Ultrasound surveillance of endovascular aneurysm repair: a safe modality versus computed tomography.

Science.gov (United States)

Collins, John T; Boros, Michael J; Combs, Kristin

2007-11-01

Routine ultrasound surveillance is adequate and safe for monitoring endovascular aneurysm repairs (EVARs). A retrospective chart review including 160 endograft patients was performed from August 2000 to September 2005. All ultrasound examinations (n = 359) were performed by a board-certified vascular surgery group's accredited laboratory. Registered vascular technologists utilized the same equipment consisting of Siemens Antares high-definition ultrasonography with tissue harmonics and color flow Doppler. An identical protocol was followed by each technologist: scan body and both limbs of the endograft and distal iliac vessels, measure anterior-posterior aneurysm sac size, and detect intrasac pulsatility and color flow. Statistical analysis utilized Pearson's correlation coefficient and the paired t-test. Forty-one endoleaks were discovered out of the 359 exams (11.4%). There were type I (7, 17%), type II (26, 63%), and combined type I with type II (8, 20%) endoleaks. Correlation with computed tomography (CT) was obtained in 35 of these cases. CT discovered three endoleaks that were not seen with ultrasound. However, these particular ultrasound exams were inadequate due to additional factors (bowel gas, body habitus, hernia), which prompted CT investigation and, hence, endoleak discovery. Of the 41 endoleaks found on ultrasound, only 14 were seen on CT. Specifically, 26 type II endoleaks were seen with ultrasound versus only nine during CT. Additional factors addressed included comparison between ultrasound and CT of residual aneurysm sac measurements and conditions limiting ultrasound examination. Although criticized in the past, color flow ultrasonography is a safe and effective modality for surveillance of aortic endografts. Utilizing ultrasound to analyze abdominal aortic aneurysm (AAA) sac dimensions and endoleak detection is statistically sound for screening AAA status post-EVAR.

[Physical treatment modalities for chronic leg ulcers].

Science.gov (United States)

Dissemond, J

2010-05-01

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

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

Science.gov (United States)

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

2014-07-01

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

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

Science.gov (United States)

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

2015-01-01

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

Concepts and treatment modalities for hypertension by traditional ...

African Journals Online (AJOL)

Clinical experiences and some research findings indicate that traditional and faith healers play a role in the management of hypertension in Africa. Therefore, the purpose of the study was to assess the concepts and treatment modalities for hypertension among traditional and faith healers in the Northern Province in South ...

Treatment modalities for patients with gambling disorder.

Science.gov (United States)

Choi, Sam-Wook; Shin, Young-Chul; Kim, Dai-Jin; Choi, Jung-Seok; Kim, Seohee; Kim, Seung-Hyun; Youn, HyunChul

2017-01-01

Gambling disorder (GD) is defined as persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress. The prevalence of GD has been shown to be 1.2-7.1% in the general population. GD can severely impact on personal and vocational wellbeing as well as lead to financial problems, and has been known to be difficult to treat. This review describes the available pharmacotherapy/psychosocial treatments for GD patients, and summarizes data on the effectiveness of these GD treatments. This review refers to newly as well as previously published studies and guidelines. The description of pharmacotherapy mainly focuses on opioid receptor antagonists, selective serotonin reuptake inhibitors, and mood stabilizers. Psychosocial treatments/strategies mainly include cognitive behavioral therapy, motivational interviewing, and Gamblers Anonymous. We also introduce relatively novel treatment modalities. This review can help clinicians to decide treatment plans for their GD patients. In addition, it can be used as a reference for designing future research.

Multi-modal brain imaging software for guiding invasive treatment of epilepsy

NARCIS (Netherlands)

Ossenblok, P.P.W.; Marien, S.; Meesters, S.P.L.; Florack, L.M.J.; Hofman, P.; Schijns, O.E.M.G.; Colon, A.

2017-01-01

Purpose: The surgical treatment of patients with complex epilepsies is changing more and more from open, invasive surgery towards minimally invasive, image guided treatment. Multi-modal brain imaging procedures are developed to delineate preoperatively the region of the brain which is responsible

Assessing Instructional Modalities: Individualized Treatment Effects for Personalized Learning

Science.gov (United States)

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

2018-01-01

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

Treatment of Graves' hyperthyroidism: evidence-based and emerging modalities

DEFF Research Database (Denmark)

Hegedüs, Laszlo

2009-01-01

Currently there are three well-established treatment options for hyperthyroid Graves' disease (GD): antithyroid drug therapy with thionamides (ATD), radioactive iodine treatment with (131)I, and thyroid surgery. This article reviews the current evidence so the reader can evaluate advantages...... and disadvantages of these treatment modalities. Surgery is rarely used, except for patients who have a large goiter or ophthalmopathy. Fewer than 50% of patients treated with ATD remain in long-term remission. Therefore, radioactive iodine is used increasingly. No data as yet support the routine use of biologic...

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

Science.gov (United States)

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

2017-09-01

Surgical removal plays an important role in treating children's craniopharyngioma. For a safe and minimally invasive craniotomy, a reformed surgical modality was proposed in this paper by combining the insertion of an Ommaya reservoir system (ORS) by stereotactic puncture, aspiration of cystic fluid in 2-day interval for consecutive 7-10 days, and the delayed tumor resection. Eleven patients (aged from 5 to 9 years old) with giant cystic craniopharyngiomas who had undergone the reformed surgical modality during November 2014 and December 2015 were collected as group A. In contrast, seven patients (aged from 5 to 11 years old) who had undergone the traditional directed operation without any prior management from January 2014 to October 2014 were collected into group B. A retrospective analysis was performed for both groups at one institution. The preoperative and postoperative clinical presentations, neuroimaging, early postoperative outcome, and the surgery-related complications of both groups were reviewed. For group A, the mean value of the maximum tumor diameters shank from 52.36 to 23.82 mm after implementing aspiration of the cystic fluid in 1-day interval for consecutive 8.23 days. Eight patients (72.73%) in group A underwent a gross total resection (GTR), while two (28.57%) patients underwent GTR in group B. The postoperative electrolyte disturbance rate and endocrine disorder rate of group B were significantly higher than those of group A (42.86 vs 36.36%; 71.43 vs 45.45%). Postoperative long-term diabetes insipidus only occurred in one patient of group B, and postoperative visual deterioration occurred in two patients of group B. Besides, one patient of group B died of severe postoperative hypothalamus dysfunction. Patients with residual tumors were applied with additional adjuvant radiotherapy, and no recurrence was observed in follow-up examinations. A favorable outcome can be achieved by combining the insertion of an ORS by stereotactic puncture

Home Hemodialysis (HHD Treatment as an Effective yet Underutilized Treatment Modality in the United States

Directory of Open Access Journals (Sweden)

Jihane J. Hajj

2017-11-01

Full Text Available End-stage renal disease (ESRD is a major health burden and its incidence has been increasing yearly reaching 120,000 cases in 2014. Home hemodialysis (HHD is a treatment modality option that has been shown to contribute to numerous clinical benefits but is largely underutilized due to many contributing factors. The purpose of this review paper is to analyze the advantages and disadvantages of HHD and the reasons for its low utilization with a special focus on its socioeconomic impact as compared to facility hemodialysis. Key factors contributing to HHD underutilization are related to the reimbursement system of the facility and nephrologists as well as the underutilization of the pre-dialysis educational benefit. Based on this comprehensive review of the literature, we propose several suggestions which may contribute to the expansion of HHD treatment modality.

Shoulder distention arthrography as a treatment modality

International Nuclear Information System (INIS)

Kang, Heung Sik; Park, Chan Sup; Kim, Jin Ho; Kim, Sang Bum

1987-01-01

18 patients with painful stiff shoulder joint were underwent shoulder distension arthrography as a treatment modality, followed by physical therapy. Range of motion of shoulder joint was evaluated at 1 week and 4 weeks after arthrography. The results were as follows; 1. Arthrographic findings were decreased volume of joint cavity, obliteration of axillary recess, small subscapularis bursa, serrated capsular margin and non-filling of biceps tendon sheath. In 3 cases, rotator cuff tear was found. 2. Range of motion of shoulder joint was improved after distension arthrography. 3. In 3 patients have rotator cuff tear, range of motion was not improved

Prostate cancer, treatment modalities and complications: an evaluation of the scientific literature

International Nuclear Information System (INIS)

Santos-Filho, Sebastiao David; Fonseca, Adenilson de Souza da; Bernardo-Filho, Mario; Missailids, Sotiris

2008-01-01

Prostate (PR) cancer (CA) is one of the most common malignant neoplasms in men all over the world. In general, if prostate cancer (PC) is detected early, treatment usually involves either surgical removal of the prostate or radiotherapy (RT). Hormone Therapy (HT) or chemotherapy (CH) is the preferred treatment for more advanced cases of PC or if CA spreads beyond the PT. A number of complications, such as urinary incontinence (IU) or erectile dysfunction (ED), can be associated with some modalities of treatment of the PC. The aim of this work is to evaluate, in PubMed, the number of publications related with prostate cancer and the main modalities of treatment, as well as some clinical complications. The searches were performed in PubMed (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi) in the period 1950 to 2008 using the words: CA, CA and PR or penis or testis, CA and PR and RT, CA and PR and surgery (SU), CA and PR and CH and, CA and PR and HT and CA and PR and RT and IU or ED, CA and PR and SU and IU or ED, CA and PR and CH and IU or ED and, CA and PR and HT and CH and IU or ED, and (V) PC and the same modalities of treatment. The data was obtained on July 20th, 2008. PC, as expected has been cited extensively and surgery has been identified as the most widely referenced modality of treatment. Furthermore, urinary incontinence and erectile dysfunction are important complications that have attracted significant scientific interest. In conclusion, these findings have shown the relevance of the PubMed to analyze quantitatively the publications in cancer and this information could be worthwhile in aiding the comprehension of some clinical aspects related with PC, as well as the development of preventative actions. The analysis of the scientific interest, considering the number of publications in the PubMed, reveals research trends in the field and demonstrates the importance of the surgical procedures in the treatment of the prostate cancer. Moreover, this finding is

Prostate cancer, treatment modalities and complications: an evaluation of the scientific literature

Energy Technology Data Exchange (ETDEWEB)

Santos-Filho, Sebastiao David; Fonseca, Adenilson de Souza da; Bernardo-Filho, Mario [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil). Inst. de Biologia Roberto Alcantara Gomes. Dept. de Biofisica e Biometria]. E-mail: santos-filho@uer.br; Missailids, Sotiris [The Open University, Milton Keynes (United Kingdom). Dept. of Chemistry and Analytical Sciences

2008-12-15

Prostate (PR) cancer (CA) is one of the most common malignant neoplasms in men all over the world. In general, if prostate cancer (PC) is detected early, treatment usually involves either surgical removal of the prostate or radiotherapy (RT). Hormone Therapy (HT) or chemotherapy (CH) is the preferred treatment for more advanced cases of PC or if CA spreads beyond the PT. A number of complications, such as urinary incontinence (IU) or erectile dysfunction (ED), can be associated with some modalities of treatment of the PC. The aim of this work is to evaluate, in PubMed, the number of publications related with prostate cancer and the main modalities of treatment, as well as some clinical complications. The searches were performed in PubMed (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi) in the period 1950 to 2008 using the words: CA, CA and PR or penis or testis, CA and PR and RT, CA and PR and surgery (SU), CA and PR and CH and, CA and PR and HT and CA and PR and RT and IU or ED, CA and PR and SU and IU or ED, CA and PR and CH and IU or ED and, CA and PR and HT and CH and IU or ED, and (V) PC and the same modalities of treatment. The data was obtained on July 20th, 2008. PC, as expected has been cited extensively and surgery has been identified as the most widely referenced modality of treatment. Furthermore, urinary incontinence and erectile dysfunction are important complications that have attracted significant scientific interest. In conclusion, these findings have shown the relevance of the PubMed to analyze quantitatively the publications in cancer and this information could be worthwhile in aiding the comprehension of some clinical aspects related with PC, as well as the development of preventative actions. The analysis of the scientific interest, considering the number of publications in the PubMed, reveals research trends in the field and demonstrates the importance of the surgical procedures in the treatment of the prostate cancer. Moreover, this finding is

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

OpenAIRE

Hyphantis, Thomas; Katsoudas, Spiros; Voudiclari, Sonia

2010-01-01

Several parameters mediate the selection of treatment modality in end-stage renal disease (ESRD). The nephrology community suggests that patient preference should be the prime determinant of modality choice. We aimed to test whether ego mechanisms of defense are associated with patients? treatment modality preferences, independent of psychological distress. In 58 eligible ESRD patients who had themselves chosen their treatment modality, we administered the Symptom Distress Checklist-90-R and ...

Biological modalities for treatment of acute spinal cord injury: a pilot study and review of the literature

Directory of Open Access Journals (Sweden)

Akbary Kutbuddin

2014-06-01

: The outcome of current study shows that although this modality of treatment is safe for the patients, it provides no additional benefits on improvement of quality of life among these patients. Key words: Spinal cord injuries; Stem cells; Spinal cord regeneration; Bone marrow transplantation

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

Science.gov (United States)

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

2017-07-01

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

Applying radiobiological principles to combined modality treatment of head and neck cancer--the time factor

International Nuclear Information System (INIS)

Peters, Lester J.; Withers, H. Rodney

1997-01-01

Purpose: Combined modality treatment is indicated for most advanced stage head and neck cancers. It is postulated that the efficacy of combined modality regimens could be enhanced by applying principles derived from radiotherapy fractionation studies to optimize the time factor in treatment scheduling. Methods and Materials: The premise that tumor clonogens surviving a therapeutic intervention undergo accelerated repopulation in a time-dependent fashion as their numbers are depleted is used as a model to interpret the results of various chemoradiotherapy and postsurgical radiotherapy protocols and to suggest ways in which future combined modality regimens can be more rationally designed. Results: Meta-analyses of chemoradiotherapy trials show the general superiority of concomitant vs. neoadjuvant sequential protocols. There is also emerging evidence that both the duration of postoperative radiotherapy and the delay in its instigation affect treatment outcome. These results are compatible with the hypothesis that the overall duration of the 'package deal' of combined modality treatment is an important determinant of outcome. However, a large decrease in duration of the 'package deal' does not necessarily translate into a therapeutic gain because the total dose has to be lowered to prevent intolerable acute reactions. In these circumstances tumor control will improve only if the reduced treatment time circumvents more tumor cell regeneration than the cytoreduction that could be achieved by the extra dose tolerable in a longer time period. More modest reductions in treatment time can be accomplished without dose reduction and so avoid this risk. The design of new protocols should take account of the fact that regeneration of tumor clonogens can be predicted to be nonuniform with time. Thus, the greatest therapeutic gain should be achieved by targeting periods of maximal regenerative capacity for shortening or, alternatively, for intensification of treatment. These

Brachytherapy as sole treatment modality in initial cervix carcinoma

International Nuclear Information System (INIS)

Heredia Z, A.

1993-01-01

The aim of this study was to evaluate brachytherapy as the only treatment modality in inoperable early cervix carcinoma patients (carcinoma in situ, IA and IBocc). In a retrospective analysis 36 patients were treated with intracavitary irradiation between 1984 and 1988 in the Radiotherapy Department of the National Institute of Neoplasmic Diseases. Distribution by stage was; carcinoma in situ: one patient (2,47%), IA: six patients (16,6%), IBooc: twenty-nine patients (80,7%). Histology revealed epidermoid carcinoma in all cases. Mean age 55 years (range: 32-78). Treatment consisted in: two intracavitary applications of Radium, for 120 hours each, with a month interval, in 30 patients (carcinoma in situ: one, IA: four, IBocc: twenty-five patients), two applications of 72 hours each, with 15 days interval in four patients (IA: one, IBocc: 3) and one single intracavitary radium application in two patients (IA and IBocc). Local control was complete in all carcinoma in situ and IA patients. Only 1 of 29 patients with IBocc stage failed to respond, in spite of having received two applications, this shows that local response is independent of the number of insertions. Incidence of complications was low, and resolved with medical treatment. One patient had rectal adenocarcinoma 3 years after treatment -it was considered as radio induced neoplasm, since time of appearance was more than two years and localization was within irradiated area. Two patients died form intercurrent diseases, one (IBocc) from persistent diseases. Two patients were lost to follow-up. Three years survival was: 100% for carcinoma in situ and IA 86,2% for IBocc. Five years survival was 80% for IA and IBocc. Brachytherapy as unique modality of treatment is highly effective in initial cervix carcinoma stages. (author). 41 refs., 14 tabs., 2 figs., 1 ill

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

International Nuclear Information System (INIS)

2016-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

NONE

2016-06-15

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

Second malignancy in relation to treatment modality of primary malignancy

International Nuclear Information System (INIS)

Singh, Harpreet; Kaur, Parveen; Vashistha, Rajesh; Singh, Jaskaran; Passi, Kamlesh; Jain, Satish

2001-01-01

Second malignant tumors among long-term survivors are a sensitive indicator of successful oncologic treatment, particularly in this area of multimodal therapy. 11 patients of abdominopelvic primary malignancy were detected to have a second malignancy of different pathology, and at a different site. These patients were assessed regarding treatment modality of initial cancer and time gap between the first and second malignancy. Lack of proper cancer registries, illiteracy, and lack of resources lead to poor patient follow-up; therefore population based studies is not possible

Phototherapy — a treatment modality for wound healing and pain relief

African Journals Online (AJOL)

Phototherapy — a treatment modality for wound healing and pain relief. D Hawkins, H Abrahamse. Abstract. When applied properly, phototherapy or Low Level Laser Therapy (LLLT) has proved to be very efficient in relieving pain and improving wound healing. However, until recently there has been a lack of scientific

Massage and modality effects on treatment of sub-acute and chronic non specific low back pain

Directory of Open Access Journals (Sweden)

Fatemeh Panahi

2011-11-01

Full Text Available Background: Low back pain (LBP is the second most common medical complaint. It’s estimated that about 70-85% of the population will suffer at least one episode of LBP during their life. The aim of present study was to compare the effects of massage and modality in patient with sub-acute and chronic non-specific LBPMethods: In this clinical trial study 30 women (MeanAge: 33.96±10.93 with sub-acute and chronic non-specific LBP (Mean pain-duration:9.68±3.38 were included in the study and randomized into two equal groups; massage and modality. Patients in both group underwent 10 sessions treatment period. Pain (numerical-pain-scale,NRS, functional disability index (oswestry-disability-index,ODI and lumbar-flexion(modified-schober-testwere recorded before and immediately after treatment period. Data was analyzed using paired t-test and independent sample t-test.Results: Significant improvement showed in both groups separately in pain-intensity, disability level, and flexion after treatment (P<0.001. Statically significant improvement was seen in massage group in comparison to modality group for NRS & ODI after treatment (PNRS=0.015, PODI=0.013. There was a not significant change in point of lumber flexion between two groupsConclusion: The results showed that both massage and modality had beneficial effects on the improvement of pain, functional disability and lumbar flexion in patients with non-specific LBP. It seems that massage is better than modality for non-specific LBP in a short period of time.

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

Science.gov (United States)

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

2004-01-01

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

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

Science.gov (United States)

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

2010-03-01

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

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

Science.gov (United States)

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

2013-06-01

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

Complex rectal polyps: other treatment modalities required when offering a transanal endoscopic microsurgery service.

LENUS (Irish Health Repository)

Joyce, Myles R

2011-09-01

Complex rectal polyps may present a clinical challenge. The study aim was to assess different treatment modalities required in the management of patients referred for transanal endoscopic microsurgery.

Total embolization of the main splenic artery as a supplemental treatment modality for hypersplenism

OpenAIRE

He, Xin-Hong; Li, Wen-Tao; Peng, Wei-Jun; Li, Guo-Dong; Wang, Sheng-Ping; Xu, Li-Chao

2011-01-01

AIM: To study the safety and feasibility of total embolization of the main splenic artery as a supplemental treatment modality for hypersplenism with thrombocytopenia or leukocytopenia accompanying liver cirrhosis.

Imaging modalities in radiation treatment planning of brain tumors

International Nuclear Information System (INIS)

Georgiev, D.

2009-01-01

The radiation therapy is a standard treatment after surgery for most of malignant and some of benignant brain tumors. The restriction in acquiring local tumor control is an inability in realization of high dose without causing radiation necrosis in irradiated area and sparing normal tissues. The development of imaging modalities during the last years is responsible for better treatment results and lower early and late toxicity. Essential is the role of image methods not only in the diagnosis and also in the precise anatomical (during last years also functional) localisation, spreading of the tumor, treatment planning process and the effects of the treatment. Target delineation is one of the great geometrical uncertainties in the treatment planning process. Early studies on the use of CT in treatment planning documented that tumor coverage without CT was clearly inadequate in 20% of the patients and marginal in another 27 %. The image fusion of CT, MBI and PET and also the use of contrast materia helps to get over those restrictions. The use of contrast material enhances the signal in 10 % of the patients with glioblastoma multiform and in a higher percentage of the patients with low-grade gliomas

COMPARATIVE STUDY OF EFFICACY OF INJECTION SCLEROTHERAPY VERSUS SURGERY AS PRIMARY MODALITY THERAPY IN PRIMARY VAGINAL HYDROCOELE : A RANDOMISED CONTROL STUDY

OpenAIRE

Jayakarthik; Patil

2015-01-01

CONTEXT (BACKGROUND): Primary/Idiopathic hydrocele is defined as an abnormal collection of serous fluid in tunica vaginalis whose cause is not known as it is neither associated with the disease of testis or epididymis. Surgery is considered as a definitive treatment, though th e reason of injection treatment falling out of favour is ill understood as studies have shown this technique to be efficacious, safe, cost effective treatment modality in idiopathic hydroceles. This...

Treatment modalities for burning mouth syndrome: a systematic review.

Science.gov (United States)

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

2018-06-01

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

Different treatment modalities for refractory vaginismus in western Saudi Arabia.

Science.gov (United States)

Fageeh, Wafa M K

2011-06-01

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

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

Science.gov (United States)

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

2014-01-01

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

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

Science.gov (United States)

Thurber, Steven

2017-06-01

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

Clinical outcomes associated with evolving treatment modalities and radiation techniques for base-of-tongue carcinoma: thirty years of institutional experience

International Nuclear Information System (INIS)

Chen, Leechuan Andy; Anker, Christopher J; Hunt, Jason P; Buchmann, Luke O; Grossmann, Kenneth F; Boucher, Kenneth; Fang, Li-Ming Christine; Shrieve, Dennis C; Hitchcock, Ying J

2015-01-01

Curative treatment for base-of-tongue squamous cell carcinoma (BOT SCC) has evolved over time; however, comparative outcomes analysis for various treatment strategies is lacking. The authors reviewed the evolution of treatment modality and radiotherapy (RT) technique for 231 consecutive BOT SCC patients at our institution between 1981 and 2011. Treatment modalities included definitive chemoradiotherapy (chemoRT) (42%), definitive RT (33%), surgery followed by RT (20%), and surgery alone (5%). RT techniques included external beam plus interstitial brachytherapy (EBRT + IB) (37%), conventional EBRT (29%), intensity-modulated radiation therapy ± simultaneous integrated boost (IMRT ± SIB) (34%). Clinical characteristics and outcomes were stratified by modality or RT technique. Treatment modality evolved from definitive RT (1980s–1990s) to definitive chemoRT (1990s–2000s). RT technique evolved from EBRT + IB (1980s–1990s) to conventional EBRT (1990s–2000s) to IMRT + SIB (2000s). With median alive follow-up of 6 years (0.3–28 years), the 5-year LC, LRC, and OS rates were 80%, 73%, and 51%. There was no difference in distribution of gender, age, stage among treatment modalities. Definitive chemoRT had improved LRC (HR 1.6) and OS (HR 1.7) compared to definitive RT. IMRT + SIB had improved LRC (HR 3.2), DFS (HR 3.4), and OS (HR 3.0) compared to conventional EBRT. Over the past 30 years, BOT SCC treatment has undergone major paradigm shifts that incorporate nonsurgical functional preservation, concurrent chemotherapy, and advanced RT techniques. Excellent locoregional control and survival outcomes are associated with accelerated IMRT with chemotherapy

Increasing Age and Treatment Modality Are Predictors for Subsequent Diagnosis of Bladder Cancer Following Prostate Cancer Diagnosis

International Nuclear Information System (INIS)

Singh, Anurag K.; Mashtare, Terry L.; McCloskey, Susan A.; Seixas-Mikelus, Stefanie A.; Kim, Hyung L.; May, Kilian Salerno

2010-01-01

Purpose: To determine the effect of prostate cancer therapy (surgery or external beam irradiation, or both or none) on the actuarial incidence of subsequent bladder cancer. Methods and Materials: The Surveillance, Epidemiology, and End Results registry from 1973 to 2005 was analyzed. Treatment was stratified as radiotherapy, surgery, both surgery and adjuvant radiation, and neither modality. Brachytherapy was excluded. Results: In all, 555,337 prostate carcinoma patients were identified; 124,141 patients were irradiated; 235,341 patients were treated surgically; 32,744 patients had both surgery and radiation; and 163,111 patients received neither modality. Bladder cancers were diagnosed in: 1,836 (1.48%) men who were irradiated (mean age, 69.4 years), 2,753 (1.09%) men who were treated surgically (mean age, 66.9 years); 683 (2.09%) men who received both modalities (mean age, 67.4 years), and 1,603 (0.98%) men who were treated with neither modality (mean age, 71.8 years). In each treatment cohort, Kaplan-Meier analyses showed that increasing age (by decade) was a significant predictor of developing bladder cancer (p < 0.0001). Incidence of bladder cancer was significantly different for either radiation or surgery alone versus no treatment, radiation versus surgery alone, and both surgery and radiation versus either modality alone (p < 0.0001). On multivariate analysis, age and irradiation were highly significant predictors of being diagnosed with bladder cancer. Conclusions: Following prostate cancer, increasing age and irradiation were highly significant predictors of being diagnosed with bladder cancer. While use of radiation increased the risk of bladder cancer compared to surgery alone or no treatment, the overall incidence of subsequent bladder cancer remained low. Routine bladder cancer surveillance is not warranted.

Engineered core-shell magnetic nanoparticle for MR dual-modal tracking and safe magnetic manipulation of ependymal cells in live rodents

Science.gov (United States)

Peng, Yung-Kang; Lui, Cathy N. P.; Chen, Yu-Wei; Chou, Shang-Wei; Chou, Pi-Tai; Yung, Ken K. L.; Edman Tsang, S. C.

2018-01-01

Tagging recognition group(s) on superparamagnetic iron oxide is known to aid localisation (imaging), stimulation and separation of biological entities using magnetic resonance imaging (MRI) and magnetic agitation/separation (MAS) techniques. Despite the wide applicability of iron oxide nanoparticles in T 2-weighted MRI and MAS, the quality of the images and safe manipulation of the exceptionally delicate neural cells in a live brain are currently the key challenges. Here, we demonstrate the engineered manganese oxide clusters-iron oxide core-shell nanoparticle as an MR dual-modal contrast agent for neural stem cells (NSCs) imaging and magnetic manipulation in live rodents. As a result, using this engineered nanoparticle and associated technologies, identification, stimulation and transportation of labelled potentially multipotent NSCs from a specific location of a live brain to another by magnetic means for self-healing therapy can therefore be made possible.

Evaluation of treatment results in patients with early glottic cancer (stage T 1a N 0, T 1b N 0) treated with Manchester irradiation modality

International Nuclear Information System (INIS)

Przeorek, W.; Skladowski, K.; Przeorek, C.

2007-01-01

Data charts of 64 patients with stage I glottic cancer treated with Manchester irradiation modality in the 1 st Radiotherapy Clinic of Msc Memorial Institute in Gliwice has been retrospectively analyzed. There were 55 males and 9 females at median age 63 years (range from 37 to 83 years). In 40 (62%) patients pathological subtype of squamous cell cancer has not been established. In 19 (30%) patients microscopic examination revealed keratinizing and in 5 (8%) nonkeratinizing type of neoplasm. In 49 (77%) patients the tumour involved only one vocal cord, in 11 (17%) both, in 3 (5%) vocal cord and commissure and 1 (1%) patient both cords and commissure. All patients were treated with 60C o machines (36 patients - 56%) or high energy photons (28 patients - 44%). Radiotherapy was conducted with so called Manchester modality with one daily fraction of 3 Gy to a total dose of 51-54 Gy. Overall treatment time varied between 21 and 23 days. Acute mucosal reaction was evaluated with the morphological-functional Dische scale as well as with the EORTC/RTOG scoring system. The criteria of treatment efficacy were: 5-year local control, 5-year survival without serious complications (3 and 4 EORTC) and 5-year survival after salvage surgery in relapsed patients. In 63 patients complete regression of the tumour was observed up to 6 months of follow-up. One patient failed at the time of radiotherapy ending. In one case distant metastases to lungs were noticed. In 6 patients local relapses were discovered of which 3 were successfully salvaged with the surgery. In one patient, 18 months after radiotherapy massive oedema of laryngeal mucosa occurred. In this case tracheostomy was needed. 5-year local control, local control after salvage surgery and survival without serious complication rates are 89%, 97% and 95% respectively. 1. Radiotherapy with Manchester modality is a safe and effective treatment of stage I glottic cancer. 2. Despite hypofractionation the risk of severe complication

Super-compactor and grouting. Efficient and safe treatment of nuclear waste

International Nuclear Information System (INIS)

Li, Hongyou; Starke, Holger; Muetzel, Wolfgang; Winter, Marc

2014-01-01

The conditioning and volume reduction of nuclear waste are increasingly important factors throughout the world. Efficient and safe treatment of nuclear waste therefore plays a decisive role. Babcock Noell designed, manufactured and supplied a complete waste treatment facility for conditioning of the solid radioactive waste of a nuclear power plant to China. This facility consists of a Sorting Station, a Super-Compactor, a Grouting Unit with Capping Device and other auxiliary equipment which is described in more detail in the following article. This article gives an overview of the efficient and safe treatment of nuclear waste. Babcock Noell is a subsidiary of the Bilfinger Power Systems and has 40 years of experience in the field of design, engineering, construction, static and dynamic calculations, manufacturing, installation, commissioning, as well as in the service and operation of a wide variety of nuclear components and facilities worldwide.

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

Science.gov (United States)

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

2017-05-01

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

Pseudofolliculitis barbae: review and update on new treatment modalities.

Science.gov (United States)

Garcia-Zuazaga, Jorge

2003-07-01

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

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

Science.gov (United States)

Hyphantis, Thomas; Katsoudas, Spiros; Voudiclari, Sonia

2010-03-24

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

SU-E-T-01: (In)dependence of Plan Quality On Treatment Modalities and Target-To-Critical Structure Geometry for Brain Tumor

Energy Technology Data Exchange (ETDEWEB)

Ruan, D; Shao, W; Low, D; Kupelian, P; Qi, S X [UCLA, Los Angeles, CA (United States)

2015-06-15

Purpose: To evaluate and test the hypothesis that plan quality may be systematically affected by treatment delivery techniques and target-tocritical structure geometric relationship in radiotherapy for brain tumor. Methods: Thirty-four consecutive brain tumor patients treated between 2011–2014 were analyzed. Among this cohort, 10 were planned with 3DCRT, 11 with RadipArc, and 13 with helical IMRT on TomoTherapy. The selected dosimetric endpoints (i.e., PTV V100, maximum brainstem/chiasm/ optic nerve doses) were considered as a vector in a highdimensional space. A Pareto analysis was performed to identify the subset of Pareto-efficient plans.The geometric relationships, specifically the overlapping volume and centroid-of-mass distance between each critical structure to the PTV were extracted as potential geometric features. The classification-tree analyses were repeated using these geometric features with and without the treatment modality as an additional categorical predictor. In both scenarios, the dominant features to prognosticate the Pareto membership were identified and the tree structures to provide optimal inference were recorded. The classification performance was further analyzed to determine the role of treatment modality in affecting plan quality. Results: Seven Pareto-efficient plans were identified based on dosimetric endpoints (3 from 3DCRT, 3 from RapicArc, 1 from Tomo), which implies that the evaluated treatment modality may have a minor influence on plan quality. Classification trees with/without the treatment modality as a predictor both achieved accuracy of 88.2%: with 100% sensitivity and 87.1% specificity for the former, and 66.7% sensitivity and 96.0% specificity for the latter. The coincidence of accuracy from both analyses further indicates no-to-weak dependence of plan quality on treatment modality. Both analyses have identified the brainstem to PTV distance as the primary predictive feature for Pareto-efficiency. Conclusion: Pareto

SU-E-T-01: (In)dependence of Plan Quality On Treatment Modalities and Target-To-Critical Structure Geometry for Brain Tumor

International Nuclear Information System (INIS)

Ruan, D; Shao, W; Low, D; Kupelian, P; Qi, S X

2015-01-01

Purpose: To evaluate and test the hypothesis that plan quality may be systematically affected by treatment delivery techniques and target-tocritical structure geometric relationship in radiotherapy for brain tumor. Methods: Thirty-four consecutive brain tumor patients treated between 2011–2014 were analyzed. Among this cohort, 10 were planned with 3DCRT, 11 with RadipArc, and 13 with helical IMRT on TomoTherapy. The selected dosimetric endpoints (i.e., PTV V100, maximum brainstem/chiasm/ optic nerve doses) were considered as a vector in a highdimensional space. A Pareto analysis was performed to identify the subset of Pareto-efficient plans.The geometric relationships, specifically the overlapping volume and centroid-of-mass distance between each critical structure to the PTV were extracted as potential geometric features. The classification-tree analyses were repeated using these geometric features with and without the treatment modality as an additional categorical predictor. In both scenarios, the dominant features to prognosticate the Pareto membership were identified and the tree structures to provide optimal inference were recorded. The classification performance was further analyzed to determine the role of treatment modality in affecting plan quality. Results: Seven Pareto-efficient plans were identified based on dosimetric endpoints (3 from 3DCRT, 3 from RapicArc, 1 from Tomo), which implies that the evaluated treatment modality may have a minor influence on plan quality. Classification trees with/without the treatment modality as a predictor both achieved accuracy of 88.2%: with 100% sensitivity and 87.1% specificity for the former, and 66.7% sensitivity and 96.0% specificity for the latter. The coincidence of accuracy from both analyses further indicates no-to-weak dependence of plan quality on treatment modality. Both analyses have identified the brainstem to PTV distance as the primary predictive feature for Pareto-efficiency. Conclusion: Pareto

Management of the obstructive sleep apnoea syndrome: More knowledge required for an optimal choice of treatment modality

NARCIS (Netherlands)

Hoekema, A

2006-01-01

In the management of the obstructive sleep apnoea syndrome (OSAS), clinicians may consider various conservative, non-invasive and surgical treatment modalities. Continuous positive airway pressure (CPAP) is regarded as the treatment of choice for, especially, moderate to severe OSAS. However, due to

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

Science.gov (United States)

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

2013-01-01

The aims of this paper are to examine the relationship between psychological trauma symptoms and Type 2 diabetes prevalence, glucose control, and treatment modality among 3776 American Indians in Phase V of the Strong Heart Family Study. This cross-sectional analysis measured psychological trauma symptoms using the National Anxiety Disorder Screening Day instrument, diabetes by American Diabetes Association criteria, and treatment modality by four categories: no medication, oral medication only, insulin only, or both oral medication and insulin. We used binary logistic regression to evaluate the association between psychological trauma symptoms and diabetes prevalence. We used ordinary least squares regression to evaluate the association between psychological trauma symptoms and glucose control. We used binary logistic regression to model the association of psychological trauma symptoms with treatment modality. Neither diabetes prevalence (22%-31%; p=0.19) nor control (8.0-8.6; p=0.25) varied significantly by psychological trauma symptoms categories. However, diabetes treatment modality was associated with psychological trauma symptoms categories, as people with greater burden used either no medication, or both oral and insulin medications (odds ratio=3.1, ppsychological trauma symptoms suggests future research investigate patient and provider treatment decision making. © 2013.

