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Summary Objective- To evaluate the role of prophylactic trimethoprim-sulfamethoxazole (co-trimoxazole) antibacterial prophylaxis in reducing morbidity and mortality in HIV-infected post-natal women in southern Africa. Methods- Double-blind placebo-controlled trial. HIV-infected women with WHO stage 2 or 3 HIV disease who had recently delivered in the Department of Obstetrics and Gynaecology at the University Teaching Hospital, Lusaka, Zambia were randomised to receive daily co-trimoxazole (cotox) or matched placebo daily for the duration of the trial. Participants were followed up for a minimum of 1-year. Primary outcome measures were mortality from any cause or hospital admission and serious adverse events. Results- Of 600 women randomised, follow-up information was available from 355 (18...

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The efficacy of a heat inactivated hepatitis B virus vaccine, containing 3 micrograms hepatitis B surface antigen (HBsAg), was studied in a high risk group of 800 susceptible homosexual men by a randomised...Full Text Available

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The spectre of exclusionary medical service provision, restricted clinic access and physician targeting in sectarian-divided Iraq underscores the crucial and timely need for qualitative research into the inter-relationship between conflict, identity and health. In response, this paper provides a critical ethnography of obstetric service provision and patient access during Shia-Sunni hostilities in Gilgit Town, capital of Pakistans Northern Areas (2005). I analyse how services were embedded in and constrained by sectarian affiliation in ways that detrimentally impacted Sunni women patients and hospital staff, resulting in profoundly diminished clinic access, reduced physician coverage and a higher observed incidence of maternal morbidity and mortality. The paper first situates obstetric med...

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Osteoarthritis, Knee

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This study examined whether cognitive behavioural therapy (CBT) could prevent the development or worsening of panic-spectrum psychopathology and anxiety symptoms in chronic obstructive pulmonary disease (COPD). 41 patients with COPD, who had undergone pulmonary rehabilitation, were randomised to either a four-session CBT intervention condition (n = 21) or a routine care condition (n = 20). Assessments were at baseline, post-intervention, and at 6-, 12- and 18-month follow-ups. Primary outcomes were the rates of panic attacks, panic disorder and anxiety symptoms. Secondary outcomes were depressive symptoms, catastrophic cognitions about breathing difficulties, disease-specific quality of life and hospital admission rates. There were no significant differences between the groups on outcome measures at baseline. By the 18-month follow-up assessment, 12 (60%) routine care group participants had experienced ...

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A Prospective randomised controlled study was done to determine statistical difference between the standard microsurgical discotomy (MC) and a minimally invasive microscopic procedure for disc prolapse...Full Text Available

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PMID:20417857

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SummaryWe consider the problem of estimating the effect of exposure on multiple continuous outcomes, when the outcomes are measured on different scales and are nested within multiple...Full Text Available

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Background: Chloroquine has in-vitro activity against influenza and could be an ideal candidate for worldwide prevention of influenza in the period between onset of a pandemic with a virulent influenza strain and the development and widespread dissemination of an effective vaccine. We aimed to assess the efficacy of such an intervention. Methods: In this randomised, double-blind, placebo-controlled trial done at a single centre in Singapore, we randomly assigned (1:1) healthy adults to receive chloroquine phosphate (500 mg/day for 1 week, then once a week to complete 12 weeks) or matching placebo by use of a computer-generated randomisation list. Participants filled an online symptom diary every week, supplemented by daily diaries and self-administered nasal swabs when unwell. Haemagglutin...

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Objectives:The supermarket industry now services many customers through online food shopping over the Internet. The Internet shopping process offers a novel opportunity...Full Text Available

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BackgroundAdhesive capsulitis is a common, painful, and disabling condition that has been managed with corticosteroid injections for over 50 years. There is debate over the use of...Full Text Available

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OBJECTIVE--To examine the effect of a reduced sodium and increased potassium and magnesium intake on blood pressure. DESIGN--Randomised double blind placebo controlled trial. SETTING--General population...Full Text Available

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ObjectiveTo test whether a disclosure intervention improves subjective health and reduces medical consumption and sick leave in somatising patients in general practice.DesignNon-blind...Full Text Available

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ObjectiveTo assess the efficacy and safety of low dose adrenaline injected subcutaneously to prevent acute adverse reactions to polyspecific antivenom serum in patients admitted...Full Text Available

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BackgroundCompared to healthy controls, cancer patients have a higher risk of unemployment, which has negative social and economic impacts on the patients and on society at large....Full Text Available

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Objectives To assess the effectiveness of calcium supplementation for improving bone mineral density in healthy children and to determine if any effect is modified by other factors and...Full Text Available

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Seventy seven patients with soft tissue shoulder lesions including adhesive capsulitis and disorders of the rotator cuff and acromioclavicular joint were admitted to a trial comparing two different...Full Text Available

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BackgroundThis study examines the prevalence and nature of bereavement help-seeking among the population who experienced an "expected" death in the five years before their survey...Full Text Available

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The existence and importance of an accelerated adjacent segment disc degeneration (ASD) after lumbar fusion have previously not been demonstrated by RCTs. The objectives of this study were, to determine...Full Text Available

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BackgroundMost traditional Chinese herbal formulas consist of at least four herbs. Four-Agents-Decoction (Si Wu Tang) is a documented eight hundred year old formula containing four...Full Text Available

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The study evaluates 160 cases of positive spermioculture taken from 522 sterile individuals examined by the authors at the Couple Sterility Outpatient unit in Department A of the Institute of Gynecology and Obstetrics at Turin University during the period between January 1984 and December 1993. The germs responsible for infection were assayed in order to evaluate the strains which showed the highest incidence every year. Whereas there was no significant change in the absolute number of cases of sterility over the period, the number of cases caused by infection increased significantly during the second five-year period. It was found that the germs predominantly implicated in the genesis of male sterility formed part of the so-called mixed flora group, responsible in women for syndromes of often asymptomatic bacterial vaginosis which are not identified and consequently not treated. PMID:8559444

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ObjectiveFamily-centered bedside rounds (FCBR) are recommended to improve trainee education, patient outcomes, and family satisfaction. However, bedside teaching...Full Text Available

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PurposeTo evaluate the clinical characteristics and outcomes of cataract surgery in highly myopic Korean subjects.MethodsWe retrospectively reviewed...Full Text Available

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Abuzakuk T, Coward P, Shenava Y, Kumar VS, Skinner JA. The management of wounds following primary lower limb arthroplasty: a prospective, randomised study comparing hydrofibre and central pad dressings. Abstract Wound care following lower limb arthroplasty has not been subject to in-depth clinical research, primarily because such wounds usually heal without complication. However, when prosthetic implants are used, serious wound problems can be disastrous (Whitehouse et al. Infect Control Hosp Epidemiol 2002;23:183-9; Lindwell OM. Clin Orthop Relat Res 1986;211:91-103). We report the results of a prospective, randomised, controlled trial comparing a hydrofibre (Aquacel) and central pad (Mepore) dressing in the management of acute wounds following primary total hip or knee arthroplasty left ...

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Summary Background- Treatments that achieve sustainable steroid-free clinical remission in Crohn-s disease are needed; however, long-term steroid-sparing efficacy data are limited. Aim- To evaluate steroid-sparing efficacy and the impact of steroid discontinuation on adverse events during treatment of Crohn's disease with adalimumab in the phase III randomised, double-blind 1-year CHARM trial and for an additional 2-years in its open-label extension ADHERE. Methods- Steroid-free remission and response and steroid-sparing (-50% steroid dose reduction) remission rates were evaluated over 3-years in patients who were taking corticosteroids at CHARM baseline. Results- Of 778 patients randomised in CHARM (including those who did not achieve clinical response to open-label induction therapy), 31...

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The use of the cervicograph with the incorporated action and alert lines in labour management in developing country obstetrics is now well established and patients in labour in Port Moresby have been thus managed since 1973. In this study the cerviograph was introduced in hospitals and health centres in Enga Province and the results analysed. Despite intensive tuition in its use, a large number of cervicographs were incorrectly constructed, especially in health centres, and its introduction made little difference to operative delivery or perinatal mortality rates. The proportion of patients crossing the action line was much higher than in Post Moresby but this difference was probably also largely due to the inaccuracy of many cervicographs. It is likely that these difficulties will not be overcome until many more nurses with intensive training in the use of the cervicograph are available and until more deliveries take place in health institutions to maintain ...

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BackgroundMany emergency ambulance calls are for older people who have fallen. As half of them are left at home, a community-based response may often be more appropriate than hospital...Full Text Available

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SummaryBackgroundInnovative prevention strategies for HIV-1 transmission are urgently needed. PRO2000 vaginal gel was efficacious against HIV-1 transmission in studies...Full Text Available

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1. The acute haemodynamic effects of intravenous nisoldipine (1, 2, 4 microg kg(-1)) and nifedipine (2.5, 5, 10 microg kg(-1)) were compared in a randomised, within-patient crossover study. Fifteen...Full Text Available

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ObjectiveTo investigate and to quantify the relationship between hospital costs and health outcomes for patients with acute myocardial infarction (AMI) in Veterans Health Administration...Full Text Available

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BackgroundThe link between maternal factors and birth outcomes is well established. Substantial changes in society and medical care over time have influenced women's reproductive...Full Text Available

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BackgroundThe optimal treatment for locally recurrent rectal cancer (LRRC) is still a matter of debate. This study assessed the outcome of LRRC patients treated with multimodality...Full Text Available

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BackgroundPercutaneous endoscopic lumbar discectomy is a relatively new technique. Very few studies have reported the clinical outcome of percutaneous endoscopic discectomy in terms...Full Text Available

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ObjectiveTo report the outcome of children with life-threatening asthma (LTA) admitted to a university Pediatric Intensive Care Unit (PICU).MethodsRetrospective...Full Text Available

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Study Objectives:To evaluate the value of mouth opening during sleep for predicting surgical outcomes after uvulopalatopharyngoplasty (UPPP).Methods:Retrospectively,...Full Text Available

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BackgroundControversy exists about how to effectively measure patient reported outcomes in IBS clinical trials. Pain numeric rating scales (NRS) are widely used in...Full Text Available

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PurposeTo assess the relationship between low-grade inflammation, measured as basal high sensitivity (hs)-CRP, and IVF outcome.MethodsWe recruited...Full Text Available

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We sought to determine the prevalence of metabolic syndrome (MS) in patients with acute myocardial infarction and its effect on clinical outcomes. Employing data from the Korea Acute Myocardial Infarction...Full Text Available

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Much public health research has been directed to studies of cancer risks due to chemical agents. Recently, increasing attention has been given to adverse reproductive outcomes as another, shorter-term...Full Text Available

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AIMSTo evaluate and compare the risk of specific safety outcomes in patients prescribed ibuprofen and paracetamol concomitantly with those in patients prescribed ibuprofen or paracetamol...Full Text Available

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The question of whether storage of red blood cells (RBCs) alters their capacity to deliver oxygen and affects patient outcomes remains in a state of clinical equipoise. Studies of the changes...Full Text Available

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Pneumatic dilation (PD) is an effective treatment for achalasia cardia. Outcome of PD, however, varies among different studies. Recently, some groups started considering laparoscopic myotomy to be competitive...Full Text Available

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... commands may be input from a terminal or they ... up the outcomes of the stochastic parameters corre- ... queue of subproblems to be solved, the first ...

