The hip joints were examined using MRI for measurements of the presence of cam (α-angle ≥55°) and clinically for range of motion (ROM) in both supine and sitting positions. The participants were divided into a cam and a noncam group based on the results of the MRI examination. Passive hip flexion, internal rotation, anterior impingement, and the FABER (flexion, abduction, and external rotation) test were used to test both hips in the supine position. With the participant sitting, the internal/external rotation of the hip joint was measured in 3 different positions of the pelvis (neutral, maximum anteversion, and retroversion) and lumbar spine (neutral, maximum extension, and flexion). Results: Differences were found between the cam and noncam groups in terms of the anterior impingement test (right, P = .010; left, P = .006), passive supine hip flexion (right: mean, 5°; cam, 117°; noncam, 122° [P = .05]; and left: mean, 8.5°; cam, 116°; noncam, 124.5° [P = .001]), supine internal rotation (right: mean, 4.9°; cam, 24°; noncam, 29° [P = .022]; and left: mean, 4.8°; cam, 26°; noncam, 31° [P = .028]), sitting internal rotation with the pelvis and lumbar spine in neutral (right: mean, 7.95°; cam, 29°; noncam, 37° [P = .001]; and left: mean, 6.5°; cam, 31.5°; noncam, 38° [P = .006]), maximum anteversion of the pelvis and extension of the lumbar spine (right: mean, 5.2°; cam, 20°; noncam, 25° [P = .004]; and left: mean, 5.85°; cam, 20.5; noncam, 26.4° [P = .004]), and maximum retroversion of the pelvis and flexion of the spine (right: mean, 8.4°; cam, 32.5°; noncam, 41° [P = .001]; and left: mean, 6.2°; cam, 36°; noncam, 42.3° [P = .012]). The cam group had reduced ROM compared with the noncam group in all clinical ROM measures. Conclusion: The presence of cam deformity on MRI correlates with reduced internal rotation in the supine and sitting positions, passive supine hip flexion, and the impingement test in adolescents. PMID:28695136

An Evaluation of Marine Boundary Layer Cloud Property Simulations in the Community Atmosphere Model Using Satellite Observations: Conventional Subgrid Parameterization versus CLUBB

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

Song, Hua; Zhang, Zhibo; Ma, Po-Lun

This paper presents a two-step evaluation of the marine boundary layer (MBL) cloud properties from two Community Atmospheric Model (version 5.3, CAM5) simulations, one based on the CAM5 standard parameterization schemes (CAM5-Base), and the other on the Cloud Layers Unified By Binormals (CLUBB) scheme (CAM5-CLUBB). In the first step, we compare the cloud properties directly from model outputs between the two simulations. We find that the CAM5-CLUBB run produces more MBL clouds in the tropical and subtropical large-scale descending regions. Moreover, the stratocumulus (Sc) to cumulus (Cu) cloud regime transition is much smoother in CAM5-CLUBB than in CAM5-Base. In addition,more » in CAM5-Base we find some grid cells with very small low cloud fraction (<20%) to have very high in-cloud water content (mixing ratio up to 400mg/kg). We find no such grid cells in the CAM5-CLUBB run. However, we also note that both simulations, especially CAM5-CLUBB, produce a significant amount of “empty” low cloud cells with significant cloud fraction (up to 70%) and near-zero in-cloud water content. In the second step, we use satellite observations from CERES, MODIS and CloudSat to evaluate the simulated MBL cloud properties by employing the COSP satellite simulators. We note that a feature of the COSP-MODIS simulator to mimic the minimum detection threshold of MODIS cloud masking removes much more low clouds from CAM5-CLUBB than it does from CAM5-Base. This leads to a surprising result — in the large-scale descending regions CAM5-CLUBB has a smaller COSP-MODIS cloud fraction and weaker shortwave cloud radiative forcing than CAM5-Base. A sensitivity study suggests that this is because CAM5-CLUBB suffers more from the above-mentioned “empty” clouds issue than CAM5-Base. The COSP-MODIS cloud droplet effective radius in CAM5-CLUBB shows a spatial increase from coastal St toward Cu, which is in qualitative agreement with MODIS observations. In contrast, COSP-MODIS cloud droplet effective radius in CAM5-Base almost remains a constant. In comparison with CloudSat observations, the histogram of the radar reflectivity from modeled MBL clouds is too narrow without a distinct separation between cloud and drizzle modes. Moreover, the probability of drizzle in both simulations is almost twice as high as the observation. Future studies are needed to understand the causes of these differences and their potential connection with the “empty” cloud issues in the model.« less

Complementary and Alternative Medicine Use Among US Adults With Headache or Migraine: Results from the 2012 National Health Interview Survey.

PubMed

Zhang, Yan; Dennis, Jeff A; Leach, Matthew J; Bishop, Felicity L; Cramer, Holger; Chung, Vincent C H; Moore, Craig; Lauche, Romy; Cook, Ron; Sibbritt, David; Adams, Jon

2017-09-01

Given the safety concerns regarding pharmacological agents, and the considerable impact of headache and migraine on the sufferer's quality of life, many people seek other treatment options beyond conventional medication and care to address their symptoms; this includes complementary and alternative medicine (CAM). Some CAM interventions have shown promising results in clinical trials of headache and migraine management. Nonetheless, there has been little research exploring the reasons for using CAM, and the types of CAM used, among this population. The study aimed to answer the following questions: (1) Which CAM modalities are used most frequently among migraine/headache sufferers? and (2) What are the self-reported reasons for CAM use among migraine/headache sufferers? This secondary analysis of data from the 2012 U.S. NHIS (a national cross-sectional survey) examined the use of CAM among migraine/headache sufferers, including the main reasons related to CAM use. Data were weighted and analyzed using STATA 14.0. The sample of 34,525 adults included 6558 (18.7%) headache/migraine sufferers. Of the headache/migraine sufferers, a substantial proportion (37.6%, n = 2427) used CAM for various conditions; however, CAM use specifically for headache/migraine was much less prevalent (3.3%, n = 216). Of those who used CAM for headache/migraine, about half used CAM in conjunction with prescription (47.8%, n = 100) or over-the-counter medication (55.1%, n = 113). As severity of headache/migraine increased so did the likelihood of using CAM (severe migraine odds ratio [OR] = 2.32; 95% confidence interval [CI]: 1.41, 3.82; both recurring headache/severe migraine OR = 3.36; 95% CI: 2.08, 5.43; when compared to those with recurring headache only). The most frequently used CAM modality among all headache/migraine sufferers (N = 6558) was manipulative therapy (22.0%, n = 1317), herbal supplementation (21.7%, n = 1389) and mind-body therapy (17.9%, n = 1100). The top 3 reasons for using CAM for headache were general wellness (28.7%, n = 60/209), improving overall health (26.8%, n = 56/209), and reducing stress (16.7%, n = 35/209). Although CAM is used by many sufferers of headache/migraine, the use of CAM specifically for the treatment of headache/migraine is relatively low in the United States. The study also assesses the key differences of CAM use among headache/migraine sufferers in NHIS 2012 compared with those in NHIS 2007, and identifies shortfalls in the evidence-base of several CAM modalities used by U.S. adults for headache/migraine. This information may assist health providers and consumers in making informed decisions about the safest and most appropriate approach to managing headache/migraine. © 2017 American Headache Society.