Treatment Modality-Dependent Risk of Diabetic Ketoacidosis in Patients with Type 1 Diabetes

DEFF Research Database (Denmark)

Hoshina, Sari; Andersen, Gregers S; Jørgensen, Marit E

2018-01-01

BACKGROUND AND AIMS: The aim of this study was to evaluate the incidence rates of diabetic ketoacidosis (DKA) according to treatment modality in patients with type 1 diabetes (T1D) in Denmark, either multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII). MATERIALS AND...... events were lower among CSII users, while the opposite was true for the smaller clinics (P = 0.016). CONCLUSIONS: Delivery of CSII in large diabetes clinics with sufficient support and patient education may ensure that CSII treatment does not lead to an increased risk of DKA....

Environmentally safe system for treatment of bio corrosion of ETICS

Directory of Open Access Journals (Sweden)

Minarovičová Katarína

2018-01-01

Full Text Available Effects of microorganisms on building facades are responsible for aesthetic, bio-geophysical and biogeochemical deterioration. The process of cleaning of contaminated facades involves the removal and eradication of micro flora on the surface of insulation using chemical products, killing cells and eliminating all living mass, including organic ingredients. The removal of bio corrosion coating from ETICS structure by means of chemical and preservative substances (biocides is currently the only effective and most used technology. Uncontrolled leaching of the used biocides is unacceptable. Meantime, new technology for environmentally safe maintenance of ETICS is needed. Scientists have been working on replacement the biocides currently used in facades treatment with eco-friendly biocides that have no negative effects on the environment or human beings. While the eco- treatment will be available, safe dewatering of chemicals being leached from the surface of the facade could be provided by e.g. special drain systems adjusted to the building type, use and age. The paper gives an overview of the problem in context of Slovakia and examples of leaching systems designed for new and renovated buildings.

Treatment Modalities in Adolescents Who present With Heavy Menstrual Bleeding.

Science.gov (United States)

Alaqzam, Tasneem S; Stanley, Angela C; Simpson, Pippa M; Flood, Veronica H; Menon, Seema

2018-03-07

This study sought to determine the relationship of bleeding disorders to iron deficiency anemia. Additionally, this study was undertaken to examine all current treatment modalities used in a menorrhagia clinic with respect to heavy menstrual bleeding management to identify the most effective options for menstrual management in the setting of an underlying bleeding disorder. DESIGN, SETTING, PARTICIPANT, INTERVENTION, AND MAIN OUTCOME MEASURES: Retrospective chart review of adolescent <21 years with heavy menstrual bleeding attending a multidisciplinary hematology-adolescent gynecology clinic. Information included demographics, bleeding diathesis, hematologic parameters, treatment, and the diagnosis was extracted from each chart. Subjects were grouped into two categories based on the diagnosis of a bleeding disorder. Hemoglobin level, iron deficiency anemia, and need for transfusion were compared between a bleeding disorder and no bleeding disorder group. Subjects were grouped into categories depending on hormonal modality and treatment success of the groups were compared. 73 subjects tested for a bleeding disorder. Of the subjects completing testing, 34 (46%) were diagnosed with a bleeding disorders. 39 (54%) subjects had heavy menstrual bleeding due to other causes. There was no significant difference in hemoglobin between those with and without a bleeding disorder. Iron deficiency anemia was significantly higher in subjects without bleeding disorder. When comparing hormone therapy success, the levonorgestrel IUD (LNG-IUD) (89%) had the highest rate of menstrual suppression followed by norethindrone acetate 5-10mg/day (83%), and the transdermal patch (80%). All subjects using both tranexamic acid and hormonal therapy had 100% achievement of menstrual suppression. A high frequency of bleeding disorder was found in those tested. Subjects with a bleeding disorder were less likely to present with severe anemia requiring blood transfusion and less likely to have iron

High energy devices versus low energy devices in orthopedics treatment modalities

Science.gov (United States)

Schultheiss, Reiner

2003-10-01

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

Radiotherapy as an effective treatment modality for follicular lymphoma: a single institution experience

Energy Technology Data Exchange (ETDEWEB)

Choi, Seo Hee; Cho, Jae Ho; Kim, Jin Seok; Cheong, June Won; Suh, Chang Ok [Dept. of Radiation Oncology, Yonsei University College of Medicine, Seoul (Korea, Republic of)

2015-12-15

Follicular lymphoma (FL) is an indolent non-Hodgkin's lymphoma that is highly sensitive to radiotherapy (RT). However, the effectiveness of RT has not been well established. We reviewed our experiences to assess the role of RT for FL and analyze treatment results. Retrospective analysis was done on 29 patients who received first RT between January 2003 and August 2013. Of 23 early stage (stage I, II) patients, 16 received RT alone, four received chemotherapy followed by RT, two received RT postoperatively, and one received salvage RT for relapse after resection. Six advanced-stage (stage III, IV) patients received RT after chemotherapy: two received consolidation RT, three received salvage RT for residual lesions, and one received RT for progressive sites. Median RT dose was 30.6 Gy (range, 21.6 to 48.6 Gy). Median follow-up duration was 62 months (range, 6 to 141 months). All patients showed complete response in the radiation field. Eight outfield relapses were reported. Seven patients received salvage treatment (three chemotherapy, four RT). Four patients showed excellent responses, especially to RT. Estimated 5-year and 10-year relapse-free survivals were 72% and 60%. In the RT-alone group, 5-year relapse-free survival was 74.5%. All advanced-stage patients were disease-free with 100% 5-year overall survival. Disease-specific death was noted in only one patient; four others died of other unrelated causes. No significant toxicity was reported. RT resulted in excellent treatment outcomes for all FL stages when used as a primary treatment modality for early stage or salvage-treatment modality for advanced-stage disease.

Effectiveness of psychotherapy in personality disorders not otherwise specified : A comparison of different treatment modalities

NARCIS (Netherlands)

Horn, E.K.; Bartak, A.; Meerman, A.M.M.A.; Rossum, B.V.; Ziegler, U.M.; Thunissen, M.A.G.; Soons, M.; Andrea, H.; Hamers, E.F.M.; Emmelkamp, P.M.G.; Stijnen, T.; Busschbach, J.J.V.; Verheul, R.

2015-01-01

Objective Although personality disorder not otherwise specified (PDNOS) is highly prevalent and associated with a high burden of disease, only a few treatment studies in this patient group exist. This study is the first to investigate the effectiveness of different modalities of psychotherapy in

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

Science.gov (United States)

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

2017-06-01

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

Spatial Analysis of Case-Mix and Dialysis Modality Associations.

Science.gov (United States)

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

2016-01-01

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

Single-tooth replacement: factors affecting different prosthetic treatment modalities

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Al-Quran Firas A

2011-12-01

Full Text Available Abstract Background The choice between several treatment options for replacing a single missing tooth is influenced by clinical, dentist- and patient-immanent factors. This study aimed to determine the patient factors that would affect the treatment decision to replace a single missing tooth and to assess the satisfaction with several options. Method 200 volunteers involved (121 females and 79 males divided into four groups, Group A: consisted of patients with conventional fixed partial dentures or patients with resin bonded fixed partial dentures. Group B: consisted of patients who received removable partial dentures while Group C: consisted of patients who received a single implant supported crown, and a control group D: consisted of patients who received no treatment. Data were collected using a questionnaire. Results The highest percentage of males within groups (58% was within the removable prostheses category. The majority of the subjects in the study reported that the main reason for replacing a missing tooth was for esthetic and function. Most important factor affecting the choice between treatment modalities was damaging the neighboring teeth. Pain, post operative sensitivity and dental phobia were important factors in choosing the prosthesis type and affected the control group patients not to have any treatment. The highest satisfaction percentage among groups studied was recorded for dental implants then FPD groups, while the least percentage were in both the control and RPD groups, for all aspects of function, esthetic and speech efficiency. Conclusions The final choice between FPD, RPD and implant depended on several factors which affected the decision making; among these is cost and patients' awareness of the different treatment options.

Indications for and results of combined modality treatment of colorectal cancer

International Nuclear Information System (INIS)

Gunderson, L.L.

1999-01-01

Combined modality chemoirradiation is commonly used as a component of treatment in combination with maximum resection for both high-risk resectable and locally advanced primary or recurrent rectal cancers. With surgically resected but high-risk rectal cancers, postoperative chemoirradiation has been shown to improve both disease control (local and distant) and survival (disease-free and overall) and was recommended as standard adjuvant treatment at the 1990 National Institute of Health (NIH) Consensus Conference on Adjuvant treatment for patients with rectal and colon cancers. Subsequent intergroup trials are being conducted to help define optimal combinations of postoperative chemoirradiation for resected high-risk rectal cancers and to test sequencing issues of preoperative versus postoperative chemoirradiation. With locally unresectable primary or recurrent colorectal cancers, standard therapy with surgery, external beam irradiation (EBRT) and chemotherapy is often unsuccessful. When intraoperative electron irradiation (IOERT) is combined with standard treatment, local control and survival appear to be improved in separate analyses from the Mayo Clinic and the Massachusetts General Hospital (MGH). However, routine use of systemic therapy is also needed as a component of treatment, in view of high rates of systemic failure. (orig.)

Indications for and results of combined modality treatment of colorectal cancer

Energy Technology Data Exchange (ETDEWEB)

Gunderson, L.L. [Mayo Medical School and Mayo Clinic, Rochester, MN (United States)

1999-05-01

Combined modality chemoirradiation is commonly used as a component of treatment in combination with maximum resection for both high-risk resectable and locally advanced primary or recurrent rectal cancers. With surgically resected but high-risk rectal cancers, postoperative chemoirradiation has been shown to improve both disease control (local and distant) and survival (disease-free and overall) and was recommended as standard adjuvant treatment at the 1990 National Institute of Health (NIH) Consensus Conference on Adjuvant treatment for patients with rectal and colon cancers. Subsequent intergroup trials are being conducted to help define optimal combinations of postoperative chemoirradiation for resected high-risk rectal cancers and to test sequencing issues of preoperative versus postoperative chemoirradiation. With locally unresectable primary or recurrent colorectal cancers, standard therapy with surgery, external beam irradiation (EBRT) and chemotherapy is often unsuccessful. When intraoperative electron irradiation (IOERT) is combined with standard treatment, local control and survival appear to be improved in separate analyses from the Mayo Clinic and the Massachusetts General Hospital (MGH). However, routine use of systemic therapy is also needed as a component of treatment, in view of high rates of systemic failure. (orig.)

Multiple collagenase injections are safe for treatment of Dupuytren's contractures.

Science.gov (United States)

Gajendran, Varun K; Hentz, Vincent; Kenney, Deborah; Curtin, Catherine M

2014-07-01

The authors report the case of a 65-year-old, right-hand-dominant man who had severe Dupuytren's disease with multiple cords and flexion contractures of the metacarpophalangeal and proximal interphalangeal joints of both hands and underwent repeated collagenase injections for treatment. Collagenase has been shown to be safe and effective in the treatment of Dupuytren's contractures when administered as a single dose, but the results of multiple injections over a prolonged period are unknown. Antibodies to collagenase develop in all patients after several treatments, raising concerns about safety and efficacy as a result of sensitization from repeated exposures. The antibodies generated as a result of repeated exposure to collagenase could theoretically render it less effective with time and could also lead to immune reactions as severe as anaphylaxis. The authors present the case of a single patient who experienced continued correction of his contractures with only minor and self-limited adverse reactions after administration of 12 collagenase doses through 15 injections during a 4-year period. Over time, the injections continued to be effective at correcting metacarpophalangeal joint contractures, but less effective at correcting proximal interphalangeal joint contractures. The patient did eventually require a fasciectomy, but the safety and modest success of the repeated collagenase injections shows promise for a less invasive treatment with a better risk profile than open fasciectomy. Although further studies are needed, repeated administration of collagenase appears to be safe and modestly effective for severe Dupuytren's contractures, although a fasciectomy may ultimately be required in the most severe cases. Copyright 2014, SLACK Incorporated.

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

Science.gov (United States)

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

2014-01-01

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

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

NARCIS (Netherlands)

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

2018-01-01

OBJECTIVE: Key for successful jugulotympanic paraganglioma management is a personalised approach aiming for the best practice for each individual patient. To this end, a systematic review is performed, evaluating the local control and complication rates for the different treatment modalities

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

Science.gov (United States)

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

2016-04-01

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

Physical modalities in chronic pain management.

Science.gov (United States)

Rakel, Barbara; Barr, John O

2003-09-01

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

Bioartificial liver and liver transplantation: new modalities for the treatment of liver failure

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DING Yitao

2017-09-01

Full Text Available The main features of liver failure are extensive necrosis of hepatocytes, rapid disease progression, and poor prognosis, and at present, there are no effective drugs and methods for the treatment of liver failure. This article summarizes four treatment methods for liver failure, i.e., medical treatment, cell transplantation, liver transplantation, and artificial liver support therapy, and elaborates on the existing treatment methods. The current medical treatment regimen should be optimized; cell transplantation has not been used in clinical practice; liver transplantation is the most effective method, but it is limited by donor liver shortage and high costs; artificial liver can effectively remove toxic substances in human body. Therefore, this article puts forward artificial liver as a transition for liver transplantation; artificial liver can buy time for liver regeneration or liver transplantation and prolong patients′ survival time and thus has a promising future. The new treatment modality of bioartificial liver combined with liver transplantation may bring good news to patients with liver failure.

The Effects of Response Effort on Safe Performance by Therapists at an Autism Treatment Facility

Science.gov (United States)

Casella, Sarah E.; Wilder, David A.; Neidert, Pamela; Rey, Catalina; Compton, Megan; Chong, Ivy

2010-01-01

The effects of response effort on safe behaviors (i.e., glove wearing, hand sanitizing, and electrical outlet replacement) exhibited by therapists at an autism treatment center were examined. Participants were exposed to 2 or 3 levels of effort (i.e., high, medium, low) for each dependent variable. Results showed increased safe performance during…

Pressure ulcers: Current understanding and newer modalities of treatment

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Surajit Bhattacharya

2015-01-01

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

Pressure ulcers: Current understanding and newer modalities of treatment

Science.gov (United States)

Bhattacharya, Surajit; Mishra, R. K.

2015-01-01

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

Selected Physical Therapy Modalities for the treatment of Diabetic Polyneuropathy

International Nuclear Information System (INIS)

Sawan, S.; Sayed, N.; Al-Gazzar, S.

2006-01-01

The purpose of this study was to examine the effect of using selected physical therapy modalities for the treatment of diabetic polyneuropathy. Thirty patients participated in this study. Patients were randomly divided into study group (ten males and five females) and control group (six males and nine females). The study group received interferential current on the lumbosacral region, followed by repeated contraction as specific technique of proprioceptive neuromuscular facilitation (PNF) to the anterior tibial group muscles. The control group did not receive physical therapy treatment. The treatment for the study group was conducted three times per week, for a period of six weeks. The patients were assessed for intensity of pain, manual muscle testing of the anterior tibial group muscles, and the level of superficial sensation on their feet. Patients were assessed the beginning of the treatment session and after the last session. The result of this study showed a significant decrease in the pain intensity, increase anterior tibial group muscles strength and increase level of superficial sensation in patients of study group in comparison to the control group at the end of the treatment. The control group did not show significant changes. It can be concluded that the combination of interferential current and repeated contraction (specific technique of PNF to the anterior tibial group muscles) is effective in decreasing the pain, increasing anterior tibial group muscles strength and the level of superficial sensation in patients suffering from diabetic polyneuropathy. (author)

Paracetamol in Patent Ductus Arteriosus Treatment: Efficacious and Safe?

Science.gov (United States)

Bardanzellu, Flaminia; Neroni, Paola; Fanos, Vassilios

2017-01-01

In preterm infants, failure or delay in spontaneous closure of Ductus Arteriosus (DA), resulting in the condition of Patent Ductus Arteriosus (PDA), represents a significant issue. A prolonged situation of PDA can be associated with several short- and long-term complications. Despite years of researches and clinical experience on PDA management, unresolved questions about the treatment and heterogeneity of clinical practices in different centers still remain, in particular regarding timing and modality of intervention. Nowadays, the most reasonable strategy seems to be reserving the treatment only to hemodynamically significant PDA. The first-line therapy is medical, and ibuprofen, related to several side effects especially in terms of nephrotoxicity, is the drug of choice. Administration of oral or intravenous paracetamol (acetaminophen) recently gained attention, appearing effective as traditional nonsteroidal anti-inflammatory drugs (NSAIDs) in PDA closure, with lower toxicity. The results of the studies analyzed in this review mostly support paracetamol efficacy in ductal closure, with inconstant low and transient elevation of liver enzymes as reported side effect. However, more studies are needed to confirm if this therapy shows a real safety profile and to evaluate its long-term outcomes, before considering paracetamol as first-choice drug in PDA treatment. PMID:28828381

Paracetamol in Patent Ductus Arteriosus Treatment: Efficacious and Safe?

Directory of Open Access Journals (Sweden)

Flaminia Bardanzellu

2017-01-01

Full Text Available In preterm infants, failure or delay in spontaneous closure of Ductus Arteriosus (DA, resulting in the condition of Patent Ductus Arteriosus (PDA, represents a significant issue. A prolonged situation of PDA can be associated with several short- and long-term complications. Despite years of researches and clinical experience on PDA management, unresolved questions about the treatment and heterogeneity of clinical practices in different centers still remain, in particular regarding timing and modality of intervention. Nowadays, the most reasonable strategy seems to be reserving the treatment only to hemodynamically significant PDA. The first-line therapy is medical, and ibuprofen, related to several side effects especially in terms of nephrotoxicity, is the drug of choice. Administration of oral or intravenous paracetamol (acetaminophen recently gained attention, appearing effective as traditional nonsteroidal anti-inflammatory drugs (NSAIDs in PDA closure, with lower toxicity. The results of the studies analyzed in this review mostly support paracetamol efficacy in ductal closure, with inconstant low and transient elevation of liver enzymes as reported side effect. However, more studies are needed to confirm if this therapy shows a real safety profile and to evaluate its long-term outcomes, before considering paracetamol as first-choice drug in PDA treatment.

Saphenofemoral ligation as a safe and effective alternative for the treatment of chronic venous leg ulcer

International Nuclear Information System (INIS)

El-Hafez, Emad A.; Seleem, Mohamed I.

2004-01-01

To evaluate the effectiveness and safety of isolated saphenofemoral junction ligation for the treatment of chronic venous leg ulcer in comparison to traditional stripping procedure. 36 patients (28 men and 8 women) with mean age of 42.3+-8.7, presented with a venous leg ulcer. After taking the full history, they underwent examination for presence of edema, cellulitis or local ulcer infection. The site and size of ulceration were recorded and ankle-brachial pressure index (ABPI) was measured, Venous valvular incompetence was assessed using Valsalva testand calf compression. Patients were divided into 2 groups. Group I, (n=10) assigned for long saphenous stripping, while group II (n=26) assigned for saphenofemoral ligationan and divided combined with ligation of major tributaries under local infiltration anesthesia. Mean operative time, postoperative complications and hospital stay were recorded. The study was carried out in Benha University Hospital, Egypt and Armed Forces Hospital, Southern Region, Khamis Mushayt, Sadi Arabia between January 2000 and December 2001. The mean operative time and the hospital stay were significantly (p<0.05) reduced in group II compared to group I. The postoperative complications were signficantly (x=7.5, p<0.05) reduced in group II. Ulcer healing started after 3 months in group II and six months in group I, but by 12 month, group II had significant (x=6.7, p<0.05) number of healed ulcers (n=22, 84.6%), compared to group I (n=7, 70%). The isolated ligation of of saphenofemoral junction is a minimally invasive, safe and effective modality for treatment of chronic leg ulcer, and being easily performed under local anesthesia and considerd to be a satisfactory procedure for treatment of leg ulcer in patients who are unfit for general anesthesia. (author)

Vacuum extraction as a treatment modality of neonatal skull depression in twin infant

International Nuclear Information System (INIS)

Amin, Adnan M.; Al-Zeky, Alaauddin M.; El-Azm, M.

2007-01-01

The management of depressed skull fractures in the newborn infant can be controversial. In this article, we report a case of twin pregnancy wherein one of the fetuses had depressed skull fractures that was not associated with any known trauma during the pregnancy or at delivery. This p ing-pong skull depression was treated by elevation with an obstetrical vacuum extractor. No complications occurred. The possible etiologies and treatment modalities for neonatal depressed fractures, being conservative or operative, are discussed. (author)

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

Science.gov (United States)

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

2017-01-05

Solitary plasmacytoma (SP) is a localized neoplastic plasma cell disorder with an annual incidence of less than 450 cases. Given the rarity of this disorder, it is difficult to conduct large-scale population studies. Consequently, very limited information on the disorder is available, making it difficult to estimate the incidence and survival rates. Furthermore, limited information is available on the efficacy of various treatment modalities in relation to primary tumor sites. The data for this retrospective study were drawn from the Surveillance, Epidemiology and End Results (SEER) database, which comprises 18 registries; patient demographics, treatment modalities and survival rates were obtained for those diagnosed with SP from 1998 to 2007. Various prognostic factors were analyzed via Kaplan-Meier analysis and log-rank test, with 5-year relative survival rate defined as the primary outcome of interest. Cox regression analysis was employed in the multivariate analysis. The SEER search from 1998 to 2007 yielded records for 1691 SP patients. The median age at diagnosis was 63 years. The patient cohort was 62.4% male, 37.6% female, 80% Caucasian, 14.6% African American and 5.4% other races. Additionally, 57.8% had osseous plasmacytoma, and 31.9% had extraosseous involvement. Unspecified plasmacytoma was noted in 10.2% of patients. The most common treatment modalities were radiotherapy (RT) (48.8%), followed by combination surgery with RT (21.2%) and surgery alone (11.6%). Univariate analysis of prognostic factors revealed that the survival outcomes were better for younger male patients who received RT with surgery (p multiple myeloma (MM) was noted in 551 patients. Age >60 years was associated with a lower 5-year survival in patients who progressed to MM compared to those who were diagnosed initially with MM (15.1 vs 16.6%). Finally, those who received RT and progressed to MM still had a higher chance of survival than those who were diagnosed with MM initially and

Novel methotrexate soft nanocarrier/fractional erbium YAG laser combination for clinical treatment of plaque psoriasis.

Science.gov (United States)

Ramez, Shahenda A; Soliman, Mona M; Fadel, Maha; Nour El-Deen, Faisal; Nasr, Maha; Youness, Eman R; Aboel-Fadl, Dalea M

2018-02-15

Psoriasis is a commonly encountered chronic dermatological disease, presenting with inflammatory symptoms in patients. Systemic treatment of psoriasis is associated with several adverse effects, therefore the development of a customized topical treatment modality for psoriasis would be an interesting alternative to systemic delivery. The therapeutic modality explored in this article was the comparative treatment of psoriatic patients using nanoparticulated methotrexate in the form of jojoba oil-based microemulsion with or without fractional erbium YAG laser. Assessment parameters included follow-up photography for up to 8 weeks of treatment, estimation of the psoriasis severity [TES (thickness, erythema, scales)] score, and histopathological skin evaluation. The prepared methotrexate microemulsion was clinically beneficial and safe in treatment of psoriasis vulgaris. The concomitant use of the fractional laser provided improvement in the psoriatic plaques within shorter time duration (3 weeks compared to 8 weeks of treatment), presenting an alternative topical treatment modality for psoriasis vulgaris.

The influence of treatment modality on illness perception and secondary prevention outcomes among patients with acute myocardial infarction

Directory of Open Access Journals (Sweden)

Ahmed Mohammad Al-Smadi

2017-07-01

Conclusion: The results of this study revealed that patients' treated with primary percutaneous coronary intervention had negative illness perception and limited behavioral changes 6 months after hospitalization in comparison with other treatment modalities such as percutaneous coronary intervention and thrombolytic treatment. Further research is recommended to confirm this association with longer follow-up study and among different cultures.

Technology for safe treatment of radioisotope organic wastes

Energy Technology Data Exchange (ETDEWEB)

Oh, Won Jin; Park, Chong Mook; Choi, W. K.; Lee, K. W.; Moon, J. K.; Yang, H. Y.; Kim, B. T.; Park, S. C

1999-12-01

An examination of chemical and radiological characteristics of RI organic liquid waste, wet oxidation by Fenton reaction and decomposition liquid waste treatment process were studied. These items will be applied to develop the equipment of wet oxidation and decomposition liquid waste treatment mixed processes for the safe treatment of RI organic liquid waste which is consisted of organic solvents such as toluene, alcohol and acetone. Two types of toluene solutions were selected as a candidate decomposition material. As for the first type, the concentration of toluene was above 20 vol percent. As for the second type, the solubility of toluene was considered. The decomposition ration by Fenton reaction was above 95 percent for both of them. From the adsorption equilibrium tests, a -Na{sup +} substituted/acid treated activated carbon and Zeocarbon mixed adsorbent was selected for the fixed adsorption column. This mixed adsorbent will be used to obtain the basic design data of liquid waste purification equipment for the treatment of decomposition liquid waste arising from the wet oxidation process. Solidification and degree of strength tests were performed with the simulated sludge/spent adsorbent of MgO as an oxide type and KH{sub 2}PO{sub 4}. From the test results, the design and fabrication of wet oxidation and liquid waste purification process equipment was made, and a performance test was carried out. (author)

Technology for safe treatment of radioisotope organic wastes

International Nuclear Information System (INIS)

Oh, Won Jin; Park, Chong Mook; Choi, W. K.; Lee, K. W.; Moon, J. K.; Yang, H. Y.; Kim, B. T.; Park, S. C.

1999-12-01

An examination of chemical and radiological characteristics of RI organic liquid waste, wet oxidation by Fenton reaction and decomposition liquid waste treatment process were studied. These items will be applied to develop the equipment of wet oxidation and decomposition liquid waste treatment mixed processes for the safe treatment of RI organic liquid waste which is consisted of organic solvents such as toluene, alcohol and acetone. Two types of toluene solutions were selected as a candidate decomposition material. As for the first type, the concentration of toluene was above 20 vol percent. As for the second type, the solubility of toluene was considered. The decomposition ration by Fenton reaction was above 95 percent for both of them. From the adsorption equilibrium tests, a -Na + substituted/acid treated activated carbon and Zeocarbon mixed adsorbent was selected for the fixed adsorption column. This mixed adsorbent will be used to obtain the basic design data of liquid waste purification equipment for the treatment of decomposition liquid waste arising from the wet oxidation process. Solidification and degree of strength tests were performed with the simulated sludge/spent adsorbent of MgO as an oxide type and KH 2 PO 4 . From the test results, the design and fabrication of wet oxidation and liquid waste purification process equipment was made, and a performance test was carried out. (author)

Retrospective evaluation of combined modality treatment and prognostic factors in patients with esophageal cancer

International Nuclear Information System (INIS)

Neuhof, Dirk; Neumayer, Florian; Debus, Juergen; Einbeck, Wolfgang; Haschemian, Kai; Mai, Sabine K.; Wenz, Frederik; Hochhaus, Andreas; Willeke, Frank; Rudi, Jochen

2005-01-01

The influence of prognostic factors and combined modality treatment on survival was evaluated retrospectively for 156 patients with esophageal cancer receiving radiotherapy in different modalities between 1991 and 2001 at the Univ. of Heidelberg and the Universitaetsklinikum Mannheim. Forty-six patients (29.5%) were treated with radiotherapy alone, 74 patients (47.4%) had combined radiochemotherapy and 36 patients (23.1%) were operated on after receiving neoadjuvant radiochemotherapy. The median follow-up time was 10 months. Female patients showed a significantly better overall survival compared with male patients (p=0.031), younger patients (age 60 years) (p=0.02). Patients with hemoglobin concentration>13.4 g/dl before therapy (median hemoglobin concentration) had a significantly better overall survival than patients with lower hemoglobin concentration (p=0.044). Patients who received combined radiochemotherapy (with or without operation) had a survival advantage compared with radiotherapy alone. Overall survival after neoadjuvant treatment followed by operation was significantly better than in the two other groups, median survival times were 20 vs. 9 (RCHT) vs. 8 months (RT) (p=0.003). The data presented show for the first time that hemoglobin concentration in addition to gender and age was a prognostic factor for patients with esophageal cancer. A low hemoglobin value was a negative predictor

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

Science.gov (United States)

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

2015-03-01

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

Radiofrequency ablation, an effective modality of treatment in tumor-induced osteomalacia: a case series of three patients.

Science.gov (United States)

Jadhav, Swati; Kasaliwal, Rajeev; Shetty, Nitin S; Kulkarni, Suyash; Rathod, Krantikumar; Popat, Bhavesh; Kakade, Harshal; Bukan, Amol; Khare, Shruti; Budyal, Sweta; Jagtap, Varsha S; Lila, Anurag R; Bandgar, Tushar; Shah, Nalini S

2014-09-01

Tumor-induced osteomalacia is curable if the tumors can be totally excised. However, when the tumors are present in locations that make surgery disproportionately risky, the need for less invasive strategies like radiofrequency ablation (RFA) is realized. We describe three patients with suspected tumor-induced osteomalacia who were treated in our department between 2006 and 2013 with tumors in surgically difficult locations and were subjected to single or multiple sessions of RFA. The response was documented in terms of symptomatic improvement, phosphorus normalization, and follow-up (99m)Technitium-labelled hydrazinonicotinyl-Tyr3-octreotide ((99m)Tc HYNIC TOC) scan. Two of the three individuals, patient A (with a 1.5 × 1.2-cm lesion in the head of the right femur) and patient B (with a 1.3 × 1.2-cm lesion on the endosteal surface of the shaft of the left femur), achieved complete remission with single sessions of RFA. Three months after the procedure, (99m)Tc HYNIC TOC scans revealed the absence of uptake at the previous sites, corroborating with the clinical improvement and phosphorus normalization. Patient C had a large 5.6 × 6.5-cm complex lesion in the lower end of the left femur with irregular margins, loculations, and bone grafts placed in previous surgery. He failed to achieve remission after multiple sessions of RFA due to the complex nature of the lesion, although the tumor burden was reduced significantly as documented on serial (99m)Tc HYNIC TOC scans. Although surgery remains the treatment of choice, RFA could be an effective, less invasive, and safe modality of treatment in judiciously selected patients.

Polycythemia vera: diagnosis, different therapy modalities and clinical value of the treatment with radiophosphorus today

International Nuclear Information System (INIS)

Bredow, J.; Pinkert, J.; Franke, W.G.; Schuler, U.

2001-01-01

The definition, diagnostic criteria and clinical findings as well as the treatment with radioactive phosphorus is described more in detail. Today, the treatment with 32 P is estimated to be an easy and safe method, especially for elderly patients (65 years or above), providing a cost-effective alternative to anti-proliferative drugs like hydroxyurea. (orig.) [de

SU-F-T-420: Dosimetry Comparison of Advanced External Beam Radiation Treatment Modalities to Brachytherapy Treatments in Patients with Cervical Cancer

Energy Technology Data Exchange (ETDEWEB)

Mwidu, U; Devic, S [McGill University, Montreal, QC (Canada); Shehadeh, M; AlKafi, M; Mahmood, R; Moftah, B [King Faisal Specialist Hospital & Research Center, Riyadh, Riyadh (Saudi Arabia)

2016-06-15

Purpose: A retrospective comparison of dose distributions achievable by High dose rate brachytherapy (HDRBT), Helical TomoTherapy (TOMO), CyberKnife (CK) and RapidArc (RA) in locally advanced inoperable cervical cancer patients is presented. Methods: Five patients with advanced stage cervical carcinoma were selected for this study after a full course of external beam radiotherapy (EBRT), chemotherapy and HDR Brachytherapy. To highlight any significant similarities/differences in dose distributions, high-risk clinical target volume (HRCTV) coverage, organs at risk (OAR) sparing, and machine specific delivery limitations, we used D90 (dose received by 90% of the volume) as the parameter for HRCTV coverage as recommended by the GEC-ESTRO Working Group. We also compared both integral and differential dose volume histograms (DVH) between different dose distributions treatment modalities for HRCTV and OAR. Results: TOMO and RA provided the most conformal dose distributions to HRCTV. Median doses (in Gy) to organs at risk were; for rectal wall: 1.7±0.6, 2.5±0.6,1.2±0.3, and 1.5±0.6, and for bladder wall: 1.6±0.1, 2.4±0.4, 0.8±0.6, and 1.5±0.5, for HDRBT, TOMO, CK, and RA, respectively. Conclusion: Contemporary EBRT modalities might be able to replace brachytherapy treatments for cervix cancer. While brachytherapy dose distributions feature high dose gradients, EBRT modalities provide highly conformal dose distributions to the target. However, it is still not clear whether a highly conformal dose or high gradient dose is more clinically relevant for the HRCTV in cervix cancer patients.