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Carotid Artery Disease; Stroke; Amaurosis Fugax; Transient Ischemic Attack (TIA)

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This is an independent reanalysis of a randomised, placebo-controlled parallel-group study on the efficacy and tolerability of a special butterbur root extract (Petadolex) for the prophylaxis of migraine. The original protocol and analysis had a number of major shortcomings. In order to follow regulatory requirements, an independent reanalysis of the original data was performed. Following a 4-week baseline phase, 33 patients were randomised to treatment with two capsules 25 mg butterbur twice a day and 27 to placebo. The mean attack frequency per month decreased from 3.4 at baseline to 1.8 after 3 months (p = 0.0024) in the verum group and from 2.9 to 2.6 in the placebo group (n.s.). The responder rate (improvement of migraine frequency > or =50%) was 45% in the verum group and 15% in the placebo group. Butterbur was well tolerated. This small trial indicates that butterbur may be effective in the prophylaxis of migraine. PMID:14752215

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Summary Background Treatment of localised renal cell carcinoma consists of partial or radical nephrectomy. A substantial proportion of patients are at risk for recurrence because no effective adjuvant therapy exists. We investigated the use of an autologous, tumour-derived heat-shock protein (glycoprotein 96)-peptide complex (HSPPC-96; vitespen) as adjuvant treatment in patients at high risk of recurrence after resection of locally advanced renal cell carcinoma. Methods In this open-label trial, patients were randomly assigned to receive either vitespen (n=409) or observation alone (n=409) after nephrectomy. Randomisation was done in a one to one ratio by a computer-generated pseudo-random number generator, with a block size of four, and was stratified by performance score, lymph node stat...

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ObjectiveWe sought to determine the clinical outcomes of patients undergoing surgical aortic valve replacement with hemodynamically confirmed severe pulmonary hypertension and aortic stenosis and compare them with the outcomes of patients not undergoing aortic valve replacement and patients undergoing aortic valve replacement with mild-to-moderate pulmonary hypertension. MethodsA total of 317 patients with severe aortic stenosis (aortic valve area 35 mm Hg) was present in 81 patients, of whom 35 (43.2%) underwent surgical aortic valve replacement. We compared the clinical outcomes of these 35 patients with the 46 patient...

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Background:Prolonged mechanical ventilation is increasingly common. It is expensive and associated with significant morbidity and mortality. Our objective is to comprehensively characterize...Full Text Available

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In the last two decades rectal cancer has changed from a surgically managed disease into a multidisciplinary treatment model resulting in considerable improvements in the survival and outcome. This...Full Text Available

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The purpose of this article is to review the literature for clinical presentation, treatment, outcome and complications of using radiotherapy for the treatment of orbital lymphoma. For this, MEDLINE,...Full Text Available

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Male reproductive proteins (MRPs), associated with sperm and semen, are the moieties responsible for carrying male genes into the next generation. Evolutionary biologists have focused on their...Full Text Available

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Outcome from trauma, surgery, and a variety of other medical conditions has been shown to be positively affected by providing treatment at facilities experiencing a high volume of patients with those conditions. An electronic literature search was made to identify English-language articles available through March 2011, addressing the effect of patient treatment volume on outcome for patients with subarachnoid hemorrhage. Limited data were identified, with 16 citations included in the current review. Over 60% of hospitals fall into the lowest case-volume quartile. Outcome is influenced by patient volume, with better outcome occurring in high-volume centers treating >60 cases per year. Patients treated at low-volume hospitals are less likely to experience definitive treatment. Furthermore, t...

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PurposeAlthough the safety and feasibility of partial adrenalectomy in patients with von Hippel-Lindau syndrome have been established, long-term outcomes have not been examined. In this study we evaluate the recurrence and functional outcomes in a von Hippel-Lindau syndrome cohort treated for pheochromocytoma with partial adrenalectomy with a followup of at least 5 years. Materials and MethodsWe reviewed the records of patients with von Hippel-Lindau syndrome treated with partial adrenalectomy for pheochromocytoma at the National Cancer Institute. Demographic, germline mutation status, surgical indication, oncologic and functional outcome data were collected. Local recurrence was defined as radiographic evidence of recurrent tumor on the ipsilateral side of partial adrenalectomy. Patients ...

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Governments are increasingly concerned to compare the quality and effectiveness of healthcare interventions but find this a complex matter. Crude hospital statistics can be dangerously misleading and...Full Text Available

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Introduction: Generally agreed outcome criteria in psychosis are required to evaluate the effectiveness of new treatment strategies. The aim of this study is to explore clinical recovery...Full Text Available

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Background There is some evidence that a patient?s pre-operative condition influences short-term and long-term post-operative outcomes. The aim of the present study is to compare the physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) and modified Glasgow prognostic score (mGPS) models in the prediction of post-operative outcome, both short term and long term, in patients undergoing resection of oesophago-gastric cancer. Patients and Methods Patients who underwent curative resection for oesophago-gastric cancer from January 2005 to May 2009 and who had data to score the POSSUM, P-POSSUM, O-POSSUM and mGPS models were included in the study. Observed morbidity and mortality rates were compared with predicted outcome in different risk groups. Bot...

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AbstractBackground Randomised controlled trials (RCTs) in the 1970s and early 1980s showed the polysaccharide serogroup A vaccine (SgAV) prevented serogroup A meningococcal meningitis (SGAMM). Subsequent non-RCTs suggested significant variations in the age-specific duration of protection among children. Objectives To determine the protective effect, duration of protection, age-specific effects and the effect of booster doses in children of the SgAV against SGAMM. Search strategy We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, issue 2) which contains the Acute Respiratory Infections Group's Specialised Register, MEDLINE (January 1950 to May Week 3, 2010) and EMBASE (January 1974 to May 2010). Selection criteria We included RCTs. Non-RCTs ...

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There is ample historical verification of 46,XX congenital adrenal hyperplasia (CAH) patients being born with essentially male genitaliawhile outcome information is scant. Prior to glucocorticoid...Full Text Available

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Purpose:To study the outcome of in-the-bag implanted square-edge polymethyl methacrylate (PMMA) intraocular lenses (IOL) with and without primary posterior capsulotomy in...Full Text Available

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Background: Recent series describing the clinical presentation, response to therapy, and long-term outcome of Zollinger-Ellison syndrome are limited. Aims: To assess the clinical characteristics and long-term outcome of patients with Zollinger-Ellison syndrome. Methods: Over a 20-year period, patients with Zollinger-Ellison syndrome were enrolled in a prospective trial evaluating the efficacy of lansoprazole. Following dose stabilization, patients were followed on a 6-monthly basis with interval history, physical examination, endoscopy with gastric biopsies, gastric acid analysis and laboratory studies. Results: 72 patients (mean age 54+/-12 years, % male 58%, % Caucasian 69%) were prospectively enrolled. The clinical presentation was stereotypical for Zollinger-Ellison syndrome. Symptoms ...

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PurposeTo conduct a retrospective analysis within a large university teaching hospital, comparing outcomes between patients receiving either radical surgery or radiotherapy as curative treatment for bladder cancer.Patients and MethodsBetween March 1996 and December 2000, 169 patients were treated radically for muscle-invasive bladder cancer. Data were collected from patient notes. Statistical analyses were performed using Kaplan-Meier methods and Cox proportional hazards regression analysis to compare radiotherapy and surgical outcome data.ResultsThere was no difference in overall, cause-specific, and distant recurrence-free survival at 5 years between the two groups, despite the radiotherapy group being older (median age, 75.3 years vs. 68.2 years). There were 31 local bladder recurrences...

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Objectives The optimal timing of pyeloplasty for children diagnosed with ureteropelvic junction obstruction (UPJO) after workup for antenatal hydronephrosis is disputed. We sought to examine the potential costs and clinical outcomes of treatment protocols featuring different indications for pediatric pyeloplasty using Markov models. Methods Cost and outcomes analysis using Markov modeling was performed for three treatment algorithms: medical management, immediate pyeloplasty (during the first year of life), and pyeloplasty after no improvement on imaging. The costs were determined from the perspective of the medical institution. The variables tracked during Markov model simulation included age at resolution of UPJO, the proportion of patients with worsened hydronephrosis, the number of pye...

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Abstract Routinely used prognostic factors fail to predict clinical outcome in a significant proportion of breast cancer patients, implying that they can not detect some important biological characteristics. Chromosomal changes have been described in breast carcinomas for many years but their significance is not clear. We compared chromosomal changes with clinico-pathological characteristics and clinical outcome in 203 breast cancer patients with a follow-up of 9-18 years. Combining data from classical cytogenetics and flow cytometry revealed chromosomal abnormalities in 142 cases (70%). Of these, 51 (35.9%) contained two or more cytogenetically abnormal clones. Polyclonality was significantly associated with poor breast-cancer-specific survival (P = 0.03) within 5 years, independent of tu...