CAM Photosynthesis in Submerged Aquatic Plants

USGS Publications Warehouse

Keeley, J.E.

1998-01-01

Crassulacean acid metabolism (CAM) is a CO2-concentrating mechanism selected in response to aridity in terrestrial habitats, and, in aquatic environments, to ambient limitations of carbon. Evidence is reviewed for its presence in five genera of aquatic vascular plants, including Isoe??tes, Sagittaria, Vallisneria, Crassula, and Littorella. Initially, aquatic CAM was considered by some to be an oxymoron, but some aquatic species have been studied in sufficient detail to say definitively that they possess CAM photosynthesis. CO2-concentrating mechanisms in photosynthetic organs require a barrier to leakage; e.g., terrestrial C4 plants have suberized bundle sheath cells and terrestrial CAM plants high stomatal resistance. In aquatic CAM plants the primary barrier to CO2 leakage is the extremely high diffusional resistance of water. This, coupled with the sink provided by extensive intercellular gas space, generates daytime CO2(Pi) comparable to terrestrial CAM plants. CAM contributes to the carbon budget by both net carbon gain and carbon recycling, and the magnitude of each is environmentally influenced. Aquatic CAM plants inhabit sites where photosynthesis is potentially limited by carbon. Many occupy moderately fertile shallow temporary pools that experience extreme diel fluctuations in carbon availability. CAM plants are able to take advantage of elevated nighttime CO2 levels in these habitats. This gives them a competitive advantage over non-CAM species that are carbon starved during the day and an advantage over species that expend energy in membrane transport of bicarbonate. Some aquatic CAM plants are distributed in highly infertile lakes, where extreme carbon limitation and light are important selective factors. Compilation of reports on diel changes in titratable acidity and malate show 69 out of 180 species have significant overnight accumulation, although evidence is presented discounting CAM in some. It is concluded that similar proportions of the aquatic and terrestrial floras have evolved CAM photosynthesis. Aquatic Isoe??tes (Lycophyta) represent the oldest lineage of CAM plants and cladistic analysis supports an origin for CAM in seasonal wetlands, from which it has radiated into oligotrophic lakes and into terrestrial habitats. Temperate Zone terrestrial species share many characteristics with amphibious ancestors, which in their temporary terrestrial stage, produce functional stomata and switch from CAM to C3. Many lacustrine Isoe??tes have retained the phenotypic plasticity of amphibious species and can adapt to an aerial environment by development of stomata and switching to C3. However, in some neotropical alpine species, adaptations to the lacustrine environment are genetically fixed and these constitutive species fail to produce stomata or loose CAM when artificially maintained in an aerial environment. It is hypothesized that neotropical lacustrine species may be more ancient in origin and have given rise to terrestrial species, which have retained most of the characteristics of their aquatic ancestry, including astomatous leaves, CAM and sediment-based carbon nutrition.

Enrichment, Isolation and Molecular Characterization of EpCAM-Negative Circulating Tumor Cells.

PubMed

Lampignano, Rita; Schneck, Helen; Neumann, Martin; Fehm, Tanja; Neubauer, Hans

2017-01-01

The presence of EpCAM-positive circulating tumor cells (CTCs) in the peripheral blood is associated with poor clinical outcomes in breast, colorectal and prostate cancer, as well as the prognosis of other tumor types. In addition, recent studies have suggested that the presence of CTCs undergoing epithelial-to-mesenchymal transition and, as such, may exhibit reduced or no expression of epithelial proteins e.g. EpCAM, might be related to disease progression in metastatic breast cancer (MBC) patients. Analyzing the neoplastic nature of this EpCAM-low/negative (EpCAM-neg) subpopulation remains an open issue as the current standard detection methods for CTCs are not efficient at identifying this subpopulation of cells. The possible association of EpCAM-neg CTCs with EpCAM-positive (EpCAM-pos) CTCs and role in the clinicopathological features and prognosis of MBC patients has still to be demonstrated. Several technologies have been developed and are currently being tested for the identification and the downstream analyses of EpCAM-pos CTCs. These technologies can be adapted and implemented into workflows to isolate and investigate EpCAM-neg cells to understand their biology and clinical relevance. This chapter will endeavour to explain the rationale behind the identification and analyses of all CTC subgroups, as well as to review the current strategies employed to enrich, isolate and characterize EpCAM-negative CTCs. Finally, the latest findings in the field will briefly be discussed with regard to their clinical relevance.

Ethnic Differences in Complementary and Alternative Medicine Use among Patients with Diabetes

PubMed Central

Villa-Caballero, Leonel; Morello, Candis M; Chynoweth, Megan E; Prieto-Rosinol, Ariadna; Polonsky, William H; Palinkas, Lawrence A; Edelman, Steven V

2010-01-01

Objective To evaluate the effect of ethnicity as a predictor of the use of complementary and alternative medicine (CAM) among patients with diabetes. Design and Settings A 16-item questionnaire investigating CAM use was distributed among patients attending the Taking Control of Your Diabetes (TCOYD) educational conferences during 2004-2006. Six TCOYD were held across the United States. Information of diabetes status and sociodemographic data was collected. CAM use was identified as pharmacological (herbs and vitamins) and nonpharmacological CAM. (e.g., prayer, yoga, and acupuncture). Results The prevalence of pharmacological and non-pharmacological CAM among 806 participants with diabetes patients was 81.9% and 80.3%, respectively. Overall, CAM prevalence was similar for Caucasians (94.2%), African Americans (95.5%), Hispanics (95.6%) and Native Americans (95.2%) and lower in Pacific Islanders/Other (83.9%) and Asians (87.8%). Pharmacologic CAM prevalence was positively associated with education (p = 0.001). The presence of diabetes was a powerful predictor of CAM use. Several significant ethnic differences were observed in specific forms of CAM use. Hispanics reported using frequently prickly pear (nopal) to complement their diabetes treatment while Caucasians more commonly used multivitamins. Conclusions Treatment with CAM widely used in persons with diabetes. Ethnic group differences determine a variety of practices, reflecting groups' cultural preferences. Future research is needed to clarify the perceived reasons for CAM use among patients with diabetes in clinical practice and the health belief system associated with diabetes by ethnic group. PMID:21130360

Ethnic differences in complementary and alternative medicine use among patients with diabetes.