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

Directory of Open Access Journals (Sweden)

Thomas Hyphantis

2010-02-01

Full Text Available Thomas Hyphantis1, Spiros Katsoudas2, Sonia Voudiclari31Associate Professor of Psychiatry, Department of Psychiatry, Medical School, University of Ioannina, Ioannina, Greece; 2Nephrologist, Renal Clinic, Hippocration General Hospital, Athens, Greece; 3Department of Nephrology, University of Athens, GreeceAbstract: Several parameters mediate the selection of treatment modality in end-stage renal disease (ESRD. The nephrology community suggests that patient preference should be the prime determinant of modality choice. We aimed to test whether ego mechanisms of defense are associated with patients’ treatment modality preferences, independent of psychological distress. In 58 eligible ESRD patients who had themselves chosen their treatment modality, we administered the Symptom Distress Checklist-90-R and the Defense Style Questionnaire. Thirtyseven patients (53.4% had chosen hemodialysis and 21 (46.6% peritoneal dialysis. Patients who preferred peritoneal dialysis were younger (odds ratio [OR], 0.89; 95% confidence interval [CI]: 0.804–0.988, had received more education (OR, 8.84; 95% CI: 1.301–60.161, and were twice as likely to adopt an adaptive defense style as compared to patients who preferred hemodialysis (57.1% vs 27.0%, respectively; P < 0.033. On the contrary, the latter were more likely to adopt an image-distorting defense style (35.1% vs 14.3%; P = 0.038 and passive–aggressive defenses (OR, 0.73: 95% CI: 0.504–1.006. These results were independent of psychological distress. Our findings indicate that the patient’s personality should be taken into account, if we are to better define which modalities are best suited to which patients. Also, physicians should bear in mind passive–aggressive behaviors that warrant attention and intervention in patients who preferred hemodialysis.Keywords: end-stage renal disease, hemodialysis, peritoneal dialysis, ego mechanisms of defense, DSQ, psychopathology

The Electrode Modality Development in Pulsed Electric Field Treatment Facilitates Biocellular Mechanism Study and Improves Cancer Ablation Efficacy

OpenAIRE

Cen, Chao; Chen, Xinhua

2017-01-01

Pulsed electric field treatment is now widely used in diverse biological and medical applications: gene delivery, electrochemotherapy, and cancer therapy. This minimally invasive technique has several advantages over traditional ablation techniques, such as nonthermal elimination and blood vessel spare effect. Different electrodes are subsequently developed for a specific treatment purpose. Here, we provide a systematic review of electrode modality development in pulsed electric field treatme...

The effect of telepsychiatric modalities on reduction of readmissions in psychiatric settings

DEFF Research Database (Denmark)

Koblauch, Henrik; Reinhardt, Sasha Maria; Lissau, Waltraut

2017-01-01

Introduction Telepsychiatric modalities are used widely in the treatment of many mental illnesses. It has also been proposed that telepsychiatric modalities could be a way to reduce readmissions. The purpose of the study was to conduct a systematic review of the literature on the effects of telep......Introduction Telepsychiatric modalities are used widely in the treatment of many mental illnesses. It has also been proposed that telepsychiatric modalities could be a way to reduce readmissions. The purpose of the study was to conduct a systematic review of the literature on the effects...... of telepsychiatric modalities on readmissions in psychiatric settings....

Tumour Debulking for Esophageal Cancer - Thermal Modalities

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David Fleischer

1992-01-01

Full Text Available Esophageal cancer usually is discovered at a late stage and curative therapy seldom is possible. The prognosis is poor and most therapy is palliative. Endoscopic therapy commonly is employed; two common treatments involve thermal modalities. The Nd:YAG laser has been employed for 10 years and is effective in relieving obstruction in approximately 90% of cases. Re-ohstruction usually occurs in two to three months and repeat treatment may be necessary. Limitations to laser use include the fact that equipment is expensive and there are technical restrictions. An alternative thermal modality is the bipolar coagulation tumour probe which employs bipolar electrocoagulation. It is less expensive and, if the tumour is circumferential, tends to be easier to use. (It should not be used if the cancer is noncircumferential. The advantages and limitations of each modality are addressed.

Modal characteristics and fatigue strength of compressor blades

International Nuclear Information System (INIS)

Kim, Kyung Kook; Lee, Young Shin

2014-01-01

High-cycle fatigue (HCF) has been identified as one of the primary causes of gas turbine engine failure. The modal characteristics and endurance strength of a 5 MW gas turbine engine blade developed by Doosan Heavy Industries and Construction Co., Ltd. in HCF fracture were verified through analysis and tests to determine the reliability of the compressor blade. A compressor blade design procedure that considers HCF life was performed in the following order: airfoil and blade profile design, modal analysis, stress distribution test, stress endurance limit test, and fatigue life verification. This study analyzed the Campbell diagram and estimated resonance risk on the basis of the natural frequency analysis and modal test of the compressor blade to guarantee safe and operational reliability. In addition, the maximum stress point of the compressor blade was determined through stress distribution analysis and test. The bonding point of the strain gage was determined by using fatigue test. Stress endurance limit test was performed based on the results of these tests. This research compared and verified the modal characteristics and endurance strengths of the compressor blades to prevent HCF fracture, which is among the major causes of gas turbine engine damage. A fatigue life design procedure of compressor blades was established. The 5 MW class gas turbine compressor blade is well designed in terms of resonance stability and fatigue endurance limit.

Modal characteristics and fatigue strength of compressor blades

Energy Technology Data Exchange (ETDEWEB)

Kim, Kyung Kook [Doosan Heavy Industries and Construction, Changwon (Korea, Republic of); Lee, Young Shin [Chungnam National University, Daejeon (Korea, Republic of)

2014-04-15

High-cycle fatigue (HCF) has been identified as one of the primary causes of gas turbine engine failure. The modal characteristics and endurance strength of a 5 MW gas turbine engine blade developed by Doosan Heavy Industries and Construction Co., Ltd. in HCF fracture were verified through analysis and tests to determine the reliability of the compressor blade. A compressor blade design procedure that considers HCF life was performed in the following order: airfoil and blade profile design, modal analysis, stress distribution test, stress endurance limit test, and fatigue life verification. This study analyzed the Campbell diagram and estimated resonance risk on the basis of the natural frequency analysis and modal test of the compressor blade to guarantee safe and operational reliability. In addition, the maximum stress point of the compressor blade was determined through stress distribution analysis and test. The bonding point of the strain gage was determined by using fatigue test. Stress endurance limit test was performed based on the results of these tests. This research compared and verified the modal characteristics and endurance strengths of the compressor blades to prevent HCF fracture, which is among the major causes of gas turbine engine damage. A fatigue life design procedure of compressor blades was established. The 5 MW class gas turbine compressor blade is well designed in terms of resonance stability and fatigue endurance limit.

Nonoperative modalities to treat symptomatic cervical spondylosis.

LENUS (Irish Health Repository)

Hirpara, Kieran Michael

2012-01-01

Cervical spondylosis is a common and disabling condition. It is generally felt that the initial management should be nonoperative, and these modalities include physiotherapy, analgesia and selective nerve root injections. Surgery should be reserved for moderate to severe myelopathy patients who have failed a period of conservative treatment and patients whose symptoms are not adequately controlled by nonoperative means. A review of the literature supporting various modalities of conservative management is presented, and it is concluded that although effective, nonoperative treatment is labour intensive, requiring regular review and careful selection of medications and physical therapy on a case by case basis.

On modal cross-coupling in the asymptotic modal limit

Science.gov (United States)

Culver, Dean; Dowell, Earl

2018-03-01

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

Treatment Modality and Quality Benchmarks of Aneurysmal Subarachnoid Hemorrhage at a Comprehensive Stroke Center

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Wengui Yu

2018-03-01

Full Text Available BackgroundAneurysmal subarachnoid hemorrhage (aSAH is the most severe type of stroke. In 2012, the Joint Commission, in collaboration with the American Heart Association/American Stroke Association (AHA/ASA, launched the Advanced Certification for Comprehensive Stroke Centers (CSCs. This new level of certification was designed to promote higher standard of care for patients with complex stroke.ObjectiveThe goal of this study was to examine the treatment modality and quality benchmarks of aSAH at one of the first five certified CSCs in the United States.MethodsConsecutive patients with aSAH at Cedars-Sinai Medical Center between April 1, 2012 and May 30, 2014 were included for this retrospective study. The ruptured aneurysm was treated with coiling or clipping within 24 h. All patients were managed per AHA guidelines. Discharge outcomes were assessed using modified Rankin Scale (mRS. The rate of aneurysm treatment, door-to-treatment time, rate of posttreatment rebleed, hospital length of stay (LOS, discharge outcome, and mortality rates were evaluated as quality indicators.ResultsThe median age (interquartile range of the 118 patients with aSAH was 55 (19. Among them, 84 (71.2% were females, 94 (79.7% were transfers from outside hospitals, and 74 (62.7% had Hunt and Hess grades 1–3. Sixty patients (50.8% were treated with coiling, 52 (44.1% with clipping, and 6 (5.1% untreated due to ictal cardiac arrest or severe comorbidities. The rate of aneurysm treatment was 95% (112/118 with median door-to-treatment time at 12.5 (8.5 h and 0.9% (1/112 posttreatment rebleed. The median ICU and hospital LOS were 12.5 (7 and 17.0 (14.5 days, respectively. Coiling was associated with significantly shorter LOS than clipping. There were 59 patients (50% with favorable outcome and 19 deaths (16.1% at hospital discharge. There was no significant difference in discharge outcome between coiling and clipping.ConclusionCare of aSAH at one of the early CSCs in the

Mental Health Disorder Therapeutic Modalities Modified for the GMS.

Science.gov (United States)

Sumneangsanor, Tipsuda; Vuthiarpa, Sararud; Somprasert, Chomchueun

2017-12-01

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

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

Science.gov (United States)

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

2017-10-13

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

[Analysis of the therapeutic effects of different treatment modalities on the outcomes of 87 patients with lung oligometastasis from nasopharyngeal carcinoma after radiotherapy].

Science.gov (United States)

Tang, Q; Hu, Q Y; Piao, Y F; Hua, Y H; Chen, X Z

2016-03-23

The aim of the present study was to evaluate the efficacy of three different modalities in treatment of lung oligometastases from nasopharyngeal carcinoma (NPC) after radiotherapy and to identify a more appropriate treatment modality. The clinical data of 87 cases of lung oligometastases from NPC were analyzed retrospectively. Among them, 33 patients underwent local small-field irradiation+ /- chemotherapy, 28 underwent whole-lung irradiation+ chemotherapy, and 26 underwent simple chemotherapy. The survival rates were calculated using Kaplan-Meier analysis. The differences among the modalities were evaluated using the log-rank test. Cox univariate and multivariate analyses were performed to determine the influencing factors. The 3-year lung metastasis survival (LMS) rates of patients with lung metastasis undergoing the three treatment modalities (local small-field irradiation+ /-chemotherapy, whole-lung irradiation+ chemotherapy and chemotherapy alone) were 89.3%, 72.7%, and 72.4%, respectively, showing a significant difference between the groups (P=0.003). Further subgroup analysis showed that the 5-year LMS rate was significantly higher in the local small-field irradiation+ /-chemotherapy group than that in the whole-lung irradiation+ chemotherapy group and chemotherapy alone group (P=0.001). The 2-year progression-free survival (PFS) rates of the three groups were 57.1%, 25.8% and 3.8%, respectively, showing significant intergroup differences (P=0.002 and P<0.001). Multivariate analysis indicated that compared with the whole lung irradiation group and the chemotherapy alone group, the local irradiation+ /- chemotherapy is an independent favorable prognostic factor for LMS and PFS (P<0.05). Local radiotherapy combined with systemic chemotherapy is the best therapeutic modality for lung oligometastases derived from NPC after radiotherapy, improving the LMS and prolonging the PFS.

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

Science.gov (United States)

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

2017-07-01

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

Modal Logics with Counting

Science.gov (United States)

Areces, Carlos; Hoffmann, Guillaume; Denis, Alexandre

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

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

Directory of Open Access Journals (Sweden)

Iskandar S

2012-12-01

Full Text Available Shelly Iskandar,1–3 Cor AJ de Jong,3 Teddy Hidayat,1 Ike MP Siregar,1 Tri H Achmad,4 Reinout van Crevel,5 Andre Van der Ven51Department of Psychiatry, Padjadjaran University/Hasan Sadikin Hospital, Bandung, Indonesia; 2Health Research Unit, Medical Faculty, Padjadjaran Univervisity, 3Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA, Nijmegen, The Netherlands; 4Department of Biochemistry, Faculty of Medicine, Padjadjaran University/Hasan Sadikin Hospital, Bandung, Indonesia; 5Department of General Internal Medicine and Nijmegen Institute for Inflammation, Infection and Immunity, Radboud University Nijmegen Medical Centre, Nijmegen, The NetherlandsBackground: In many settings, people who inject drugs (PWID have limited access to human immunodeficiency virus (HIV care which is provided in several hospitals and primary health centers in big cities. Substance abuse treatment (SAT can be used as the entry-point to HIV programs. The aim of this study is to describe the characteristics of the PWID who had accessed SAT and determine which SAT modality associates significantly with HIV programs.Methods: PWID were recruited by respondent-driven sampling in an urban setting in Java, Indonesia and interviewed with the Addiction Severity Index (ASI, Blood-Borne Virus Transmission Risk Assessment Questionnaires, and Knowledge Questionnaire on HIV/AIDS. The information regarding the use of substance abuse treatment and HIV program were based on questions in ASI.Results: Seventy-seven percent of 210 PWID had accessed SAT at least once. PWID who had accessed a SAT modality reported more severe drug problems. The most widely used SAT were opioid substitution (57% and traditional/faith-based treatment (56%. Accessing substitution treatment (adjusted odds ratio [OR] = 5.8; 95% confidence interval [CI]: 2.5–13.9 or residential drug-free treatment (adjusted OR = 3.7; 95% CI: 1.4–9.7 was significantly associated with HIV testing, whereas

Knowledge and attitude of parents toward oral health maintenance and treatment modalities for their children

Directory of Open Access Journals (Sweden)

Pooja Bodhale

2014-01-01

Full Text Available Background and Aim: Parents have an important role in making decisions about their child′s oral health. The purpose of this study was to determine parental awareness of their children′s oral health maintenance and their attitude toward dental treatment. Materials and Methods: Total 284 parents from different socioeconomic groups participated in the study. Data were collected using a self-administered questionnaire addressing various aspects of knowledge and attitude of parents toward oral health and treatment modalities. Results: Awareness among parents was significantly lower in low socioeconomic group. Their attitude toward dental treatment differed significantly in which only 53% parents from high socioeconomic group preferred going to the pediatric dentist. Conclusion: The level of awareness among parents is relatively low and there is need for the implementation of oral health awareness programs for parents to change their attitude toward dental treatment of their children.

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

Energy Technology Data Exchange (ETDEWEB)

Ashenafi, M; Koch, N; Peng, J; Terwillinger, L; Wilder, J; McDonald, D; Mart, C; Jenrette, J; Vanek, K [Medical University of South Carolina, Charleston, SC (United States)

2016-06-15

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

A Review of Recent Advances in the Diagnosis and Treatment Modalities for Long Head of Bicep Tendinopathy

Directory of Open Access Journals (Sweden)

Robert B. Lewis

2016-01-01

Full Text Available This article reviews the assessment and management of the pathology of the long head of the biceps tendon, a disease commonly encountered by primary care physicians and orthopedic surgeons. We include a discussion of relevant anatomy, function, pathoanatomy, natural history of the disease, diagnostic methods, and treatment options. Recent literature on the function of the long head of the bicep (LHB is reviewed. Literature on our evolving understanding of the pathoanatomy behind LHB tendinopathy is discussed. We also discuss the effectiveness of current diagnostic and treatment modalities.

Status for NEXIM New X-ray Imaging Modalities for safe and high quality food

DEFF Research Database (Denmark)

Einarsdottir, Hildur; Ersbøll, Bjarne Kjær; Larsen, Rasmus

2014-01-01

. The main focuses are determined to be threefold: 1)Improving the detectability of low density foreign bodies incidentally present in food products. 2)Development of new modalities for assessment of quality traits in food production, for instance connective tissue and fatty acid composition. 3)Develop...... to developing laboratory-based setups further towards an in-line scanning system. Additionally, close co-operation with industrial partners has further emphasized the need for new techniques for quality control, product development and foreign object detection....

Treatment modalities of oral mucositis after radiation of head and neck cancers

International Nuclear Information System (INIS)

Lapeyre, M.; Charra-Brunaud, C.; Kaminsky, M.C.; Geoffrois, L.; Dolivet, G.; Pourel, N.; Marchal, C.; Bey, P.; Maire, F.; Simon, M.; Toussaint, B.

2001-01-01

Acute mucositis is common after radiotherapy for head and neck cancers. During the past 3 decades, there was a gradual evolution in the treatment modalities for locally advanced carcinomas (concomitant radio-chemotherapy, accelerated radiotherapy). These new strategies are accompanied by an increase in early mucosal reactions. At the present time, there is no widely accepted prophylaxis or effective treatment. Many traditional remedies or new agents seem ineffective (Sucralfate, Chlorhexidine, GM-CSF, Silver nitrate, Prostaglandin, anti-oxidants, Benzydamine hydrochloride), while others seem promising (Povidone-iodine, nonabsorbable antibiotic lozenges and anti-fungal, local GM-CSF, Glutamide, Low-energy laser, corticosteroids). Radioprotectors are controversial and should be only used in experimental protocols and not in routine practice. However, some recommendations can be proposed: general prevention and global care before cancer therapy should be systematic (oral hygiene, dental and periodontal treatment, advice to avoid the use of tobacco and alcohol); frequent oral rinsing with a bland mouthwash (Povidone-iodine or others) should be used at the start of treatment because there are significant modifications of the oral microflora increased by a disturbed salivary flow; these mouthwashes could be associated with nonabsorbable antibiotic lozenges or anti-fungal topical (bicarbonates, Amphotericine B); Systematic percutaneous fluoroscopic gastrostomy should be decided before any aggressive treatments (concomitant radio-chemotherapy, accelerated radiotherapy); pain should be controlled; finally, the radiation technique should be optimized (mucosal sparing block, conformal radiotherapy and intensity modulated radiation therapy). (authors)

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

International Nuclear Information System (INIS)

Liu, S; Wu, Y; Chang, X; Li, H; Yang, D

2016-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

Liu, S; Wu, Y; Chang, X; Li, H; Yang, D [Washington University School of Medicine, St. Louis, MO (United States)

2016-06-15

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

Current adjuvant treatment modalities for gastric cancer: From history to the future

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Kilic, Leyla; Ordu, Cetin; Yildiz, Ibrahim; Sen, Fatma; Keskin, Serkan; Ciftci, Rumeysa; Pilanci, Kezban Nur

2016-01-01

The discrepancy between the surgical technique and the type of adjuvant chemotherapy used in clinical trials and patient outcomes in terms of overall survival rates has led to the generation of different adjuvant treatment protocols in distinct parts of the world. The adjuvant treatment recommendation is generally chemoradiotherapy in the United States, perioperative chemotherapy in the United Kingdom and parts of Europe, and chemotherapy in Asia. These options mainly rely on the United States Intergroup-0116, United Kingdom British Medical Research Council Adjuvant Gastric Infusional Chemotherapy, and the Asian Adjuvant Chemotherapy Trial of S-1 for Gastric Cancer and Capecitabine and Oxaliplatin Adjuvant Study in Stomach Cancer trials. However, the benefits were evident for only certain patients, which were not very homogeneous regarding the type of surgery, chemotherapy regimens, and stage of disease. Whether the dissimilarities in survival are attributable to surgical technique or intrinsic biological differences is a subject of debate. Regardless of the extent of surgery, multimodal therapy may offer modest survival advantage at least for diseases with lymph node involvement. Moreover, in the era of individualized treatment for most of the other cancer types, identification of special subgroups comprising those who will derive more or no benefit from adjuvant therapy merits further investigation. The aim of this review is to reveal the historical evolution and future reflections of adjuvant treatment modalities for resected gastric cancer patients. PMID:27190583

Wilson's disease: two treatment modalities. Correlations to pretreatment and posttreatment brain MRI

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Leiros da Costa, Maria do Desterro; Spitz, Mariana; Bacheschi, Luiz Alberto; Barbosa, Egberto Reis; Leite, Claudia Costa; Lucato, Leandro Tavares

2009-01-01

Brain magnetic resonance imaging (MRI) studies on Wilson's disease (WD) show lack of correlations between neurological and neuroimaging features. Long-term follow-up reports with sequential brain MRI in patients with neurological WD comparing different modalities of treatment are scarce. Eighteen patients with neurological WD underwent pretreatment and posttreatment brain MRI scans to evaluate the range of abnormalities and the evolution along these different periods. All patients underwent at least two MRI scans at different intervals, up to 11 years after the beginning of treatment. MRI findings were correlated with clinical picture, clinical severity, duration of neurological symptoms, and treatment with two different drugs. Patients were divided into two groups according to treatment: d-penicillamine (D-P), zinc (Zn), and Zn after the onset of severe intolerance to D-P. MRI scans before treatment showed, in all patients, hypersignal intensity lesions on T2- and proton-density-weighted images bilaterally and symmetrically at basal nuclei, thalamus, brain stem, cerebellum, brain cortex, and brain white matter. The most common neurological symptoms were: dysarthria, parkinsonism, dystonia, tremor, psychiatric disturbances, dysphagia, risus sardonicus, ataxia, chorea, and athetosis. From the neurological point of view, there was no difference on the evolution between the group treated exclusively with D-P and the one treated with Zn. Analysis of MRI scans with longer intervals after the beginning of treatment depicted a trend for neuroimaging worsening, without neurological correspondence, among patients treated with Zn. Neuroimaging pattern of evolution was more favorable for the group that received exclusively D-P. (orig.)

Prognostic factors and multidisciplinary treatment modalities for brain metastases from colorectal cancer: analysis of 93 patients

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Gu, Xiao-Dong; Cai, Yan-Tao; Zhou, Yi-Ming; Li, Zhen-Yang; Xiang, Jian-Bin; Chen, Zong-You

2015-01-01

The purpose of this study was to review patient characteristics and evaluate the potential factors affecting prognosis in cases of brain metastasis (BM) from colorectal cancer (CRC). We retrospectively reviewed 93 cases of BM from CRC in our hospital. Patient demographics, neurologic symptoms, and location and number of BMs were recorded. Factors analyzed included: age; sex; Karnofsky performance score; number of BMs; presence of extracranial metastases; dimensions; location of tumors; treatment modalities. The overall 1- and 2-year survival rates were 27.7 and 9.9 %. On multivariate analysis, the number of BMs, extracranial metastases and the initial treatment modalities were found to be independent prognostic factors for overall survival. Patients treated with surgical resection followed by WBRT or SRS had an improved prognosis relative to those treated with surgery alone (P = 0.02 and P = 0.02, respectively). No significance difference in survival rate was found between patients treated with SRS alone or SRS plus WBRT (P = 0.11). Surgical resection of BMs from CRC in selected patients may help prolong survival. Additional radiotherapy following surgery is valuable in improving prognosis. Extracranial metastasis, multiple BM lesions and initial non operation can be considered as independent factors associated with poor prognosis

Hyperimmunoglobulin E syndrome: Genetics, immunopathogenesis, clinical findings, and treatment modalities

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Hassan Hashemi

2017-01-01

Full Text Available The hyperimmunoglobulin E syndromes (HIESs are very rare immunodeficiency syndromes with multisystem involvement, including immune system, skeleton, connective tissue, and dentition. HIES are characterized by the classic triad of high serum levels of immunoglobulin E (IgE, recurrent staphylococcal cold skin abscess, and recurrent pneumonia with pneumatocele formation. Most cases of HIES are sporadic although can be inherited as autosomal dominant and autosomal recessive traits. A fundamental immunologic defect in HIES is not clearly elucidated but abnormal neutrophil chemotaxis due to decreased production or secretion of interferon γ has main role in the immunopathogenesis of syndrome, also distorted Th1/Th2 cytokine profile toward a Th2 bias contributes to the impaired cellular immunity and a specific pattern of infection susceptibility as well as atopic-allergic constitution of syndrome. The ophthalmic manifestations of this disorder include conjunctivitis, keratitis, spontaneous corneal perforation, recurrent giant chalazia, extensive xanthelasma, tumors of the eyelid, strabismus, and bilateral keratoconus. The diagnosis of HIES is inconclusive, dependent on the evolution of a constellation of complex multisystemic symptoms and signs which develop over the years. Until time, no treatment modality is curative for basic defect in HIES, in terms of cytokines/chemokines derangement. Of note, bone marrow transplant and a monoclonal anti-IgE (omalizumab are hoped to be successful treatment in future.

A systematic review on recurrent respiratory papillomatosis: clinical effect and duration of benefit of different treatment modalities

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Elina Kiverniti

2011-12-01

Full Text Available The aim of this study is to compare different modalities used for the treatment of recurrent respiratory papillomatosis (RRP in adults and children in terms of their clinical effect and the duration of benefit. Systematic review of papers was written in the English language and published between 1977 and 2007. Outcomes are number of patients with a clinical response and length of time the response lasted for. We found 28 useful studies. There were 1,045 subjects, 416 children and 339 adults who underwent different treatments for RRP between 1976 and 2007. The methods used consisted of cidofovir, interferon, surgical excision, indole-3-carbinol, acyclovir, mumps vaccine, and photodynamic therapy. 62.5% of patients had a complete response on cidofovir (11 studies, 45.14% on interferon (8 studies, 33.33% on I3C (2 studies, 44.36% after surgery (5 studies, 77.55% after the mumps vaccine (1 study, 100% on acyclovir (1 study, and 9.09% after photodynamic therapy (1 study. The effect of different modalities lasted between 9 and 27 months. In conclusion, it is impossible to reach any reliable conclusions as to which method is the most durable and effective. There is a great need for randomised control multicentre trials on the treatment of RRP, so that reliable results can be produced.

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

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

2015-11-01

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

Integrated treatment modality of cathodal-transcranial direct current stimulation with peripheral sensory stimulation affords neuroprotection in a rat stroke model.

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Liu, Yu-Hang; Chan, Su Jing; Pan, Han-Chi; Bandla, Aishwarya; King, Nicolas K K; Wong, Peter Tsun Hon; Chen, You-Yin; Ng, Wai Hoe; Thakor, Nitish V; Liao, Lun-De

2017-10-01

Cathodal-transcranial direct current stimulation induces therapeutic effects in animal ischemia models by preventing the expansion of ischemic injury during the hyperacute phase of ischemia. However, its efficacy is limited by an accompanying decrease in cerebral blood flow. On the other hand, peripheral sensory stimulation can increase blood flow to specific brain areas resulting in rescue of neurovascular functions from ischemic damage. Therefore, the two modalities appear to complement each other to form an integrated treatment modality. Our results showed that hemodynamics was improved in a photothrombotic ischemia model, as cerebral blood volume and hemoglobin oxygen saturation ([Formula: see text]) recovered to 71% and 76% of the baseline values, respectively. Furthermore, neural activities, including somatosensory-evoked potentials (110% increase), the alpha-to-delta ratio (27% increase), and the [Formula: see text] ratio (27% decrease), were also restored. Infarct volume was reduced by 50% with a 2-fold preservation in the number of neurons and a 6-fold reduction in the number of active microglia in the infarct region compared with the untreated group. Grip strength was also better preserved (28% higher) compared with the untreated group. Overall, this nonpharmacological, nonintrusive approach could be prospectively developed into a clinical treatment modality.

First-in-human study of PET and optical dual-modality image-guided surgery in glioblastoma using 68Ga-IRDye800CW-BBN.

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Li, Deling; Zhang, Jingjing; Chi, Chongwei; Xiao, Xiong; Wang, Junmei; Lang, Lixin; Ali, Iqbal; Niu, Gang; Zhang, Liwei; Tian, Jie; Ji, Nan; Zhu, Zhaohui; Chen, Xiaoyuan

2018-01-01

Purpose : Despite the use of fluorescence-guided surgery (FGS), maximum safe resection of glioblastoma multiforme (GBM) remains a major challenge. It has restricted surgeons between preoperative diagnosis and intraoperative treatment. Currently, an integrated approach combining preoperative assessment with intraoperative guidance would be a significant step in this direction. Experimental design : We developed a novel 68 Ga-IRDye800CW-BBN PET/near-infrared fluorescence (NIRF) dual-modality imaging probe targeting gastrin-releasing peptide receptor (GRPR) in GBM. The preclinical in vivo tumor imaging and FGS were first evaluated using an orthotopic U87MG glioma xenograft model. Subsequently, the first-in-human prospective cohort study (NCT 02910804) of GBM patients were conducted with preoperative PET assessment and intraoperative FGS. Results : The orthotopic tumors in mice could be precisely resected using the near-infrared intraoperative system. Translational cohort research in 14 GBM patients demonstrated an excellent correlation between preoperative positive PET uptake and intraoperative NIRF signal. The tumor fluorescence signals were significantly higher than those from adjacent brain tissue in vivo and ex vivo (p dual-modality imaging technique is feasible for integrated pre- and intraoperative targeted imaging via the same molecular receptor and improved intraoperative GBM visualization and maximum safe resection.

Modality

DEFF Research Database (Denmark)

Klinge, Alex; Müller, Henrik Høeg

Modality: Studies in Form and Function reflects the diversity of theoretical frameworks and the heterogeneity of linguistic phenomena under the general heading of modality. Researchers in the fields of logic, philosophy and linguistics have for many years been pondering the elusive nature...... of modality and grappled with ways of capturing it. The 11 studies included here cover the span from contributions that seek to clarify controversial theoretical constructs to studies which take an empirical approach to linguistic categories and cross-linguistic typological issues. The key concepts addressed...

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

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Button Melissa

2009-01-01

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

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

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

2009-04-01

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

Effect of Various Treatment Modalities on Surface Characteristics and Shear Bond Strengths of Polyetheretherketone-Based Core Materials.

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Çulhaoğlu, Ahmet Kürşat; Özkır, Serhat Emre; Şahin, Volkan; Yılmaz, Burak; Kılıçarslan, Mehmet Ali

2017-11-13

To investigate the effect of different surface treatments on the surface roughness (Ra), wettability, and shear bond strength of polyetheretherketone (PEEK) to composite resin. One hundred ninety eight PEEK specimens were divided into six groups (n = 33). Specimen surfaces were treated with the following surface treatment modalities: silicoating (CoJet), acetone treatment, acid etching (H 2 SO 4 ), airborne particle abrasion (Al 2 O 3 ), laser irradiation (Yb:PL laser), and the nontreated surface serving as the control. Surface roughness was measured with an profilometer (n = 11) and a goniometer was used to measure the surface wettability through contact angle (θ)(n = 11). PEEK surfaces were veneered with a composite resin (n = 11). The specimens were then thermocycled for 10,000 cycles at 5 to 55°C. Shear bond strengths between the PEEK and composite resin were measured with an universal test machine. One-way ANOVA was used to analyze the data. Tukey's post-hoc test was used to determine significant differences between groups (α = 0.05). Surface roughness and wettability of PEEK surfaces along with shear bond strength of PEEK to composite resin were influenced by the surface treatments. (p PEEK surfaces treated by laser irradiation (2.85 ± 0.2 µm) followed by airborne particle abrasion (2.26 ± 0.33 µm), whereas other surface treatment modalities provided similar Ra values, with the acid-etched PEEK surfaces having the lowest mean Ra values (0.35 ± 0.14 µm). Silicoating provided the most wettable PEEK surfaces (48.04 ± 6.28º), followed by either acetone treatment (70.19 ± 4.49º) or acid treatment (76.07 ± 6.61º). Decreased wettability was observed for airborne particle abraded (84.83 ± 4.56º) and laser-treated PEEK surfaces (103.06 ± 4.88º). The highest mean shear bond strength values were observed for acid-etched PEEK surfaces (15.82 ± 4.23 MPa) followed by laser irradiated (11.46 ± 1.97 MPa), airborne particle abraded (10.81 ± 3.06 MPa

A novel treatment modality for recurrent aphthous stomatitis – Single application of doxycycline hyclate

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R Thriveni

2018-01-01

Full Text Available Background and Objectives: Recurrent aphthous ulcers are common painful mucosal conditions affecting the oral cavity. Despite of so many treatment modalities, there is no specific and definitive treatment. Hence a study was carried out to evaluate the clinical effects Single Application of Doxycycline Hyclate 100 mg for Recurrent apthous Stomatitis (RAS. Materials and Methods: Forty study subjects were included in the study. Patients were randomly assigned into two groups. There were 20 patients in each group; Group A patients received Doxycycline Hyclate 100 mg in the first visit, Group B patients received placebo. The results were analyzed with unpaired 't' test. Results: The data indicated a significant reduction in pain in group A (i.e., faster reduction in pain compared with group B. Interpretation and Conclusion: A single application of doxycycline hyclate decreased pain and speeded recovery.