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BackgroundModern metal-on-metal hip resurfacing implants are being increasingly used for young and active patients, although the long-term outcome and failure mechanisms of these...Full Text Available

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Transcatheter arterial chemoembolization (TACE) has become the standard treatment modality for unresectable hepatocellular carcinoma (HCC). Nonetheless, the clinical outcomes in patients with unresectable...Full Text Available

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BackgroundResponse shift theory suggests that improvements in health lead patients to change their internal standards and re-assess former health states as worse than initially rated...Full Text Available

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The functional outcome after stroke is unpredictable; it is not accurately predicted by clinical pictures upon hospital admission. The presence of apoptotic neurons in the ischemic penumbra and perihematoma...Full Text Available

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Fetal growth restriction (FGR) is an adverse pregnancy outcome associated with significant perinatal and paediatric morbidity and mortality, and an increased risk of chronic disease later in adult life....Full Text Available

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Study DesignThis is a retrospective study that was done according to clinical and radiological evaluation.PurposeWe analyzed the clinical and radiological...Full Text Available

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BackgroundPatients’ general tendency to adhere to health care provider-recommended treatments is associated with a number of health outcomes, but whether it influences pain...Full Text Available

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Aim:Report of 125 pediatric patients of empyema thoracis treated by open decortication, highlighting the presentation, delay in referral, operative findings, the response...Full Text Available

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Hip fractures are associated with a high rate of mortality and profound temporary and sometimes permanent impairment of quality of life. Current guidelines indicate that surgeons should perform surgery...Full Text Available

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Disorders of mitochondrial fat metabolism lead to sudden death in infants and children. Although survival is possible, the underlying molecular mechanisms which enable this outcome have not yet been...Full Text Available

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Goals of workThe goal of this study was to evaluate, at a population level, the association between specialized palliative care services (SPCS) and short- and long-term caregiver...Full Text Available

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Background and objectives: The relationship between serum potassium (S_K) and mortality in chronic kidney disease (CKD) has not been systematically investigated.Design, setting, participants,...Full Text Available

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ObjectivesTo examine the strength of the volume–outcome relationship among paramedics, a group of providers that has not been previously studied in this context. By identifying...Full Text Available

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The relationship between malaria transmission intensity and clinical disease is important for predicting the outcome of control measures that reduce transmission. Comparisons of hospital data...Full Text Available

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SummaryRadiotherapy is used commonly in the treatment of gynecologic malignancies. Many patients experience emotional distress prior to the initiation of radiotherapy, during...Full Text Available

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Thirty chemicals or substances currently undergoing long-term carcinogenicity bioassays in rodents have been used in a project to further evaluate methods and information that may have the capability...Full Text Available

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AimsTo describe nurse burnout, job dissatisfaction, and quality of care in Japanese hospitals, and to determine how these outcomes are associated with work environment...Full Text Available

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The objective of this study was to evaluate the effect of pregabalin in painful cervical or lumbosacral radiculopathy treated in Primary Care settings under routine clinical practice. An observational,...Full Text Available

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Background and objectives: Blacks are over-represented among dialysis patients, but they have better survival rates than whites. It is unclear if the over-representation of blacks on dialysis is due...Full Text Available

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Cognitive rehabilitation is an effective intervention for addressing cognitive impairments in patients with schizophrenia. Previous research has shown that the early application of Cognitive...Full Text Available

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The identification of predictive biomarkers is at the core of modern toxicology. So far, a number of approaches have been proposed. These rely on statistical inference of toxicity response from either...Full Text Available

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Currently, the outcome of patients with intermediate-and poor-risk germ cell tumors at diagnosis is optimized by the use of risk-appropriate chemotherapy and post-chemotherapy surgical resection of...Full Text Available

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BackgroundHigh serum uric acid concentration (hyperuricemia) has been studied for its relationship with multiple adverse health outcomes, such as metabolic syndrome. Intervention...Full Text Available

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Electronic personal health records (ePHRs) can potentially maximize access and coordination of health information and improve patient/clinician collaboration, patient self-management, and health outcomes....Full Text Available

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ContextResponse Evaluation Criteria in Solid Tumors [RECIST (unidimensional)], World Health Organization [WHO (bi-dimensional)] and European Association for Study...Full Text Available

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ObjectiveTo evaluate the effectiveness of a community pharmacist–based home blood pressure (BP) monitoring program.DesignTrial of a high-intensity...Full Text Available

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The outcome of various osteoprogenitor-cell transplantation protocols was assessed using Col1a1-GFP reporter transgenic mice. The model requires the recipient mice to undergo lethal total body irradiation...Full Text Available

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Abstract Aims: This study performed a systematic review and meta-analysis on glycemic control and pregnancy outcomes in women with type 1 diabetes mellitus (T1DM) treated with lispro (LP) versus regular insulin (RI) since before pregnancy. Methods: We performed a MEDLINE and EMBASE search. Abstracts (and full articles when appropriate) were reviewed by two independent researchers. Inclusion criteria were patients with T1DM, data on women treated with RI and LP since before pregnancy until delivery in the same article, at least five pregnancies in each group, and information on at least one pregnancy outcome. Quality assessment was performed using the Newcastle?Ottawa Quality Assessment Scale for cohort studies. Results: Outcome data were summarized with Revman version 5.0 (ims.cochrane.org...

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BackgroundMany interventions found to be effective in health services research studies fail to translate into meaningful patient care outcomes across multiple contexts. Health services...Full Text Available

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Objectives. Ninety-one fetuses with dilated or hypertrophic cardiomyopathy (DCM, HCM) and myocarditis were studied. Results. Group 1 “DCM”...Full Text Available

Energy Technology Data Exchange (ETDEWEB)

An application of the renormalized random phase approximation to nuclear structure is presented for the semi-magic nuclei /sup 88/Sr and /sup 90/Zr. It is reported the outcome for the microscopic approach in comparison with the semiphenomenological version for the particle-hole forces.

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The current study investigated relations among ethnic similarity in caregiver-therapist pairs of youth participating in Multisystemic Therapy, therapist adherence, and youth long-term behavioral and criminal outcomes. Participants were 1,979 youth and families treated by 429 therapists across provider organizations in 45 sites. Relations were found, independently, and in the presence of ethnic similarity, between adherence and reductions in youth externalizing and internalizing behavior problems 1-year posttreatment and youth criminal charges 4 years posttreatment. Relations between ethnic similarity and outcomes were found only for reductions in youth externalizing behavior problems and not when adherence was included in the model. Adherence ratings were higher, however, in ethnically similar caregiver-therapist pairs, and evidence was found that this increased adherence predicted slightly better outcomes for youth. ...

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Background:This study evaluated the outcomes of patients with complex or persistent thoracobiliary fistulae following penetrating liver trauma, who underwent endoscopic biliary intervention...Full Text Available

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IntroductionRadiotherapy outcomes might be further improved by a greater understanding of the individual variations in normal tissue reactions that determine tolerance. Most published...Full Text Available

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IntroductionIn critically ill patients the relationship between the storage age of red blood cells (RBCs) transfused and outcomes are controversial. To determine if duration of RBC...Full Text Available

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Detrended fluctuation analysis (DFA) is a recently developed technique suitable for describing scaling behavior of variability in physiological signals. The purpose of this study is to explore...Full Text Available

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Background & objectives: Fatigue is a debilitating symptom experienced by patients undergoing dialysis, but there is only limited information on its prevalence and its association with patient...Full Text Available

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ObjectiveThe purpose of this study was to compare clinical and radiological outcomes of percutaneous endoscopic lumbar discectomy (PELD) and open lumbar microdiscectomy (OLM) for...Full Text Available

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ObjectiveDisc herniations at the L1-L2 and L2-L3 levels are different from those at lower levels of the lumbar spine with regard to clinical characteristics and surgical outcome....Full Text Available

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Average human behavior in cue combination tasks is well predicted by Bayesian inference models. As this capability is acquired over developmental timescales, the question arises, how it is learned....Full Text Available

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Anxiety may cause adverse outcomes through physiologic pathways in patients with cardiac disease. The purpose of this dissertation was to investigate anxiety and its correlates in persons with acute myocardial infarction (AMI) and heart failure (HF). The ...

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BackgroundSocial isolation affects a significant proportion of older people and is associated with poor health outcomes. The current evidence base regarding the effectiveness of...Full Text Available

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IntroductionLaparoscopic distal pancreatectomy has been described for more than a decade now and has been considered technically feasible, safe, and with reproducible outcomes. It...Full Text Available

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BackgroundHip surface replacement arthroplasty (SRA) can be an alternative for total hip arthroplasty. The short and long-term outcome of hip surface replacement arthroplasty mainly...Full Text Available

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Abstract Background- Vitiligo, characterized by destruction of melanocytes, causes a patchy depigmentation of the skin. It has been hypothesized to have an autoimmune pathogenesis. Autoimmune disorders are more common among women and may be associated with adverse pregnancy outcomes, such as recurrent abortions, intrauterine growth restriction (IUGR), and pre-eclampsia. Objective- The purpose of this study was to investigate whether patients with vitiligo have increased rates of gestational complications. Methods- A retrospective comparative study was undertaken comparing pregnancy complications of patients with and without vitiligo. The population was composed of all singleton deliveries that occurred at the Soroka University Medical Center in Israel during the years 1988-2006. Women lack...

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Strategic management of key accounts has become an important component of many companies' sales efforts. This research introduces a strategic framework of key account performance that integrates theory from relationship marketing, key account management, and customer equity. Using the three drivers of customer equity - value equity, brand equity, and relationship equity - the framework captures both the relational outcomes (relationship commitment and trust) and financial performance outcomes (profitability and share of spend) of strategic decisions made in key account programs. Implications and future research are then discussed.

International Nuclear Information System (INIS)

The OASIS Registry started annual collection of longitudinal data on patients on home parenteral nutrition (HPN) in 1984. This report describes outcome profiles on 1594 HPN patients in seven disease categories. Analysis showed clinical outcome was principally a reflection of the underlying diagnosis. Patients with Crohn's disease, ischemic bowel disease, motility disorders, radiation enteritis, and congenital bowel dysfunction all had a fairly long-term clinical outcome, whereas those with active cancer and acquired immunodeficiency syndrome (AIDS) had a short-term outcome. The long-term group had a 3-year survival rate of 65 to 80%, they averaged 2.6 complications requiring hospitalization per year, and 49% experienced complete rehabilitation. The short-term group had a mean survival of 6 months; they averaged 4.6 complications per year and about 15% experienced complete rehabilitation. The registry ...

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The purpose of this study is to investigate the role of femoral marrow MR imaging as predictor of outcome for hemopoietic stem cell transplantation (HSCT) in beta-thalassemia major. MR imaging of the proximal femur, including T1- and T2-weighted spin echo and short-tau inversion recovery and in-phase and out-of-phase fast field echo images, was prospectively performed in 27 thalassemia major patients being prepared for HSCT. The area of red marrow and its percentage of the proximal femur were measured, and the presence of marrow hemosiderosis was assessed. Age-adjusted multivariate logistic regression was used to determine the relationship between red marrow area percentage and marrow hemosiderosis and HSCT outcome. Red area percentage were less in patients with successful (90.25{+-}4.14%) compared to unsuccessful transplants (94.54% {+-}2.93%; p=0.01). Red marrow area percentage correlated positively with duration of symptoms(r=0.428, p=0.026) ...