PubMed

Villa-Caballero, Leonel; Morello, Candis M; Chynoweth, Megan E; Prieto-Rosinol, Ariadna; Polonsky, William H; Palinkas, Lawrence A; Edelman, Steven V

2010-12-01

To evaluate the effect of ethnicity as a predictor of the use of complementary and alternative medicine (CAM) among patients with diabetes. A 16-item questionnaire investigating CAM use was distributed among patients attending the Taking Control of Your Diabetes (TCOYD) educational conferences during 2004-2006. Six TCOYD were held across the United States. Information of diabetes status and sociodemographic data was collected. CAM use was identified as pharmacologic (herbs and vitamins) and nonpharmacologic CAMs (e.g., prayer, yoga, and acupuncture). The prevalence of pharmacologic and non-pharmacologic CAMs among 806 participants with diabetes patients was 81.9% and 80.3%, respectively. Overall, CAM prevalence was similar for Caucasians (94.2%), African Americans (95.5%), Hispanics (95.6%) and Native Americans (95.2%) and lower in Pacific Islanders/others (83.9%) and Asians (87.8%). Pharmacologic CAM prevalence was positively associated with education (p=0.001). The presence of diabetes was a powerful predictor of CAM use. Several significant ethnic differences were observed in specific forms of CAM use. Hispanics reported using frequently prickly pear (nopal) to complement their diabetes treatment while Caucasians more commonly used multivitamins. Treatment with CAM widely used in persons with diabetes. Ethnic group differences determine a variety of practices, reflecting groups' cultural preferences. Future research is needed to clarify the perceived reasons for CAM use among patients with diabetes in clinical practice and the health belief system associated with diabetes by ethnic group. Published by Elsevier Ltd.

A dynamic alpha-beta inter-subunit agonist signaling complex is a novel feedback mechanism for regulating L-type Ca2+ channel opening.

PubMed

Zhang, Rong; Dzhura, Igor; Grueter, Chad E; Thiel, William; Colbran, Roger J; Anderson, Mark E

2005-09-01

L-type Ca2+ channels are macromolecular protein complexes in neurons and myocytes that open in response to cell membrane depolarization to supply Ca2+ for regulating gene transcription and vesicle secretion and triggering cell contraction. L-type Ca2+ channels include a pore-forming alpha and an auxiliary beta subunit, and alpha subunit openings are regulated by cellular Ca2+ through a mechanism involving the Ca2+-sensing protein calmodulin (CaM) and CaM binding motifs in the alpha subunit cytoplasmic C terminus. Here we show that these CaM binding motifs are "auto-agonists" that increase alpha subunit openings by binding the beta subunit. The CaM binding domains are necessary and sufficient for the alpha subunit C terminus to bind the beta subunit in vitro, and excess CaM blocks this interaction. Addition of CaM binding domains to native cardiac L-type Ca2+ channels in excised cell membrane patches increases openings, and this agonist effect is prevented by excess CaM. Recombinant LTCC openings are also increased by exogenous CaM binding domains by a mechanism requiring the beta subunit, and excess CaM blocks this effect. Thus, the bifunctional ability of the alpha subunit CaM binding motifs to competitively associate with the beta subunit or CaM provides a novel paradigm for feedback control of cellular Ca2+ entry.

Expected and perceived efficacy of complementary and alternative medicine: A comparison views of patients with cancer and oncologists.

PubMed

Kim, Sang Hyuck; Shin, Dong Wook; Nam, You-Seon; Kim, So Young; Yang, Hyung-Kook; Cho, Be Long; Park, Keeho; Jo, Heui-Sug; Yim, Chang-Yeol; Kam, Sin; Park, Jong-Hyock

2016-10-01

This study sought to identify discrepancies between the expectations of patients with cancer and oncologists regarding the efficacy of complementary and alternative medicines (CAMs), and to determine how patients evaluate CAM efficacy after its use. Data from the Cancer Patient Experience Study, a nationwide survey, were used. Seven subdivided efficacy domains were included in the survey. An oncologist-patient matching analysis was done to assess the concordance of CAM efficacies between oncologists and patients with cancer. In addition, the patients' expectations of CAM efficacies were compared before and after use. Out of 719 participants, 201 patients with cancer (28.0%) reported using CAMs. The patients with cancer generally tended to be more positive about CAM efficacies than the oncologists. The largest discrepancy in efficacy perception was found in the efficacy domain of survival benefit, which included complete disease remission and prolonged survival. Many patients reported that they did not experience the positive efficacy they had anticipated before use. However, a substantial proportion of patients indicated that CAMs were as effective as they had expected, even though there is little evidence supporting the CAM efficacies. There was a marked discrepancy and a lack of concordance in expectations of CAM efficacy between patients with cancer and oncologists. Better communication between the patients and oncologists regarding CAM efficacy would be needed to make the patients to have shared expectations, and to reduce unnecessary CAM use. Copyright © 2016. Published by Elsevier Ltd.

N-glycosylation at the SynCAM (synaptic cell adhesion molecule) immunoglobulin interface modulates synaptic adhesion.

PubMed

Fogel, Adam I; Li, Yue; Giza, Joanna; Wang, Qing; Lam, Tukiet T; Modis, Yorgo; Biederer, Thomas

2010-11-05

Select adhesion molecules connect pre- and postsynaptic membranes and organize developing synapses. The regulation of these trans-synaptic interactions is an important neurobiological question. We have previously shown that the synaptic cell adhesion molecules (SynCAMs) 1 and 2 engage in homo- and heterophilic interactions and bridge the synaptic cleft to induce presynaptic terminals. Here, we demonstrate that site-specific N-glycosylation impacts the structure and function of adhesive SynCAM interactions. Through crystallographic analysis of SynCAM 2, we identified within the adhesive interface of its Ig1 domain an N-glycan on residue Asn(60). Structural modeling of the corresponding SynCAM 1 Ig1 domain indicates that its glycosylation sites Asn(70)/Asn(104) flank the binding interface of this domain. Mass spectrometric and mutational studies confirm and characterize the modification of these three sites. These site-specific N-glycans affect SynCAM adhesion yet act in a differential manner. Although glycosylation of SynCAM 2 at Asn(60) reduces adhesion, N-glycans at Asn(70)/Asn(104) of SynCAM 1 increase its interactions. The modification of SynCAM 1 with sialic acids contributes to the glycan-dependent strengthening of its binding. Functionally, N-glycosylation promotes the trans-synaptic interactions of SynCAM 1 and is required for synapse induction. These results demonstrate that N-glycosylation of SynCAM proteins differentially affects their binding interface and implicate post-translational modification as a mechanism to regulate trans-synaptic adhesion.