Light-based therapies in acne treatment

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Pei, Susan; Inamadar, Arun C.; Adya, Keshavmurthy A.; Tsoukas, Maria M.

2015-01-01

The use of light and laser in the treatment of acne is increasing as these modalities are safe, effective, and associated with no or minimal complications when used appropriately. These light and laser sources are also being used in combination with pharmacological and/or physical measures to synergize their effects and optimize the therapeutic outcome. This review focuses on optical devices used in treating acne and serves to delineate the current application of various methods, including their utility and efficacy. PMID:26009707

Is there room for combined modality treatments? Dosimetric comparison of boost strategies for advanced head and neck and prostate cancer

International Nuclear Information System (INIS)

Gora, Joanna; Hopfgartner, Johannes; Kuess, Peter; Paskeviciute, Brigita; Georg, Dietmar

2013-01-01

The purpose of the study was to determine the dosimetric difference between three emerging treatment modalities-volumetric-modulated arc therapy (VMAT), intensity-modulated proton beam therapy (IMPT) and intensity-modulated carbon ion beam therapy (IMIT)-for two tumour sites where selective boosting of the tumour is applied. For 10 patients with locally advanced head and neck (H and N) cancer and 10 with high-risk prostate cancer (PC) a VMAT plan was generated for PTV initial that included lymph node regions, delivering 50 Gy (IsoE) for H and N and 50.4 Gy (IsoE) for PC patients. Furthermore, separate boost plans (VMAT, IMPT and IMIT) were created to boost PTV boost up to 70 Gy (IsoE) and 78 Gy (IsoE) for H and N and PC cases, respectively. Doses to brainstem, myelon, larynx and parotid glands were assessed for H and N cases. Additionally, various organs at risk (OARs) (e.g. cochlea, middle ear, masticator space) were evaluated that are currently discussed with respect to quality of life after treatment. For PC cases, bladder, rectum and femoral heads were considered as OARs. For both tumour sites target goals were easily met. Looking at OAR sparing, generally VMAT + VMAT was worst. VMAT + IMIT had the potential to spare some structures in very close target vicinity (such as cochlea, middle ear, masticator space) significantly better than VMAT + IMPT. Mean doses for rectal and bladder wall were on average 4 Gy (IsoE) and 1.5 Gy (IsoE) higher, respectively, compared to photons plus particles scenarios. Similar results were found for parotid glands and larynx. Concerning target coverage, no significant differences were observed between the three treatment concepts. Clear dosimetric benefits were observed for particle beam therapy as boost modality. However, the clinical benefit of combined modality treatments remains to be demonstrated. (author)

Psychotherapy as a treatment modality for psychiatric disorders: Perceptions of general public of Karachi, Pakistan

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Zafar Abdul

2009-06-01

Full Text Available Abstract Background Psychiatric disorders affect about 450 million individuals worldwide. A number of treatment modalities such as psychotropic medications, psychotherapy and electroconvulsive therapy can be used to treat these disorders. Attitudes of general public play a pivotal role in effective utilization of mental health services. We explored the perceptions of general public of Karachi, Pakistan regarding psychotherapy. Methods A cross-sectional study was conducted in Karachi, Pakistan during July-August, 2008. A three-step sampling strategy and a structured questionnaire were employed to survey knowledge and perceptions of adult general public about psychotherapy. Descriptive statistics were used for baseline characteristics. Logistic regression models were used to investigate any significant associations between baseline characteristics of the participants and their perceptions. Results The study sample comprised of 985 individuals (536 males; 531 financially independent with an average age of 36.7 years (SD 13.54 years and 12.5 years (SD 3.09 years of education were included. Majority (59.4%; n = 585 claimed to be aware of psychotherapy as a treatment option for psychiatric disorders but 47.5% of these (n = 278/585 failed to identify its correct definition. Concerns voiced by the participants about psychotherapy included stigma (48.7% and breech in confidentiality (39.5%; 60.7% opined it cost effective and 86.5% favored its use as an adjuvant modality. A preference for psychotherapy as the treatment strategy for psychiatric disorders was demonstrated by 46.6% (n = 459/985. Younger, more educated, financially independent and female participants were more likely to prefer psychotherapy as were those who deemed it cost effective. Conclusion Positive attitudes regarding the acceptability, clinical utility and cost-effectiveness of psychotherapy were observed in a sample representative of general public of Karachi, Pakistan. These findings

New modalities in radiation therapy for treatment of cancer

International Nuclear Information System (INIS)

Kumar, Deepak

2013-01-01

Cancer is a generic term for a large group of diseases characterized by rapid creation of abnormal cells that grow beyond their usual boundaries, and which can then invade adjoining parts of the body and spread to other organs. Cancer mortality is the second and most common cause of death in the USA and in most European countries. In India, it is the fourth leading disease and the major cause of death. Cancer remains one of the most dreadful disease and approximately ten million cases of cancer occur in the world every year. The course of cancer treatment depends on the type of cancer, its location, and its state of advancement. Cancer is treated with surgery, chemotherapy, radiation therapy, hormone therapy, biological therapy and targeted therapy. Radiation therapy is an important an affordable modality for cancer treatment with minimal side effects. Radiation kills cancer cells with high-energy rays targeted directly to the tumor. Radiation therapy works by damaging the DNA and preventing its replication: therefore, it preferentially kills cancer cells, which rapidly divides. Radiation therapy is used for cure, control, and palliation of cancers in more than 60% of cancer patients. The goal of radiotherapy is to treat the cancer and spare the normal tissue as much as possible. Advances have been made in radiotherapy that allow delivery of higher doses of radiation to the tumor while sparing a greater amount of surrounding tissue, thus achieving more cures and fewer acute and long-term side effects. Technological advances and research are being continued to result in improvements in the field. Several new devices and techniques are used these days in radiotherapy for accurate treatment of cancer. Teletherapy (external radiation therapy) used focused radiation beams targeting well defined tumor through extremely detailed imaging scans. Conventional external beam radiation therapy (2DXRT) is delivered via two-dimensional beams using linear accelerator machines (X

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

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Lygidakis, N A

2010-04-01

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

Biology-based combined-modality radiotherapy: workshop report

International Nuclear Information System (INIS)

Mason, Kathryn A.; Komaki, Ritsuko; Cox, James D.; Milas, Luka

2001-01-01

Purpose: The purpose of this workshop summary is to provide an overview of preclinical and clinical data on combined-modality radiotherapy. Methods and Materials: The 8th Annual Radiation Workshop at Round Top was held April 13-16, 2000 at the International Festival Institute (Round Top, TX). Results: Presentations by 30 speakers (from Germany, Netherlands, Australia, England, and France along with U.S. participants and M. D. Anderson Cancer Center faculty) formed the framework for discussions on the current status and future perspectives of biology-based combined-modality radiotherapy. Conclusion: Cellular and molecular pathways available for radiation modification by chemical and biologic agents are numerous, providing new opportunities for translational research in radiation oncology and for more effective combined-modality treatment of cancer

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

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Sandhu, Rajwant; Dyson, Benjamin J.

2013-01-01

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

A multi-modal treatment approach for the shoulder: A 4 patient case series

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Pollard Henry

2005-09-01

Full Text Available Abstract Background This paper describes the clinical management of four cases of shoulder impingement syndrome using a conservative multimodal treatment approach. Clinical Features Four patients presented to a chiropractic clinic with chronic shoulder pain, tenderness in the shoulder region and a limited range of motion with pain and catching. After physical and orthopaedic examination a clinical diagnosis of shoulder impingement syndrome was reached. The four patients were admitted to a multi-modal treatment protocol including soft tissue therapy (ischaemic pressure and cross-friction massage, 7 minutes of phonophoresis (driving of medication into tissue with ultrasound with 1% cortisone cream, diversified spinal and peripheral joint manipulation and rotator cuff and shoulder girdle muscle exercises. The outcome measures for the study were subjective/objective visual analogue pain scales (VAS, range of motion (goniometer and return to normal daily, work and sporting activities. All four subjects at the end of the treatment protocol were symptom free with all outcome measures being normal. At 1 month follow up all patients continued to be symptom free with full range of motion and complete return to normal daily activities. Conclusion This case series demonstrates the potential benefit of a multimodal chiropractic protocol in resolving symptoms associated with a suspected clinical diagnosis of shoulder impingement syndrome.

Combined modality treatment including intraoperative radiotherapy in locally advanced and recurrent rectal cancer

International Nuclear Information System (INIS)

Tveit, Kjell Maque; Wiig, Johan N.; Olsen, Dag Rune; Storaas, Andreas; Poulsen, Jan Peter; Giercksky, Karl-Erik

1997-01-01

Background: Treatment of locally advanced and recurrent rectal cancer usually has a high local recurrence rate and poor survival. Promising results have been reported by combined external radiotherapy, extensive surgery and intraoperative radiotherapy (IORT). Methods: One hundred fifteen patients with locally advanced rectal cancers fixed to the pelvic wall or locally recurrent rectal cancers underwent preoperative external radiotherapy with 46-50 Gy. Six to 8 weeks later radical pelvic surgery was attempted, and was combined with intraoperative electron beam radiotherapy (15-20 Gy) in 66 patients. The patients were followed closely to evaluate complication rate, local and distant recurrence rate and survival. Results: Surgery with no macroscopic tumour remaining was obtained in 65% of the patients with no postoperative deaths. Pelvic infection was the major complication (21%). Although the observation time is short (3-60 months), the local recurrence rate seems low (22%) and survival seems promising (about 60% at 4 years) in patients with complete tumour resection, in contrast to patients with residual tumour (none living at 4 years). Conclusions: The combined modality treatment with preoperative external radiotherapy and extensive pelvic surgery with IORT is sufficiently promising to start a randomized trial on the clinical value of IORT as a boost treatment in the multidisciplinary approach to this disease

The Modal Dimension

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Giluano Torrengo

2018-05-01

Full Text Available Space and time are two obvious candidates as dimensions of reality. Yet, are they the only two dimensions of reality? Famously, David Lewis maintained the doctrine of ―modal realism‖, the thesis that possible worlds exist and are entities as concrete as the actual world that we live in. In this paper, I will explore the idea that modality can be construed as a dimension along with space and time. However, although Lewis‘ modal realism is the main source of inspiration for this construal of modality, I will argue that something else is required for having a modal dimension.

The Electrode Modality Development in Pulsed Electric Field Treatment Facilitates Biocellular Mechanism Study and Improves Cancer Ablation Efficacy.

Science.gov (United States)

Cen, Chao; Chen, Xinhua

2017-01-01

Pulsed electric field treatment is now widely used in diverse biological and medical applications: gene delivery, electrochemotherapy, and cancer therapy. This minimally invasive technique has several advantages over traditional ablation techniques, such as nonthermal elimination and blood vessel spare effect. Different electrodes are subsequently developed for a specific treatment purpose. Here, we provide a systematic review of electrode modality development in pulsed electric field treatment. For electrodes invented for experiment in vitro, sheet electrode and electrode cuvette, electrodes with high-speed fluorescence imaging system, electrodes with patch-clamp, and electrodes with confocal laser scanning microscopy are introduced. For electrodes invented for experiment in vivo, monopolar electrodes, five-needle array electrodes, single-needle bipolar electrode, parallel plate electrodes, and suction electrode are introduced. The pulsed electric field provides a promising treatment for cancer.

Multi-Modality Registration And Fusion Of Medical Image Data

International Nuclear Information System (INIS)

Kassak, P.; Vencko, D.; Cerovsky, I.

2008-01-01

Digitalisation of health care providing facilities allows US to maximize the usage of digital data from one patient obtained by various modalities. Complex view on to the problem can be achieved from the site of morphology as well as functionality. Multi-modal registration and fusion of medical image data is one of the examples that provides improved insight and allows more precise approach and treatment. (author)

Generation of Composite Dose and Biological Effective Dose (BED) Over Multiple Treatment Modalities and Multistage Planning Using Deformable Image Registration

International Nuclear Information System (INIS)

Zhang, Geoffrey; Huang, T-C; Feygelman, Vladimir; Stevens, Craig; Forster, Kenneth

2010-01-01

Currently there are no commercially available tools to generate composite plans across different treatment modalities and/or different planning image sets. Without a composite plan, it may be difficult to perform a meaningful dosimetric evaluation of the overall treatment course. In this paper, we introduce a method to generate composite biological effective dose (BED) plans over multiple radiotherapy treatment modalities and/or multistage plans, using deformable image registration. Two cases were used to demonstrate the method. Case I was prostate cancer treated with intensity-modulated radiation therapy (IMRT) and a permanent seed implant. Case II involved lung cancer treated with two treatment plans generated on two separate computed tomography image sets. Thin-plate spline or optical flow methods were used as appropriate to generate deformation matrices. The deformation matrices were then applied to the dose matrices and the resulting physical doses were converted to BED and added to yield the composite plan. Cell proliferation and sublethal repair were considered in the BED calculations. The difference in BED between normal tissues and tumor volumes was accounted for by using different BED models, α/β values, and cell potential doubling times. The method to generate composite BED plans presented in this paper provides information not available with the traditional simple dose summation or physical dose summation. With the understanding of limitations and uncertainties of the algorithms involved, it may be valuable for the overall treatment plan evaluation.

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

Science.gov (United States)

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

2012-10-01

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

Experimental modal analysis

Energy Technology Data Exchange (ETDEWEB)

Ibsen, Lars Bo; Liingaard, M.

2006-12-15

This technical report concerns the basic theory and principles for experimental modal analysis. The sections within the report are: Output-only modal analysis software, general digital analysis, basics of structural dynamics and modal analysis and system identification. (au)

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

Energy Technology Data Exchange (ETDEWEB)

Halasz, Lia M. [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Jacene, Heather A. [Department of Imaging, Dana-Farber Cancer Institute, and Department of Radiology, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Catalano, Paul J. [Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Van den Abbeele, Annick D. [Department of Imaging, Dana-Farber Cancer Institute, and Department of Radiology, Brigham and Women' s Hospital, Boston, Massachusetts (United States); LaCasce, Ann [Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Mauch, Peter M. [Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Ng, Andrea K., E-mail: ang@lroc.harvard.edu [Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women' s Hospital, Boston, Massachusetts (United States)

2012-08-01

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

Soft, fortified ice-cream for head and neck cancer patients: a useful first step in nutritional and swallowing difficulties associated with multi-modal management.

Science.gov (United States)

Trinidade, Aaron; Martinelli, Katrina; Andreou, Zenon; Kothari, Prasad

2012-04-01

Patients with head and neck cancer have complex swallowing and nutritional concerns. Most patients are malnourished, and treatment modalities within the aerodigestive tract have profound effects on future swallowing and nutrition. The objective of this study is to investigate whether the introduction of fortified soft ice-cream to post-operative head and neck cancer patients would increase compliance with oral-feeding regimes. Using a questionnaire study, an ice-cream machine that produces fortified soft ice-cream was introduced onto our ward, and 30 patients were asked to fill out questionnaires based on their experience in addition to their oral-feeding regime. Results indicate that overall patient satisfaction and compliance with oral-feeding regimes increased: 77% felt that the taste was excellent and also felt that it was easy to eat; 60% felt that it eased the symptoms associated with their symptoms, in particular its cold temperature. We conclude from the results that the inability of patients undergoing multi-modal treatment for upper aerodigestive tract cancer to enjoy normal foods and its effects on their quality of life is underestimated. Providing a food to that is palatable, familiar and acceptable as it is safe and nutritionally sound can increase compliance with oral-feeding regimes. The ice-cream was safe to use in the early post-operative period, especially soothing in patients undergoing upper aerodigestive radiotherapy and high in protein and calorific content. Our practice may have wider benefits, including patients with oral and oropharyngeal infections, the elderly and patients with neurological dysphagia resulting from stroke.

Long-term results using LigaSure™ 5 mm instrument for treatment of Zenker's diverticulum

DEFF Research Database (Denmark)

Andersen, Michelle Fog; Trolle, Waldemar; Anthonsen, Kristian

2017-01-01

The purpose of the present study was to evaluate the long-term results and patient's satisfaction of a new approach using the LigaSure™ 5 mm instrument for treatment of Zenker's diverticulum (ZD) and to compare with other long-term results using traditional treatment modalities. Between December ...... to traditional endoscopic techniques and is now the standard treatment method for ZD in our departments.......The purpose of the present study was to evaluate the long-term results and patient's satisfaction of a new approach using the LigaSure™ 5 mm instrument for treatment of Zenker's diverticulum (ZD) and to compare with other long-term results using traditional treatment modalities. Between December......%) reported no symptoms at all. Our results suggest that endoscopic management of ZD with the LigaSure™ 5 mm instrument is a minimally invasive, fast and safe method with solid long-term outcome with relief of symptoms and patient satisfaction. This new operative instrument was not found inferior...

Muscle disorders and dentition-related aspects in temporomandibular disorders: controversies in the most commonly used treatment modalities

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Jerjes Waseem

2008-10-01

Full Text Available Abstract This review explores the aetiology of temporomandibular disorders and discusses the controversies in variable treatment modalities. Pathologies of the temporomandibular joint (TMJ and its' associated muscles of mastication are jointly termed temporomandibular disorders (TMDs. TMDs present with a variety of symptoms which include pain in the joint and its surrounding area, jaw clicking, limited jaw opening and headaches. It is mainly reported by middle aged females who tend to recognize the symptoms more readily than males and therefore more commonly seek professional help. Several aetiological factors have been acknowledged including local trauma, bruxism, malocclusion, stress and psychiatric illnesses. The Research Diagnostic Criteria of the Temporomandibular Disorders (RDC/TMD is advanced to other criteria as it takes into consideration the socio-psychological status of the patient. Several treatment modalities have been recommended including homecare practices, splint therapy, occlusal adjustment, analgesics and the use of psychotropic medication; as well as surgery, supplementary therapy and cognitive behavioural therapy. Although splint therapy and occlusal adjustment have been extensively used, there is no evidence to suggest that they can be curative; a number of evidence-based trials have concluded that these appliances should not be suggested as part of the routine care. Surgery, except in very rare cases, is discouraged since it is the most invasive alternative; recent studies have shown healthier outcome with cognitive behavioural therapy.

C-SAFE: A Computer-Delivered Sexual Health Promotion Program for Latinas.

Science.gov (United States)

Klein, Charles H; Kuhn, Tamara; Altamirano, Midori; Lomonaco, Carmela

2017-07-01

This article describes the development and evaluation of C-SAFE (Sexual Awareness for Everyone), a computer-delivered sexual health promotion program for Latinas. We first describe the process of adapting an evidence-based, group-level intervention into an individually administered computer-delivered program. We then present the methods and results of a randomized control trial with 321 Latinas in California and Florida to test C-SAFE's preliminary efficacy in reducing sexual health risk. We found no statistically significant differences between the two conditions at a six-month follow-up in terms of sexual behaviors or attitudes toward sexually transmitted infections and condoms, although C-SAFE women reported fewer days in the past month when their mental health was not good (p = .02). C-SAFE condition women also reported more satisfaction than control condition women in their assessment of information presentation (on a scale of 1 = poor and 5 = excellent; C-SAFE = 4.45 vs. control = 4.25, p = .053) and having learned something new (C-SAFE = 95.1% vs. control = 79.3%, χ 2 importance of teachable moments, matching of delivery modalities to implementation contexts, and possible directions for evidence-based sexual health promotion programs given the current sexual health landscape.

Metaphysical Modality, Modality of Predicate and the Theory of "Decisive Necessity”

Directory of Open Access Journals (Sweden)

L. Nabavi

2010-01-01

Full Text Available Aristotle in the Organon (1949: 9,30 a ,15-19 explicitly states that in a categorical syllogism when the minor premise is absolute (without modality operator and the major is necessary, the conclusion will be necessary too. This Aristotle's view has been the source of many conflicts and disputes in the history of logic. The famous logicians and historians of logic in the twentieth century as "Nicholas Rescher" and "Becker" believe that Aristotle's view is justifiable and defensible (at least compared to the first figure only if, the modality of major premise is considered as the property of predicate (modality de re. Today, we know very well that the modality of predicate is closely linked to Metaphysical and philosophical Modality. “Shihab al-Din al- Suhrawardi” in the theory of "Decisive (Battateh Necessity” by accepting this base, explicitly states that, in the beginning, the modality must be mentioned as a part of the predicate and then the modality of relation or copula is summarized and reduced to necessity. The modern formalization of the most important part of this theory is as follows: ("x (àAx É à Bx º ("x □ (àAx É à BxThis paper discusses the historical overview of the metaphysical modality firstly and then shows that the theory of "Decisive Necessity” is true and justified in a model of modal logic with equivalent accessibility relation and homogeneous possible world view (fixed domain.

Pluto/Charon exploration utilizing a bi-modal PBR nuclear propulsion/power system

Science.gov (United States)

Venetoklis, Peter S.

1995-01-01

The paper describes a Pluto/Charon orbiter utilizing a bi-modal nuclear propulsion and power system based on the Particle Bed Reactor. The orbiter is sized for launch to Nuclear-Safe orbit atop a Titan IV or equivalent launch veicle. The bi-modal system provides thermal propulsion for Earth orbital departure and Pluto orbital capture, and 10 kWe of electric power for payload functions and for in-system maneuvering with ion thrusters. Ion thrusters are used to perform inclination changes about Pluto, a transfer from low Pluto orbit to low Charon orbit, and inclination changes about charon. A nominal payload can be deliverd in as little as 15 years, 1000 kg in 17 years, and close to 2000 kg in 20 years. Scientific return is enormously aided by the availability of up to 10 kWe, due to greater data transfer rates and more/better instruments. The bi-modal system can provide power at Pluto/Charon for 10 or more years, enabling an extremely robust, scientifically rewarding, and cost-effective exploration mission.

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

Science.gov (United States)

Butler, Andrew J; James, Karin H

2011-10-31

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

Modal interval analysis new tools for numerical information

CERN Document Server

Sainz, Miguel A; Calm, Remei; Herrero, Pau; Jorba, Lambert; Vehi, Josep

2014-01-01

This book presents an innovative new approach to interval analysis. Modal Interval Analysis (MIA) is an attempt to go beyond the limitations of classic intervals in terms of their structural, algebraic and logical features. The starting point of MIA is quite simple: It consists in defining a modal interval that attaches a quantifier to a classical interval and in introducing the basic relation of inclusion between modal intervals by means of the inclusion of the sets of predicates they accept. This modal approach introduces interval extensions of the real continuous functions, identifies equivalences between logical formulas and interval inclusions, and provides the semantic theorems that justify these equivalences, along with guidelines for arriving at these inclusions. Applications of these equivalences in different areas illustrate the obtained results. The book also presents a new interval object: marks, which aspire to be a new form of numerical treatment of errors in measurements and computations.

INTRALESIONAL MEASLES, MUMPS AND RUBELLA (MMR VACCINE-AN EFFECTIVE THERAPEUTIC TOOL IN THE TREATMENT OF WART

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Raju

2015-11-01

Full Text Available BACKGROUND: Warts are common cutaneous viral infection. Various therapeutic modalities have been using in treatment of wart, but none of them are standardised. Immunotherapy is new current approach in the treatment of wart. AIMS: To know the efficacy and safety profile of Measles Mumps Rubella (MMR Vaccine in the treatment of wart. METHODS: MMR vaccine was injected into a largest single wart intralesionally and subsequent injections given every 2 weeks apart for about 3 to 5 times. Every month followup of patients was done to know the clearance of wart. RESULTS: Complete remission of warts seen in 70.4% of patients, partial remission seen in 22.2% and no response was seen in 7.4% of patients. No serious adverse side effects were seen in the current study. CONCLUSION: MMR vaccine can be considered as a safe, effective, inexpensive intralesional immunotherapeutic modality in the treatment of wart.

Operational Modal Analysis Tutorial

DEFF Research Database (Denmark)

Brincker, Rune; Andersen, Palle

of modal parameters of practical interest - including the mode shape scaling factor - with a high degree of accuracy. It is also argued that the operational technology offers the user a number of advantages over traditional modal testing. The operational modal technology allows the user to perform a modal......In this paper the basic principles in operational modal testing and analysis are presented and discussed. A brief review of the techniques for operational modal testing and identification is presented, and it is argued, that there is now a wide range of techniques for effective identification...

THE FIRST EXPERIENCE OF USING LOCAL HYPERTHERMIA IN COMBINED MODALITY TREATMENT OF OPERABLE NON-SMALL CELL LUNG CANCER

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A. Yu. Dobrodeev

2015-01-01

Full Text Available The paper presents the first experience in treating 5 patients with stage II–III non-small cell lung cancer using combined modality treatment including 40 Gy preoperative hyperfractionated radiotherapy with concurrent 2 cycles of paclitaxel/carboplatin chemotherapy and local hyperthermia (10 sessions followed by radical surgery. The overal response rate to preoperative treatment was 80 %. Chemotherapy was well tolerated and hyperthermia resulted no in adverse effects. All patients underwent surgery (4 lobectomies and 1 pneumonectomy. No complications were observed in the postoperative period. The follow-up period ranged from 6 to 20 months. No evidence of disease progression and radiation-induced damages were observed.

Erythromycin as a safe and effective treatment option for erythema annulare centrifugum

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Fu-Chen Chuang

2015-01-01

Full Text Available Background: Erythema annulare centrifugum (EAC is an inflammatory dermatosis with unknown etiology. It is usually self-limited, but chronic disease may be difficult to treat. We observed incidentally the therapeutic effect of erythromycin for EAC among patients taking erythromycin for other diseases. Aim: To evaluate the treatment response of erythromycin for EAC. Materials and Methods: During the study period, from July 2007 to February 2011, all patients with EAC were assigned to erythromycin stearate tablet 1000 mg per day for two weeks. EAC was diagnosed by a constellation of clinical and pathological findings. The efficacy (before and after the treatment was assessed clinically by one dermatologist and photographically by two blinded dermatologists. Secondary outcomes included adverse drug effects and recurrence. Results: Eight patients were enrolled in this study. Most patients had chronic relapsing disease with poor response to previous treatment. All the patients showed rapid response with profound reduction in the size of lesion and erythema two weeks after initiation of erythromycin treatment. The response was so obvious and complete that a coincidental response was less likely. Three patients had recurrence of disease and they tended to have more extensive lesions. Readministration of erythromycin was effective. All patients tolerated the treatment well. Conclusion: Our study documented erythromycin as a safe and cost-effective treatment for EAC.

Giant juvenile fibroadenoma: a case and review of novel modalities in treatment.

Science.gov (United States)

Sosin, Michael; Feldman, Elizabeth

2012-01-01

A giant juvenile fibroadenoma is defined as a fibroadenoma greater than 5 centimeters in size occurring in the pediatric population. It frequently affects adolescents. Rapid growth of the mass may result in breast asymmetry and deformity. Varying techniques in surgical extirpation have been described in order to optimize aesthetics and minimize distortion. The advent of new methods to remove benign breast disease is in its infancy stages. Many practitioners are unaware of the novel options that are emerging in the treatment of fibroadenoma. We describe an excision of a 12 centimeter giant juvenile fibroadenoma and adjacent juvenile fibroadenoma using a strategically atypical incision that resulted in excellent cosmesis and contour of the breast without subsequent reconstruction. Multiple modalities of removing a fibroadenoma are described with a review of the associated risks, benefits, and long term implications as well as a discussion on the indication for reconstructive surgery in patients with giant juvenile fibroadenoma.

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

Science.gov (United States)

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

2010-01-01

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

Current diagnostic modalities for vulnerable plaque detection

NARCIS (Netherlands)

J.A. Schaar (Johannes); F. Mastik (Frits); E.S. Regar (Eveline); C.A. den Uil (Corstiaan); F.J.H. Gijsen (Frank); J.J. Wentzel (Jolanda); P.W.J.C. Serruys (Patrick); A.F.W. van der Steen (Ton)

2007-01-01

textabstractRupture of vulnerable plaques is the main cause of acute coronary syndrome and myocardial infarction. Identification of vulnerable plaques is therefore essential to enable the development of treatment modalities to stabilize such plaques. Several diagnostic methods are currently tested

Per-oral Endoscopic Myotomy (POEM): A safe and effective treatment for achalasia in geriatric

Science.gov (United States)

Hernández-Mondragón, Oscar Víctor; Solórzano-Pineda, Omar Michel; Blancas-Valencia, Juan Manuel; González-Martínez, Marina Alejandra

2017-01-01

Esophageal achalasia is a primary motor disorder of the esophagus characterized by impair relaxation of the lower esophageal sphincter and absent of esophageal peristalsis. Per-oral endoscopic myotomy is an alternative treatment to surgical Heller myotomy in patients over 65 years old. The aim of this paper was to describe the results of peroral endoscopic myotomy (POEM) or the treatment of achalasia in geriatric patients. We included patients over 65 years old with POEM, from retrospective cohort review, in which POEM was performed with a standardized technique in our department. 12 patients were included, the procedure was successful in 98% of patients, minor adverse events occurred without mortality. POEM is a safe and effective technique for the treatment of achalasia, the results of the study are similar to those reported in The literature.

Meditations on Metaphysical Modality

OpenAIRE

Willis, Edmund Lindsay James

2011-01-01

Although metaphysical modality has been much discussed and exploited by philosophers, its precise nature is often left unanalysed and obscure. This dissertation marks an attempt to understand it better. After examining modality in general, the specific topic is introduced through consideration of the views of Kripke and Lewis. Comparisons are then made with logical, scientific and conceptual modalities. Finally, it is argued that metaphysical modality is that variety of modality which is alet...

Wilson's disease: two treatment modalities. Correlations to pretreatment and posttreatment brain MRI

Energy Technology Data Exchange (ETDEWEB)

Leiros da Costa, Maria do Desterro [Federal University of Paraiba, Movement Disorders Unit, Paraiba (Brazil); Spitz, Mariana; Bacheschi, Luiz Alberto; Barbosa, Egberto Reis [University of Sao Paulo, Movement Disorders Unit, Sao Paulo (Brazil); Leite, Claudia Costa; Lucato, Leandro Tavares [University of Sao Paulo, Department of Radiology, Sao Paulo (Brazil)

2009-10-15

Brain magnetic resonance imaging (MRI) studies on Wilson's disease (WD) show lack of correlations between neurological and neuroimaging features. Long-term follow-up reports with sequential brain MRI in patients with neurological WD comparing different modalities of treatment are scarce. Eighteen patients with neurological WD underwent pretreatment and posttreatment brain MRI scans to evaluate the range of abnormalities and the evolution along these different periods. All patients underwent at least two MRI scans at different intervals, up to 11 years after the beginning of treatment. MRI findings were correlated with clinical picture, clinical severity, duration of neurological symptoms, and treatment with two different drugs. Patients were divided into two groups according to treatment: d-penicillamine (D-P), zinc (Zn), and Zn after the onset of severe intolerance to D-P. MRI scans before treatment showed, in all patients, hypersignal intensity lesions on T2- and proton-density-weighted images bilaterally and symmetrically at basal nuclei, thalamus, brain stem, cerebellum, brain cortex, and brain white matter. The most common neurological symptoms were: dysarthria, parkinsonism, dystonia, tremor, psychiatric disturbances, dysphagia, risus sardonicus, ataxia, chorea, and athetosis. From the neurological point of view, there was no difference on the evolution between the group treated exclusively with D-P and the one treated with Zn. Analysis of MRI scans with longer intervals after the beginning of treatment depicted a trend for neuroimaging worsening, without neurological correspondence, among patients treated with Zn. Neuroimaging pattern of evolution was more favorable for the group that received exclusively D-P. (orig.)

Role of intralesional bleomycin in the treatment of complicated hemangiomas: prospective clinical study.

Science.gov (United States)

Omidvari, Shapour; Nezakatgoo, Nosrat; Ahmadloo, Niloofar; Mohammadianpanah, Mohammad; Mosalaei, Ahmad

2005-05-01

Hemangioma is the most common tumor of infancy. Although it has a basically benign nature and usually spontaneously regresses, a small percentage (5%) have complications that need treatment. Many different therapeutic modalities can be used in this tumor. To investigate the effect of a new method of treatment (intralesional bleomycin injection) in complicated hemangiomas. In the Department of Radiation Oncology at Nemazee Hospital in Shiraz, Iran, from April 1992 to October 1998, 32 patients with complicated hemangioma were treated with four to six courses of direct injection of bleomycin into the lesion. After a minimum follow-up of 6 years, there was 70 to 100% regression in 18 patients, 50 to 70% in 7 cases, and less than 50% reduction in 7 patients. Intralesional injection of bleomycin is an easy, safe, and effective therapeutic modality in complicated cutaneous hemangiomas.

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

Science.gov (United States)

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

2018-06-01

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

Metaphysical Modality, Modality of Predicate and the Theory of

Directory of Open Access Journals (Sweden)

l nabavi

2010-05-01

This paper discusses the historical overview of the metaphysical modality firstly and then shows that the theory of "Decisive Necessity” is true and justified in a model of modal logic with equivalent accessibility relation and homogeneous possible world view (fixed domain.