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Background: The outcome of acute myocardial infarction (AMI) complicated with cardiogenic shock is poor. The aim of this study was to analyse, whether upfront abciximab administration could improve the outcomes of cardiogenic shock. Methods: This multicentre open trial randomized 80 patients with AMI complicated by cardiogenic shock expected to undergo primary PCI into group A (routine upfront-pre-procedural-abciximab bolus followed by 12-h abciximab infusion) and group B (standard therapy). The study primary objective was 30-day combined outcome (death/reinfarction/stroke/new severe renal failure). Results: PCI was technically successful in 90% (A) versus 87.5% (B) patients. Abciximab was used in 100% (A) versus 35% (B). The primary endpoint occurred in 17 group A patients (42.5%) and 11 ...

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Background 2009 pandemic influenza A(H1N1) has led to a global increase in severe respiratory illness. Little is known about kidney outcomes and dialytic requirements in critically ill patients infected with pandemic H1N1. Study Design Prospective observational study. Setting & Participants 50 patients with pandemic H1N1 admitted to any of 7 intensive care units in Manitoba, Canada, were prospectively followed. Outcome & Measurements Outcomes were kidney injury and kidney failure defined using RIFLE (risk, injury, failure, loss, end-stage disease) criteria or need for dialysis therapy. Results The pandemic H1N1 group was composed of 50 critically ill patients with pandemic H1N1 with severe respiratory syndrome (47 confirmed cases, 3 probable). Kidney injury, kidney failure, a...

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Abstract Toll-like receptor 2 (TLR2) is an immune sensor for gram-positive bacterial cell wall components. Single-nucleotide polymorphisms (SNPs) in the TLR2 gene that impair its function may, therefore, influence the risk and outcomes of gram-positive bacterial infections. In a cohort of 694 liver transplant recipients, we assessed the TLR2 SNP that is translated into an amino acid substitution of arginine for glutamine at position 753 (R753Q), and we found that its presence was associated with the clinical characteristics and outcomes of gram-positive bacterial infections. The proportions of patients with the TLR2 R753Q SNP did not significantly differ between those with gram-positive bacterial infections and those without gram-positive bacterial infections (9.6% versus 9.6%, P = 0.999)....

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Summary Background Pemphigus vulgaris and pemphigus foliaceus are rare, potentially life-threatening, autoimmune disorders characterized by antibodies to epidermal adhesion molecules. Clinical characteristics are painful chronic erosions of mucous membranes and of the skin. There are only few published studies on the impact of the disease on the health status (HS) of patients with these conditions. Objectives To assess the impact of disease on the HS of patients with pemphigus. Methods Fifty-eight patients enrolled at the Bullous Skin Diseases Unit of IDI-IRCCS in the period January-June 2006 were assessed for their HS using the Medical Outcomes Study 36-item short form health survey (SF-36) questionnaire and for anxiety and depression using the Institute for Personality and Ability Testin...

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While both sperm number and quality are now recognized to be important in determining the outcome of sperm competition, very few studies have experimentally assessed the influence of these two parameters simultaneously. We studied the effect of sperm quality and number on competitive fertilization success in an internal-fertilizing fish, the guppy (Poecilia reticulata), which is characterized by high levels of sperm competition. We artificially inseminated virgin females with varying proportion of sperm from two competing males, while holding constant the total number of sperm transferred to the female. Sperm morphology and sperm swimming velocity were also determined prior to insemination. The paternity outcome of sperm competition trials was assessed through molecular analyses of the res...

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Summary Background: Red blood cell (RBC) transfusion in hemorrhagic shock is life saving. However, several clinical trials have shown that blood transfusion in the critically ill patient might be associated with adverse outcomes. Furthermore, an association between prolonged blood storage and adverse effects of RBC transfusion has been postulated. The aim of this study is to examine the effect of blood storage time on resuscitation outcome, in an animal model of hemorrhagic shock. Methods: 20 Wistar rats were phlebotomized in order to induce reversible hemorrhagic shock. Half of them were resuscitated with blood stored for a short period of time (4 days), and the other ones were resuscitated with blood stored for a prolonged time (14 days). Blood samples for hemoglobin, pH, lactate, bicarb...

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Abstract Introduction.- Sling erosion/extrusion is a complication after suburethral sling insertion for female stress urinary incontinence that occurs in approximately 6% of patients. Symptoms may include vaginal discharge, infections, postcoital bleeding, and alterations of the sexual function. Little is known about the effect of sling erosion on the sexual function of the male partner. Aim.- The aim of this study was to determine male sexual function in partners of women who had undergone sling insertion for stress urinary incontinence and who developed sling erosion postoperatively. Main Outcome Measures.- Main outcome measures were the Brief Male Sexual Function Inventory (BMSFI) and visual analog scale (VAS) scores. Methods.- Male partners of patients who presented with sling erosion ...

International Nuclear Information System (INIS)

Complex numbers are an intrinsic part of the mathematical formalism of quantum theory and are perhaps its most characteristic feature. In this article, we show that the complex nature of the quantum formalism can be derived directly from the assumption that a pair of real numbers is associated with each sequence of measurement outcomes, with the probability of this sequence being a real-valued function of this number pair. By making use of elementary symmetry conditions, and without assuming that these real number pairs have any other algebraic structure, we show that these pairs must be manipulated according to the rules of complex arithmetic. We demonstrate that these complex numbers combine according to Feynman's sum and product rules, with the modulus-squared yielding the probability of a sequence of outcomes.

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Summary Many important moral decisions, particularly at the policy level, require the evaluation of choices involving outcomes of variable magnitude and probability. Many economic decisions involve the same problem. It is not known whether and to what extent these structurally isomorphic decisions rely on common neural mechanisms. Subjects undergoing fMRI evaluated the moral acceptability of sacrificing a single life to save a larger group of variable size and probability of dying without action. Paralleling research on economic decision making, the ventromedial prefrontal cortex and ventral striatum were specifically sensitive to the "expected moral value" of actions, i.e., the expected number of lives lost/saved. Likewise, the right anterior insula was specifically sensitive to outcome p...

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There are 2 models of male adjustment of sperm investment in the ejaculate in relation to sperm competition. The "risk model" predicts that as "risk" of sperm competition increases, sperm investment also increases. This prediction has been supported in many species, including mammals. The "intensity model" involves the number of competing males copulating with the same female and predicts that males will allocate the highest sperm investment at low sperm competition intensity (SCI) and then decreasing sperm investments as SCI increases. Two alternative outcomes are that sperm investment is unaffected by SCI and that sperm investment increases as SCI increases. There are studies supporting all 3 possible outcomes in relation to SCI but no data on mammals. The present paper presents the firs...

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Equinovarus of the foot is the most common lower extremity deformity following traumatic brain injury. We evaluated outcomes of the split anterior tibialis tendon transfer (SPLATT) for correction of equinovarus in 47 patients with hemiplegic traumatic brain injury and specifically studied differences in outcomes with two tendon fixation techniques. Seventeen patients constituting Group I underwent fixation with one technique and 30 constituting Group II had another technique. Patients in both groups had appropriate procedures based on dynamic electromyography and gait analyses. Both groups were demographically comparable. All 47 feet were corrected to plantigrade position. Thirty-six of 47 patients became brace-free at final followup. There was a notable decrease in the use of ambulatory a...

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BackgroundAlthough self-expandable metal stent (SEMS) insertion is widely used for relief of malignant colorectal obstructions, the immediate technical and clinical failure rates of SEMSs and the associated risk factors remain largely unknown. ObjectiveTo identify rates and factors predictive of technical and clinical failure of SEMSs when their use is attempted for the decompression of malignant colorectal obstruction. DesignRetrospective chart review. SettingA tertiary-care academic medical center in South Korea. PatientsThis study involved a total of 412 patients with malignant colorectal obstruction in whom SEMS insertion was attempted. InterventionPlacement of colonic SEMSs. Main Outcome MeasurementsTechnical success and immediate and long-term clinical success rates. ResultsTechnical...

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Background Laparoscopic inguinal hernia repair has been around since the 1990s. A novel surgical approach known as laparoendoscopic single-site surgery (LESS) has been developed to reduce the port-related morbidities and improve the cosmetic outcomes of laparoscopic surgery, including totally extraperitoneal (TEP) inguinal hernia repair. The aim of the present study was to evaluate the safety and feasibility of the LESS TEP technique for inguinal hernia repair and compare the outcomes with the standard TEP approach. Methods Between January and May 2009, 54 consecutive healthy patients (48 men and 6 women) underwent LESS TEP inguinal hernia repair at our institute. All procedures were performed using our homemade single port for simultaneous passage of the laparoscope and instruments. The p...

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A Zinc/Air Battery Review and Strategic Planning Meeting was held in 1993. One outcome of the meeting was recognition of the need for a report on the current status of the technology. This report contains contributions from many of the attendees at the above meeting and expresses their views on where the technology is today and what could/should be done to improve its performance.

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Ventricular septal defect after acute myocardial infarction (AMI) is a complication associated with poor outcome in the absence of intervention. We report a case of successful TEE guided transcatheter closure of a post myocardial infarction (MI) ventricular septal defect (VSD) with an Amplatzer occluder in a 79 years old male with cardiogenic shock.

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Highlights of the meeting are briefly summarized in this paper. Most of the papers presented at the meeting dealt with remediation and pollution prevention practices. A major focus of the technical sessions was on the identification of pollution sources. Identification of exposures to specific chemicals with disease outcomes was also discussed. Other papers focused on ecological exposures and their effects on wildlife to identify the presence of contaminants. 4 refs.

UK PubMed Central (United Kingdom)

We reported a relevant activity of the combination between sorafenib and octreotide long-acting release (LAR) in advanced hepatocellular carcinoma (HCC) patients. In this work, we have studied if oxidative...Full Text Available

International Nuclear Information System (INIS)

Perspectives from industry, academe, and the NRC are brought together in this report and used to develop a logical framework that links management and organization factors and safety in nuclear power plant performance. The framework focuses on intermediate outcomes which can be predicted by organizational and management factors, and which are subsequently linked to safety. The intermediate outcomes are efficiency, compliance, quality, and innovation. The organization and management factors can be classified in terms of environment, context, organizational governance, organizational design, and emergent processes. Initial empirical analyses were conducted on a limited set of hypotheses derived from the framework. One set of hypotheses concerned the relationships between one of the intermediate outcome variables, efficiency, as measured by critical hours and outage rate, and safety, as measured by 5 NRC indicators. Results of ...