Collaborating with medicine? Perceptions of Australian naturopaths on integrating within the conventional medical system.

PubMed

Wardle, J; Steel, A; Lauche, R; Adams, J

2017-11-01

Complementary and alternative medicine (CAM) is an increasingly prevalent part of contemporary health care. Whilst there have been some attempts to understand the dynamics of CAM integration in the health care system from the perspective of conventional care providers and patients, little research has examined the view of CAM practitioners. This study aims to identify the experiences of integration within a conventional healthcare system as perceived by naturopaths. Qualitative semi-structured interviews were conducted using a purposeful sample of 20 practising naturopaths in South East Queensland, Australia to discuss their experiences and perceptions of integrating with conventional medical providers. Analysis of the interviews revealed five broad challenges for the integration of CAM according to naturopaths: competing paradigms between CAM and conventional medicine; co-option of CAM by conventional medical practitioners; the preservation of separate CAM and conventional medical worlds by patients and providers due to lack of formalised relations; negative feedback and biases created through selective or limited experience or information with CAM; and indifferent, reactive and one-sided interaction between CAM and conventional medical providers. Naturopaths support the integration of health services and attempt to provide safe and appropriate care to their patients through collaborative approaches to practice. The challenges identified by naturopaths associated with integration of CAM with conventional providers may impact the quality of care of patients who choose to integrate CAM and conventional approaches to health. Given the significant role of naturopaths in contemporary health-care systems, these challenges require further research and policy attention.

Impact of age, sex, socioeconomic status, and physical activity on associated movements and motor speed in preschool children.

PubMed

Kakebeeke, Tanja H; Zysset, Annina E; Messerli-Bürgy, Nadine; Chaouch, Aziz; Stülb, Kerstin; Leeger-Aschmann, Claudia S; Schmutz, Einat A; Arhab, Amar; Rousson, Valentin; Kriemler, Susi; Munsch, Simone; Puder, Jardena J; Jenni, Oskar G

2018-02-01

Young children generally show contralateral associated movements (CAMs) when they are making an effort to perform a unimanual task. CAM and motor speed are two relevant aspects of motor proficiency in young children. These CAMs decrease over age, while motor speed increases. As both CAM and motor speed are associated with age, we were interested in whether these two parameters are also linked with each other. In this study, three manual dexterity tasks with the dominant and nondominant hands (pegboard, repetitive hand, and repetitive finger tasks) were used to investigate the effect of covariates (age, sex, socioeconomic status, total physical activity) on both motor speed and CAMs in preschool children. There was a significant age effect for both motor speed and CAMs in all tasks when the dominant hand was used. When the nondominant hand was used, the decrease in the intensity of CAMs over age was not consistently significant. The influence of physical activity and socioeconomic status on motor proficiency was small. Furthermore, the correlation between motor speed and CAMs, although significant, was low. Motor speed improved with age over three fine motor tasks in preschool children. Decrease in CAMs was observed but it was not always significant when the nondominant hand was working. Motor speed and CAMs were only weakly associated. We conclude that the excitatory pathways responsible for motor speed and inhibitory pathways responsible for reducing CAMs occupy two different domains in the brain and therefore mostly behave independently of each other.

L1CAM expression in endometrial carcinomas: an ENITEC collaboration study.

PubMed

van der Putten, Louis Jm; Visser, Nicole Cm; van de Vijver, Koen; Santacana, Maria; Bronsert, Peter; Bulten, Johan; Hirschfeld, Marc; Colas, Eva; Gil-Moreno, Antonio; Garcia, Angel; Mancebo, Gemma; Alameda, Fransesc; Trovik, Jone; Kopperud, Reidun K; Huvila, Jutta; Schrauwen, Stefanie; Koskas, Martin; Walker, Francine; Weinberger, Vit; Minar, Lubos; Jandakova, Eva; Snijders, Marc Plm; van den Berg-van Erp, Saskia; Matias-Guiu, Xavier; Salvesen, Helga B; Amant, Frederic; Massuger, Leon Fag; Pijnenborg, Johanna Ma

2016-09-06

Identification of aggressive endometrioid endometrial carcinomas (EECs) and non-endometrioid carcinomas (NEECs) is essential to improve outcome. L1 cell adhesion molecule (L1CAM) expression is a strong prognostic marker in stage I EECs, but less is known about L1CAM expression in advanced-stage EECs and NEECs. This study analyses L1CAM expression in a clinically representative cohort of endometrial carcinomas. The expression of L1CAM was immunohistochemically determined in 1199 endometrial carcinomas, treated at one of the European Network for Individualized Treatment of Endometrial Cancer (ENITEC) centres. Staining was considered positive when >10% of the tumour cells expressed L1CAM. The association between L1CAM expression and several clincopathological characteristics and disease outcome was calculated. In all, L1CAM was expressed in 10% of the 935 stage I EECs, 18% of the 160 advanced stage EECs, and 75% of the 104 NEECs. The expression of L1CAM was associated with advanced stage, nodal involvement, high tumour grade, non-endometrioid histology, lymphovascular space invasion, and distant recurrences in all cases, and with reduced survival in the EECs, but not in the NEECs. The expression of L1CAM is a strong predictor of poor outcome in EECs, but not NEECs. It is strongly associated with non-endometrioid histology and distant spread, and could improve the postoperative selection of high-risk endometrial carcinomas. The value of L1CAM expression in the preoperative selection of high-risk endometrial carcinomas should be studied.

'Thinking outside the box': complementary and alternative therapies use in paediatric oncology patients.

PubMed

Molassiotis, Alexander; Cubbin, Denise

2004-03-01

The aim of this study was to determine the prevalence of complementary and alternative medicine (CAM) use among children with cancer who had received or were receiving treatment at a large hospital in the UK, including the identification of the most commonly used therapies and parental motives for doing so. Using a cross-sectional survey design, questionnaires were sent to parents of paediatric patients diagnosed with cancer. Of the 49 respondents, 32.7% reported using some type of CAM. The most commonly used therapies included multivitamins, aromatherapy massage, diets and music as therapy. Most children had used more than one therapy. Many of the factors that motivated parents to use CAM were related to helping or supporting their child's medical treatment. The main benefits identified from using CAM included increased confidence, pain relief and relaxation. The longer the time since diagnosis the more children tended to use CAM. The reasons for parents not using CAM included the child doing well and therefore not seeing the need for CAM use; not being aware of CAM; CAM not being offered and lack of information available. Parents identified a need for more information to be available both at ward level and for information about CAM to be discussed by medical staff, particularly at the start of treatment. The results indicate that CAM is frequently used by children and young people with cancer and that their use plays a substantial role in helping children through their conventional cancer treatment.