Tomotherapeutic stereotactic body radiation therapy: Techniques and comparison between modalities

International Nuclear Information System (INIS)

Fuss, Martin; Chengyu Shi; Papanikolaou, Niko

2006-01-01

Presentation and comparison of tomotherapeutic intensity-modulated techniques for planning and delivery of stereotactic body radiation therapy. Serial tomotherapeutic SBRT has been planned and delivered at our institution since 8/2001. Since 12/2005, 12 patients have been treated using a helical tomotherapy unit. For these 12 patients both helical and serial tomotherapy plans were computed and clinically approved. Techniques and considerations of tomotherapy SBRT planning, associated image-guidance, and delivery are presented. The respective treatment plans were compared based on dosimetric parameters as well as time to develop a treatment plan and delivery times. Also the associated quality of megavoltage CT (MVCT) image-guidance inherent to the helical tomotherapy unit was assessed. Tumor volumes averaged 9.3, 9.8, and 58.7 cm 3 for liver, lung, and spinal targets. Helical and serial tomotherapy plans showed comparable plan quality with respect to maximum and average doses to the gross tumor and planning target volumes. Time to develop helical tomotherapy plans averaged 3.5 h while serial tomotherapy planning consistently required less than one hour. Treatment delivery was also slower using helical tomotherapy, with differences of less than 10 min between modalities. MVCT image-guidance proved satisfactory for bony and lung targets, but failed to depict liver lesions, owing to poor soft-tissue contrast. SBRT planning and delivery is clinically feasible using either tomotherapeutic modality. While treatment planning time was consistently shorter and more readily accomplished in a standardized approach using the serial tomotherapy modality, actual plan quality and treatment delivery times are grossly comparable between the modalities. MVCT volumetric image-guidance, was observed to be valuable for thoracic and spinal target volumes, whereas it proved challenging for liver targets

[Results of the treatment of congenital diaphagmatic hernia with conventional terapeutics modalities].

Science.gov (United States)

Luis, A L; Avila, L F; Encinas, J L; Andrés, A M; Suárez, O; Elorza, D; Rodríguez, I; Martínez, L; Murcia, J; Lassaletta, L; Tovar, J A

2006-07-01

In this study, we analyze our results in the treatment of congenital diaphragmatic hernia (CDH) using conventional ventilatory therapy without ECMO. fifty one CDH patients (27 males and 24 females) treated at our institution between 1997 and 2004 were reviewed. Data referred to obstetrics, prenatal diagnosis, newborn care, type of hernia and surgical treatment were analyzed. We recorded ventilatory treatment modalities and the outcome of the patients. We also compared the survival of our series with those expected using the formula proposed by the CDH study group in 2001. We finally analized separately those patients with early clinical presentation and who fulfilled ECMO criteria. Data from necropsies were also recovered when available. Prenatal diagnosis was made in 58% of the patients. Fifty nine percent were born by c-section. The diaphragmatic defect was left-sided in 42 patients, right in 8 and bilateral in 1. Ten patients needed a prosthetic patch to close the defect. Eighteen out of the 51 patients (35%) died, 11 of them without surgical treatment. Early presentation of clinical picture was evident in 44 patients; among them 46% required high frequency ventilation and 53% nitric oxide therapy. Medium age at operation was 56+/-49 hours. The 7 children with late clinical presentation are alive. Among the 44 remaining patients, 26 are also alive (59,09%), data similar to those expected by the formula (62.39%, p>0.05). Fifteen patients had oxigenation index (IO) over 40, with a stimated survival rate of 48%, a statistically significant lower rate when compared to patients with IO40 survived; in 4 out of the 7 available necropsy studies, a severe lung hypoplasia was found (index lung weight/body weight ventilatory measures in patients with IO40 are rarely candidates to ECMO therapy because of the associated severe lung hypoplasia confirmed by necropsy studies.

Toward predicate approaches to modality

CERN Document Server

Stern, Johannes

2016-01-01

In this volume, the author investigates and argues for, a particular answer to the question: What is the right way to logically analyze modalities from natural language within formal languages? The answer is: by formalizing modal expressions in terms of predicates. But, as in the case of truth, the most intuitive modal principles lead to paradox once the modal notions are conceived as predicates. The book discusses the philosophical interpretation of these modal paradoxes and argues that any satisfactory approach to modality will have to face the paradoxes independently of the grammatical category of the modal notion. By systematizing modal principles with respect to their joint consistency and inconsistency, Stern provides an overview of the options and limitations of the predicate approach to modality that may serve as a useful starting point for future work on predicate approaches to modality. Stern also develops a general strategy for constructing philosophically attractive theories of modal notions conce...

Common Sense in Choice: The Effect of Sensory Modality on Neural Value Representations

Science.gov (United States)

2018-01-01

Abstract Although it is well established that the ventromedial prefrontal cortex (vmPFC) represents value using a common currency across categories of rewards, it is unknown whether the vmPFC represents value irrespective of the sensory modality in which alternatives are presented. In the current study, male and female human subjects completed a decision-making task while their neural activity was recorded using functional magnetic resonance imaging. On each trial, subjects chose between a safe alternative and a lottery, which was presented visually or aurally. A univariate conjunction analysis revealed that the anterior portion of the vmPFC tracks subjective value (SV) irrespective of the sensory modality. Using a novel cross-modality multivariate classifier, we were able to decode auditory value based on visual trials and vice versa. In addition, we found that the visual and auditory sensory cortices, which were identified using functional localizers, are also sensitive to the value of stimuli, albeit in a modality-specific manner. Whereas both primary and higher-order auditory cortices represented auditory SV (aSV), only a higher-order visual area represented visual SV (vSV). These findings expand our understanding of the common currency network of the brain and shed a new light on the interplay between sensory and value information processing. PMID:29619408

Common Sense in Choice: The Effect of Sensory Modality on Neural Value Representations.

Science.gov (United States)

Shuster, Anastasia; Levy, Dino J

2018-01-01

Although it is well established that the ventromedial prefrontal cortex (vmPFC) represents value using a common currency across categories of rewards, it is unknown whether the vmPFC represents value irrespective of the sensory modality in which alternatives are presented. In the current study, male and female human subjects completed a decision-making task while their neural activity was recorded using functional magnetic resonance imaging. On each trial, subjects chose between a safe alternative and a lottery, which was presented visually or aurally. A univariate conjunction analysis revealed that the anterior portion of the vmPFC tracks subjective value (SV) irrespective of the sensory modality. Using a novel cross-modality multivariate classifier, we were able to decode auditory value based on visual trials and vice versa. In addition, we found that the visual and auditory sensory cortices, which were identified using functional localizers, are also sensitive to the value of stimuli, albeit in a modality-specific manner. Whereas both primary and higher-order auditory cortices represented auditory SV (aSV), only a higher-order visual area represented visual SV (vSV). These findings expand our understanding of the common currency network of the brain and shed a new light on the interplay between sensory and value information processing.

A systematic review of therapeutic modalities used in sleep bruxism

Directory of Open Access Journals (Sweden)

May Wathiq Al-Khudhairy

2015-01-01

Full Text Available Aim: Sleep bruxism (SB has been present for over a century. There are many treatment modalities in the literature. The objective of this systematic review of randomized controlled clinical therapeutic trials of SB in adults diagnosed by clinical and/or electromyogram and/or polysomnography of SB is to elucidate the most effective of treatment modalities via documentation of the levels of evidence. Materials and Method: This review conducted electronically on PubMed included only English Full text human clinical trials with or without randomization. Twenty-one articles were included in this review. The therapeutic modalities of SB were classified into behavioral therapy, appliance therapy, local pharmacotherapy, and systemic pharmacotherapy. Each article was further allotted a level of evidence. Results: This review suggests that Oral appliances expressed the most positive outcome on SB episodes per hour of sleep. Conclusion: There is still not sufficient evidence to support behavioral and pharmaco-therapeutic approach

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

Science.gov (United States)

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

2015-01-01

To evaluate effects of intensive insulin treatment modalities on cardiovascular biomarkers in patients with type 1 diabetes mellitus (T1DM). A total of 25 patients with T1DM receiving intensive insulin therapy either in the form of continuous insulin pump (IP group; n=13) or as multiple daily injections (MDI group; n=12) and 13 controls (control group, n=13) were included. Data on demographics, anthropometrics, diabetes history, and laboratory findings including glycemic and lipid parameters, and cardiovascular biomarkers [C-reactive protein (mg/dL), homocysteine (μmol/L), fibrinogen (mg/dL), oxidized LDL (ng/dL), PAI-1 (ng/mL), MCP-1 (pg/mL) and VEGF (pg/mL)] were recorded in each group. Correlation of cardiovascular biomarkers to other parameters was also evaluated in T1DM patients. Apart from significantly higher mean (SD) values for HbA1c [6.1 (0.3) vs. 5.6 (0.5)% (43 (3) vs. 38 (5) mmol/mol), p1.5 (13.6) vs. 58.2 (10.8), p1) in the IP than in the MDI group, no significance difference was noted between insulin treatment modalities as well as between patient and control groups in terms of demographic, anthropometric and laboratory parameters. Negative correlation of MCP-1 to treatment duration (r=-0.615, p=0.025), and HDL-c to CRP (r=-0.685, p=0.010) and VEGF (r=-0.678, p=0.011) was noted in IP group, whereas positive correlation of PAI-1 to diabetes age (r=0.805, p=0.002) and treatment duration was noted in MDI group. Our findings in a cohort of T1DM patients with optimal glycemic control revealed that intensive insulin therapy was not associated with an increase in atherosclerotic markers in T1DM, regardless of whether continuous IP infusion or MDIs was administered. Copyright © 2015 Diabetes India. Published by Elsevier Ltd. All rights reserved.

A comparison of treatment modalities for renal calculi between 100 and 300 mm2: are shockwave lithotripsy, ureteroscopy, and percutaneous nephrolithotomy equivalent?

Science.gov (United States)

Wiesenthal, Joshua D; Ghiculete, Daniela; D'A Honey, R John; Pace, Kenneth T

2011-03-01

Shockwave lithotripsy (SWL) is considered a standard treatment for patients with upper-tract stones that are less than 10 mm in diameter, whereas stones that are larger than 20 mm are best managed by percutaneous nephrolithotomy (PCNL). The management of stones between these sizes remains controversial. Our purpose was to review our contemporary series of SWL, ureteroscopy (URS), and PCNL outcomes for intermediate-sized upper tract calculi (100-300 mm(2)). Analysis was restricted to those patients who were treated for a renal calculus that measured between 100 and 300 mm(2) during a 4-year span. Demographic, stone, patient, treatment, and follow-up data were collected from a prospectively maintained database. A total of 137 patients were referred with nonstaghorn calculi with an area between 100 and 300 mm(2). Fifty-three (38.7%) patients were treated with SWL, while 41 (29.9%) and 43 (31.4%) underwent ureteroscopy and PCNL, respectively. Mean stone area was higher in the PCNL group (P < 0.001), whereas stone density was higher for patients undergoing SWL (P = 0.002). Single treatment success rates were better for PCNL at 95.3%,vs 87.8% for ureteroscopy and 60.4% for SWL, P < 0.001. When allowing for two SWL treatments, the success rate improved to 79.2%, thus equalizing the success of the three treatment modalities (P = 0.66). Auxiliary treatments were more common after SWL (42.3%; P < 0.01). For intermediate-sized upper-tract stones, when allowing for up to two SWL treatments, there was no significant difference between treatment modalities. Thus, SWL is a reasonably successful treatment alternative for patients who are not fit for a general anesthetic or who prefer SWL over competing treatments, provided they accept a potentially higher number of treatments.

Supervised Cross-Modal Factor Analysis for Multiple Modal Data Classification

KAUST Repository

Wang, Jingbin

2015-10-09

In this paper we study the problem of learning from multiple modal data for purpose of document classification. In this problem, each document is composed two different modals of data, i.e., An image and a text. Cross-modal factor analysis (CFA) has been proposed to project the two different modals of data to a shared data space, so that the classification of a image or a text can be performed directly in this space. A disadvantage of CFA is that it has ignored the supervision information. In this paper, we improve CFA by incorporating the supervision information to represent and classify both image and text modals of documents. We project both image and text data to a shared data space by factor analysis, and then train a class label predictor in the shared space to use the class label information. The factor analysis parameter and the predictor parameter are learned jointly by solving one single objective function. With this objective function, we minimize the distance between the projections of image and text of the same document, and the classification error of the projection measured by hinge loss function. The objective function is optimized by an alternate optimization strategy in an iterative algorithm. Experiments in two different multiple modal document data sets show the advantage of the proposed algorithm over other CFA methods.

[New SGLT2 inhibitor empagliflozin: modern and safe treatment of diabetes].

Science.gov (United States)

Rušavý, Zdeněk

2014-11-01

Empagliflozin is agent of new antidiabetic drugs that cause glycosuria blocking the glucose reuptake in the proxi-mal tubule. The loss of 50-100 g of glucose / 24 hours in the urine results in a reduction of fasting glucose, especially post-prandial glucose, the energy expenditure of 200-400 kcal / day and blood pressure lowering. Treatment efficacy does not decrease over time, as it is not dependent on its own insulin production. The work evaluates the safety of modern treatment with empagliflozin which will soon appear in the portfolio of antidiabetic agents in the Czech Republic. The conducted studies with a special focus on empagliflozin treatment have shown high efficacy, safety and good tolerability of drug. It has been described a higher incidence of genital infections with non-severe course, especially in women. The drug does not cause hypoglycaemia. In combination with sulfonylurea hypoglycaemia may occur. Empagliflozin does not cause clinically significant dehydration or hypotension in patients about 60 years of age, but some caution in empagliflozin treatment should be in elderly and fragile patients. The big convenience of empagliflozin is its clinically non-significant interactions with other drugs and simple dosage of 1 tablet / day orally. In conclusion, empagliflozin is highly effective oral antidiabetic agent with a potential of wide application in all stages of type 2 diabetes in monotherapy or combined with other medication. The treatment is associated with weight loss and blood pressure lowering. The drug is effective and safe until eGFR 45 ml / s, in lower values the treatment should be discontinued. The occurrence of side effects is rare, except increased incidence of genital infections especially in women and increased risk of hypoglycaemia when empagliflozin is combined with sulfonylurea.

Use of yttrium-90 hydroxyapatite radiosynovectomy as a primary modality of treatment in diffuse pigmented villonodular synovitis of the knee joint: A first case report

International Nuclear Information System (INIS)

Kamaleshwaran, Koramadai Karuppusamy; Rajan, David; Krishnan, Boopathi; Gounder, Thirumalaisamy Subbaih; Chakraborty, Sudipta; Kalarickal, Radhakrishnan; Mohanan, Vyshakh; Shinto, Ajit Sugunan

2015-01-01

Pigmented villonodular synovitis (PVNS) is a rare, relatively benign, intra-articular lesion characterized by a slowly progressive proliferation of synovial tissue. Knee is the most frequently involved joint. Localized and diffuse forms of synovial involvement were reported. In extensive diffuse cases, total synovectomy is needed, almost impossible to achieve. Hence, other treatment modalities such as intra-articular injection of yttrium-90 have been tried and shown to be effective in reducing the rate of local recurrence with “acceptable” joint damage. Radiosynovectomy is based on the irradiation of the joint synovium by the intra-articular administration of various β-emitting radiopharmaceuticals. We describe the first case report of use of yttrium-90 hydroxyapatite particulates in a 33-year-old male who presented with diffuse PVNS of knee joint as a primary modality of treatment

Use of the functional imaging modalities, f MRI r CBV and PET FDG, alters radiation therapy 3-D treatment planning in patients with malignant gliomas

International Nuclear Information System (INIS)

Fitzek, M.; Pardo, F.S.; Busierre, M.; Lev, M.; Fischman, A.; Denny, N.; Hanser, B.; Rosen, B.R.; Smith, A.; Aronen, H.

1995-01-01

Background: Malignant gliomas present one of the most difficult challenges to definitive radiation therapy, not only with respect to local control, but also with respect to clinical functional status. While tumor target volume definitions for malignant gliomas are often based on CT and conventional MRI, the functional imaging modalities, echo planar r CBV (regional cerebral blood volume mapping) and 18F-fluorodeoxyglucose PET, are more sensitive modalities for the detection of neovascularization, perhaps one of the earliest signs of glial tumor initiation and progression. Methods: In order to address the clinical utility of functional imaging in radiation therapy 3-D treatment planning, we compared tumor target volume definitions and overall dosimetry in patients either undergoing co-registration of conventional Gadolinium-enhanced MRI, or co-registration of functional imaging modalities, prior to radiation therapy 3-D treatment planning. Fourteen patients were planned using 3-D radiation therapy treatment planning, either with or without inclusion of data on functional imaging. All patients received proton beam, as well as megavoltage x-ray radiation therapy, with the ratio of photon:proton optimized to the individual clinical case at hand. Both PET FDG and f MRI scans were obtained postoperatively pre-radiation, during radiation therapy, one month following completion of radiation therapy, and at three month follow-up intervals. Dose volume histograms were constructed in order to assess dose optimization, not only with respect to tumor, but also with respect to normal tissue tolerance (e.g., motor strip, dominant speech area, brainstem, optic nerves). Results: In 5 of 14 cases, functional imaging modalities, as compared with conventional MRI and CT, contributed additional information that was useful in radiation therapy treatment planning. In general, both fMRI rCBV and PET FDG uptake decreased during the course of radiation therapy. In 1 patient, however, fMRI r

Combined Modality Approaches in the Management of Adult Glioblastoma

International Nuclear Information System (INIS)

Shirazi, Haider A.; Grimm, Sean; Raizer, Jeffrey; Mehta, Minesh P.

2011-01-01

Over the past two decades, management of newly diagnosed glioblastoma has undergone significant evolution. While surgery has long been a mainstay of management for this disease, and while radiotherapy has a proven survival role, initial efforts at radiotherapy dose escalation, use of radiosurgery, brachytherapy, and altered fractionation did not improve patient survival. Recently, multiple modality therapy integrating maximal safe resection, postoperative radiation, and new systemic therapies have resulted in improved patient outcomes compared with older regimens utilizing surgery and postoperative radiation alone. Numerous trials are currently underway investigating the combination of surgery, radiation, and systemic therapy with targeted agents to find ways to further improve outcomes for adults with glioblastoma.

Combined Modality Approaches in the Management of Adult Glioblastoma

Energy Technology Data Exchange (ETDEWEB)

Shirazi, Haider A. [Department of Radiation Oncology, Feinberg School of Medicine, Northwestern University, Chicago, IL (United States); Grimm, Sean; Raizer, Jeffrey [Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL (United States); Mehta, Minesh P., E-mail: mmehta@nmff.org [Department of Radiation Oncology, Feinberg School of Medicine, Northwestern University, Chicago, IL (United States)

2011-10-28

Over the past two decades, management of newly diagnosed glioblastoma has undergone significant evolution. While surgery has long been a mainstay of management for this disease, and while radiotherapy has a proven survival role, initial efforts at radiotherapy dose escalation, use of radiosurgery, brachytherapy, and altered fractionation did not improve patient survival. Recently, multiple modality therapy integrating maximal safe resection, postoperative radiation, and new systemic therapies have resulted in improved patient outcomes compared with older regimens utilizing surgery and postoperative radiation alone. Numerous trials are currently underway investigating the combination of surgery, radiation, and systemic therapy with targeted agents to find ways to further improve outcomes for adults with glioblastoma.

A famciclovir + celecoxib combination treatment is safe and efficacious in the treatment of fibromyalgia

Directory of Open Access Journals (Sweden)

Pridgen WL

2017-02-01

Full Text Available William L Pridgen,1 Carol Duffy,2 Judy F Gendreau,3 R Michael Gendreau3 1Innovative Med Concepts, LLC, 2Department of Biological Sciences, University of Alabama, Tuscaloosa, AL, 3Gendreau Consulting, LLC, Poway, CA, USA Objective: Infections and other stressors have been implicated in the development of fibromyalgia. We hypothesized that these stressors could result in recurrent reactivations of latent herpes virus infections, which could lead to the development of fibromyalgia. This study evaluated a famciclovir + celecoxib drug combination (IMC-1, active against suspected herpes virus reactivation and infection, for the treatment of fibromyalgia.Methods: A total of 143 fibromyalgia patients were enrolled at 12 sites in a 16-week, double-blinded, placebo-controlled proof-of-concept trial. Randomized patients received either IMC-1 or placebo in a 1:1 ratio. Outcome measures included a 24-hour recall pain Numerical Rating Scale, the Revised Fibromyalgia Impact Questionnaire (FIQ-R, the Patient’s Global Impression of Change (PGIC questionnaire, the Multidimensional Fatigue Inventory, the NIH Patient-Reported Outcomes Measurement Information System (PROMIS, and the Beck Depression Inventory-II conducted at baseline and weeks 6, 12, and 16 of the study.Results: A significant decrease in fibromyalgia-related pain was observed for patients on IMC-1 treatment versus placebo. PGIC response rates were significantly improved with IMC-1 treatment. Overall, patient self-reported functioning, as measured by the FIQ-R, was significantly improved. Fatigue was also significantly improved as measured by the PROMIS fatigue inventory. The safety profile was encouraging. Despite the celecoxib component of IMC-1, gastrointestinal and nervous system treatment emergent adverse events were reported less frequently in the IMC-1 group, and study completion rates favored IMC-1 treatment.Conclusion: IMC-1 was efficacious and safe in treating symptoms of fibromyalgia

PENGARUH GOOD CORPORATE GOVERNANCE, KINERJA KEUANGAN, MODAL INTELEKTUAL TERHADAP PENGUNGKAPAN MODAL INTELEKTUAL

Directory of Open Access Journals (Sweden)

Gilang Anies Saendy

2015-10-01

Full Text Available Dampak perkembangan globalisasi membutuhkan informasi lebih lanjut, terutama informasi tentang modal intelektual perusahaan. Tapi, dalam kondisi nyata informasi modal intelektual masih rendah, yakni sekitar 27-35%. Objek penelitian ini adalah perbankan yang terdapat dalam direktori Pasar Modal Indonesia (ICMD 2010-2013. Jumlah populasi adalah 36 perbankan dan 17 sampel dengan menggunakan purposive sampling. Metode yang digunakan adalah analisis jalur. Hasil penelitian ini menunjukkan bahwa tidak pengaruh antara pelaksanaan GCG untuk pengungkapan modal intelektual dan kinerja keuangan. Selain itu, ada pengaruh positif antara kinerja modal intelektual terhadap kinerja keuangan dan kinerja keuangan untuk pengungkapan modal intelektual. Selanjutnya, hasil penelitian menunjukkan bahwa tidak efek mediasi melalui kinerja keuangan perusahaan antara implementasi GCG dalam pengungkapan modal intelektual. Hasilnya juga mengatakan ada efek mediasi antara pelaksanaan GCG untuk pengungkapan modal intelektual pikir kinerja modal intelektual. The development due to the increase of globalization gives impact to the need of having more information. One of them is the need to have information on company’s intellectual capital. But, in real condition, intellectual capital information is still low. It is about 27-35%. The objects of this research are banks organized in Indonesian Capital Market Directory (ICMD from 2010-2013. Total populations were 36 banks, and finally 17 samples were selected by using purposive sampling. The method used is path analysis. The results of this research show that there is no influence between GCG’s implementation on intellectual capital disclosure and financial performance. However, there are  positive influences of intellectual capital performance on the financial performance, and financial performance on the disclosure of intellectual capital. Besides, this research said that there is no effect of mediation through the company

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

Science.gov (United States)

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

2016-01-01

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

Reduction of the treated volume to involved node radiation therapy as part of combined modality treatment for early stage aggressive non-Hodgkin’s lymphoma

International Nuclear Information System (INIS)

Verhappen, Marieke H.; Poortmans, Philip M.P.; Raaijmakers, Esther; Raemaekers, John M.M.

2013-01-01

Background and purpose: This retrospective study investigated whether focused involved node radiation therapy (INRT) can safely replace involved field RT (IFRT) in patients with early stage aggressive NHL. Patients and methods: We included 258 patients with stage I/II aggressive NHL who received combined modality treatment (87%) or primary RT alone (13%). RT consisted of a total dose of 30–40 Gy in 15–20 fractions IFRT or INRT. We compared survival, relapse pattern, radiation-related toxicity and quality of life for both RT techniques. Results: Type of RT was not related to the outcome in either the uni- or multivariate survival analysis. Relapses developed in 59 of 252 patients (23%) of which 47 (80%) were documented as distant recurrence only. Failure of the INRT technique was noted in one patient. There was no significant difference in acute radiation-related toxicity between RT-groups but IFRT showed a significantly higher incidence of higher grade toxicities. Patients treated with INRT had a significantly better physical functioning and global quality of life compared to the IFRT group. Conclusions: Given the retrospective nature of this study, no solid conclusions can be drawn. However, in view of the equivalent efficacy and more favorable toxicity profile, the replacement of IFRT by INRT in combination with chemo-(immuno)-therapy looks very attractive for patients with early stage aggressive NHL

Prune-belly syndrome detected by ultrasound in the first trimester and the usefulness of vesicocentesis as a modality of treatment.

Science.gov (United States)

Byon, Mina; Kim, Gwang Jun

2013-07-01

Prune-belly syndrome may be related to lower urinary tract obstruction (LUTO). LUTO in the early gestational age exacerbates fetal renal function and may require intrauterine intervention. If early developed LUTO causes bladder distension and abdominal musculature deficiency, it will result in prune belly syndrome. Therefore, early detection of the disease and proper treatment before the renal impairment is important. However, there are few literatures concerning the treatment of prune belly syndrome in the first trimester. We report a case of prune belly syndrome diagnosed at 11+6 weeks of gestation and the value of vesicocentesis as a modality of treatment. Ultrasound showed dilated fetal bladder and vesicocentesis was successful in reducing the volume of the bladder. However, the pregnancy was terminated upon request.

Implementation and applications of dual-modality imaging

Science.gov (United States)

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

2004-06-01

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

Advances of operational modal identification

International Nuclear Information System (INIS)

Zhang, L.

2001-01-01

Operational modal analysis has shown many advantages compared to the traditional one. In this paper, the development of ambient modal identification in time domain is summarized. The mathematical models for modal identification have been presented as unified framework for time domain (TD) System realization algorithms, such as polyrefence (PRCE), extended Ibrahim time domain (EITD) and eigensystem realization algorithm (ERA), etc., and recently developed Stochastic subspace technique (SST). The latest technique named as frequency domain decomposition (FDD) is introduced for operational modal identification, which has many advantages as a frequency domain (FD) technique. Applications of the operational modal analysis in civil and mechanical engineering have shown the success and accuracy of the advanced operational modal identification algorithms- FDD and SST techniques. The major issues of TD and FD operational modal identification are also discussed. (author)

Mixed-Modality Stimulation to Evoke Two Modalities Simultaneously in One Channel for Electrocutaneous Sensory Feedback.

Science.gov (United States)

Choi, Kyunghwan; Kim, Pyungkang; Kim, Kyung-Soo; Kim, Soohyun

2017-12-01

One of the long-standing challenges in upper limb prosthetics is restoring the sensory feedback that is missing due to amputation. Two approaches have previously been presented to provide various types of sensory information to users, namely, multi-modality sensory feedback and using an array of single-modality stimulators. However, the feedback systems used in these approaches were too bulky to be embedded in prosthesis sockets. In this paper, we propose an electrocutaneous sensory feedback method that is capable of conveying two modalities simultaneously with only one electrode. The stimulation method, which we call mixed-modality stimulation, utilizes the phenomenon in which the superposition of two electric pulse trains of different frequencies is able to evoke two different modalities (i.e., pressure and tapping) at the same time. We conducted psychophysical experiments in which healthy subjects were required to recognize the intensity of pressure or the frequency of tapping from mixed-modality or two-channel stimulations. The results demonstrated that the subjects were able to discriminate the features of the two modalities in one electrode during mixed-modality stimulation and that the accuracies of successful recognitions (mean ± standard deviation) for the two feedback variables were 84.3 ± 7% for mixed-modality stimulation and 89.5 ± 6% for two-channel dual-modality stimulation, showing no statistically significant difference. Therefore, mixed-modality stimulation is an attractive method for modulating two modalities independently with only one electrode, and it could be used for implementing a compact sensory feedback system that is able to provide two different types of sensory information from prosthetics.

Lattice of optical islets: a novel treatment modality in photomedicine

International Nuclear Information System (INIS)

Altshuler, Gregory; Smirnov, Mikhail; Yaroslavsky, Ilya

2005-01-01

A majority of photothermal applications of laser and non-laser light sources in medicine (in particular, in dermatology) are based on the paradigm of (extended) selective photothermolysis. However, realization of this principle in its strict form may not always be possible and/or practical. Spatial (or geometric) selectivity (as opposed to wavelength and temporal selectivity) can provide an alternative approach delivering effective and safe treatment techniques. A method of creating a lattice of localized areas of light-tissue interaction (optical islets) is an example of this 'spatially confined' approach. The lattice of optical islets can be formed using a variety of energy sources and delivery optics, including application of lenslet arrays, phase masks and matrices of exogenous chromophores. Using a state-of-the-art theory of optical and thermal light-tissue interactions and a comprehensive computer model of skin, we have conducted a theoretical and numerical analysis of the process of formation of such a lattice in human tissue. Effects of the wavelength, beam geometry, pulsewidth and physical properties of tissues have been considered. Conditions for obtaining optical, thermal and damage islet lattices in the human skin without inducing adverse side effects (e.g. bulk damage) have been established

New therapeutic modalities to modulate orthodontic tooth movement

Directory of Open Access Journals (Sweden)

Ildeu Andrade Jr

2014-12-01

Full Text Available Modulation of orthodontic tooth movement (OTM is desirable not only to patients because it shortens treatment time, but also to orthodontists, since treatment duration is associated with increased risk of gingival inflammation, decalcification, dental caries, and root resorption. The increased focus on the biological basis of tooth movement has rendered Orthodontics a more comprehensive specialty that incorporates facets of all fields of medicine. Current knowledge raises the possibility of using new therapeutic modalities for modulation of OTM, such as corticotomy, laser therapy, vibration (low-intensity pulsed ultrasound, local injections of biomodulators and gene therapy; with the latter being applicable in the near future. They are intended to enhance or inhibit recruitment, differentiation and/or activation of bone cells, accelerate or reduce OTM, increase stability of orthodontic results, as well as assist with the prevention of root resorption. This article summarizes recent studies on each one of these therapeutic modalities, provides readers with information about how they affect OTM and points out future clinical perspectives.

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

Science.gov (United States)

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

2018-02-01

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

Modal Logics and Definability

OpenAIRE

Kuusisto, Antti

2013-01-01

In recent years, research into the mathematical foundations of modal logic has become increasingly popular. One of the main reasons for this is the fact that modal logic seems to adapt well to the requirements of a wide range of different fields of application. This paper is a summary of some of the author’s contributions to the understanding of modal definability theory.

Combined modality treatment improves tumor control and overall survival in patients with early stage Hodgkin's lymphoma: a systematic review

DEFF Research Database (Denmark)

Herbst, Christine; Rehan, Fareed A; Brillant, Corinne

2010-01-01

as well as conference proceedings from January 1980 to February 2009 for randomized controlled trials comparing chemotherapy alone versus the same chemotherapy regimen plus radiotherapy. Progression free survival and similar outcomes were analyzed together as tumor control. Effect measures used were......Combined modality treatment (CMT) of chemotherapy followed by localized radiotherapy is standard treatment for patients with early stage Hodgkin's lymphoma. However, the role of radiotherapy has been questioned recently and some clinical study groups advocate chemotherapy only for this indication....... We thus performed a systematic review with meta-analysis of randomized controlled trials comparing chemotherapy alone with CMT in patients with early stage Hodgkin's lymphoma with respect to response rate, tumor control and overall survival (OS). We searched Medline, EMBASE and the Cochrane Library...

NIF Periscope Wall Modal Study Comparison of Results for 2 FEA Models with 2 Modal Tests

International Nuclear Information System (INIS)

Eli, M W; Gerhard, M A; Lee, C L; Sommer, S C; Woehrle, T G

2000-01-01

This report summarizes experimentally and numerically determined modal properties for one of the reinforced concrete end walls of the NIF Periscope Support Structure in Laser Bay 1. Two methods were used to determine these modal properties: (1) Computational finite-element analyses (modal extraction process); and (2) Experimental modal analysis based on measured test data. This report also includes experimentally determined modal properties for a prototype LM3/Polarizer line-replaceable unit (LRU) and a prototype PEPC LRU. Two important parameters, used during the design phase, are validated through testing [ref 1]. These parameters are the natural frequencies and modal damping (of the system in question) for the first several global modes of vibration. Experimental modal testing provides these modal values, along with the corresponding mode shapes. Another important parameter, the input excitation (expected during normal operation of the NIF laser system) [ref 1], can be verified by performing a series of ambient vibration measurements in the vicinity of the particular system (or subsystem) of interest. The topic of ambient input excitation will be covered in a separate report. Due to the large mass of the Periscope Pedestal, it is difficult to excite the entire series of Periscope Pedestal Walls all at once. It was decided that the experimental modal tests would be performed on just one Periscope End Wall in Laser Bay 1. Experimental modal properties for the Periscope End Wall have been used to validate and update the FE analyses. Results from the analyses and modal tests support the conclusion that the Periscope Pedestal will not exceed the stability budget, which is described in reference 1. The results of the modal tests for the Periscope End Wall in Laser Bay 1 have provided examples of modal properties that can be derived from future modal tests of the entire Periscope Assembly (excluding the LRU's). This next series of larger modal tests can be performed

A novel and effective acupuncture modality as a complementary therapy to acute pain relief in inpatients with rib fractures.