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AimsThe prevalence and importance of liver function test (LFT) abnormalities in a large contemporary cohort of heart failure patients have not been systematically evaluated.Full Text Available

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... (restricted)] 2009, Volume 39, Issue 5 523-529 Parents, peers, or school inputs: Which components of school outcomes are capitalized into house value? by Brasington, David M. & Haurin, Donald R. [Downloadable! (restricted)] 530-541 Trade liberalisation and agglomeration with firm heterogeneity: Forward and backward linkages by Okubo, Toshihiro [Downloadable! (restricted)] 542-552 Alternative measures of homeownership gaps across segregated ...

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BackgroundSelf-management of asthma may improve asthma outcomes. The Internet has been suggested as a tool for the monitoring and self-management of asthma....Full Text Available

UK PubMed Central (United Kingdom)

Cystic fibrosis (CF) is a monogenic disease characterized by a high variability of disease severity and outcome that points to the role of environmental factors and modulating genes that shape the course...Full Text Available

UK PubMed Central (United Kingdom)

This study prospectively assessed the outcome of 134 cemented titanium stems and serum ion levels. The stems were polished (0.1 μm Ra) with circular cross section. At the end point,...Full Text Available

UK PubMed Central (United Kingdom)

Background:Acute Coronary Syndrome (ACS) can occur in patients with prior coronary artery bypass grafting (CABG). In the Gulf Registry of acute coronary events (Gulf RACE), we identified...Full Text Available

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We performed a randomized trial to compare IVF outcomes in 54 poor responder patients undergoing a microdose leuprolide acetate (LA) protocol or a GnRH antagonist protocol incorporating a luteal phase E2 patch and GnRH antagonist in the preceding menstrual cycle. Cancellation rates, number of oocytes retrieved, clinical pregnancy rates (PR), and ongoing PRs were similar between the two groups.

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We consider the problem of rotation in a homogeneous Bianchi type IX cosmological model. Studying the Wheeler-De Witt equation corresponding to this minisuperspace, and adopting a particular choice of the factor ordering, we are able to find a particular solution which is strongly peaked about isotropy. This result confirms all the previous investigations in this field, and suggests the conclusion that the machian nature of our universe is the natural, i.e. most likely, outcome of the Planck epoch. (orig.).

Science.gov (United States)

Parenting programmes are effective interventions for preventing and treating conduct problems in young children. Up to 20% of children in disadvantaged areas have conduct disorder. Recent government initiatives such as targeting early years services to designated disadvantaged Flying Start areas in Wales have resulted in increased nursery-care provision for pre-schoolers, yet little has been done to equip nursery staff with effective child behaviour management strategies. The purpose of this non-randomised trial platform study was to establish the feasibility of delivery and the effectiveness of the new Incredible Years Toddler Parent Programme in supporting nursery staff in managing difficult behaviour in the nursery. The Parent Programme is a 12-session (a two-hour session/week) course for carers/parents of children aged one to three years old, which encourages carers to: establish positive relationships with children through play and child-centred activities; ...

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To establish the optimum barium-based reduced-laxative tagging regimen prior to CT colonography (CTC). Ninety-five subjects underwent reduced-laxative (13 g senna/18 g magnesium citrate) CTC prior to same-day colonoscopy and were randomised to one of four tagging regimens using 20 ml 40%w/v barium sulphate: regimen A: four doses, B: three doses, C: three doses plus 220 ml 2.1% barium sulphate, or D: three doses plus 15 ml diatriazoate megluamine. Patient experience was assessed immediately after CTC and 1 week later. Two radiologists graded residual stool (1: none/scattered to 4: >50% circumference) and tagging efficacy for stool (1: untagged to 5: 100% tagged) and fluid (1: untagged, 2: layered, 3: tagged), noting the HU of tagged fluid. Preparation was good (76-94% segments graded 1), although best for regimen D (P = 0.02). Across all regimens, stool tagging quality was high (mean 3.7-4.5) and not significantly different among regimens. The HU of layered ...

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Purpose: To report outcomes of a single institution study of stereotactic body radiotherapy (SBRT) for unresectable cholangiocarcinoma. The dose-volume dependency of the observed gastrointestinal toxicity is explored. Methods and materials: Twenty-seven patients with unresectable cholangiocarcinoma (n = 26 Klatskin tumours and one intrahepatic cholangiocarcinoma (IHCC)) were treated by linac-based SBRT. The dose schedule was 45 Gy in three fractions prescribed to the isocenter. Results: The median progression-free survival and overall survival were 6.7 and 10.6 months, respectively. With a median follow-up of 5.4 years, 6 patients had severe duodenal/pyloric ulceration and 3 patients developed duodenal stenosis. Duodenal radiation exposure was higher in patients developing moderate to high-grade gastrointestinal toxicity with the difference in mean maximum dose to 1 cm"3 of duodenum reaching statistical significance. A statistically significant association between ...

International Nuclear Information System (INIS)

The movement from traditional regulatory hearings to negotiated settlements represents both a departure from cost of service regulation and a relaxation of regulatory oversight. Under negotiation parties are able to renegotiate inclusions in their cost of service while simultaneously creating a profit margin for the regulated firm where none existed under the cost of service outcome of a traditional hearing. This paper constructs a model to illustrate the existence of positive gains to pipeline and shipper from the re-allocation of expenses through time in the regulated pipeline services market in Canada. Behaviour consistent with the model is observable in anecdotal and econometric evidence gathered from the library of the National Energy Board of Canada, responsible for pipeline toll regulation in Canada. Empirical investigation by into settlement procedures in the Florida electricity market reveals similar findings; however, this analysis represents the first ...

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Equinovarus of the foot is the most common lower extremity deformity following traumatic brain injury. We evaluated outcomes of the split anterior tibialis tendon transfer (SPLATT) for correction of equinovarus in 47 patients with hemiplegic traumatic brain injury and specifically studied differences in outcomes with two tendon fixation techniques. Seventeen patients constituting Group I underwent fixation with one technique and 30 constituting Group II had another technique. Patients in both groups had appropriate procedures based on dynamic electromyography and gait analyses. Both groups were demographically comparable. All 47 feet were corrected to plantigrade position. Thirty-six of 47 patients became brace-free at final followup. There was a notable decrease in the use of ambulatory aids and ambulatory status improved in both groups. There were three fixation-related complications in Group I and none in Group II. Surgical correction of the ...

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Maternal exposure to ambient air pollution has increasingly been linked to adverse pregnancy outcomes. The evidence linking this exposure to congenital anomalies is still limited and controversial. This case-control study investigated the association between maternal exposure to ambient particulate matter with aerodynamic diameter less than 10 ?m (PM(10)), sulfur dioxide (SO(2)), nitrogen dioxide, nitric oxide (NO), ozone (O(3)), and carbon monoxide (CO) and the occurrence of congenital heart disease in the population of Northeast England (1993-2003). Each case and control was assigned weekly average (weeks 3-8 of pregnancy) of pollutant levels measured by the closest monitor to the mother's residential postcode. Using exposure as both continuous and categorical variables, logistic regression models were constructed to quantify the adjusted odds ratios of exposure to air pollutants and the occurrence of each outcome group. We found exposure to ...

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The visual impact of wind turbines is one of the main factors affecting public acceptance of wind parks. This paper evaluates the visual impact of a wind park in Chania, Crete, using the Spanish method of evaluation. The outcomes are combined with the psychometric testing of the residents by the use of questionnaires and with the values of the Spanish method about various scenarios concerning the size of the wind park (double, half, one wind turbine). The results of the study prove that the quantification of the potential visual impact could minimize this, apparently, main reason that affects public acceptance. (author)

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ArgoNeuT, a Liquid Argon Time Projection Chamber (LAr-TPC), has recently collected thousands of neutrino and anti-neutrino events between 0.1 and 10 GeV in the NuMI beamline at Fermilab (FNAL). Among other issues, the experiment will measure the cross section of the neutrino and anti-neutrino Charged Current Quasi-Elastic (CCQE) interaction on Ar target and analyze the vertex activity associated with such events. Outcomes from the reconstruction of the events provide the main subject of this paper.

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A respected veteran among state utility regulators raises a sober warning that it may not be possible for the telecommunications industry to survive half regulated and half unregulated, which is its posture for the present. He foresees a danger that the unregulated sector may be successful in capturing all the profitable portions of the market, leaving only the unprofitable areas to the regulated sector, which will then experience serious dislocations and even system breakdowns. Avoidance of such an outcome to the deregulatory steps presently being taken will require an uncommon degree of prudence and wisdom in those state officials who remain charged with regulatory responsibility for local exchange telephone facilities and service.

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In the last 40 years, significant advances have been made in the understanding of the neurophysiologic processes involved in the experience of trauma and pain. This knowledge, together with the rapid growth and understanding in the behavioral health sciences, has expanded to include a much better appreciation of how these fields are converging and contribute to a process called neuroplasticity. These basic mechanisms common to all patients have important implications for clinical outcome and for improving clinical practice. This article is written for clinicians who manage patients with sacroiliac joint dysfunction, a specific type of nonspecific low back pain.

International Nuclear Information System (INIS)

A sample of garnet-biotite plagiogneiss, GBPg-1 is currently being developed as a certified reference material at the Vinogradov Institute of Geochemistry. It was used as the sample that was distributed round 7 of International Proficiency Testing Program (GeoPT7) and was analyzed by 76 geoanalytical laboratories around the world. Twenty Russian laboratories involved in the interlaboratory experiment also analyzed GBPg-1. The resultant analytical data obtained from these two experiments has allowed GBPg-1 to be certified as a state standard sample for 50 elements. It also enabled a comparison of the quality of data developed by the Russian and international geoanalytical laboratories, to optimize the outcome of this interlaboratory experiment.

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The current status of at-risk and adjudicated youth with behavioral challenges provides a context for addressing needed future directions for research and practice in fields that impact this population. This context includes the myriad characteristics and complex needs of these youth, the programs and services currently available in communities and secure settings, and youth outcomes following incarceration. Recent and emerging national, state, and local initiatives and the benefits that have been realized or are anticipated from their application are presented. The challenges to achieving and sustaining these systems changes are then discussed. The paper concludes with recommendations for future research and practice, based on the issues raised in this special issue and elsewhere. (Contains 1 endnote.)