N-Glycosylation at the SynCAM (Synaptic Cell Adhesion Molecule) Immunoglobulin Interface Modulates Synaptic Adhesion*

PubMed Central

Fogel, Adam I.; Li, Yue; Giza, Joanna; Wang, Qing; Lam, TuKiet T.; Modis, Yorgo; Biederer, Thomas

2010-01-01

Select adhesion molecules connect pre- and postsynaptic membranes and organize developing synapses. The regulation of these trans-synaptic interactions is an important neurobiological question. We have previously shown that the synaptic cell adhesion molecules (SynCAMs) 1 and 2 engage in homo- and heterophilic interactions and bridge the synaptic cleft to induce presynaptic terminals. Here, we demonstrate that site-specific N-glycosylation impacts the structure and function of adhesive SynCAM interactions. Through crystallographic analysis of SynCAM 2, we identified within the adhesive interface of its Ig1 domain an N-glycan on residue Asn60. Structural modeling of the corresponding SynCAM 1 Ig1 domain indicates that its glycosylation sites Asn70/Asn104 flank the binding interface of this domain. Mass spectrometric and mutational studies confirm and characterize the modification of these three sites. These site-specific N-glycans affect SynCAM adhesion yet act in a differential manner. Although glycosylation of SynCAM 2 at Asn60 reduces adhesion, N-glycans at Asn70/Asn104 of SynCAM 1 increase its interactions. The modification of SynCAM 1 with sialic acids contributes to the glycan-dependent strengthening of its binding. Functionally, N-glycosylation promotes the trans-synaptic interactions of SynCAM 1 and is required for synapse induction. These results demonstrate that N-glycosylation of SynCAM proteins differentially affects their binding interface and implicate post-translational modification as a mechanism to regulate trans-synaptic adhesion. PMID:20739279

Marginal and internal fits of fixed dental prostheses zirconia retainers.

PubMed

Beuer, Florian; Aggstaller, Hans; Edelhoff, Daniel; Gernet, Wolfgang; Sorensen, John

2009-01-01

CAM (computer-aided manufacturing) and CAD (computer-aided design)/CAM systems facilitate the use of zirconia substructure materials for all-ceramic fixed partial dentures. This in vitro study compared the precision of fit of frameworks milled from semi-sintered zirconia blocks that were designed and machined with two CAD/CAM and one CAM system. Three-unit posterior fixed dental prostheses (FDP) (n=10) were fabricated for standardized dies by: a milling center CAD/CAM system (Etkon), a laboratory CAD/CAM system (Cerec InLab), and a laboratory CAM system (Cercon). After adaptation by a dental technician, the FDP were cemented on definitive dies, embedded and sectioned. The marginal and internal fits were measured under an optical microscope at 50x magnification. A one-way analysis of variance (ANOVA) was used to compare data (alpha=0.05). The mean (S.D.) for the marginal fit and internal fit adaptation were: 29.1 microm (14.0) and 62.7 microm (18.9) for the milling center system, 56.6 microm (19.6) and 73.5 microm (20.6) for the laboratory CAD/CAM system, and 81.4 microm (20.3) and 119.2 microm (37.5) for the laboratory CAM system. One-way ANOVA showed significant differences between systems for marginal fit (P<0.001) and internal fit (P<0.001). All systems showed marginal gaps below 120 microm and were therefore considered clinically acceptable. The CAD/CAM systems were more precise than the CAM system.

SuperCam_MastUnit

NASA Astrophysics Data System (ADS)

Deleuze, M. D.; Bernardi, P. B.; Caïs, Ph. C.; Perez, R. P.; Rees, J. M. R.; Pares, L. P.; Dubois, B. D.; Parot, Y. P.; Quertier, B. Q.; Maurice, S. M.; Maccabe, K. M.; Wiens, R. W.; Rull, F. R.

2016-10-01

This paper will describe and give a development status of SuperCam's mast unit. SuperCam will be carried on the Mars 2020 rover, and consists in an enhanced version of the ChemCam LIBS which is still performing at the surface of Mars, on Curiosity.

Buying CAM.

ERIC Educational Resources Information Center

Meloy, Jim; And Others

1990-01-01

The relationship between computer-aided design (CAD), computer-aided manufacturing (CAM), and computer numerical control (CNC) computer applications is described. Tips for helping educate the CAM buyer on what to look for and what to avoid when searching for the most appropriate instructional CAM package are provided. (KR)

Emerging model systems for functional genomics analysis of Crassulacean acid metabolism

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

Hartwell, James; Dever, Louisa V.; Boxall, Susanna F.

Crassulacean acid metabolism (CAM) is one of three main pathways of photosynthetic carbon dioxide fixation found in higher plants. It stands out for its ability to underpin dramatic improvements in plant water use efficiency, which in turn has led to a recent renaissance in CAM research. The current ease with which candidate CAM-associated genes and proteins can be identified through high-throughput sequencing has opened up a new horizon for the development of diverse model CAM species that are amenable to genetic manipulations. The adoption of these model CAM species is underpinning rapid advances in our understanding of the complete genemore » set for CAM. Here, we highlight recent breakthroughs in the functional characterisation of CAM genes that have been achieved through transgenic approaches.« less

Emerging model systems for functional genomics analysis of Crassulacean acid metabolism

DOE PAGES

Hartwell, James; Dever, Louisa V.; Boxall, Susanna F.

2016-04-12

Crassulacean acid metabolism (CAM) is one of three main pathways of photosynthetic carbon dioxide fixation found in higher plants. It stands out for its ability to underpin dramatic improvements in plant water use efficiency, which in turn has led to a recent renaissance in CAM research. The current ease with which candidate CAM-associated genes and proteins can be identified through high-throughput sequencing has opened up a new horizon for the development of diverse model CAM species that are amenable to genetic manipulations. The adoption of these model CAM species is underpinning rapid advances in our understanding of the complete genemore » set for CAM. Here, we highlight recent breakthroughs in the functional characterisation of CAM genes that have been achieved through transgenic approaches.« less

Multiwavelength monitoring of the BL Lacertae object PKS 2155-304. 3: Ground-based observations in 1991 November

NASA Technical Reports Server (NTRS)

Courvoisier, T. J.-L.; Blecha, A.; Bouchet, P.; Bratschi, P.; Carini, M. T.; Donahue, M.; Edelson, R.; Feigelson, E. D.; Filippenko, A. V.; Glass, I. S.