Science.gov (United States)

Ho, Hsin-Yi; Chen, Chao-Wei; Li, Ming-Chieh; Hsu, Yu-Pao; Kang, Shih-Ching; Liu, Erh-Hao; Lee, Ko-Hung

2014-01-01

Pain control has been emphasized as a priority for both practitioners and inpatients with rib fractures, since analgesia could only offer limited relief from severe pain. A prospective and randomized controlled trial was conducted to analyze the efficacy and efficiency of acupuncture in acute pain relief for inpatients with rib fractures. A total of 58 inpatients were recruited and allocated to two groups, receiving identical doses of conventional oral analgesics as well as filiform needles as treatment and thumbtack intradermal (TI) needles placed upon the skin surface as a control, respectively, via novel acupuncture modality once daily for three consecutive days. The effect of pain relief was evaluated during activities that induce pain, and sustained maximal inspiration (SMI) lung volumes and sleep quality were assessed. The patients treated with filiform needles had more effective pain relief than those in the TI needle group during deep breathing, coughing, and turning over the body (p pain relief via acupuncture. The active evaluation could provide a more adaptive model for assessing pain intensity due to rib fractures. This novel acupuncture modality in which the needle insertion sites are corresponding to the pain spots can be a safe and viable therapy for relieving pain in inpatients with rib fractures.

Photodynamic Therapy in Treatment of Oral Lichen Planus

Science.gov (United States)

Mostafa, Diana; Tarakji, Bassel

2015-01-01

Oral lichen planus (OLP) is a relatively common chronic immunologic mucocutaneous disorder. Although there are many presenting treatments, some of them proved its failure. Recently, the use of photodynamic therapy (PDT) has been expanding due to its numerous advantages, as it is safe, convenient, and non-invasive and has toxic effect towards selective tissues. This article provides comprehensive review on OLP, its etiology, clinical features and recent non-pharmacological treatments. We also describe the topical PDT and its mechanisms. Our purpose was to evaluate the efficacy of PDT in treatment of OLP through collecting the data of the related clinical studies. We searched in PubMed website for the clinical studies that were reported from 2000 to 2014 using specific keywords: “photodynamic therapy” and “treatment of oral lichen planus”. Inclusion criteria were English publications only were concerned. In the selected studies of photodynamic treatment, adult patients (more than 20 years) were conducted and the OLP lesions were clinically and histologically confirmed. Exclusion criteria were classical and pharmacological treatments of OLP were excluded and also the using of PDT on skin lesions of lichen planus. We established five clinical studies in this review where all of them reported improvement and effectiveness of PDT in treatment of OLP lesions. The main outcome of comparing the related clinical studies is that the photodynamic is considered as a safe, effective and promising treatment modality for OLP. PMID:25883701

Advances in Modal Logic

DEFF Research Database (Denmark)

Modal logic is a subject with ancient roots in the western logical tradition. Up until the last few generations, it was pursued mainly as a branch of philosophy. But in recent years, the subject has taken new directions with connections to topics in computer science and mathematics. This volume...... is the proceedings of the conference of record in its fi eld, Advances in Modal Logic. Its contributions are state-of-the-art papers. The topics include decidability and complexity results for specifi c modal logics, proof theory of modal logic, logics for reasoning about time and space, provability logic, dynamic...... epistemic logic, and the logic of evidence....

A prospective, open, comparative study of 5% potassium hydroxide solution versus cryotherapy in the treatment of genital warts in men.

Science.gov (United States)

Camargo, Caio Lamunier de Abreu; Belda Junior, Walter; Fagundes, Luiz Jorge; Romiti, Ricardo

2014-01-01

Genital warts are caused by human papillomavirus infection and represent one of the most common sexually transmitted diseases. Many infections are transient but the virus may recur, persist, or become latent. To date, there is no effective antiviral treatment to eliminate HPV infection and most therapies are aimed at the destruction of visible lesions. Potassium hydroxide is a strong alkali that has been shown to be safe and effective for the treatment of genital warts and molluscum contagiosum. Cryotherapy is considered one of the most established treatments for genital warts. No comparative trials have been reported to date on the use of potassium hydroxide for genital warts. A prospective, open-label, randomized clinical trial was conducted to compare topical potassium hydroxide versus cryotherapy in the treatment of genital warts affecting immunocompetent, sexually active men. Over a period of 10 months, 48 patients were enrolled. They were randomly divided into two groups and selected on an alternative basis for either potassium hydroxide therapy or cryotherapy. While response to therapy did not differ substantially between both treatment modalities, side effects such as local pain and post-treatment hypopigmentation were considerably more prevalent in the groups treated using cryotherapy. In our study, potassium hydroxide therapy proved to be at least as effective as cryotherapy and offered the benefit of a better safety profile. Topical 5% potassium hydroxide presents an effective, safe, and low-cost treatment modality for genital warts in men and should be included in the spectrum of therapies for genital warts.

A prospective, open, comparative study of 5% potassium hydroxide solution versus cryotherapy in the treatment of genital warts in men*

Science.gov (United States)

Camargo, Caio Lamunier de Abreu; Belda, Walter; Fagundes, Luiz Jorge; Romiti, Ricardo

2014-01-01

BACKGROUND Genital warts are caused by human papillomavirus infection and represent one of the most common sexually transmitted diseases. Many infections are transient but the virus may recur, persist, or become latent. To date, there is no effective antiviral treatment to eliminate HPV infection and most therapies are aimed at the destruction of visible lesions. Potassium hydroxide is a strong alkali that has been shown to be safe and effective for the treatment of genital warts and molluscum contagiosum. Cryotherapy is considered one of the most established treatments for genital warts. No comparative trials have been reported to date on the use of potassium hydroxide for genital warts. OBJECTIVE A prospective, open-label, randomized clinical trial was conducted to compare topical potassium hydroxide versus cryotherapy in the treatment of genital warts affecting immunocompetent, sexually active men. METHODS Over a period of 10 months, 48 patients were enrolled. They were randomly divided into two groups and selected on an alternative basis for either potassium hydroxide therapy or cryotherapy. While response to therapy did not differ substantially between both treatment modalities, side effects such as local pain and post-treatment hypopigmentation were considerably more prevalent in the groups treated using cryotherapy. RESULT In our study, potassium hydroxide therapy proved to be at least as effective as cryotherapy and offered the benefit of a better safety profile. CONCLUSION Topical 5% potassium hydroxide presents an effective, safe, and low-cost treatment modality for genital warts in men and should be included in the spectrum of therapies for genital warts. PMID:24770498

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

Science.gov (United States)

Sandhu, Rajwant; Dyson, Benjamin James

2016-05-01

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

Evidence for a supra-modal representation of emotion from cross-modal adaptation.

Science.gov (United States)

Pye, Annie; Bestelmeyer, Patricia E G

2015-01-01

Successful social interaction hinges on accurate perception of emotional signals. These signals are typically conveyed multi-modally by the face and voice. Previous research has demonstrated uni-modal contrastive aftereffects for emotionally expressive faces or voices. Here we were interested in whether these aftereffects transfer across modality as theoretical models predict. We show that adaptation to facial expressions elicits significant auditory aftereffects. Adaptation to angry facial expressions caused ambiguous vocal stimuli drawn from an anger-fear morphed continuum to be perceived as less angry and more fearful relative to adaptation to fearful faces. In a second experiment, we demonstrate that these aftereffects are not dependent on learned face-voice congruence, i.e. adaptation to one facial identity transferred to an unmatched voice identity. Taken together, our findings provide support for a supra-modal representation of emotion and suggest further that identity and emotion may be processed independently from one another, at least at the supra-modal level of the processing hierarchy. Copyright © 2014 Elsevier B.V. All rights reserved.

Automated Modal Parameter Estimation for Operational Modal Analysis of Large Systems

DEFF Research Database (Denmark)

Andersen, Palle; Brincker, Rune; Goursat, Maurice

2007-01-01

In this paper the problems of doing automatic modal parameter extraction and how to account for large number of data to process are considered. Two different approaches for obtaining the modal parameters automatically using OMA are presented: The Frequency Domain Decomposition (FDD) technique and...

Comparison of three radiotherapy modalities on biochemical control and overall survival for the treatment of prostate cancer: A systematic review

International Nuclear Information System (INIS)

Pieters, Bradley R.; Back, Djuna Z. de; Koning, Caro C.E.; Zwinderman, Aeilko H.

2009-01-01

Background and Purpose: For the radiation treatment of prostate cancer high dose should be delivered for optimal biochemical control. Treatment can be given by dose-escalated external beam radiotherapy (EBRT) or external beam radiotherapy combined with a radioactive seed implantation (EBSeeds) or high-dose rate (HDR) brachytherapy (EBTI). Differences in outcome between the modalities were assessed by a systematic review. Materials and methods: A systematic search was performed resulting in 40 articles to be used. Data were extracted on biochemical control and overall survival at 3, 5, and 8 years and other time points mentioned in the articles. Also known prognostic parameters were noted. Comparison of the modalities was done by a Weibull survival analysis and estimation of Hazard Ratio's (HR) was done with 95% confidence intervals (95% CIs). Results: The HR for biochemical recurrence was 1.40 (95% CI 1.31-1.51) for EBRT relative to EBTI, and was 1.37 (95% CI 1.26-1.49) for EBSeeds relative to EBTI. The HR for overall survival was 1.50 (95% CI 1.29-1.73) for EBRT relative to EBTI, and was 2.33 (95% CI 2.04-2.66) for EBSeeds relative to EBTI. Conclusion: The combination of external beam radiotherapy and HDR brachytherapy results in a superior biochemical control and overall survival found in a systematic review on radiotherapy for prostate cancer.

Mandibular Condyle Fractures and Treatment Modalities

Directory of Open Access Journals (Sweden)

Halil ibrahim Kisa

2014-08-01

Full Text Available Maxillofacial injuries are most commonly associated with falls, motor and vehicle accidents, sports-related trauma, and interpersonel violence. The complexity of mandibular condyle region and its anatomic proximity to other craniofacial structures complicate diagnosis and treatment. Thus, treatment approaches of mandibular condyle fracture are still controversial. In the literature, different success rates are reported about observation versus treatment, closed reduction versus open reduction and fixation methods. In the present article, controversial issues related to mandibular condyle fractures were reviewed under the light of current literature. In conclusion, the simplest way that can be done with the least risk of complication should be chosen during treatment planning. In addition, current adjunctive treatment methods accelerating healing of fracture should be considered. [Archives Medical Review Journal 2014; 23(4.000: 658-671

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

Science.gov (United States)

Stephan, Denise Nadine; Koch, Iring

2016-11-01

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

Organ preservation in invasive bladder cancer: Brachytherapy, an alternative to cystectomy and combined modality treatment?

International Nuclear Information System (INIS)

Pos, Floris; Horenblas, Simon; Dom, Paul; Moonen, Luc; Bartelink, Harry

2005-01-01

Purpose: To evaluate our long-term results of bladder preservation with brachytherapy in the treatment of bladder cancer. Methods and materials: Between 1987 and 2000, 108 patients with T1-G3 and T2-T3a stages of bladder cancer were treated with a transurethral resection (TUR) and a course of external beam radiotherapy (30 Gy in 15 fractions) followed by brachytherapy (40 Gy). All tumors were solitary lesions with a diameter ≤5 cm. Median follow-up was 54 months (range, 1-178 months). Results: The 5-year and 10-year overall survival rates were 62% and 50%, respectively. The 5-year and 10-year disease-specific survival rates were 73% and 67%, respectively. The actuarial local control rate was 73% at 5 and 73% at 10 years, respectively. The 5-year and 10-year disease-specific survival rates for patients with a preserved bladder were 68% and 59%, respectively. Of all long-term surviving patients, 90% preserved their native bladders. The treatment was well tolerated. Acute toxicity was mild. Two patients experienced serious late toxicity: 1 patient developed a persisting vesicocutaneous fistula and the other a stricture of the urethra and ureters. Conclusion: For patients with solitary, organ confined invasive bladder cancer ≤5 cm, bladder preservation with brachytherapy is an excellent alternative to radical cystectomy and combined modality treatment

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

OpenAIRE

Thomas Hyphantis; Spiros Katsoudas; Sonia Voudiclari

2010-01-01

Thomas Hyphantis1, Spiros Katsoudas2, Sonia Voudiclari31Associate Professor of Psychiatry, Department of Psychiatry, Medical School, University of Ioannina, Ioannina, Greece; 2Nephrologist, Renal Clinic, Hippocration General Hospital, Athens, Greece; 3Department of Nephrology, University of Athens, GreeceAbstract: Several parameters mediate the selection of treatment modality in end-stage renal disease (ESRD). The nephrology community suggests that patient preference should be the prime deter...

Cost effectiveness of endometrial ablation with the NovaSure® system versus other global ablation modalities and hysterectomy for treatment of abnormal uterine bleeding: US commercial and Medicaid payer perspectives

Directory of Open Access Journals (Sweden)

Miller JD

2015-01-01

Full Text Available Jeffrey D Miller,1 Gregory M Lenhart,1 Machaon M Bonafede,1 Cindy M Basinski,2 Andrea S Lukes,3 Kathleen A Troeger4 1Truven Health Analytics, Cambridge, MA, 2Basinski, LLC, Newburgh, IN, 3Carolina Women’s Research and Wellness Center, Durham, NC, 4Hologic, Inc, Marlborough, MA, USA Objectives: Abnormal uterine bleeding (AUB interferes with physical, emotional, and social well-being, impacting the quality of life of more than 10 million women in the USA. Hysterectomy, the most common surgical treatment of AUB, has significant morbidity, low mortality, long recovery, and high associated health care costs. Global endometrial ablation (GEA provides a surgical alternative with reduced morbidity, cost, and recovery time. The NovaSure® system utilizes unique radiofrequency impedance-based GEA technology. This study evaluated cost effectiveness of AUB treatment with NovaSure ablation versus other GEA modalities and versus hysterectomy from the US commercial and Medicaid payer perspectives. Methods: A health state transition (semi-Markov model was developed using epidemiologic, clinical, and economic data from commercial and Medicaid claims database analyses, supplemented by published literature. Three hypothetical cohorts of women receiving AUB interventions were simulated over 1-, 3-, and 5-year horizons to evaluate clinical and economic outcomes for NovaSure, other GEA modalities, and hysterectomy. Results: Model analyses show lower costs for NovaSure-treated patients than for those treated with other GEA modalities or hysterectomy over all time frames under commercial payer and Medicaid perspectives. By Year 3, cost savings versus other GEA were $930 (commercial and $3,000 (Medicaid; cost savings versus hysterectomy were $6,500 (commercial and $8,900 (Medicaid. Coinciding with a 43%–71% reduction in need for re-ablation, there were 69%–88% fewer intervention/reintervention complications for NovaSure-treated patients versus other GEA modalities

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

Science.gov (United States)

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

2017-01-01

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

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

Science.gov (United States)

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

2018-05-29

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

Safe sex

Science.gov (United States)

... sex; Sexually transmitted - safe sex; GC - safe sex; Gonorrhea - safe sex; Herpes - safe sex; HIV - safe sex; ... contact. STIs include: Chlamydia Genital herpes Genital warts Gonorrhea Hepatitis HIV HPV Syphilis STIs are also called ...

[Treatment of autonomous and cystic thyroid nodules with intranodular ethanol injection].

Science.gov (United States)

Braga-Basaria, Milena; Trippia, Marcus Adriano; Stolf, Anderson Ravy; Mesa, Cléo; Graf, Hans

2002-01-01

Intranodular ethanol injection has been used for the past 10 years as an efficient modality for treating patients with thyroid nodules. Several studies have reported the success of this therapy in autonomous and cystic nodules and, more recently, in cold benign nodules. To evaluate the efficacy of this therapeutic modality on the treatment of autonomous and cystic thyroid nodules. 42 patients (26 with cystic and 16 with autonomous nodules) were treated with ultrasound guided intranodular 99% ethanol injection and followed for 6 months. No major complications were observed during or after treatment, however, most of the patients reported slight to moderate pain and/or discomfort after the injection. Most of the nodules showed reduction after the treatment. Autonomous nodules had a mean reduction of 50.3% and cystic nodules of 69.3%. No significant differences in pretreatment serum total T3, total T4 or TSH were observed among the patients in the cystic group. Patients in the autonomous group with hyperfunctioning nodules showed a decrease in serum total T3, total T4 and an increase in serum TSH levels, hence, proving the effectiveness of this therapy. Intranodular ethanol injection is a safe and efficient treatment for autonomous and cystic nodules of the thyroid.

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

Science.gov (United States)

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

2018-04-01

Key for successful jugulotympanic paraganglioma management is a personalised approach aiming for the best practice for each individual patient. To this end, a systematic review is performed, evaluating the local control and complication rates for the different treatment modalities stratified by the broadly accepted Fisch classification. A systematic literature review according to the PRISMA statement was performed. A detailed overview of individual treatment outcomes per Fisch class is provided. Local control, cranial nerve damage, complications, function recovery. Eighteen studies were selected, resembling 83 patients treated with radiotherapy and 299 with surgery. Excellent local control was found post-surgery for class A and B tumours, and risk of cranial nerve damage was class C1-4 tumours, local control was 80%-95% post-surgery (84% post-radiotherapy), and cranial nerve damage was found in 71%-76% (none post-radiotherapy; P class. For class C1-4De/Di tumours, local control was 38%-86% (98% post-radiotherapy; P class. For class A and B tumours, surgery is a suitable treatment option. For class C and D tumours, radiotherapy results in lower complication rates and similar or better local control rates when compared to the surgical group. © 2017 John Wiley & Sons Ltd.

One year's experience by COGEMA logistics of application of the new modal regulations

International Nuclear Information System (INIS)

Malesys, P.

2002-01-01

International transport of radioactive materials is regulated by international and regional modal regulations that apply to all dangerous goods. The requirements for radioactive materials in the modal regulations are based on those of the 'Regulations for the Safe Transport of Radioactive Material' set forth by the International Atomic Energy Agency (IAEA). The last edition of the IAEA regulations was published in 1996 (TS-R-1 (ST-1, Revised)), then incorporated in the modal regulations, and finally implemented, with various transitional periods throughout 2001. As a final result, since 1 January 2002 it has been mandatory, for all modes, to perform transports in accordance with the 1996 edition of the IAEA transport regulations. In the mean time, all the international and regional regulations have also been reformatted, and each of them has now adopted the unified format of the United Nations 'Recommendations on the Transport of Dangerous Goods - Model Regulations', often referred to as the Orange Book. This paper presents the experience of COGEMA Logistics with the application of this new set of regulations to design of packages, transport operations, and administrative matters. Both the advantages provided by these new regulations and the difficulties which were (and are still being) met are presented. (author)

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

Science.gov (United States)

Seufert, Tina; Schutze, Maren; Brunken, Roland

2009-01-01

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

Cimetidine: A Safe Treatment Option for Cutaneous Warts in Pediatric Heart Transplant Recipients

Directory of Open Access Journals (Sweden)

Bibhuti B Das

2018-04-01

Full Text Available Background and Objectives: Immunosuppressed individuals are at particularly increased risk for human papilloma virus-related infections. The primary objective of our study is to determine if there are any adverse effects associated with high-dose cimetidine treatment. A secondary objective is to report our experience with cimetidine in the treatment of cutaneous warts in pediatric heart transplant recipients. Methods and Results: This was a retrospective observational study. A total of 8 pediatric heart transplant recipients diagnosed with multiple recalcitrant warts were the subject of the study. All patients were treated with cimetidine (30–40 mg/kg/day in two divided doses for 3 to 6 month durations. All patients had complete resolution of their lesions except 1 patient who had no clinical improvement. Of these 8 patients, one had recurrence of warts at one year follow-up, which resolved with restarting cimetidine therapy. One patient who had only 3 months of cimetidine therapy had immediate relapse after cimetidine was stopped. None of them had significant change in their tacrolimus trough, serum creatinine, and alanine transaminase levels. No adverse events were reported except one patient experienced mild gynecomastia. Conclusion: Cimetidine can be a safe and alternative treatment option for multiple warts in pediatric heart transplant recipients.

Scopes and limits of modality in quantum mechanics

International Nuclear Information System (INIS)

Domenech, G.; Freytes, H.; de Ronde, C.

2006-01-01

We develop an algebraic frame for the simultaneous treatment of actual and possible properties of quantum systems. We show that, in spite of the fact that the language is enriched with the addition of a modal operator to the orthomodular structure, contextuality remains a central feature of quantum systems. (Abstract Copyright [2006], Wiley Periodicals, Inc.)

Scopes and limits of modality in quantum mechanics

Energy Technology Data Exchange (ETDEWEB)

Domenech, G. [Instituto de Astronomia y Fisica del Espacio (IAFE), Buenos Aires (Argentina); Freytes, H. [Dipartimento di Scienze e Pedagogiche e Filosofiche, Universita degli Studi di Cagliari, Cagliari (Italy); de Ronde, C. [Center Leo Apostel (CLEA) and Foundations of the Exact Sciences (FUND), Brussels Free University, Brussels (Belgium)

2006-12-15

We develop an algebraic frame for the simultaneous treatment of actual and possible properties of quantum systems. We show that, in spite of the fact that the language is enriched with the addition of a modal operator to the orthomodular structure, contextuality remains a central feature of quantum systems. (Abstract Copyright [2006], Wiley Periodicals, Inc.)

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

Science.gov (United States)

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

2015-11-01

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

A systematic review of ultrasound-accelerated catheter-directed thrombolysis in the treatment of deep vein thrombosis.

Science.gov (United States)

Shi, Yadong; Shi, Wanyin; Chen, Liang; Gu, Jianping

2018-04-01

To review the clinical evidence for ultrasound-accelerated catheter-directed thrombolysis (UACDT) using the EKOS system in the treatment of deep vein thrombosis (DVT) in terms of case selection, procedural outcomes, clinical outcomes and safety outcomes. A systematic literature search strategy was used to identify the use of the EKOS system in the treatment of DVT using the following electronic databases: MEDLINE, EMBASE, the Cochrane databases and the Web of Science. The references in the relevant literature were also screened. Our literature search identified a total of 16 unique clinical studies. Twelve of the sixteen studies were retrospective case series studies. To date, only one randomised controlled trial (RCT) is available. Overall, UACDT using the EKOS system was performed 548 times in 512 patients. Among all cases, 77-100% achieved substantial lysis (> 50%) based on the different definitions of the individual studies. This treatment modality appears to be safe, as there were no reported procedure-related pulmonary embolisms (PE) and only one procedure-related death was reported. Bleeding events were reported in 14 of the 16 studies, and 3.9% (20/512) of the cases of bleeding were considered major. During the follow-up, post-thrombotic syndrome was observed in 17.1% (20/117) of cases. UACDT using the EKOS system is an effective, safe and promising treatment modality for DVT, but the existing clinical evidence is inadequate to make UACDT using the EKOS system the first-line choice for DVT. Additional prospective large-sample RCTs with long-term follow-ups are warranted to define the role of UACDT using the EKOS system in the treatment of DVT.

The SafeBoosC II randomized trial

DEFF Research Database (Denmark)

Plomgaard, Anne M; van Oeveren, Wim; Petersen, Tue Hvass

2016-01-01

BACKGROUND: The SafeBoosC phase II multicentre randomized clinical trial investigated the benefits and harms of monitoring cerebral oxygenation by near-infrared spectroscopy (NIRS) combined with an evidence-based treatment guideline vs. no NIRS data and treatment as usual in the control group...

Argon green-Nd: YAG dual laser posterior hyaloidotomy: An innovative approach toward treatment of premacular hemorrhage

Directory of Open Access Journals (Sweden)

Ashish Sharma

2013-01-01

Full Text Available Background: Neodymium: YAG (Nd: YAG laser and argon laser has been used to treat premacular hemorrhage either alone or rarely in combination. Materials and Methods: We describe a new technique of treating premacular hemorrhage by performing hyaloidotomy using a combination of argon green-Nd: YAG laser. We utilized subthreshold energy levels of Nd: YAG laser of 2.0 mJ as compared to the normal recommendation of 3.6-50 mJ. Results and Conclusions: This technique is easy, effective, and safe to manage premacular hemorrhage. The principle behind this combined laser treatment was to make the internal limiting membrane (ILM taut by initial exposure to argon green laser, which allowed us to employ the subthreshold energy levels of Nd: YAG laser. We would like to assess the role of this combined treatment modality in comparison to other modalities, including solitary laser therapy in the management of premacular hemorrhage by performing a prospective, randomized long-term study.

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

Science.gov (United States)

Vandierendonck, André

2016-01-01

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

Prospective, longitudinal, multi-modal functional imaging for radical chemo-IMRT treatment of locally advanced head and neck cancer: the INSIGHT study

International Nuclear Information System (INIS)

Welsh, Liam; Panek, Rafal; McQuaid, Dualta; Dunlop, Alex; Schmidt, Maria; Riddell, Angela; Koh, Dow-Mu; Doran, Simon; Murray, Iain; Du, Yong; Chua, Sue; Hansen, Vibeke; Wong, Kee H.; Dean, Jamie; Gulliford, Sarah; Bhide, Shreerang; Leach, Martin O.; Nutting, Christopher; Harrington, Kevin; Newbold, Kate

2015-01-01

Radical chemo-radiotherapy (CRT) is an effective organ-sparing treatment option for patients with locally advanced head and neck cancer (LAHNC). Despite advances in treatment for LAHNC, a significant minority of these patients continue to fail to achieve complete response with standard CRT. By constructing a multi-modality functional imaging (FI) predictive biomarker for CRT outcome for patients with LAHNC we hope to be able to reliably identify those patients at high risk of failing standard CRT. Such a biomarker would in future enable CRT to be tailored to the specific biological characteristics of each patients’ tumour, potentially leading to improved treatment outcomes. The INSIGHT study is a single-centre, prospective, longitudinal multi-modality imaging study using functional MRI and FDG-PET/CT for patients with LAHNC squamous cell carcinomas receiving radical CRT. Two cohorts of patients are being recruited: one treated with, and another treated without, induction chemotherapy. All patients receive radical intensity modulated radiotherapy with concurrent chemotherapy. Patients undergo functional imaging before, during and 3 months after completion of radiotherapy, as well as at the time of relapse, should that occur within the first two years after treatment. Serum samples are collected from patients at the same time points as the FI scans for analysis of a panel of serum markers of tumour hypoxia. The primary aim of the INSIGHT study is to acquire a prospective multi-parametric longitudinal data set comprising functional MRI, FDG PET/CT, and serum biomarker data from patients with LAHNC undergoing primary radical CRT. This data set will be used to construct a predictive imaging biomarker for outcome after CRT for LAHNC. This predictive imaging biomarker will be used in future studies of functional imaging based treatment stratification for patients with LAHNC. Additional objectives are: defining the reproducibility of FI parameters; determining robust

Kerathocyst odontogenic tumor: Importance of selection the best treatment modality and a periodical follow-up to prevent from recurrence: A case report and literature review

Directory of Open Access Journals (Sweden)

Nasim Jafaripozve

2013-01-01

Full Text Available The keratocystic odontogenic tumor (KCOT is a relatively common oral and maxillofacial lesion with specific characteristics such us rapid growth, extension into the surrounding tissues and high rates of recurrence. Various treatment modalities have been reported. Due to the very thin and friable lining characteristic of the tumor, enucleation can be difficult undertaken and for this reason it is associated with the highest recurrence rates. A 22-year-old male referred to our clinic due to a slight expansion in the right mandible from 2 years ago. He has a history of occurrence of KCOT in this region that was treated surgically by enucleation and curettage 5 years ago. Cone beam computed tomography showed a multilocular radiolucent lesion that extended from the angle of the mandible to the symphysis. Incisional biopsy showed a KCOT recurrence that surgically treated with resection of the right mandible by continuity preservation. Selection of the best treatment modality and also a periodical lifelong follow-up is very important to reduce the rate of recurrence and morbidity of the patient.

Setting priorities for safe motherhood interventions in resource-scarce settings.

Science.gov (United States)

Prata, Ndola; Sreenivas, Amita; Greig, Fiona; Walsh, Julia; Potts, Malcolm

2010-01-01

Guide policy-makers in prioritizing safe motherhood interventions. Three models (LOW, MED, HIGH) were constructed based on 34 sub-Saharan African countries to assess the relative cost-effectiveness of available safe motherhood interventions. Cost and effectiveness data were compiled and inserted into the WHO Mother Baby Package Costing Spreadsheet. For each model we assessed the percentage in maternal mortality reduction after implementing all interventions, and optimal combinations of interventions given restricted budgets of US$ 0.50, US$ 1.00, US$ 1.50 per capital maternal health expenditures respectively for LOW, MED, and HIGH models. The most cost-effective interventions were family planning and safe abortion (fpsa), antenatal care including misoprostol distribution for postpartum hemorrhage prevention at home deliveries (anc-miso), followed by sepsis treatment (sepsis) and facility-based postpartum hemorrhage management (pph). The combination of interventions that avert the greatest number of maternal deaths should be prioritized and expanded to cover the greatest number of women at risk. Those which save the most number of lives in each model are 'fpsa, anc-miso' and 'fpsa, sepsis, safe delivery' for LOW; 'fpsa, anc-miso' and 'fpsa, sepsis, safe delivery' for MED; and 'fpsa, anc-miso, sepsis, eclampsia treatment, safe delivery' for HIGH settings. Safe motherhood interventions save a significant number of newborn lives.

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

Science.gov (United States)

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

2015-01-01

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

Bimodal extinction without cross-modal extinction.

OpenAIRE

Inhoff, A W; Rafal, R D; Posner, M J

1992-01-01

Three patients with unilateral neurological injury were clinically examined. All showed consistent unilateral extinction in the tactile and visual modalities on simultaneous intramodal stimulation. There was virtually no evidence for cross-modal extinction, however, so that contralateral stimulation of one modality would have extinguished perception of ipsilateral stimuli in the other modality. It is concluded that the attentional system controlling the encoding of tactile and visual stimuli ...

[Intratympanic injection therapy for therapy refractory acute hearing loss: A safe option for secondary treatment].

Science.gov (United States)

Mühlmeier, G; Maier, S; Maier, M; Maier, H

2015-10-01

High-dose corticosteroids are currently recommended for idiopathic sudden sensorineural hearing loss (ISSNHL) treatment. Intratympanic injections (ITI) are of growing importance, especially in cases of therapy resistance. The selection of patients for this procedure in SSNHL has not been adequately examined so far. A total of 77 patients with ISSNHL after ineffective systemic pretreatment underwent intratympanic administration of dexamethasone and hyaluronic acid. Improvement after treatment was determined by pure tone audiometry for both ears before and of the treated ear after ITI. In this study 34 female and 43 male patients with mean age of 57 years showed a pre-ITI hearing loss of 35 dB in the lower frequencies and 69 dB in the higher frequencies. The mean hearing gain was 10 dB and the response rate was 62%. Absolute hearing gain revealed significant improvements at 500 Hz, 1 kHz and 2 kHz. Under inclusion of contralateral thresholds there were hardly any differences up to 4 kHz. In a detailed analysis of responders moderate improvements could be observed even in higher frequencies. Overall, no relevant adverse events occurred. Treatment of ISSNHL resistant to systemic regimens by ITI of steroids provides an option that offers additional prospects of auditory improvement for affected patients. The presented results indicate that these modalities are also valid for patients with pancochlear ISSNHL.

Genetic and cellular techniques emerge as promising modalities for the treatment of diabetic foot syndrome

Directory of Open Access Journals (Sweden)

Vladimir Iosifovich Konenkov

2014-03-01

Full Text Available Two patient groups potentially to benefit most from these novel methods are patients with critical lower limb ischemia (CLLI in whom angiosurgery is not indicated, and patients with trophic ulcers resistant to conventional therapy. A series of clinical trials has shown positive effects of transferring VEGF, HIF-1, FGF, PDGF, HGF and certain other growth factor genes to stimulate blood vessel formation and healing of diabetic ulcers. Autologous transplantation of mononuclear bone marrow and peripheral blood cells, endothelial progenitor cells, mesenchymal stem cells and stromal cell of the adipose tissue has also demonstrated its clinical potential in patients with diabetes mellitus and CLLI. Randomized clinical trials report beneficial effects of gene and cell therapy on such surrogate endpoints as ischemic index, rest pain and ulcer healing, though data on amputation rates is controversial. Further studies are necessary to determine optimal dosage and route of administration of biological agents and predictors of their efficacy, as well as long-term safety of these novel treatment modalities.

Modal logics are coalgebraic

NARCIS (Netherlands)

Cirstea, C.; Kurz, A.; Pattinson, D.; Schröder, L.; Venema, Y.

2011-01-01

Applications of modal logics are abundant in computer science, and a large number of structurally different modal logics have been successfully employed in a diverse spectrum of application contexts. Coalgebraic semantics, on the other hand, provides a uniform and encompassing view on the large

Checking the virtual treatment modality Wedge from Siemens; Verificacion de la modalidad de tratamiento virtual WEDGE de SIEMENS

Energy Technology Data Exchange (ETDEWEB)

Suero Rodrigo, M. A.; Marques Fraguela, E.

2011-07-01

The treatment modality Virtual Wedge (VW) or implemented by Siemens virtual wedge in electron linear accelerators achieved dose distributions are similar but not identical, to those obtained with physical wedges. Among the advantages against the latter is the greater ease of use, wedge factor close to one, and lower peripheral dose. However, these benefits are to be effective requires a through quality control dependence because a larger number of parameters that control the generation of the beam, the dose monitor system and the movement of the jaws of the collimator. We performed a study of the wedge taking into account different configurations that can affect their behavior from the dosimetric point of view.

First, keep it safe: Integration of a complementary medicine service within a hospital.