International Nuclear Information System (INIS)

Steam generator tube denting is primarily caused by build-up of corrosion products at the tubesheet and the tube support plates. The mechanism of dent growth and the identification of tubes which should be removed from service have been studied. The practical outcome has been to prevent in-service tube leaks and to avoid unnecessary plugging of large numbers of tubes. A finite element study of tubesheet deformation (of pulled leaking tubes from reactors) was undertaken. Profilometry results for characterizing dents are given. Although several modifications have been made the high resolution profilometry system performance and the results obtained have proved satisfactory. (U.K.).

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This report describes the activities conducted with DOE funds at Oregon Health Sciences University between 9/15/94 and 9/29/99. The activities fall into four major categories: Information Technology, Information Services and Support, Medical Informatics and Outcomes Research, and collaboration with other institutions. The focus of these activities was to implement and maintain a regional healthcare information network.

International Nuclear Information System (INIS)

Direct nuclear reactions are commonly understood in terms of distorted wave (DW) formalisms. In the case of a single nucleon knockout or transfer reaction the DW analysis provides a reasonable understanding of the observed data. On the other hand the predictions based on different available information inputs have been verified with the observations consistently. In the case of direct reactions involving nuclear clusters however, the DW predictions have been found to disagree with the observations in most cases. The outcome of these and other improvements in the intermediate energy nuclear phenomena involving direct reactions are highlighted. (author). 13 refs., 18 figs.

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The use of X-ray scattering techniques in pharmaceutical science is increasing, in part through increased collaborations with the materials science community, and through increased availability of instrumentation, particularly synchrotron sources. The ability to understand not only the biopharmaceutical outcome, but also arguably, more importantly, the structural aspects of drugs and drug delivery systems, is essential to progressing pharmaceutical science; this review serves as an introduction to the major techniques and the wide range of areas in which X-ray scattering may be applied in understanding and controlling structure in pharmaceutical systems.

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Patients with end stage renal failure (ESRD) require renal replacement therapy in the form of dialysis or renal transplantation. There is an increasing number of people receiving maintenance dialysis as patients with ESRD are increasing faster than the supply of transplantable organs. The mortality rate on dialysis is 4-6 times that of the general population and is substantially reduced by transplantation. For the past 8 years, dialysis research has focused on improving patient outcomes and quality of life on dialysis. This review examines recent advances in haemodialysis and peritoneal dialysis in a historical context and considers future research possibilities. PMID:19329705

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Acute vertebrobasilar occlusion (VBO) is associated with a high risk of stroke and death. Although local thrombolysis may achieve recanalization and improve outcome, mortality is still between 35% and 75%. However, without recanalization the chance of a good outcome is extremely poor, with mortality rates of 80-90%. Early treatment is a fundamental factor, but detailed studies of the exact time management of the diagnostic and interventional workflow are still lacking. Data on 18 patients were retrospectively evaluated. Time periods between symptom onset, admission to hospital, time of diagnosis, and beginning of intervention were correlated with postinterventional neurological status. The Glasgow Coma Scale and National Institute of Health Stroke Scale (NIHSS) were used to examine patients before and after local thrombolysis. Additionally, multivariate statistics were applied to reveal similarities between patients with neurological ...

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Purpose: To conduct a retrospective analysis within a large university teaching hospital, comparing outcomes between patients receiving either radical surgery or radiotherapy as curative treatment for bladder cancer. Patients and Methods: Between March 1996 and December 2000, 169 patients were treated radically for muscle-invasive bladder cancer. Data were collected from patient notes. Statistical analyses were performed using Kaplan-Meier methods and Cox proportional hazards regression analysis to compare radiotherapy and surgical outcome data. Results: There was no difference in overall, cause-specific, and distant recurrence-free survival at 5 years between the two groups, despite the radiotherapy group being older (median age, 75.3 years vs. 68.2 years). There were 31 local bladder recurrences in the radiotherapy group (24 solitary), but there was no significant difference in distant recurrence-free survival. In a more recent (2002-2006) ...

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Intracapsular femoral neck fractures remain unsolved fractures even after improvement in techniques of diagnosis and internal fixation. Individuals who sustain displaced femoral neck fractures are at high risk of developing avascular necrosis and non-union. Although several methods for predicting the viability of femoral head have been reported, they are not effective or widely used because of unreliability, potential complications and technical difficulties. Dynamic MRI was introduced in the recent past as a simple, non-invasive technique to predict the femoral head viability after the femoral neck fractures. In this study role of dynamic MRI was studied in 30 patients with 31 intracapsular femoral neck fractures. Fractures were divided in to three types according to dynamic curve patterns on MRI evaluation and were followed up for 6 months to 2 years to observe the final outcome. Sensitivity, Specificity and the Accuracy of dynamic MRI in predicting vascularity ...

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Purpose: The occurrence of extraosseous Ewing's sarcoma (ES) in deep soft tissues has been well described, but cases in which this tumor occurs in a primary cutaneous or subcutaneous site have rarely been reported. The superficial variant may be less aggressive than are the more common bony and deep soft tissue counterparts with an apparently favorable outcome. A retrospective review of patients with cutaneous or subcutaneous ES was conducted to analyze outcome and patterns of failure. Methods and Materials: Between July 1985 and March 1997, 14 patients with cutaneous or subcutaneous ES were treated at St. Jude Children's Research Hospital. The median age at presentation was 16 years (range 7-21 years). Anatomic locations included trunk and pelvis (7), upper or lower extremity (4), and head and neck (3). The median size of the lesion was 3 cm (range, 1-12 cm). Thirteen had definitive surgical resections, and one had biopsy of the mass at the ...

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We have been piloting web-based multimedia learning modules (MLMs), developed by the Physics Education Research Group at the University of Illinois at Urbana Champaign (UIUC), as a "prelecture assignment" in several introductory physics courses at California State Polytechnic University at Pomona. In this study, we report the results from a controlled study utilizing modules on electricity and magnetism as a part of a blended hybrid-online course. We asked students in the experimental section to view the MLMs prior to attending the face-to-face class, and to make sure this would not result in additional instructional time, we reduced the weekly class time by one-third. We found that despite reduced class time, student-learning outcomes were not hindered; in fact, the implementation of the UIUC MLMs resulted in a positive effect on student performance on conceptual tests and classroom discussion questions. (Contains 4 figures and 1 table.)

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Climate change represents the largest social dilemma humans have ever faced, where individual actors maximise their personal gain by emitting greenhouse gases into the atmosphere even though this is detrimental to the collective global good. Cooperation on a global scale is urgently required if we are to overcome this problem. However, this is difficult to achieve because cooperators pay the cost of reducing emissions while any benefits are shared between cooperators and free-riders alike. In a risk-free, rational world cooperative behaviour can be promoted through mechanisms that increase the benefit of cooperating relative to free-riding, such as rewards or sanctions. In reality, however, outcomes are seldom certain and humans rarely behave rationally when confronted with risky prospects...

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This study reports the outcome of real-time ultrasonographic screening tests of a healthy population. The study group consisted of 33 female teachers who were found to have asymptomatic gallstone disease. All cases were followed up to determine the incidence of biliary colic or complications. After a 38-month period of follow-up, seven subjects (21.2%) developed either biliary colic or complication. Study results revealed that the 38-month cumulative probability of the development of biliary colic or complication was 36%. Data shown that development of biliary colic or complications was positively associated with obesity, but no assocition was found with age, number of activities, or duration of contraceptive pill-taking. Having such a high percentage of subjects who developed biliary colic or complications within a relatively short period of time suggests that the silent gallstone is not innocent. PMID:17372404

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Husband AC, Crawford S, McCoy LA, Pacaud D. The effectiveness of glucose, sucrose, and fructose in treating hypoglycemia in children with type 1 diabetes. Objective: There is a lack of evidence regarding the most effective treatment option for managing naturally occurring hypoglycemia in children with type 1 diabetes. The objectives of this study were (i) to determine if sucrose and fructose are equally effective as glucose in the treatment of spontaneous hypoglycemia in children with type 1 diabetes; and (ii) to determine prestudy and poststudy hypoglycemia treatment preferences. Methods: Thirty-three subjects [aged 5.4-15.5 yr and average duration of type 1 diabetes of 3.1 yr (SD = 2.3)] participated in a randomized, crossover design. The main outcome was the effectiveness of treatment a...

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Purpose To evaluate disease failure patterns and overall survival (OS) of women with triple-negative (TN) breast cancer who underwent breast-conserving therapy (BCT) and to understand the relationship of TN tumors with other prognostic factors. Patients and Methods The Surveillance, Epidemiology, and End Results (SEER) registry identified 562 women diagnosed and/or treated with unilateral invasive breast cancer during 2003?2004 at three Emory hospitals. After medical record review, 193 eligible women, with all tumor types, received BCT. Primary endpoints (local, regional, and distant recurrences) and secondary endpoint (OS) were evaluated using chi-square tests and Cox proportional hazards models. Results Of the 193 women, 33 (17.1%) had TN tumors and 160 (82.9%) had non-TN tumors. Patient...

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The surgical management of osteoradionecrosis of the temporal bone has met with limited success because of the difficulty in accurate assessment of the viability of nonnecrotic bone intraoperatively. Failure to resect all nonviable bone results in recurrence of a necrotic focus. With the use of hyperbaric oxygen therapy to stabilize marginal bone and oral tetracycline to label viable bone preoperatively, removal of all nonviable bone can be accomplished. Postoperatively, a second course of hyperbaric therapy enhances wound healing, thus assuring a successful outcome. This article details a successful systematic approach that was developed to resect a necrotic focus in the temporal bone of a 10-year-old boy who had undergone a full course of radiotherapy for treatment of a rhabdomyosarcoma.

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The most advanced frontier of allogeneic hematopoietic stem cell transplantation (allo-HSCT) is represented by the use of an HLA-partially matched relative as donor. In this type of transplantation, donor-derived natural killer (NK) cells, which are alloreactive towardtoward recipient cells, significantly contribute to the eradication of leukemia blasts. Alloreactive NK cells may also kill host dendritic cells and T lymphocytes, thus preventing graft-versus-host disease and graft rejection, respectively. Sophisticated strategies of adoptive infusion of T-cell lines/clones specific for the most life-threatening pathogens (namely cytomegalovirus, Epstein-Barr virus, Aspergillus and Adenovirus) have been envisaged, and successfully tested in a few pilot trials, to protect the recipient in the...