1995-01-01

We present ground-based observations of the BL Lac object PKS 2155-304 during 1991 November. These data were obtained as part of a large international campaign of observations spanning the electro-magnetic spectrum from the radio waves to the X-rays. The data presented here include radio and UBVRI fluxes, as well as optical polarimetry. The U to I data show the same behavior in all bands and that only upper limits to any lag can be deduced from the cross-correlation of the light curves. The spectral slope in the U-I domain remained constant on all epochs but 2. There is no correlation between changes in the spectral slope and large variations in the total or polarized flux. The radio flux variations did not follow the same pattern of variability as the optical and infrared fluxes. The polarized flux varied by a larger factor than the total flux. The variations of the polarized flux are poorly correlated with those of the total flux in the optical (and hence UV domain; see the accompanying paper by Edelson et al.) nor with those of the soft X-rays. We conclude that the variability of PKS 2155-304 in the optical and near-infrared spectral domains are easier to understand in the context of variable geometry or bulk Lorentz factor than of variable electron acceleration and cooling rates.

“We make choices we think are going to save us”: Debate and stance identification for online breast cancer CAM discussions

PubMed Central

Zhang, Shaodian; Qiu, Lin; Chen, Frank; Zhang, Weinan; Yu, Yong; Elhadad, Noémie

2017-01-01

Patients discuss complementary and alternative medicine (CAM) in online health communities. Sometimes, patients’ conflicting opinions toward CAM-related issues trigger debates in the community. The objectives of this paper are to identify such debates, identify controversial CAM therapies in a popular online breast cancer community, as well as patients’ stances towards them. To scale our analysis, we trained a set of classifiers. We first constructed a supervised classifier based on a long short-term memory neural network (LSTM) stacked over a convolutional neural network (CNN) to detect automatically CAM-related debates from a popular breast cancer forum. Members’ stances in these debates were also identified by a CNN-based classifier. Finally, posts automatically flagged as debates by the classifier were analyzed to explore which specific CAM therapies trigger debates more often than others. Our methods are able to detect CAM debates with F score of 77%, and identify stances with F score of 70%. The debate classifier identified about 1/6 of all CAM-related posts as debate. About 60% of CAM-related debate posts represent the supportive stance toward CAM usage. Qualitative analysis shows that some specific therapies, such as Gerson therapy and usage of laetrile, trigger debates frequently among members of the breast cancer community. This study demonstrates that neural networks can effectively locate debates on usage and effectiveness of controversial CAM therapies, and can help make sense of patients’ opinions on such issues under dispute. As to CAM for breast cancer, perceptions of their effectiveness vary among patients. Many of the specific therapies trigger debates frequently and are worth more exploration in future work. PMID:28967000

Complementary and alternative medicine use by osteoporotic patients in Australia (CAMEO-A): a prospective study.

PubMed

Mak, Jenson C S; Faux, Steven

2010-05-01

Complementary and alternative medicine (CAM) therapies have become increasingly popular and are used regularly by patients with osteoporosis in Australasia and worldwide. This study was done to determine the prevalence and patterns of use of CAM in an Australian osteoporosis clinic. This was a prospective, cross-sectional questionnaire-based study of 202 patients attending an academic osteoporosis clinic in Sydney, Australia. Subject had a mean age of 68.5 +/- 10.9 years, 79.7% were female, and 55.9% were born overseas. CAM use was reported by 104 patients (51.5%) using the standard and 62 patients (30.7%) using the stringent definition of CAM. The most frequent CAM were multivitamins (24.0%), acupuncture (19.2%), t'ai chi (14.4%), and yoga (12.5%). Seventy-three percent (73%) did not consult a physician before starting CAM and 23.1% stated that their treating specialists were unaware of CAM use. The most common reasons for using CAM were having a holistic approach (53.0%) and inadequate pain control (29.0%). CAM users were associated with Asian country of birth (23.1% versus 12.2%, p = 0.03), more frequent clinic visits over a 12-month period (1.8 versus 1.5 times, p = 0.03), and a trend for a worse lumbar spine T-score (-2.35 versus -2.20 SD, p = 0.05) and higher rates of university education (26.0% versus 14.3%, p = 0.05). It is estimated that $696 million is spent annually on CAM by patients with osteoporosis. Patients attending osteoporosis clinics frequently use CAM. Physicians may need to routinely inquire about a history of CAM use to ensure better screening for possible adverse clinical interactions.

"We make choices we think are going to save us": Debate and stance identification for online breast cancer CAM discussions.

PubMed

Zhang, Shaodian; Qiu, Lin; Chen, Frank; Zhang, Weinan; Yu, Yong; Elhadad, Noémie

2017-04-01

Patients discuss complementary and alternative medicine (CAM) in online health communities. Sometimes, patients' conflicting opinions toward CAM-related issues trigger debates in the community. The objectives of this paper are to identify such debates, identify controversial CAM therapies in a popular online breast cancer community, as well as patients' stances towards them. To scale our analysis, we trained a set of classifiers. We first constructed a supervised classifier based on a long short-term memory neural network (LSTM) stacked over a convolutional neural network (CNN) to detect automatically CAM-related debates from a popular breast cancer forum. Members' stances in these debates were also identified by a CNN-based classifier. Finally, posts automatically flagged as debates by the classifier were analyzed to explore which specific CAM therapies trigger debates more often than others. Our methods are able to detect CAM debates with F score of 77%, and identify stances with F score of 70%. The debate classifier identified about 1/6 of all CAM-related posts as debate. About 60% of CAM-related debate posts represent the supportive stance toward CAM usage. Qualitative analysis shows that some specific therapies, such as Gerson therapy and usage of laetrile, trigger debates frequently among members of the breast cancer community. This study demonstrates that neural networks can effectively locate debates on usage and effectiveness of controversial CAM therapies, and can help make sense of patients' opinions on such issues under dispute. As to CAM for breast cancer, perceptions of their effectiveness vary among patients. Many of the specific therapies trigger debates frequently and are worth more exploration in future work.

Complementary and alternative medicine: Do physicians believe they can meet the requirements of the Collège des médecins du Québec?