Science.gov (United States)

Schiff, Elad; Levy, Ilana; Arnon, Zahi; Ben-Arye, Eran; Attias, Samuel

2018-05-01

This paper sought to explore risk/safety considerations associated with the integration of a complementary medicine (CM) service within a public academic medical centre in Israel. We reviewed various sources pertaining to the CM service (interviews with CM staff, patients' electronic charts, service guidelines, correspondence with hospital administration) and conducted a thematic analysis to evaluate safety-related incidents during the 7 years of operation. In addition, we systematically assessed the charts for reports of treatment-associated adverse effects, which were documented in an obligatory field on treatment reports. After reviewing transcripts of interviews with 12 CM practitioners and with the director and vice-director of the CM service as well as transcripts of 8560 consultations that included 7383 treatments, we categorised 3 major domains of CM safety management: (i) prevention of safety-related incidents by appropriate selection of CM practitioners and modalities, (ii) actual adverse incidents and (iii) prevention of their recurrence using both hospital and CM service safety protocols. CM staff reported 5 categories of adverse incidents, most of which were minor. Twenty-nine adverse incidents were documented in the 7383 treatment sessions (0.4%). Safety management needs to be addressed both before introducing CM services in hospitals and throughout their integration. Important considerations for the safe integration of CM practices in the hospital include communication between CM and conventional practitioners, adherence to hospital safety rules, implementing a systematic approach for detecting and reporting safety-related incidents and continuous adaptation of the CM service safety protocols. © 2018 John Wiley & Sons Ltd.

Primary central nervous system lymphoma: age and performance status are more important than treatment modality

International Nuclear Information System (INIS)

Corry, June; Smith, Jennifer G.; Wirth, Andrew; Quong, George; Liew, Kuen Hoe

1998-01-01

Purpose: To assess prognostic factors and treatment modalities of patients with primary central nervous system lymphoma (PCNSL) in terms of response rates, patterns of failure and overall survival. Methods and Materials: Sixty-two patients presenting with PCNSL between 1982 and 1994 at Peter MacCallum Cancer Institute with no evidence of human immunodeficiency virus infection were included in the study. Their median age was 60 years; World Health Organisation (WHO) performance status was ≥2 in 85%. All patients were planned to receive whole brain irradiation; 7 also received spinal irradiation. The median planned dose to the target volume was 50.4 Gy. Twenty patients were planned to receive chemotherapy as well. Patients were followed up to June 20, 1995, giving a median follow-up for 14 surviving patients of 5.4 years, range 0.3 to 10.2 years. Results: The clinical response rate to treatment was 77% [95% confidence interval (CI) 65 to 87%]. The estimated median overall survival was 20.6 months (CI 12.4 to 33.4 months). On univariate analysis male gender, age <60 years, WHO performance status ≤1, treatment to the target volume ≥45 Gy, and treatment with additional chemotherapy, were associated with a significantly better overall survival (p < 0.05). On multivariate analysis only age and performance status remained significant prognostic variables. Relapse involved the central nervous system or cerebrospinal fluid (CSF) in all patients with known sites of relapse except three who had ocular relapse only. There was a low incidence of relapse in the initial brain site (23% of known cases) and a high incidence (50%) of CSF/spinal cord relapse. Of 48 deaths, 15 were related to initial or subsequent treatment. Conclusions: Patient outcome is strongly influenced by age and performance status. Studies suggesting better survival for patients treated with chemoradiation may reflect patient selection rather than treatment variables. Optimal management remains to be

The modal study

International Nuclear Information System (INIS)

Cook, J.R.

1988-01-01

The term ''Modal Study'' refers to a research program conducted for the Nuclear Regulatory Commission (NRC) on the level of protection provided by NRC-certified packages during the shipment of spent nuclear fuel form U.S. power reactors. The objective of the study was to examine the response of the packages to actual highway and railway accident conditions. The Modal Study results show that NRC-certified spent fuel casks would perform their safety functions under severe, actual accident conditions. The study also explains how NRC's cask design conditions, which are expressed in engineering terms, relate to actual accident conditions, with which the public is more familiar. The Modal Study, along with other transportation studies, physical testing of casks, and the spent fuel shipment safety record confirm the view that casks provide a high level of public safety during spent fuel transport

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

Science.gov (United States)

Gruber, Ronald R; Block, Richard A

2017-01-01

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

Endoscope-guided pneumatic dilation for treatment of esophageal achalasia

Science.gov (United States)

Chuah, Seng-Kee; Wu, Keng-Liang; Hu, Tsung-Hui; Tai, Wei-Chen; Changchien, Chi-Sin

2010-01-01

Pneumatic dilation (PD) is considered to be the first line nonsurgical therapy for achalasia. The principle of the procedure is to weaken the lower esophageal sphincter by tearing its muscle fibers by generating radial force. The endoscope-guided procedure is done without fluoroscopic control. Clinicians usually use a low-compliance balloon such as Rigiflex dilator to perform endoscope-guided PD for the treatment of esophageal achalasia. It has the advantage of determining mucosal injury during the dilation process, so that a repeat endoscopy is not needed to assess the mucosal tearing. Previous studies have shown that endoscope-guided PD is an efficient and safe nonsurgical therapy with results that compare well with other treatment modalities. Although the results may be promising, long-term follow-up is required in the near future. PMID:20101764

Field efficacy evaluation and post-treatment contamination risk assessment of an ultraviolet disinfection and safe storage system.

Science.gov (United States)

Reygadas, Fermin; Gruber, Joshua S; Ray, Isha; Nelson, Kara L

2015-11-15

Inconsistent use of household water treatment and safe storage (HWTS) systems reduces their potential health benefits. Ultraviolet (UV) disinfection is more convenient than some existing HWTS systems, but it does not provide post-treatment residual disinfectant, which could leave drinking water vulnerable to recontamination. In this paper, using as-treated analyses, we report on the field efficacy of a UV disinfection system at improving household drinking water quality in rural Mexico. We further assess the risk of post-treatment contamination from the UV system, and develop a process-based model to better understand household risk factors for recontamination. This study was part of a larger cluster-randomized stepped wedge trial, and the results complement previously published population-level results of the intervention on diarrheal prevalence and water quality. Based on the presence of Escherichia coli (proportion of households with ≥ 1 E. coli/100 mL), we estimated a risk difference of -28.0% (95% confidence interval (CI): -33.9%, -22.1%) when comparing intervention to control households; -38.6% (CI: -48.9%, -28.2%) when comparing post- and pre-intervention results; and -37.1% (CI: -45.2%, -28.9%) when comparing UV disinfected water to alternatives within the household. We found substantial increases in post-treatment E. coli contamination when comparing samples from the UV system effluent (5.0%) to samples taken from the storage container (21.1%) and drinking glasses (26.0%). We found that improved household infrastructure, additional extractions from the storage container, additional time from when the storage container was filled, and increased experience of the UV system operator were associated with reductions in post-treatment contamination. Our results suggest that the UV system is efficacious at improving household water quality when used as intended. Promoting safe storage habits is essential for an effective UV system dissemination. The drinking

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

Energy Technology Data Exchange (ETDEWEB)

Li, Wan Lu, E-mail: lvvlchina@msn.cn [Department of Pathology, Yonsei University Wonju College of Medicine, Wonju (Korea, Republic of); Lee, Mi-Ra, E-mail: mira1125@yonsei.ac.kr [Department of Pathology, Yonsei University Wonju College of Medicine, Wonju (Korea, Republic of); Cho, Mee-Yon, E-mail: meeyon@yonsei.ac.kr [Department of Pathology, Yonsei University Wonju College of Medicine, Wonju (Korea, Republic of); Institute of Genomic Cohort, Yonsei University Wonju College of Medicine, Wonju (Korea, Republic of)

2016-03-04

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

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

International Nuclear Information System (INIS)

Li, Wan Lu; Lee, Mi-Ra; Cho, Mee-Yon

2016-01-01

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

Long-term clinical outcome in patients with stage-i nonseminomatous germ cell cancer: a critical review of own treatment modalities in a retrospective study

Directory of Open Access Journals (Sweden)

Sandra Seseke

2008-12-01

Full Text Available PURPOSE: The optimal management of patients with clinical stage I non-seminomatous germ cell testicular cancer (NSGCT I was considered controversial until the European Germ Cell Cancer Consensus Group determined unambiguous treatment strategies. In order to assess the long-term outcome we evaluated the data of patients with NSGCT I. MATERIALS AND METHODS: In a retrospective evaluation, we included 52 patients with a mean age of 26 years (range 15-58 who were treated with different modalities at our department between 1989 and 2003. Mean follow-up was 5.9 years (range 2-14 years. After orchiectomy, 39 patients were treated with chemotherapy, 7 patients underwent retroperitoneal lymph node dissection and 6 men were managed using a surveillance strategy. Survival, recurrence rate and time of recurrence were evaluated. The histological staging and treatment modality was related to the relapse. RESULTS: Tumor specific overall mortality was 3.8%. The mortality and relapse rate of the surveillance strategy, retroperitoneal lymph node dissection and chemotherapy was 16.7% / 50%, 14.3% / 14.3% and 0% / 2.5% respectively. All relapsed patients in the surveillance group as well as in the RPLND group had at least one risk factor for developing metastatic disease. CONCLUSIONS: Following the European consensus on diagnosis and treatment of germ cell cancer in patients with NSGCT Stage I any treatment decision must be individually related to the patient according to prognostic factors and care capacity of the treating centre. In case of doubt, adjuvant chemotherapy should be the treatment of choice, as it provides the lowest risk of relapse or tumor related death.

Reliability of mechanisms with periodic random modal frequencies using an extreme value-based approach

International Nuclear Information System (INIS)

Savage, Gordon J.; Zhang, Xufang; Son, Young Kap; Pandey, Mahesh D.

2016-01-01

Resonance in a dynamic system is to be avoided since it often leads to impaired performance, overstressing, fatigue fracture and adverse human reactions. Thus, it is necessary to know the modal frequencies and ensure they do not coincide with any applied periodic loadings. For a rotating planar mechanism, the coefficients in the mass and stiffness matrices are periodically varying, and if the underlying geometry and material properties are treated as random variables then the modal frequencies are both position-dependent and probabilistic. The avoidance of resonance is now a complex problem. Herein, free vibration analysis helps determine ranges of modal frequencies that in turn, identify the running speeds of the mechanism to be avoided. This paper presents an efficient and accurate sample-based approach to determine probabilistic minimum and maximum extremes of the fundamental frequencies and the angular positions of their occurrence. Then, given critical lower and upper frequency constraints it is straightforward to determine reliability in terms of probability of exceedance. The novelty of the proposed approach is that the original expensive and implicit mechanistic model is replaced by an explicit meta-model that captures the tolerances of the design variables over the entire range of angular positions: position-dependent eigenvalues can be found easily and quickly. Extreme-value statistics of the modal frequencies and extreme-value statistics of the angular positions are readily computed through MCS. Limit-state surfaces that connect the frequencies to the design variables may be easily constructed. Error analysis identifies three errors and the paper presents ways to control them so the methodology can be sufficiently accurate. A numerical example of a flexible four-bar linkage shows the proposed methodology has engineering applications. The impact of the proposed methodology is two-fold: it presents a safe-side analysis based on free vibration methods to

A Causal Theory of Modality

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José Tomás Alvarado

2009-08-01

Full Text Available This work presents a causal conception of metaphysical modality in which a state of affairs is metaphysically possible if and only if it can be caused (in the past, the present or the future by current entities. The conception is contrasted with what is called the “combinatorial” conception of modality, in which everything can co-exist with anything else. This work explains how the notion of ‘causality’ should be construed in the causal theory, what difference exists between modalities thus defined from nomological modality, how accessibility relations between possible worlds should be interpreted, and what is the relation between the causal conception and the necessity of origin.

SDZ ASM 981: an emerging safe and effective treatment for atopic dermatitis.

Science.gov (United States)

Luger, T; Van Leent, E J; Graeber, M; Hedgecock, S; Thurston, M; Kandra, A; Berth-Jones, J; Bjerke, J; Christophers, E; Knop, J; Knulst, A C; Morren, M; Morris, A; Reitamo, S; Roed-Petersen, J; Schoepf, E; Thestrup-Pedersen, K; Van Der Valk, P G; Bos, J D

2001-04-01

SDZ ASM 981 is a selective inhibitor of the production of pro-inflammatory cytokines from T cells and mast cells in vitro. It is the first ascomycin macrolactam derivative under development for the treatment of inflammatory skin diseases. This study was designed to determine the safety and efficacy of SDZ ASM 981 cream at concentrations of 0.05%, 0.2%, 0.6% and 1.0% in the treatment of patients with atopic dermatitis and to select the concentration to be used in phase III studies. This was a double-blind, randomized, parallel-group, multicentre dose-finding study. A total of 260 patients were randomly assigned to treatment with SDZ ASM 981 cream at concentrations of 0.05%, 0.2%, 0.6%, or 1.0%, matching vehicle cream, or the internal control 0.1% betamethasone-17-valerate cream (BMV). Treatment was given twice daily for up to 3 weeks. A clear dose-response relationship for SDZ ASM 981 was evident, with 0.2%, 0.6% and 1.0% SDZ ASM 981 creams all being significantly more effective than vehicle (P = 0.041, 0.001 and 0.008, respectively) in terms of baseline to end-point changes in the Eczema Area Severity Index (EASI) and pruritus score. The 1.0% cream was the most effective SDZ ASM 981 concentration. BMV was more effective than the SDZ ASM 981 creams tested in this study. It appears that the efficacy plateau was not reached with the SDZ ASM 981 creams within 3 weeks treatment. SDZ ASM 981 was well tolerated. Burning or a feeling of warmth were the only adverse events reported more frequently in the 0.6% and 1.0% SDZ ASM 981 treatment groups than in the vehicle treatment group (42.9%, 48.9% and 34.9%, respectively). Few systemic adverse events were reported during the study (headache was the most frequent systemic event reported by 15 of 252 patients) and none was considered to be related to treatment. The local tolerability profile of the 1.0% cream was similar to that of the lower concentrations. 1.0% SDZ ASM 981 cream, which was shown to be safe, well tolerated and

Treatment of AKI in developing and developed countries: An international survey of pediatric dialysis modalities.

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Rupesh Raina

Full Text Available Acute kidney injury (AKI is a common cause of morbidity and mortality worldwide, with a pediatric incidence ranging from 19.3% to 24.1%. Treatment of pediatric AKI is a source of debate in varying geographical regions. Currently CRRT is the treatment for pediatric AKI, but limitations due to cost and accessibility force use of adult equipment and other therapeutic options such as peritoneal dialysis (PD and hemodialysis (HD. It was hypothesized that more cost-effective measures would likely be used in developing countries due to lesser resource availability.A 26-question internet-based survey was distributed to 650 pediatric Nephrologists. There was a response rate of 34.3% (223 responses. The survey was distributed via pedneph and pcrrt email servers, inquiring about demographics, technology, resources, pediatric-specific supplies, and preference in renal replacement therapy (RRT in pediatric AKI. The main method of analysis was to compare responses about treatments between nephrologists in developed countries and nephrologists in developing countries using difference-of-proportions tests.PD was available in all centers surveyed, while HD was available in 85.1% and 54.1% (p = 0.00, CRRT was available in 60% and 33.3% (p = 0.001, and SLED was available in 20% and 25% (p = 0.45 centers of developed and developing world respectively. In developing countries, 68.5% (p = 0.000 of physicians preferred PD to costlier therapies, while in developed countries it was found that physicians favored HD (72%, p = 0.00 or CRRT (24%, p = 0.041 in infants.Lack of availability of resources, trained physicians and funds often preclude standards of care in developing countries, and there is much development needed in terms of meeting higher global standards for treating pediatric AKI patients. PD remains the main modality of choice for treatment of AKI in infants in developing world.

Noise elimination algorithm for modal analysis

Energy Technology Data Exchange (ETDEWEB)

Bao, X. X., E-mail: baoxingxian@upc.edu.cn [Department of Naval Architecture and Ocean Engineering, China University of Petroleum (East China), Qingdao 266580 (China); Li, C. L. [Key Laboratory of Marine Geology and Environment, Institute of Oceanology, Chinese Academy of Sciences, Qingdao 266071 (China); Xiong, C. B. [The First Institute of Oceanography, State Oceanic Administration, Qingdao 266061 (China)

2015-07-27

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

“Stop the ticking before it blows:” treatment modalities of peri-implantitis

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Rachna Jain

2016-01-01

Full Text Available The serendipitous discovery of osseointegration and the subsequent development of dental implants have irrefutably marked an epoch-making point of inflection in not only the basic approach of the clinicians toward treating edentulism but also in the attitudes and preferences of the patients in getting their oral rehabilitation issues resolved. This decisive shift also triggered explosive research targeting improvement in various aspects of dental implants. However, initial success in osseointegration does not necessarily translate into success in long-term function. A successfully osseointegrated implant may be afflicted with early or late complications in due course of service. Of these, peri-implantitis (PI is considered one of the most common causes of implant failure. For the treatment of peri-implant diseases (mucositis and PI, various conservative and surgical approaches are available. Mucositis and moderate forms of PI can be contained effectively using conservative methods. These include the administration of systemic and local antibiotics alone or in conjunction with other treatment modalities such as nonsurgical therapy which consists of mechanical debridement of the affected areas, irrigation with antiseptics (such as chlorhexidine, saline, and 10% hydrogen peroxide with or without surface decontamination, laser-supported therapy, photodynamic therapy as well as light-activated disinfection also known as photodynamic antimicrobial chemotherapy along with maintaining adequate plaque control. In cases with advanced PI, surgical therapies are more effective than conservative approaches. Open flap debridement can be done, and depending on the configuration of the defect, regenerative therapies such as guided tissue regenerative and the use of bone graft materials may be applicable for defect filling whereas resective surgery can be considered for the elimination of peri-implant lesions.

Cross-modal decoupling in temporal attention.

Science.gov (United States)

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

2014-06-01

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

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

Energy Technology Data Exchange (ETDEWEB)

Krämer, Michael, E-mail: m.kraemer@gsi.de; Scifoni, Emanuele; Schuy, Christoph; Rovituso, Marta; Maier, Andreas; Kaderka, Robert; Kraft-Weyrather, Wilma [Biophysics, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Planckstr. 1, 64291 Darmstadt (Germany); Tinganelli, Walter; Durante, Marco [Biophysics, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Planckstr. 1, 64291 Darmstadt, Germany and Trento Institute for Fundamental Physics and Application (TIFPA-INFN), 38123, via Sommarive 14, Trento (Italy); Brons, Stephan; Tessonnier, Thomas [Heidelberger Ionenstrahl-Therapiezentrum (HIT), Im Neuenheimer Feld 450, 69120 Heidelberg, Germany and Radioonkologie und Strahlentherapie, Universitätsklinikums Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg (Germany); Parodi, Katia [Heidelberger Ionenstrahl-Therapiezentrum (HIT), Im Neuenheimer Feld 450, 69120 Heidelberg (Germany); Radioonkologie und Strahlentherapie, Universitätsklinikums Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg (Germany); Ludwig-Maximilians-Universitaet Muenchen (LMU Munich), Department of Medical Physics, Am Coulombwall 1, 85748 Munich (Germany)

2016-04-15

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

Tolerability of Combined Modality Therapy for Rectal Cancer in Elderly Patients Aged 75 Years and Older

International Nuclear Information System (INIS)

Margalit, Danielle N.; Mamon, Harvey J.; Ancukiewicz, Marek; Kobayashi, Wendy; Ryan, David P.; Blaszkowsky, Lawrence S.; Clark, Jeffrey; Willett, Christopher G.; Hong, Theodore S.

2011-01-01

Purpose: To determine the rate of treatment deviations during combined modality therapy for rectal cancer in elderly patients aged 75 years and older. Methods and Materials: We reviewed the records of consecutively treated patients with rectal cancer aged 75 years and older treated with combined modality therapy at Massachusetts General Hospital and Brigham and Women’s Hospital from 2002 to 2007. The primary endpoint was the rate of treatment deviation, defined as a treatment break, dose reduction, early discontinuation of therapy, or hospitalization during combined modality therapy. Patient comorbidity was rated using the validated Adult Comorbidity Evaluation 27 Test (ACE-27) comorbidity index. Fisher’s exact test and the Mantel–Haenszel trend test were used to identify predictors of treatment tolerability. Results: Thirty-six eligible patients had a median age of 79.0 years (range, 75–87 years); 53% (19/36) had no or mild comorbidity and 47% (17/36) had moderate or severe comorbidity. In all, 58% of patients (21/36) were treated with preoperative chemoradiotherapy (CRT) and 33% (12/36) with postoperative CRT. Although 92% patients (33/36) completed the planned radiotherapy (RT) dose, 25% (9/36) required an RT-treatment break, 11% (4/36) were hospitalized, and 33% (12/36) had a dose reduction, break, or discontinuation of concurrent chemotherapy. In all, 39% of patients (14/36) completed ≥4 months of adjuvant chemotherapy, and 17% (6/36) completed therapy without a treatment deviation. More patients with no to mild comorbidity completed treatment than did patients with moderate to severe comorbidity (21% vs. 12%, p = 0.66). The rate of deviation did not differ between patients who had preoperative or postoperative CRT (19% vs. 17%, p = 1.0). Conclusions: The majority of elderly patients with rectal cancer in this series required early termination of treatment, treatment interruptions, or dose reductions. These data suggest that further intensification

Band ligation of gastric antral vascular ectasia is a safe and effective endoscopic treatment.

Science.gov (United States)

Keohane, John; Berro, Wael; Harewood, Gavin C; Murray, Frank E; Patchett, Stephen E

2013-07-01

Gastric antral vascular ectasia (GAVE) or 'watermelon stomach' is a rare and often misdiagnosed cause of occult upper gastrointestinal bleeding. Treatment includes conservative measures such as transfusion and endoscopic therapy. A recent report suggests that endoscopic band ligation (EBL) offers an effective alternative treatment. The aim of the present study is to demonstrate our experiences with this novel technique, and to compare argon plasma coagulation (APC) with EBL in terms of safety and efficacy. A retrospective analysis of all endoscopies with a diagnosis of GAVE was carried out between 2004 and 2010. Case records were examined for information pertaining to the number of procedures carried out, mean blood transfusions, mean hemoglobin, and complications. A total of 23 cases of GAVE were treated. The mean age was 73.9 (55-89) years. Female to male ratio was 17:6 and mean follow up was 26 months. Eight patients were treated with EBL with a mean number of treatments of 2.5 (1-5). This resulted in a statistically significant improvement in the endoscopic appearance and a trend towards fewer transfusions. Of the eight patients treated with EBL, six (75%) patients had previously failed APC treatment despite having a mean of 4.7 sessions. Band ligation was not associated with any short- or medium-term complications. The 15 patients who had APC alone had a mean of four (1-11) treatments. Only seven (46.7%) of these patients had any endoscopic improvement with a mean of four sessions. EBL represents a safe and effective treatment for GAVE. © 2012 The Authors. Digestive Endoscopy © 2012 Japan Gastroenterological Endoscopy Society.

Decision making in treatment strategy of AVMs. Treatment board system at Tohoku University

International Nuclear Information System (INIS)

Jokura, Hidefumi; Yoshimoto, Takashi

1999-01-01

Treatment of some large, deep-seated arteriovenous malformations is still a challenge to neurosurgeons. The recent development of non-invasive imaging modalities has increased the chance of finding asymptomatic AVM's, for which evaluation for treatment is more complicated than in symptomatic cases. Currently there are 3 major treatment options for AVM: microsurgical removal, radiosurgery, and intravascular embolization. It is not easy to choose the best single modality or combination of modalities for individual patients, who have different types of onset, neurological deficits, size and location, and social background. After the installation of the Gamma Knife in November 1991, we established an 'AVM Treatment Board.' It comprises vascular neurosurgeons, endovascular neurosurgeons, and radio-neurosurgeons, and meetings are held twice a month. Every AVM case referred to us is presented to the board, and treatment strategy is selected after a discussion among experts who know the advantages and drawbacks of each treatment modality. We describe this board system in detail and emphasize the importance of gathering expertise in decision making. (author)

Safe pill-dispensing.

Science.gov (United States)

Testa, Massimiliano; Pollard, John

2007-01-01

Each patient is supplied with a smart-card containing a Radio Frequency IDentification (RFID) chip storing a unique identification code. The patient places the Smart-card on a pill-dispenser unit containing an RFID reader. The RFID chip is read and the code sent to a Base-station via a wireless Bluetooth link. A database containing both patient details and treatment information is queried at the Base-station using the RFID as the search key. The patient's treatment data (i.e., drug names, quantities, time, etc.) are retrieved and sent back to the pill-dispenser unit via Bluetooth. Appropriate quantities of the required medications are automatically dispensed, unless the patient has already taken his/her daily dose. Safe, confidential communication and operation is ensured.

Conceptual structure within and between modalities

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Katia eDilkina

2013-01-01

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

Automatic intra-modality brain image registration method

International Nuclear Information System (INIS)

Whitaker, J.M.; Ardekani, B.A.; Braun, M.

1996-01-01

Full text: Registration of 3D images of brain of the same or different subjects has potential importance in clinical diagnosis, treatment planning and neurological research. The broad aim of our work is to produce an automatic and robust intra-modality, brain image registration algorithm for intra-subject and inter-subject studies. Our algorithm is composed of two stages. Initial alignment is achieved by finding the values of nine transformation parameters (representing translation, rotation and scale) that minimise the nonoverlapping regions of the head. This is achieved by minimisation of the sum of the exclusive OR of two binary head images, produced using the head extraction procedure described by Ardekani et al. (J Comput Assist Tomogr, 19:613-623, 1995). The initial alignment successfully determines the scale parameters and gross translation and rotation parameters. Fine alignment uses an objective function described for inter-modality registration in Ardekani et al. (ibid.). The algorithm segments one of the images to be aligned into a set of connected components using K-means clustering. Registration is achieved by minimising the K-means variance of the segmentation induced in the other image. Similarity of images of the same modality makes the method attractive for intra-modality registration. A 3D MR image, with voxel dimensions, 2x2x6 mm, was misaligned. The registered image shows visually accurate registration. The average displacement of a pixel from its correct location was measured to be 3.3 mm. The algorithm was tested on intra-subject MR images and was found to produce good qualitative results. Using the data available, the algorithm produced promising qualitative results in intra-subject registration. Further work is necessary in its application to intersubject registration, due to large variability in brain structure between subjects. Clinical evaluation of the algorithm for selected applications is required

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

Science.gov (United States)

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

2009-10-01

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

The Modality-Match Effect in Recognition Memory

Science.gov (United States)

Mulligan, Neil W.; Osborn, Katherine

2009-01-01

The modality-match effect in recognition refers to superior memory for words presented in the same modality at study and test. Prior research on this effect is ambiguous and inconsistent. The present study demonstrates that the modality-match effect is found when modality is rendered salient at either encoding or retrieval. Specifically, in…

Evaluation of the CDC safe water-storage intervention to improve ...

African Journals Online (AJOL)

Evaluation of the CDC safe water-storage intervention to improve the microbiological quality of point-of-use drinking water in rural communities in South Africa. ... use of safe household water-storage devices and water treatment processes and improvement of hygiene and sanitation practices in these rural households.

STRUKTUR MODAL DAN MODAL KERJA PT XYZ SERTA PENGARUHNYA TERHADAP KINERJA PERUSAHAAN

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Untung Setiono

2017-01-01

Full Text Available n 2012, the electronic payment system transactions reached IDR 104.830 trillion or increase 46,52% from the previous year.  PT. XYZ is the  pioneer in the electronic payment system Indonesia  and still one of the leading companies in electronic payment system interbank, through ATM (Automatic Teller Machine and EDC (Electronic Data Capture in Indonesia.  In 2012 the company spent USD 3,4 million on software tandem from a foreign vendor.  Therefore it is important to study (1 policy on the modal structure of the company, (2 the working capital policy of the company, (3 the monetary performance relationship of the company based on the 2 policies.  The method used to analyze the data is multiple linear regression analysis; this method is used to calculate the relationship between the structure variable of the capital and working capital.  The result is; 1 the structure policy on the capital of the company is in accordance with the Pecking Order theory where the company uses their own capital before applying the long term debt to the others, 2 the inefficient policy on the company’s working capital is because most of the active asset is in monthly deposit bonds and even extended  the active debt, 3 the relationship between short term debt and liquidity ratio is negative while the total debt (short and long term has a positive correlation with the solvability/leverage ratio of the company.  The research recommends the management to decrease the active asset and uses it for long term investment not only for timed deposit.Keywords:  ATM, EDC, capital structure, financial performance     AbstrakVoulme transaksi dalam menggunakan sistem pembayaran elektronis pada tahun 2012 mencapai Rp104.830 triliun atau meningkat sekitar 46,52% dari tahun sebelumnya. PT XYZ adalah salah satu perusahaan pionir dalam sistem bidang pembayaran elektronis di Indonesia dan tetap menjadi pemain utama dalam sistem pembayaran elektronis antar bank, ATM

Treatment of lymphangiomas with OK-432 (Picibanil).

Science.gov (United States)

Rautio, Riitta; Keski-Nisula, Leo; Laranne, Jussi; Laasonen, Erkki

2003-01-01

To determine the efficacy of OK-432 sclerotherapy in the treatment of lymphangiomas. The treatment was begun for 14 patients with lymphangioma. The age range of the patients at the time of the first injection was from 10 months to 42 years. Eleven of the lesions involved the head and neck region, two the thorax and one was localized in the extremity. Prior to treatment all patients were investigated with either magnetic resonance imaging, computed tomography, ultrasound or a combination of these modalities. The injections were performed with ultrasound and/or fluoroscopic guidance. Eight patients received OK-432 as first-line treatment; five were treated after surgery and one after medical therapy. On average, 2.2 intracystic injections were performed per patient. Nine of the lesions were macrocystic and five were mixed lesions. Eleven patients showed complete or marked response to the OK-432 sclerotherapy, two patients had moderate shrinkage of their lesions and only one patient showed no response to therapy. Macrocystic lesions showed the best response to therapy. Those patients who received OK-432 as first-line treatment showed complete or marked response. It was found that treatment of lymphangiomas with OK-432 was safe and effective.

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

Science.gov (United States)

Amin, Noha; Doupis, John

2016-01-01

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

The role of surgical neuroangiography in the treatment of epistaxis

International Nuclear Information System (INIS)

Miller, M.H.; Terbrugge, K.; Chiu, F.; Lasjaunias, P.

1986-01-01

The potential benefit of embolization procedures has not been fully recognized by North American otolaryngologists, who often choose surgical ligation over embolization. Complications associated with improper endovascular treatment further interfere with the demand for this treatment modality. The authors suggest that embolization for epistaxis is safe and reliable if performed by well-trained teams. A thorough understanding of vascular anatomy, anatomic variations, and the dangerous anastomosis is mandatory. They have performed (combined experience) surgical neuroangiography in more than 70 patients with persistent and recurrent epistaxis. The underlying pathology in the patients treated by embolization was quite varied. The nasal packings could always be removed in the angiography room immediately after the embolization procedure. A protocol approach to angiography as proposed by one of the authors (P. L.) is strongly recommended. Superselective catheterization allows the safe deposition of embolic material. Proper embolization will lead to early mobilization of the patient. The vascular supply to the nasal fossa and the pitfalls associated with embolization of this area are discussed in detail, as are the goals and results that can be expected with proper embolization of the various disease processes associated with epistaxis

Providing safe drinking water to 1.2 billion unserved people

Energy Technology Data Exchange (ETDEWEB)

Gadgil, Ashok J.; Derby, Elisabeth A.

2003-06-01

Despite substantial advances in the past 100 years in public health, technology and medicine, 20% of the world population, mostly comprised of the poor population segments in developing countries (DCs), still does not have access to safe drinking water. To reach the United Nations (UN) Millennium Goal of halving the number of people without access to safe water by 2015, the global community will need to provide an additional one billion urban residents and 600 million rural residents with safe water within the next twelve years. This paper examines current water treatment measures and implementation methods for delivery of safe drinking water, and offers suggestions for making progress towards the goal of providing a timely and equitable solution for safe water provision. For water treatment, based on the serious limitations of boiling water and chlorination, we suggest an approach based on filtration coupled with ultraviolet (UV) disinfection, combined with public education. Additionally, owing to the capacity limitations for non-governmental organizations (NGOs) to take on this task primarily on their own, we suggest a strategy based on financially sustainable models that include the private sector as well as NGOs.

Preferential reasoning for modal logics

CSIR Research Space (South Africa)

Britz, K

2011-11-01

Full Text Available Modal logic is the foundation for a versatile and well-established class of knowledge representation formalisms in artificial intelligence. Enriching modal logics with non-monotonic reasoning capabilities such as preferential reasoning as developed...

Kajian Eksperimental Parameter Modal Bangunan Dua Lantai dengan Metode Modal Analisis

Directory of Open Access Journals (Sweden)

Islahuddin Islahuddin

2016-12-01

Full Text Available Abstrak: Pengukuran getaran merupakan kegiatan yang umum dilakukan dalam perawatan prediktif. Perawatan prediktifbiasanya menggunakan pengukuran sinyal getaran untuk mendeteksi kerusakan yang terjadi pada mesin. Sinyalgetaran yang terukur tersebut, kemudian ditransformasikan dalam bentuk grafik fungsi respon frekuensi (FRF.Selanjutnya FRF diolah sedemikian rupasehingga diperoleh modus getar struktur. Dari modus getar yang diperoleh,maka dapat dianalisa kemungkinan kerusakan yang terjadi pada mesin dengan melihat besarnya amplitudo getarannya.Penelitian ini bertujuan untuk menganalisa karakteristik dinamik dari sistem getaran yang terjadi pada model strukturbangunan dua lantai. Pengujian dilakukan denganmemberikan gaya eksitasi menggunakan impact hammer.Akselerometer digunakan mengukur sinyal getaran yang terjadi pada struktur. Posisi penempatan akselerometerdilakukan bervariasi untuk delapan titik pengujian yang berbeda. Sedangkan posisi pemberian gaya eksitasi tetap untuksemua titik pengujian. Pada penelitian ini menggunakan metode modal analisis eksperimen untuk mengetahuikarakteristik dinamik dari model struktur bangunan dua lantai. Teknik modal analisis ini digunakan untuk mendapatkanparameter modal seperti frekuensi, rasio redaman, dan modus getar. Hasil yang diperoleh dari penelitian inimenunjukkan bahwafrekuensi pribadipertama pada amplitudo maksimum mempunyai nilai yang sama, yaitu 2,313 Hz.Sedangkan untuk frekuensi pribadi kedua pada amplitudo maksimumnya terdapat perbedaan, yaitu pada titik pengujian3 dan 7. Hal ini dapat disebabkan oleh pemberian gaya eksitasi yang tidak sama dengan titik-titik pengujian yang lain.Kata kunci: Karakteristik dinamik, analisis modal eksperimen, frekuensi pribadi, FRF Abstract: Measuring vibration is an activity which is generally carried out in a predictive maintenance. In maintaining, vibratesignal measurement is usually used for machine damage detection. The signal measurement is then being

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

Science.gov (United States)

Li, Qiong; Wang, Zhenhong

2016-08-01

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

Completeness for flat modal fixpoint logics

NARCIS (Netherlands)

Santocanale, L.; Venema, Y.