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This article examines the hidden history of criminal justice in late colonial Australia by focussing on Aboriginal inter se offending. Most Aboriginal defendants appearing in late colonial criminal courts were prosecuted for violent crimes against other Aboriginal people. The article explores how common such cases were and the degree to which the acknowledgment of cultural difference affected justice process and outcomes. The frequent invocation of 'custom' commonly led juries to recommend the mercy of the Crown to those Aboriginal defendants found guilty of committing a homicide. I argue that 'custom' was increasingly used by settler judicial processes as a shorthand way of explaining what was otherwise seen as unexplainable. In the twentieth century 'custom' would receive greater attenti...

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Deltombe T, Gustin T. Selective tibial neurotomy in the treatment of spastic equinovarus foot in hemiplegic patients: a 2-year longitudinal follow-up of 30 cases. Objective To assess the long-term efficacy of selective tibial neurotomy in the treatment of spastic equinovarus foot in hemiplegic patients. Design Intervention study (before-after trial) with an observational design and 2-year follow-up. Setting Spasticity group in a university hospital. Participants Hemiplegic patients (N=30) with spastic equinovarus foot. Intervention A selective neurotomy was performed at the level of the motor nerve branches of the tibial nerve. Main Outcome Measures Spasticity (Ashworth scale), muscle strength (Medical Research Council scale), passive ankle dorsiflexion, gait parameters (6 min walking test...

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BACKGROUND: Epinephrine injection is the most common endoscopic therapy for peptic ulcer bleeding. Controversy exists concerning the optimal dose of proton pump inhibitors (PPI) for patients with bleeding peptic ulcers after successful endoscopic therapy. The objective of this study was to determine the optimal dose of PPI after successful endoscopic epinephrine injection in patients with bleeding peptic ulcers. METHODS: A total of 200 peptic ulcer patients with active bleeding or nonbleeding visible vessels (NBVV) who had obtained initial hemostasis with endoscopic injection of epinephrine were randomized to receive omeprazole 40 mg infusion every 6 h, omeprazole 40 mg infusion every 12 h or cimetidine (CIM) 400 mg infusion every 12 h. Outcomes were checked at 14 days after enrollment. RE...

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Abstract Aim- Conventional outcomes such as survival, tumour recurrence and complication rates after surgery for rectal cancer have been rigorously assessed, but the importance of maintaining quality of life (QOL) after surgery for rectal cancer has received less attention. The aim of the current study was to analyse QOL and the occurrence of pelvic dysfunction after the surgical treatment of rectal cancer. Method- Between May 2005 and May 2008, 150 patients with rectal cancer underwent abdominoperineal resection (APR) or anterior resection (AR). Seventy-four answered two preoperative questionnaires. At a follow up of 1-year, 65 were alive without sign of recurrence and answered the same questionnaires: (a) validated RAND 36-item health survey QOL questionnaire; and (b) self-administered d...

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Idiopathic pulmonary fibrosis is the most lethal form of diffuse lung fibrosis, killing approximately half of those affected within 2-3 years of diagnosis. Until recently, no therapies had been shown to have an impact on disease progression. The Clinical Studies Assessing Pirfenidone (Esbriet) in IPF: Research of Efficacy and Safety Outcomes (CAPACITY) program comprised two almost identical double-blind placebo-controlled studies assessing the effects of pirfenidone on change in forced vital capacity, the primary end point, over a 72-week period. One of these studies was positive, matching in magnitude the benefit seen in two previous positive Japanese studies. The other study did not meet its primary end point but positive trends were consistent in this and a number of secondary end point...

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Objectives Vietnamese patients? views on healthcare are changing as surgical interventions become more commonplace, but their views on perioperative care have remained largely unstudied during this period of rapid change. This study assesses Vietnamese patients? impression of anesthesia safety and postoperative pain in relation to clinical outcomes with the aim of improving patient-centered perioperative care. Methods The study cohort consisted of 180 hospitalized patients who were followed for 24?h following abdominal surgery. The assessments of these patients on the use of anesthesia and postoperative pain were measured by means of a 5-point Likert scale survey. Perioperative events were recorded on standardized forms by medical staff. The relationship between relevant factors affecting ...

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To determine the proportion of rheumatoid arthritis (RA) patients receiving preventive health care according to US Preventive Services Task Force recommendations compared with a community-based population sample, with emphasis on dyslipidemia testing, given the increased risk of cardiovascular disease (CVD) in RA patients. Patients with RA (ICD-9 code 714.0 at ?2 office visits with a rheumatologist) and a primary care physician (PCP) at the Geisinger Health System (GHS) were identified through electronic health records. The records were searched back from 3/31/08 for the length of time required to satisfy each outcome measure. Percentages were compared with population testing rates using the Pearson Chi-square test. Eight hundred and thirty-one RA patients were compared to 169,476 subjects...

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Two experiments used the McGill Pain Questionnaire (MPQ) to examine the affective dimension of pain in patients whose pain was secondary to malignancy. In experiment I, segregating groups of cancer patients on the basis of extreme scores (high versus low) on the MPQ failed to produce segregation on independent measures of affect and infirmity. This outcome contrasts with earlier work with chronic benign pain patients. Experiment II compared cancer pain patients matched with benign pain patients on intensity of pain report on the affective dimension of the MPQ. Cancer pain patients reported a reliably higher affective loading to their pain. These data suggest that cancer pain patients employ different criteria than benign pain patients in selecting affective pain descriptors. Possible explanations for this difference are discussed. PMID:7070825

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High-level expression of mitotic arrest defective protein 2 (MAD2), a central component of the spindle assembly checkpoint, has been observed in a variety of human malignancies. Aim of the present study was to observe the expression of MAD2 in human non-small-cell lung cancer (NSCLC) and explore its clinicopathologic significance and evaluate MAD2 expression as a prognostic marker. MAD2 transcript was found to be overexpressed in the great majority of lung cancers by semi-quantitative RT-PCR. A total of 358 NSCLCs were analyzed immunohistochemically on tissue microarrays. High-level MAD2 expression was observed in 26.3% (94 of 358 cases), and correlated with male sex (P=0.0002), tumor progression (pT status) (P=0.0009), visceral or parietal pleural invasion (P=0.0151), non-adenocarcinoma, ...

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Introduction: Restrictions in prescribing broad spectrum antimicrobials have been part of a strategy to reduce Clostridium difficile cases in the UK in recent years. However, there has been little work on assessing the safety of alternative antimicrobial agents. Methods: We performed an uncontrolled prospective observational survey over a 1-year period to determine the effectiveness and safety of a new antimicrobial stewardship programme in a district hospital in the UK. Results: In total, 227 Gram-negative bacteraemias (203 episodes) occurred in the study period. Guidelines were adequate in 194 of 203 (95%) episodes and 163 episodes (80.2%) received adequate therapy. Patients in the inadequate therapy group had >2-fold increased likelihood of death [odds ratio (OR) = 2.63, 95% confidence ...

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A model for risk and reliability analysis of complex multifunctional production process systems is presented. The model employs Monte-Carlo and Markov Chain algorithms that uses a weighted index to train and simulate the fuzzy hazard data sets which represents failure outcomes of risk component transient and non-transient systems. Early simulation results shows that hazard rates and the risk of containment loss from typical floating production and storage offloading (FPSO)-Riser system for the risk components in parallel or series increases exponentially with time and decreases as safety ratings fraction increases. The reliability value decreases with time and safety fraction (SFAC) for all fuzzy hazard classifications. The results of the computed mean time before repair (MTBR) show that t...

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This study examined the extent to which science, technology, engineering, and math (STEM) students reported having had mentors of their own race and gender and the extent to which they have adopted the idea that matching by race and gender matters. The study also documented the effects of race and gender matching on three academic outcomes, self-reported grade point average, efficacy, and confidence, based on data collected from 1,013 undergraduate and graduate students and postdoctoral scholars actively participating in MentorNet's online community. Analyses indicated that having a mentor of one's own gender or race was felt to be important by many students, especially women and students of Color. Students who had a mentor of their own gender or race reported receiving more help, but matc...

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The consequences of exit, voice, loyalty, and neglect behavior were examined using retrospective questionnaires (Study 1) and 2 social interaction diary studies (Study 2). Exit and neglect were generally associated with more negative partner responses and reduced feelings of value and closeness, and were reported to be more harmful to the relationship. Voice was associated with more positive partner responses and greater value and intimacy, and was perceived to be most beneficial to the relationship. In contrast, loyalty was perceived to have the same detrimental consequences as destructive behaviors (Study 1) and did not predict more positive outcomes within daily interactions (Study 2). These results indicate that, despite good intentions, loyal intimates are often left feeling ignored a...

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Purpose Elective laparoscopic sigmoid resection (LSR) for symptomatic diverticular disease is supposed to have significant short-term advantages compared to open surgery (open sigmoid resection (OSR)). This opinion is rather based on inferences from trials on colonic resections for malignant diseases or minor laparoscopic surgery. This randomized controlled trial was conducted to compare quality of life as well as morbidity and clinical outcome after LSR vs. OSR following a midterm follow-up period. Methods Patients presenting with a symptomatic sigmoid diverticular disease stage II/III (Stock/Hansen) were randomly allocated to LSR or OSR in a prospective multicenter trial. Endpoints included the quality of life assessed with a standardized questionnaire, postoperative mortality, and compl...

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Coronary angiography has provided an unrivalled appreciation of coronary anatomy fostering a far greater appreciation of the extent of atherosclerotic disease. However, the subjectivity of coronary angiography at determining the extent of plaque has been exposed with IVUS. Indices of coronary physiology have provided valuable adjunctive information as to the physiological importance of specific lesions. Fractional flow reserve is an established method for evaluating the significance of epicardial stenoses. Fractional flow reserve guided percutaneous coronary intervention is associated with improved outcomes when compared to a conventional angiographic guided strategy, particularly in intermediate lesions. The use of coronary physiology in the cath lab represents a new avenue to guide appro...

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Background The Norwood procedure consists of three palliative operations, performed in neonates with hypoplastic left heart syndrome. Especially the first stage (Norwood I) is associated with the highest mortality rates in paediatric cardiac surgery (up to 25%). During surgery, the aorta is reconstructed and a systemic-to-pulmonary shunt is applied. Originally the modified Blalock-Taussig shunt was used, but recently the right-ventricle-to-pulmonary-artery shunt is increasingly being employed. We reviewed the results of our operative strategy, where an individualised choice of shunt is made. Furthermore, attempts to reduce interstage mortality (between Norwood I and II) were assessed. Methods All neonates who underwent Norwood stage I palliation from August 2004 until November 2010 were in...