PubMed

Gaboury, Isabelle; Johnson, Noémie; Robin, Christine; Luc, Mireille; O'Connor, Daniel; Patenaude, Johane; Pélissier-Simard, Luce; Xhignesse, Marianne

2016-12-01

To determine whether medical training prepares FPs to meet the requirements of the Collège des médecins du Québec for their role in advising patients on the use of complementary and alternative medicine (CAM). Secondary analysis of survey results. Quebec. Family physicians and GPs in active practice. Perceptions of the role of the physician as an advisor on CAM; level of comfort responding to questions and advising patients on CAM; frequency with which patients ask their physicians about CAM; personal position on CAM; and desire for training on CAM. The response rate was 19.5% (195 respondents of 1000) and the sample appears to be representative of the target population. Most respondents (85.8%) reported being asked about CAM several times a month. A similar proportion (86.7%) believed it was their role to advise patients on CAM. However, of this group, only 33.1% reported being able to do so. There is an association between an urban practice and knowledge of the advisory role of physicians. More than three-quarters of respondents expressed interest in receiving additional training on CAM. There is a gap between the training that Quebec physicians receive on CAM and their need to meet legal and ethical obligations designed to protect the public where CAM products and therapies are concerned. One solution might be more thorough training on CAM to help physicians meet the Collège des médecins du Québec requirements. Copyright© the College of Family Physicians of Canada.

WADeG Cell Phone

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

2009-09-01

The on cell phone software captures the images from the CMOS camera periodically, stores the pictures, and periodically transmits those images over the cellular network to the server. The cell phone software consists of several modules: CamTest.cpp, CamStarter.cpp, StreamIOHandler .cpp, and covertSmartDevice.cpp. The camera application on the SmartPhone is CamStarter, which is "the" user interface for the camera system. The CamStarter user interface allows a user to start/stop the camera application and transfer files to the server. The CamStarter application interfaces to the CamTest application through registry settings. Both the CamStarter and CamTest applications must be separately deployed on themore » smartphone to run the camera system application. When a user selects the Start button in CamStarter, CamTest is created as a process. The smartphone begins taking small pictures (CAPTURE mode), analyzing those pictures for certain conditions, and saving those pictures on the smartphone. This process will terminate when the user selects the Stop button. The camtest code spins off an asynchronous thread, StreamIOHandler, to check for pictures taken by the camera. The received image is then tested by StreamIOHandler to see if it meets certain conditions. If those conditions are met, the CamTest program is notified through the setting of a registry key value and the image is saved in a designated directory in a custom BMP file which includes a header and the image data. When the user selects the Transfer button in the CamStarter user interface, the covertsmartdevice code is created as a process. Covertsmartdevice gets all of the files in a designated directory, opens a socket connection to the server, sends each file, and then terminates.« less

Cecropin A-melittin mutant with improved proteolytic stability and enhanced antimicrobial activity against bacteria and fungi associated with gastroenteritis in vitro.

PubMed

Ji, Shengyue; Li, Weili; Zhang, Lei; Zhang, Yue; Cao, Binyun

2014-09-05

Cecropin A-melittin (CAM), a chimeric antimicrobial peptide with potent antimicrobial activity, is threatened by some special extracellular proteases when used to deal with certain drug-resistant pathogenic microbes in the gastrointestinal tract. Thus, a four-tryptophan-substitution mutant (CAM-W) from CAM was developed via the replacement of special amino acid residues to enhance the antimicrobial potency and to improve the proteolytic stability of this agent. The pharmaceutical index of CAM-W was investigated, with a focus on biological potency, cytotoxicity, and proteolytic stability, as well as pH and thermal resistance. CAM-W exhibited potent antimicrobial activity and was approximately 3-12 times higher than that of CAM. CAM-W also exhibited a strong antifungal activity against a series of common pathogenic fungi, in a lower IC50 range between 2.1mg/L and 3.3mg/L than that of its reference CAM ranging from 9.8mg/L to 14.2mg/L. Besides, CAM-W showed moderate cytotoxicity (IC50>300mg/L) in erythrocyte lysis test. In addition, CAM-W overcame challenges under various conditions, including specific temperatures (20, 30, 40, 50, 60, 70, 80, and 90°C), pH values (2.0, 3.0, 4.0, 5.0, 6.0, 7.0, 8.0, and 9.0), and proteases (trypsin, pepsin, human neutrophil elastase, Pseudomonas aeruginosa elastase, and Staphylococcus aureus V8 protease) that are commonly present in human gastrointestinal tract. These results suggest that the four-tryptophan-substitution can confer CAM-W with a high pharmaceutical index, which is important for CAM-W to become a potential alternative to conventional antibiotics against bacteria and fungi associated with gastroenteritis. Copyright © 2014 Elsevier Inc. All rights reserved.

Use of electronic personal health records (PHRs) for complementary and alternative medicine (CAM) disclosure: Implications for integrative health care.

PubMed

Yeo, Younsook; Park, Jisung; Roh, Soonhee; Levkoff, Sue

2016-06-01

To test a hypothesis that patients' use of Internet-based personal health records (PHRs) will be positively related to their disclosure of their CAM use to medical doctors, controlling for covariates' effects (e.g., health, human capital, and demographics), and to examine the factors influencing patients' CAM use disclosures. Cross-sectional survey. We analyzed data in a subsample of CAM users who used both the internet and healthcare services (n=1457) from the Health Information National Trends Survey, a nationally representative study of U.S. adults (≥18), by using a multivariate logistic analysis. Among the subsample, 52.7% disclosed their use of CAM to their doctors and 19.3% used PHRs. Both the bivariate (64.1% vs. 35.9%, p<0.01) and multivariate (β=0.558, SE=0.220, OR=1.75, p<0.05) analyses revealed a positive relationship between PHR use and CAM use disclosure. Other significant factors for CAM use disclosure included being older, being a female, having insurance, and having regular source of care. Particularly, foreign-born adults had significantly lower odds of disclosing their CAM use than U.S.-born adults. We found that patients' PHR use facilitated their disclosure of CAM use to medical doctors. To ensure integrative healthcare and integrative medicine in the healthcare sector and optimum care for patients, education for CAM users regarding PHR adoption is encouraged. Next-generation PHR designs should consider incorporating domains for CAM data that allow patients to store CAM data and also incorporating 'intelligent' PHRs, whose contents can be converted into the patient's first language. Copyright © 2016 Elsevier Ltd. All rights reserved.

Complementary and alternative medicine use: Results from a descriptive study of pregnant women in Udi local Government area of Enugu state, Nigeria.

PubMed

Onyiapat, Jane-Lovena; Okafor, Chinyelu; Okoronkwo, Ijeoma; Anarado, Agnes; Chukwukelu, Ekene; Nwaneri, Ada; Okpala, Pat

2017-04-04

The use of CAM by pregnant women is very popular in developed countries. The trend is increasing globally and lack of evidence of safety particularly when used during pregnancy may lead to complications. Pregnancy is a vulnerable period especially during the first trimester. There is scarcity of empirical evidence on CAM use particularly among women in Udi LGA of Enugu State and South East Nigeria. Moreover, studies carried out in Nigeria have been limited to herbal medicine use, which is one aspect of CAM. This study was designed to obtain information on the use of Complementary and Alternative Medicine among pregnant women. The study was a cross sectional descriptive survey of 396 pregnant women systematically drawn from twenty political wards in Udi Local Government Area (LGA) of Enugu State. Interviewer administered questionnaire developed by the researchers was used for data collection. Data were analyzed using descriptive statistics. Majority (82.1%) of the pregnant women in Udi LGA used CAM during pregnancy out of which 53.8% had used CAM in previous pregnancies. CAM used ranges from one single type to sixteen different types with biological products eg, herbal tea, herbal mixture being the most commonly used CAM. Whereas most (89.5%) of the CAM used by pregnant women was consumed orally, approximately half of the pregnant women used CAM together with conventional medicine. The use of CAM by women during pregnancy was high in Udi LGA. Therefore, maternity care providers especially midwives need to elicit CAM commonly used by women during pregnancy and counsel them appropriately for best care and safety. Researchers should focus on establishing the efficacy of CAM products.

Clinical indications and perceived effectiveness of complementary and alternative medicine in departments of obstetrics in Germany: a questionnaire study.

PubMed

Münstedt, Karsten; Brenken, Anja; Kalder, Matthias

2009-09-01

Our earlier study on complementary and alternative medicine (CAM) methods showed that acupuncture, homeopathy, and aromatherapy are available in most obstetrics departments in Germany but it did not evaluate the clinical indications for using CAM. The present study aimed to explore further the effectiveness of CAM use in obstetrics. We sent all departments of obstetrics in North Rhine-Westphalia a questionnaire designed to delineate their use of acupuncture, homeopathy, and aromatherapy during childbirth. It sought details on who provided the CAM therapy (midwife or physician). We asked respondents to indicate on a five-point scale how reasonable or otherwise they would consider the provision of CAM in each of six common problem situations and to estimate for each the proportion of patients given the CAM treatment. Respondents were also asked about the rationale for offering CAM, quality assurance and side effects. Spearman's bivariate correlation, cross-tabulation and Pearson's chi(2) test were used for statistical analysis. About 73.4% (138/187) of the departments responded. Acupuncture and homoeopathy were most widely used. Although obstetricians are responsible for patient care, decisions to provide CAM were largely taken by midwives, and the midwives' belief in the methods' effectiveness and patient demand were the principle motivating factors. Rates of CAM use in the six problem scenarios evaluated were directly related to practitioners' perceptions of the methods' therapeutic effectiveness. CAM methods were widely offered despite the lack of evidence of effectiveness or information on adverse consequences. In Germany, including CAM in the mandatory national quality assurance measures and perinatal surveys would provide valuable information; CAM use elsewhere merits further study.

Use of complementary and alternative medicine in children with recurrent acute otitis media in Italy.

PubMed

Marchisio, P; Bianchini, S; Galeone, C; Baggi, E; Rossi, E; Albertario, G; Torretta, S; Pignataro, L; Esposito, S; Principi, N

2011-01-01

Controlling environmental factors, chemoprophylaxis, immunoprophylaxis and surgery are considered possible means of preventing recurrent acute otitis media (RAOM), but there are no available data concerning the paediatric use of complementary and alternative medicine (CAM). We evaluated the uses of CAM (homeopathy and/or herbal medicine) as means of preventing AOM in children with a history of RAOM. Eight hundred and forty Italian children with RAOM (≥3 episodes in six months) aged 1-7 years were surveyed in 2009 using a face-to-face questionnaire, filled by parents or caregivers, that explored the prevalence, determinants, reasons, cost, and perceived safety and efficacy of CAM. About one-half (46%) of the children used CAM, significantly more than the number who used immunoprophylaxis (influenza vaccine 15%; p<0.05), PCV-7 34%; p<0.05) or chemoprophylaxis (2%; p<0.001). Use of CAM in the family was the only important factor positively associated with the use of CAM in children (adjusted OR 7.94; 95% CI: 5.26-11.99). The main reasons for using CAM were a fear of the adverse effects of conventional medicine (40%) and to increase host defences (20%). CAM was widely seen as safe (95%) and highly effective (68%). CAM prescribers were paediatricians in 50.7% of cases; self-initiation was reported by 23% of respondents. CAM expenditure was between Euro 25 and Euro 50/month in 27.6% of cases and ≥ Euro 50/month in 16%. Children with RAOM should be considered among the categories of subjects likely to be using CAM. Together with the fact that paediatricians are the main prescribers, this is worrying because of the current lack of evidence regarding the efficacy, safety and cost-effectiveness of CAM in the prevention of RAOM.

How to locate and appraise qualitative research in complementary and alternative medicine

PubMed Central

2013-01-01

Background The aim of this publication is to present a case study of how to locate and appraise qualitative studies for the conduct of a meta-ethnography in the field of complementary and alternative medicine (CAM). CAM is commonly associated with individualized medicine. However, one established scientific approach to the individual, qualitative research, thus far has been explicitly used very rarely. This article demonstrates a case example of how qualitative research in the field of CAM studies was identified and critically appraised. Methods Several search terms and techniques were tested for the identification and appraisal of qualitative CAM research in the conduct of a meta-ethnography. Sixty-seven electronic databases were searched for the identification of qualitative CAM trials, including CAM databases, nursing, nutrition, psychological, social, medical databases, the Cochrane Library and DIMDI. Results 9578 citations were screened, 223 articles met the pre-specified inclusion criteria, 63 full text publications were reviewed, 38 articles were appraised qualitatively and 30 articles were included. The search began with PubMed, yielding 87% of the included publications of all databases with few additional relevant findings in the specific databases. CINHAL and DIMDI also revealed a high number of precise hits. Although CAMbase and CAM-QUEST® focus on CAM research only, almost no hits of qualitative trials were found there. Searching with broad text terms was the most effective search strategy in all databases. Conclusions This publication presents a case study on how to locate and appraise qualitative studies in the field of CAM. The example shows that the literature search for qualitative studies in the field of CAM is most effective when the search is begun in PubMed followed by CINHAL or DIMDI using broad text terms. Exclusive CAM databases delivered no additional findings to locate qualitative CAM studies. PMID:23731997