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A multivariate logistic regression model, based upon National Automotive Sampling System Crashworthiness Data System (NASS-CDS) data for calendar years 1999-2008, was developed to predict the probability that a crash-involved vehicle will contain one or more occupants with serious or incapacitating injuries. These vehicles were defined as containing at least one occupant coded with an Injury Severity Score (ISS) of greater than or equal to 15, in planar, non-rollover crash events involving Model Year 2000 and newer cars, light trucks, and vans. The target injury outcome measure was developed by the Centers for Disease Control and Prevention (CDC)-led National Expert Panel on Field Triage in their recent revision of the Field Triage Decision Scheme (American College of Surgeons, 2006). The ...

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Context. Cardiovascular medication overdoses can be difficult to treat. Various treatment modalities are currently recommended. Objective. To describe patient outcomes and adverse events of high-dose insulin therapy in consecutive overdose patients in cardiogenic shock after implementation of a high-dose insulin protocol (1-10 U/kg/h, while avoiding or tapering off vasopressors). Methods. This is an observational consecutive case series of patients identified from a registry. Data were collected by retrospective chart review of patients treated by our toxicology service with this protocol from February 2007 until March 2010. Results. Twelve patients were treated with high-dose insulin. The mean age was 36.5 years (SD 11.7). Seven patients had pre-existing vasopressor therapy, and all were ...

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Statement of problem Although the esthetic outcome of a collarless metal ceramic restoration is superior to that of a restoration with a metal margin, its mechanical strength has not been evaluated. Purpose The purpose of this study was to evaluate and compare the fracture resistance of metal ceramic restorations with metal margins to that of metal ceramic restorations with circumferential porcelain margins, after exposure to masticatory simulation. Material and methods Twenty-four metal ceramic restorations were fabricated and paired with 24 cobalt-chrome tooth analogs. Twelve of the specimens had metal margins, while the remainder had circumferential porcelain margins. The restorations were cemented on the metal tooth analogs with a resin-modified glass ionomer luting agent (FujiCEM). Al...

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Objective: To reduce mental health symptoms and high-risk behaviors and increase social support and service utilization among street-living youth, the authors conducted a pilot study to assess the feasibility of the social enterprise intervention (SEI) at a homeless youth agency. Method: Convenience sampling was used to recruit 16 street-living youth from the agency. SEI participants received 7 months of vocational and small business training and service referrals. A comparison sample of 12 agency youth was used. Results: Findings from independent sample t tests demonstrate that SEI participants displayed significant improvements at 9 months in life satisfaction, family contact, peer support, and depressive symptoms. Conclusions: Preliminary findings suggest that the SEI was feasible within the agency setting and associated with higher mental health and social outcomes. (Contains 3 figures and 3 tables.)

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Around the world there is a small industry of non-governmental organisations that provide health care in niche areas that cannot be met by national health care provision. One topic is facial deformity that can have a dramatic effect on quality of life. In this study we investigate the morbidity and outcome of a British surgical team working for a 2-week period in Ethiopia. Thirty-five patients who presented with facial deformities had 47 operations during a 2-week period. Data were recorded for a minimum of 3 weeks postoperatively. Operative techniques were classified as simple or complex. Postoperative complications were assessed and classified as major, intermediate, and minor. In addition, the character of each complication was recorded and the cause elucidated. After 3 weeks the clinic...

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IntroductionThe elimination of microorganisms from the root canal system necessitates the use of combination of irrigating solutions to enhance their antimicrobial property. The combination of irrigants and their interaction sometimes could be detrimental to the outcome of the root canal therapy. The purposes of this study were (1) to evaluate the interaction between 7% maleic acid (MA) and 2% chlorhexidine gluconate solution (CHX) and to find out the availability of individual irrigant and (2) to determine the free available chlorine content when 7% MA was mixed with 2.5% sodium hypochlorite (NaOCl) solution. MethodsInteraction between MA and CHX was assessed by high-performance liquid chromatography. Available chlorine content in NaOCl was evaluated by the standard iodine/thiosulfate tit...

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Background Fracture healing in osteoporosis is delayed. Quality and speed of fracture healing in osteoporotic fractures are crucial with regard to the outcome of patients. The question arises whether established antiosteoporotic drugs can further improve fracture healing. Materials and methods Osteoporosis manifests predominantly in the metaphyseal bone. Nevertheless, an established metaphyseal fracture model is lacking. A standardized metaphyseal fracture-healing model with stable plate fixation was developed for rat tibiae. The healing process was analyzed by biomechanical, gene expression, and histomorphometric methods in ovariectomized (OVX) and sham-operated rats (SHAM), compared to standardized estrogen (E)- and raloxifene (R)-supplemented diets. Results Estrogen and raloxifene impro...

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The two primary objectives of the proposal were (1) to enhance science and technology infrastructure, faculty development, and curriculum by integrating technology throughout science education programs of study, and (2) to increase faculty and students` knowledge of and skills in modern technologies that are designed to enhance the effectiveness of teaching and learning through education, research and communications. These two primary objectives have been accomplished through: Installation and operation of a technology-ready classroom; Upgrading CIS 200 Introduction to Computers; Upgrading all science laboratory courses to include integration of science and technology through installation of computers; Faculty development through attendance at workshops, seminars, or conferences related to technology applicable to sciences; and Undergraduate research internships at the Oak Ridge National Laboratory. The paper briefly discusses the outcome of implementing this ...

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Endophytes are microorganisms that live within healthy plant tissues, and include fungi and bacteria. They can be mutualists, comensals or even latent pathogens. Presence of these endosymbionts may affect host physiology, for example by consuming products of photosynthesis (endophytes are heterotrophs) or producing toxic metabolites. In this work two fungicides were used to eliminate fungal endophytes from seedlings of guarea guidonia. light saturated photosynthesis (Amax) was measured in endophytefree plants and compared with control plants. Each fungicide killed different fungal endosymbionts. phomopsis was more susceptible to benomyl while colletotrichum was more susceptible to propiconazole. Although suggestive, values of Amax were not significantly different for each treatment compared with control plants. No prediction can be made at this point about the final outcome of a given plantendophytic fungi interaction

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The objective of this study was to examine the effect of a nonsteroidal anti-inflammatory drug (NSAID) plaster for knee osteoarthritis among Japanese patients. An open-labeled, randomized, controlled, multiclinic trial was performed involving outpatient clinic groups. Two comparative groups?plaster NSAIDs and oral NSAIDs?were randomly allocated. The drugs used were limited to the current top three in both groups in Japan. Treatments were assessed after four?weeks and compared with the baseline scores. Outcomes were evaluated by two psychometric measures: Japanese knee osteoarthritis measure, and pain with the visual analogue scale. The total number of patients included in the final evaluation was 165 (87 for the plaster group and 78 for the oral group). Between these two groups there were ...

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The approval (2003) and enforcement (2005) of a smoking ban in Italy have been viewed by many as an unexpectedly successful example of policy change. The present paper, by applying a processualist approach, concentrates on two policy cycles between 2000 and 2005. These had opposing outcomes: an incomplete decisional stage and an authoritative decision, enforced two years later. Through the analysis of the different phases of agenda setting, alternative specification and decision making, we have compared the quality of participation of policy entrepreneurs in the two cycles, their political strategies and, in these, the relevance of issue image. The case allows us to direct the attention of scholars and practitioners to an early phase of the policy implementation process - which we have nam...

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ABSTRACT This research examined whether the Internet improves life satisfaction. The study surveyed 195 college students, and a structural model was built to explain effects of the Internet on school life satisfaction using a confirmatory factor analysis (CFA). In line with social cognitive theory and literature on social effects of the Internet, current data supported the hypotheses that Internet use, perceived online social support, and online social self-efficacy had direct positive impacts on school life satisfaction. Offline extroversion, online extroversion, online social self-efficacy, and online social outcome expectations influenced school life satisfaction indirectly: offline extroversion acted through social online self-efficacy and online extroversion; online social self-effica...

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Summary 1.-Plant-plant interactions fluctuate between competition and facilitation depending upon ecological conditions and species traits. Facilitative interactions are expected to increase in frequency via associational defences with increasing consumer pressure. The ability of species to cope with competition and/or ecological stressors may alter the outcome of plant-plant interactions. 2.-We conducted a transplant experiment to determine if native and non-native grasses and forbs respond similarly to interactions with Juncus effusus L., an unpalatable benefactor species, along a grazing intensity gradient in two contrasting pasture types: intensively managed and semi-natural. We expected competitive taller, erect species (grasses) and non-natives to obtain stronger facilitative effects...

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Whether or not a current account deficit sustainable has important implications for policy. If the current account deficits of a nation is sustainable, then it implies that the government should have no incentive to default on its international debt. In this article we examine whether or not the current account deficits for the OECD countries can be characterized by a unit root process with regime switching. The econometric methodology allows us to distinguish periods that are associated with unsustainable outcomes from those in which the intertemporal national long-run budget constraint (LRBC) holds. Among the main results, it is found that it is very likely that the LRBC will not hold for the Australia, the Czech Republic, Finland, Hungary, New Zealand, Portugal or Spain, thus signifying...

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Abstract The fit of patient coping style and psychotherapy focus has been suggested as improving treatment outcome. This article reviews the definitions, measures, and previous research surrounding this hypothesis. An original meta-analysis of 12 carefully selected studies (N = 1,291 patients) resulted in a weighted, mean effect size (d) of .55 in favor of a fit between externalizing patients and symptom-focused treatment or, alternatively, internalizing patients and insight-focused treatment. This medium-size effect indicates that nondiagnostic patient factors, like coping style, are important considerations in the selection of effective therapies. Clinical examples and clinical recommendations are provided. 2010 Wiley Periodicals, Inc. J Clin Psychol: In Session 67:176-183, 2011.

CERN Document Server

The unconventional technologies, currently applied at a certain category of materials, difficult to be processed through usual techniques, have undergone during the last 60 years all the stages, since their discovery to their use on a large scale. They are based on elementary mechanisms which run the processing through classic methods, yet, they use in addition the interconnections of these methods. This leads to a plus in performance by increasing the outcomes precision, reducing the processing time, increasing the quality of the finite product, etc. This performance can be much increased by using the computer and a software product in assisting the human operator in the processing by an unconventional method such as; the electric or electro-chemical erosion, the complex electric-electro-chemical erosion, the processing by a laser fascicle and so on. The present work presents such an application based on a data base combining the previous experimental results, ...