2010-01-01

This paper exhibits a general and uniform method to prove axiomatic completeness for certain modal fixpoint logics. Given a set Γ of modal formulas of the form γ(x,p1,…,pn), where x occurs only positively in γ, we obtain the flat modal fixpoint language L♯(Γ) by adding to the language of polymodal

Modal analysis of main steam line piping under high energy line break condition

Energy Technology Data Exchange (ETDEWEB)

Kim, Tae-Jin; Kim, Seung Hyun; Je, Sang-Yun; Chang, Yoon-Suk [Kyung Hee University, Yongin (Korea, Republic of)

2016-10-15

If HELB (High Energy Line Break) occurs in NPPs (Nuclear Power Plants), not only environmental effect like release of radioactive material but also secondary structural defects should be considered. Jet impingement phenomenon caused by sudden pipe rupture may lead to severe damage on neighboring safe-related components and other structure. Lots of studies have been conducted to assess dynamic behaviors of the SG and MSL piping while pipe whip restraints and jet impingement shields are taken into account during design stage. Arroyo et al. performed modal analyses of a simple square component to examine the jet impingement phenomenon. Also, structural characteristics were predicted to assure structural integrity against the HELB. In this study, we examined dynamic characteristics of SG and MSL piping in a typical 1000MWe NPP. Simulation was performed by using two commercial computational softwares. In particular, modal analyses were conducted to determine mode shapes and natural frequencies of the structure and maximum displacements. The data obtain from each software were compared and observation was discussed in relation to the jet impingement phenomenon. In this research, modal analyses on the SG and MSL piping were carried out to get natural frequencies, vibration mode shapes and maximum displacements. Thereby, the following key finding was observed. (1) Maximum displacement was calculated at the top of SG outlet nozzle with y-directional bending at the third mode. (2) The differences between two models were respectively 7% in natural frequencies and less than 1% in maximum displacements.

Sacral root neuromodulation in the treatment of various voiding and storage problems.

Science.gov (United States)

Shaker, H; Hassouna, M M

1999-01-01

This paper reviews the use of sacral neuromodulation as a treatment modality for patients with bladder dysfunction. The dual functions of the urinary bladder are to act as a reservoir and to evacuate under voluntary control. Bladder dysfunction is a descriptive term describing the loss or the impairment of one or both of these functions. In the first part of the manuscript we describe the different components of sacral neuromodulation: the screening test known as percutaneous nerve evaluation (PNE), which involves screening patients who could potentially benefit from the therapy. Those who show a satisfactory response will have a permanent neuroprosthesis implanted. The technical aspects of both components of neuromodulation are described in detail, as well as the technical difficulties encountered. In the second part we present our long-term results in patients with sacral neuromodulation. Sacral neuromodulation is a safe and efficient therapeutic modality that helps patients with refractory voiding dysfunction restore their bladder function.

Safe introduction of new procedures and emerging technologies in surgery: education, credentialing, and privileging.

Science.gov (United States)

Sachdeva, Ajit K; Russell, Thomas R

2007-08-01

Ongoing horizon scanning is needed to identify new procedures and emerging technologies that should be evaluated for introduction into surgical practice. Following evidence-based evaluation, if a new modality is found ready for adoption in practice, surgeons need education in the safe and effective use of the new modality. The educational experience should include structured teaching and learning, verification of new knowledge and skills, preceptoring or proctoring, and monitoring of outcomes. Credentialing and privileging to perform a new procedure or use an emerging technology should be based on evaluation of knowledge and skills and outcomes of surgical care, and not merely on the numbers of procedures performed. Education of the surgical team is also essential. The entire process involving education, verification of knowledge and skills, credentialing, and privileging must be transparent. Patients need to play a central role in making informed decisions regarding their care that involves use of a new procedure or an emerging technology, and they should participate actively in their perioperative care.

FieldSAFE

DEFF Research Database (Denmark)

Kragh, Mikkel Fly; Christiansen, Peter; Laursen, Morten Stigaard

2017-01-01

In this paper, we present a novel multi-modal dataset for obstacle detection in agriculture. The dataset comprises approximately 2 hours of raw sensor data from a tractor-mounted sensor system in a grass mowing scenario in Denmark, October 2016. Sensing modalities include stereo camera, thermal...... camera, web camera, 360-degree camera, lidar, and radar, while precise localization is available from fused IMU and GNSS. Both static and moving obstacles are present including humans, mannequin dolls, rocks, barrels, buildings, vehicles, and vegetation. All obstacles have ground truth object labels...

Manifold regularized multi-task feature selection for multi-modality classification in Alzheimer's disease.

Science.gov (United States)

Jie, Biao; Zhang, Daoqiang; Cheng, Bo; Shen, Dinggang

2013-01-01

Accurate diagnosis of Alzheimer's disease (AD), as well as its prodromal stage (i.e., mild cognitive impairment, MCI), is very important for possible delay and early treatment of the disease. Recently, multi-modality methods have been used for fusing information from multiple different and complementary imaging and non-imaging modalities. Although there are a number of existing multi-modality methods, few of them have addressed the problem of joint identification of disease-related brain regions from multi-modality data for classification. In this paper, we proposed a manifold regularized multi-task learning framework to jointly select features from multi-modality data. Specifically, we formulate the multi-modality classification as a multi-task learning framework, where each task focuses on the classification based on each modality. In order to capture the intrinsic relatedness among multiple tasks (i.e., modalities), we adopted a group sparsity regularizer, which ensures only a small number of features to be selected jointly. In addition, we introduced a new manifold based Laplacian regularization term to preserve the geometric distribution of original data from each task, which can lead to the selection of more discriminative features. Furthermore, we extend our method to the semi-supervised setting, which is very important since the acquisition of a large set of labeled data (i.e., diagnosis of disease) is usually expensive and time-consuming, while the collection of unlabeled data is relatively much easier. To validate our method, we have performed extensive evaluations on the baseline Magnetic resonance imaging (MRI) and fluorodeoxyglucose positron emission tomography (FDG-PET) data of Alzheimer's Disease Neuroimaging Initiative (ADNI) database. Our experimental results demonstrate the effectiveness of the proposed method.

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

Directory of Open Access Journals (Sweden)

Mi Z

2014-12-01

Full Text Available Zhibao Mi,1 Dimitri Novitzky,2 Joseph F Collins,1 David KC Cooper3 1Cooperative Studies Program Coordinating Center, VA Maryland Health Care Systems, Perry Point, MD, USA; 2Department of Cardiothoracic Surgery, University of South Florida, Tampa, FL, USA; 3Thomas E Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, USA Abstract: The management of brain-dead organ donors is complex. The use of inotropic agents and replacement of depleted hormones (hormonal replacement therapy is crucial for successful multiple organ procurement, yet the optimal hormonal replacement has not been identified, and the statistical adjustment to determine the best selection is not trivial. Traditional pair-wise comparisons between every pair of treatments, and multiple comparisons to all (MCA, are statistically conservative. Hsu’s multiple comparisons with the best (MCB – adapted from the Dunnett’s multiple comparisons with control (MCC – has been used for selecting the best treatment based on continuous variables. We selected the best hormonal replacement modality for successful multiple organ procurement using a two-step approach. First, we estimated the predicted margins by constructing generalized linear models (GLM or generalized linear mixed models (GLMM, and then we applied the multiple comparison methods to identify the best hormonal replacement modality given that the testing of hormonal replacement modalities is independent. Based on 10-year data from the United Network for Organ Sharing (UNOS, among 16 hormonal replacement modalities, and using the 95% simultaneous confidence intervals, we found that the combination of thyroid hormone, a corticosteroid, antidiuretic hormone, and insulin was the best modality for multiple organ procurement for transplantation. Keywords: best treatment selection, brain-dead organ donors, hormonal replacement, multiple binary endpoints, organ procurement, multiple comparisons

Load Estimation from Natural input Modal Analysis

DEFF Research Database (Denmark)

Aenlle, Manuel López; Brincker, Rune; Canteli, Alfonso Fernández

2005-01-01

One application of Natural Input Modal Analysis consists in estimating the unknown load acting on structures such as wind loads, wave loads, traffic loads, etc. In this paper, a procedure to determine loading from a truncated modal model, as well as the results of an experimental testing programme...... estimation. In the experimental program a small structure subjected to vibration was used to estimate the loading from the measurements and the experimental modal space. The modal parameters were estimated by Natural Input Modal Analysis and the scaling factors of the mode shapes obtained by the mass change...

MODALITY OF TREATMENT IN ESSENTIAL THROMBOCYTHEMIA

Directory of Open Access Journals (Sweden)

Lana Macukanovic-Golubovic

2008-10-01

Full Text Available Essential thrombocytosis (ET is clonal chronic myeloproliferative disorder which originates from abnormality of a multipotent hematopoietic stem cell.It is characterized by an increased platelet count, megakaryocytic hyperplasia and by hemorrhagic or thrombotic tendency. Symptoms and signs may include weakness, headaches, paresthesias, bleeding, splenomegaly, and digital ischemia. ET patients showed equal or slightly shorter survival than age- and sex-matched healthy population. Major causes of death were thrombotic and hemorrhagic complications or malignant progression due to both the natural history of the disease and, possibly, the use of chemotherapeutic agents.Diagnostic criteria for essential thrombocythemia were proposed in 2005 by the PVSG and demand diagnosis of exclusion.Myelosuppressive therapy to lower the platelet count usually consists of hydroxyurea, interferon alpha or anagrelide. Hydroxyurea is the most commonly used treatment, because of its efficacy, low cost and rare acute toxicity. Interferon alpha is a biological response modifier. It is not known to be teratogenic and does not cross the placenta, and is often the treatment of choice during pregnancy. Anagrelid suppresses bone marrow megakaryocytes by interfering with the maturation process and decreasing platelet production without affecting other blood cell lines. Low-dose aspirin may be used to control microvascular symptoms.Recommendations for management of patients with essential thrombocythemia were given by ASH. From a treatment standpoint, hydroxyurea is now confirmed to be the drug of choice for high-risk patients with essential thrombocythemia. Interferon alpha and anagrelide are reasonable second-line agents. Low-risk patients should receive low-dose aspirin alone. For the intermediate-risk patients, a consensus could not be reached on a recommendation for platelet-lowering treatment.

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

International Nuclear Information System (INIS)

Tsai, W.-L.; Tsai, I-C.; Lee Tain; Hsieh, C.-W.

2008-01-01

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

76 FR 12719 - Safe Schools/Healthy Students Program; Office of Safe and Drug-Free Schools; Safe Schools/Healthy...

Science.gov (United States)

2011-03-08

... DEPARTMENT OF EDUCATION Safe Schools/Healthy Students Program; Office of Safe and Drug- Free Schools; Safe Schools/Healthy Students Program; Catalog of Federal Domestic Assistance (CFDA) Numbers: 84... priorities, requirements, and definitions under the Safe Schools/Healthy Students (SS/HS) program. Since...

Cancer in the oropharynx: Cost calculation of different treatment modalities for controlled primaries, relapses and grade III/IV complications

International Nuclear Information System (INIS)

Nijdam, Wideke; Levendag, Peter; Noever, Inge; Groot, Carin Uyl-de; Agthoven, Michel van

2005-01-01

Background and purpose: This paper presents a model for cost calculation using the different treatment modalities for oropharyngeal (OPh) cancers used in our hospital. We compared full hospital costs, the associated costs of localregional relapses (LRR) and/or treatment related grade III/IV complications. Materials and methods: Patients with OPh cancer are treated in the Erasmus MC preferably by an organ function preservation protocol. That is, by external beam radiation therapy (EBRT) followed by a brachytherapy (BT) boost, and neck dissection in case of N+ disease (BT-group: 157 patients). If BT is not feasible, resection with postoperative EBRT (S-group [S=Surgery]: 110 patients) or EBRT-alone (EBRT-group: 77 patients) is being pursued. Actuarial localregional control (LRC), disease free survival (DFS) and overall survival (OS) at 5-years were calculated according to the Kaplan-Meier method. The mean costs per treatment group for diagnosis, primary Tx per se, follow-up, (salvage of) locoregional relapse (LRR), distant metastasis (DM), and/or grade III/IV complications needing clinical admission, were computed. Results: For the BT-, S-, or EBRT treatment groups, LRC rates at 5-years were 85, 82, and 55%, for the DFS, 61, 48, and 43%, and for the OS 65, 52, and 40%, respectively. The mean costs of primary Tx in case of the BT-group is EURO 13,466; for the S-group EURO 24,219, and EURO 12,502 for the EBRT-group. The mean costs of S (the main salvage modality) for a LRR of the BT group or EBRT-group, were EURO 17,861 and EURO 15,887, respectively. The mean costs of clinical management of Grade III/IV complications were EURO 7184 (BT-group), EURO 16,675 (S-group) and EURO 6437 (EBRT-group). Conclusion: The clinical outcome illustrates excellent LRC rates at 5-years for BT (85%), as well as for S (82%). The relatively low 55% LRC rate at 5-years for EBRT probably reflects a negative selection of patients. It is of interest that the total mean costs of patients alive

On Modal Refinement and Consistency

DEFF Research Database (Denmark)

Nyman, Ulrik; Larsen, Kim Guldstrand; Wasowski, Andrzej

2007-01-01

Almost 20 years after the original conception, we revisit several fundamental question about modal transition systems. First, we demonstrate the incompleteness of the standard modal refinement using a counterexample due to Hüttel. Deciding any refinement, complete with respect to the standard...

Reliability and safety of a new upper cervical spine injury treatment algorithm

Directory of Open Access Journals (Sweden)

Andrei Fernandes Joaquim

Full Text Available ABSTRACT In the present study, we evaluated the reliability and safety of a new upper cervical spine injury treatment algorithm to help in the selection of the best treatment modality for these injuries. Methods Thirty cases, previously treated according to the new algorithm, were presented to four spine surgeons who were questioned about their personal suggestion for treatment, and the treatment suggested according to the application of the algorithm. After four weeks, the same questions were asked again to evaluate reliability (intra- and inter-observer using the Kappa index. Results The reliability of the treatment suggested by applying the algorithm was superior to the reliability of the surgeons’ personal suggestion for treatment. When applying the upper cervical spine injury treatment algorithm, an agreement with the treatment actually performed was obtained in more than 89% of the cases. Conclusion The system is safe and reliable for treating traumatic upper cervical spine injuries. The algorithm can be used to help surgeons in the decision between conservative versus surgical treatment of these injuries.

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

Science.gov (United States)

Singh, Kunwarjeet; Gupta, Nidhi

2012-01-01

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

Manual ward reduction of gastroschisis without anesthesia, a safe procedure – 8 years experience

Directory of Open Access Journals (Sweden)

Kamal Nain Rattan

2017-01-01

Full Text Available Introduction: Gastroschisis is the most common type of abdominal wall defect at birth. Various modalities of treatment have been proposed ranging from primary closure to the staged closure using prosthetic materials under general anesthesia. One of the modalities is manual ward reduction with primary repair of gastroschisis without anesthesia. We are reporting our 8 years of experience with manual ward reduction of gastroschisis with primary repair without anesthesia.Materials and methods: It is a retrospective analysis of all patients of gastroschisis who presented in our institution from January 2008 to June 2016. The data were analyzed for antenatal diagnosis, sex, day of presentation, weight of baby, associated anomalies, management by manual reduction without anesthesia and post reduction morbidity and mortality.Results: Out of a total of 68 patients, 28 were females and 40 were males. Fifty-five cases (80.8% were antenatally diagnosed. Fifty-nine patients (86.7% presented within 24 hours of birth while the rest had delayed presentation. Preterms (< 37 weeks were 18 (26.4%. Cases of simple gastroschisis were 22 while those complicated were 46. The average birth weight was 1.88 kg with the lowest weight of 1 kg who was a 27-week preterm. In 60 patients (88.2%, bedside manual reduction without anesthesia and primary closure was possible while in 8 patients it could not be done owing to delayed presentation and complications. The mortality in these patients was 40%.Conclusion: Manual reduction and primary closure of gastroschisis without anesthesia is a safe procedure. It requires no ventilator support and can be managed with antibiotics, total parenteral nutrition (TPN and continuous positive airway pressure (CPAP in the post-reduction period.

Treatment of gingival hyperpigmentation by open spray cryotherapy

Directory of Open Access Journals (Sweden)

Belkız Uyar

2013-03-01

Full Text Available Background and Design: Although gingival hyperpigmentation is not a medical problem, people who have moderate or severe gingival pigmentation, particularly patients having a gummy smile, frequently request cosmetic treatment. For gingival depigmentation, different treatment modalities have been reported such as surgical treatment, cryotherapy, electrosurgery, and laser therapy. Materials and Methods: Twenty-one patients with gingival melanin pigmentation were included in the study. We applied liquid nitrogen to the hyperpigmented area for 5-10 seconds using open spray technique with a cryogun. Clinical observations for intensity of pigmentation were recorded at baseline and 3 months after the treatment. Clinical parameters, such as bleeding, swelling, redness, and healing, were evaluated immediately after the cryotherapy and 24 hours, and 1 week after the treatment. We used a numeric pain scale to evaluate the pain level. Results: Three months after the treatment, the mean gingival melanin pigmentation score decreased from 41.62±16.58 to 19.28±11.85. The difference between pretreatment and posttreatment mean scores was found to be statistically significant.Discussion: Removal of gingival melanin pigmentation can be performed safely by open spray cryotherapy in dermatology clinics.

Thyroidectomy for the treatment of Graves’ thyrotoxicosis in thioamide-induced agranulocytosis and sepsis

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Colin L Knight

2017-09-01

Full Text Available A 51 year old man presented with sepsis in the setting of thioamide-induced agranulocytosis. Empiric broad-spectrum antibiotics was followed by directed narrow-spectrum antibiotics, and his neutrophil count recovered with support from granulocyte-colony stimulating factor (G-CSF analogue transfusions. After a brief period of multi-modal therapy for nine days including potassium iodide (Lugol’s iodine, cholestyramine, propanolol and lithium to temper his persisting hyperthyroidism, a total thyroidectomy was performed while thyroid hormone levels remained at thyrotoxic levels. Postoperative recovery was uncomplicated and he was discharged home on thyroxine. There is limited available evidence to guide treatment in this unique cohort of patients who require prompt management to avert impending clinical deterioration. This case report summarises the successful emergent control of thyrotoxicosis in the setting of thioamide-induced agranulocytosis complicated by sepsis, and demonstrates the safe use of multi-modal pharmacological therapies in preparation for total thyroidectomy.

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

Science.gov (United States)

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

2017-01-01

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

Remifentanil analgesia during laser treatment for retinopathy of prematurity: a practical approach in neonatal intensive care unit.

Science.gov (United States)

Demirel, Nihal; Bas, Ahmet Y; Kavurt, Sumru; Celik, Istemi H; Yucel, Husniye; Turkbay, Dursun; Hekimoğlu, Emre; Koc, Orhan

2014-11-01

Retinopathy of prematurity (ROP) is a significant cause of childhood blindness. The aim of this study is to determine the feasibility of remifentanil analgesia during laser treatment of ROP performed in the neonatal intensive care unit (NICU). Remifentanil was infused continuously during the procedure starting with a dose of 0.2 µg/kg/min and increased gradually to 0.6 µg/kg/min to provide an adequate level of analgesia. We enrolled 64 infants. Remifentanil was infused continuously at a mean rate of 0.4 ± 0.1 μg/kg/min. No major adverse effects were observed except in two patients with reversible bradycardia and hypotension. Premature infant pain profile (PIPP) scores revealed no pain. Patients with bronchopulmonary dysplasia had similar remifentanil dosage, intubation duration, and extubation time. Remifentanil analgesia for ROP treatment performed in the NICU by pediatricians is a safe and effective modality. This modality offers a practical solution in hospitals without readily available pediatric anesthetists. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

[Gender dysphoria in children and adolescents - treatment guidelines and follow-up study].

Science.gov (United States)

Meyenburg, Bernd; Kröger, Anne; Neugebauer, Rebecca

2015-01-01

Treatment guidelines for transidentity in children and adolescents are presently under discussion. We present an overview of the various treatment modalities. Further, follow-up data on children and adolescents referred for gender-identity problems are presented. Of the 84 patients seen for the first time more than 3 years before follow-up, 37 mailed in the completed questionnaires. In addition, 33 patients agreed to answer some short follow-up questions. We assessed steps of treatment, gender role, psychopathology, and psychotherapy. We compared differences in psychopathology in patients with vs. without gender role change and in patients with intense vs. less intense psychotherapy. A total of 22 patients had completely changed gender role, and some had started hormonal treatment und sex reassignment surgery. Most patients were satisfied with the treatment results. All patients showed less psychopathology on follow-up, independent of role change or intensity of psychotherapy. In general, the patients reported little psychopathology. Our follow-up results support the present treatment approach. In patients with little psychopathology, low-frequency supportive treatment appears sufficient to obtain safe judgement on hormonal of surgical treatment.

Experienced Sensory Modalities in Dream Recall

OpenAIRE

岡田, 斉

2000-01-01

The purpose of the present study is to survey the frequency of visual, auditory, kinaesthetic, cutaneous, organic, gustatory, and olfactory experience in dream recall. A total of 1267 undergraduate students completed a dream recall frequency questionnaire, which contained a question about dream recall frequency and about recall frequency of seven sensory modalities. Results showed that seven sensory modalities were divided into two groups; normally perceived sensory modalities in dreaming, wh...

Safe and symptomatic medicinal use of surface-functionalized Mn3O4 nanoparticles for hyperbilirubinemia treatment in mice.

Science.gov (United States)

Polley, Nabarun; Saha, Srimoyee; Adhikari, Aniruddha; Banerjee, Somtirtha; Darbar, Soumendra; Das, Sukhen; Pal, Samir Kumar

2015-01-01

Testing the potential of citrate-capped Mn3O4 nanoparticles (NPs) as a therapeutic agent for alternative rapid treatment of hyperbilirubinemia through direct removal of bilirubin (BR) from blood in mice. NPs were synthesized and the mechanism of BR degradation in presence and absence of biological macromolecules were characterized in vitro. To test the in vivo BR degradation ability of NPs, CCl4-intoxicated mice were intraperitoneally injected with NPs. We demonstrated ultrahigh efficacy of the NPs in symptomatic treatment of hyperbilirubinemia for rapid reduction of BR in mice compared with conventional medicine silymarin without any toxicological implications. These findings may pave the way for practical clinical use of the NPs as safe medication of hyperbilirubinemia in human subjects.

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

Science.gov (United States)

Webster, Raymond E.

1980-01-01

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

Cool and Safe: Multiplicity in Safe Innovation at Unilever

Science.gov (United States)

Penders, Bart

2011-01-01

This article presents the making of a safe innovation: the application of ice structuring protein (ISP) in edible ices. It argues that safety is not the absence of risk but is an active accomplishment; innovations are not "made safe afterward" but "safe innovations are made". Furthermore, there are multiple safeties to be accomplished in the…

Krull dimension in modal logic

NARCIS (Netherlands)

Bezhanishvili, G.; Bezhanishvili, N.; Lucero-Bryan, J.; van Mill, J.

2017-01-01

We develop the theory of Krull dimension for S4-algebras and Heyting algebras. This leads to the concept of modal Krull dimension for topological spaces. We compare modal Krull dimension to other well-known dimension functions, and show that it can detect differences between topological spaces that

Modal Logics for Cryptographic Processes

DEFF Research Database (Denmark)

Frendrup, U.; Huttel, Hans; Jensen, N. J.

2002-01-01

We present three modal logics for the spi-calculus and show that they capture strong versions of the environment sensitive bisimulation introduced by Boreale et al. Our logics differ from conventional modal logics for process calculi in that they allow us to describe the knowledge of an attacker ...

Load Estimation from Modal Parameters

DEFF Research Database (Denmark)

Aenlle, Manuel López; Brincker, Rune; Fernández, Pelayo Fernández

2007-01-01

In Natural Input Modal Analysis the modal parameters are estimated just from the responses while the loading is not recorded. However, engineers are sometimes interested in knowing some features of the loading acting on a structure. In this paper, a procedure to determine the loading from a FRF m...

Reimbursement and economic factors influencing dialysis modality choice around the world

Science.gov (United States)

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

2008-01-01

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

Manifold Regularized Multi-Task Feature Selection for Multi-Modality Classification in Alzheimer’s Disease

Science.gov (United States)

Jie, Biao; Cheng, Bo

2014-01-01

Accurate diagnosis of Alzheimer’s disease (AD), as well as its pro-dromal stage (i.e., mild cognitive impairment, MCI), is very important for possible delay and early treatment of the disease. Recently, multi-modality methods have been used for fusing information from multiple different and complementary imaging and non-imaging modalities. Although there are a number of existing multi-modality methods, few of them have addressed the problem of joint identification of disease-related brain regions from multi-modality data for classification. In this paper, we proposed a manifold regularized multi-task learning framework to jointly select features from multi-modality data. Specifically, we formulate the multi-modality classification as a multi-task learning framework, where each task focuses on the classification based on each modality. In order to capture the intrinsic relatedness among multiple tasks (i.e., modalities), we adopted a group sparsity regularizer, which ensures only a small number of features to be selected jointly. In addition, we introduced a new manifold based Laplacian regularization term to preserve the geometric distribution of original data from each task, which can lead to the selection of more discriminative features. Furthermore, we extend our method to the semi-supervised setting, which is very important since the acquisition of a large set of labeled data (i.e., diagnosis of disease) is usually expensive and time-consuming, while the collection of unlabeled data is relatively much easier. To validate our method, we have performed extensive evaluations on the baseline Magnetic resonance imaging (MRI) and fluorodeoxyglucose positron emission tomography (FDG-PET) data of Alzheimer’s Disease Neuroimaging Initiative (ADNI) database. Our experimental results demonstrate the effectiveness of the proposed method. PMID:24505676

Contemporary diagnostic imaging approaches in treatment of urolithiasis

International Nuclear Information System (INIS)

Velichkov, B.; Naoumov, N.

2004-01-01

Based on an extensive review of the literature and on their own clinical experience, authors attempts to present clear guidelines for the management of urolithiasis. Ninety-eight per cent of stones can be successfully fragmented by the application of shock-waves, but the ability of the kidney and ureter to clear the resulting fragments is far more important in terms of successful treatment outcome. Extracorporeal shock-waves lithotripsy (ESWL) is a safe procedure for the treatment of urolithiasis; nevertheless some problems remain. In ureteric stones, ureteroscopy (rigid or flexible device) allows a rate of stone-free patients better than ESWL. For treatment of large staghorn calculi combined approach of Percutaneous Nephrolithotripsy (PCNL) and ESWL is preferred. For stones located at lower calyx, the stone-free rate in patients treated by ESWL fell to 50%, when unfavourable anatomy is present. Ultimate goal of treating stones by whatever means is to get the patient stone-free and prevent recurrence. The good technique of performing and interpretation of diagnostic imaging modalities is of critical importance in terms of diagnosing, successful treatment and follow up of results of treatment of urolithiasis

The modality effect and echoic persistence.

Science.gov (United States)

Watkins, O C; Watkins, M J

1980-09-01

The modality effect refers to the higher level of recall of the last few items of a list when presentation is auditory as opposed to visual. It is usually attributed to echoic memory. The effect may be sharply reduced by an ostensibly irrelevant auditory item appended to the end of the list. Previous research suggests that this "suffix effect" arises only when the suffix item occurs within 2 sec of the last list item. This finding strengthens the widely held assumption that echoic information decays within 2 sec, and has led to the assumption that if echoic information is to be useful in serial recall it must first be encoded into a more durable modality-independent form. Both assumptions conflict with the research reported here. The first two experiments demonstrate substantial suffix effects with suffix delays of 2 and 4 sec, indicating that echoic information lasts at least 4 sec. This finding implies that echoic information may aid recall directly, an implication that was supported in Experiments 3 and 4. In Experiment 3 serial recall was interrupted with a brief distractor task. The modality effect was smaller when this task was auditory than when it was visual, suggesting that echoic information was still available immediately prior to recency recall. In Experiment 4 list presentation was broken by a 4-sec pause; the modalities of the list halves were combined factorially. Interest focused on the recency positions of the first half. A modality effect was found at these positions when the second half was visual but not when it was auditory. This is contrary to the hypothesis that echoic information is encoded before recall, but is consistent with the hypothesis that echoic information is encoded before recall, but is consistent with the alternative hypothesis that echoic information is used directly at recall. The final two experiments concern the modality effect found when a delay is interpolated between list presentation and recall. Experiment 5 showed that

Modular sequent calculi for classical modal logics

NARCIS (Netherlands)

Gilbert, David; Maffezioli, Paolo

This paper develops sequent calculi for several classical modal logics. Utilizing a polymodal translation of the standard modal language, we are able to establish a base system for the minimal classical modal logic E from which we generate extensions (to include M, C, and N) in a modular manner. Our

Ultrasound-Guided Thrombin Injection Is a Safe and Effective Treatment for Femoral Artery Pseudoaneurysm in the Morbidly Obese.

Science.gov (United States)

Yoo, Taehwan; Starr, Jean E; Go, Michael R; Vaccaro, Patrick S; Satiani, Bhagwan; Haurani, Mounir J

2017-08-01

Ultrasound-guided thrombin injection (UGTI) is a well-established practice for the treatment of femoral artery pseudoaneurysm. This procedure is highly successful but dependent on appropriate pseudoaneurysm anatomy and adequate ultrasound visualization. Morbid obesity can present a significant technical challenge due to increased groin adiposity, resulting in poor visualization of critical structures needed to safely perform the procedure. We aim to evaluate the safety and efficacy of UGTI to treat femoral artery pseudoaneurysm in the morbidly obese. This is a retrospective cohort study in which all patients who underwent UGTI at The Ohio State University Ross Heart Hospital from 2009 to 2014 were analyzed for patient characteristics and stratified by body mass index (BMI). Patients with BMI ≥ 35 were considered morbidly obese and were compared to patients with a BMI injection. There were 41 nonmorbidly obese and 13 morbidly obese patients. Mean age was 64.5 years. The cohort was 44.4% male. There were 6 failures, of which 1 underwent successful repeat injection and 5 underwent open surgical repair. There was no statistically significant difference in failure between nonmorbidly obese and morbidly obese patients (9.8% vs 15.4%, P = .45). There were no embolic/thrombotic complications. Ultrasound-guided thrombin injection is a safe and effective therapy in the morbidly obese for the treatment of femoral artery pseudoaneurysm. In the hands of experienced sonographers and surgeons with adequate visualization of the pseudoaneurysm sac, UGTI should remain a standard therapy in the morbidly obese.

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

Science.gov (United States)

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

2017-07-01

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

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

Science.gov (United States)

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

2012-04-01

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

Does Modality Matter? The Effects of Reading, Listening, and Dual Modality on Comprehension

Directory of Open Access Journals (Sweden)

Beth A. Rogowsky

2016-09-01

Full Text Available With advancing technology, there is increasing interest in differences between listening versus reading comprehension or doing both simultaneously. Ninety-one participants were randomly assigned to one of three groups that received the same instructional material (the preface and a chapter from a non-fiction book, but each in a different input modality (digital audiobook, e-text, dual modality. After completing the material, participants took the same comprehension test in written form to establish both immediate comprehension (Time 1 and 2-week retention (Time 2. No statistically significant differences were found for any analyses pertaining to effects of the three different instructional conditions on comprehension at Time 1 or Time 2. Additional analyses showed that both males and females in each condition recalled an equal amount of information, regardless of whether they listened to an audiobook, read from an electronic tablet, or both listened and read simultaneously (dual modality.

Parametric modal transition systems

DEFF Research Database (Denmark)

Beneš, Nikola; Křetínský, Jan; Larsen, Kim Guldstrand

2011-01-01

Modal transition systems (MTS) is a well-studied specification formalism of reactive systems supporting a step-wise refinement methodology. Despite its many advantages, the formalism as well as its currently known extensions are incapable of expressing some practically needed aspects in the refin......Modal transition systems (MTS) is a well-studied specification formalism of reactive systems supporting a step-wise refinement methodology. Despite its many advantages, the formalism as well as its currently known extensions are incapable of expressing some practically needed aspects...

Efficacy of combination of glycolic acid peeling with topical regimen in treatment of melasma.

Science.gov (United States)

Chaudhary, Savita; Dayal, Surabhi

2013-10-01

Various treatment modalities are available for management of melasma, ranging from topical and oral to chemical peeling, but none is promising alone. Very few studies are available regarding efficacy of combination of topical treatment with chemical peeling. Combination of chemical peeling and topical regimen can be a good treatment modality in the management of this recalcitrant disorder. To assess the efficacy of combination of topical regimen (2% hydroquinone, 1% hydrocortisone and 0.05% tretinoin) with serial glycolic acid peeling in the treatment of melasma in Indian patients. Forty Indian patients of moderate to severe epidermal variety melasma were divided into two groups of 20 each. One Group i.e. peel group received topical regimen (2% hydroquinone, 1% hydrocortisone and 0.05% tretinoin) with serial glycolic acid peeling and other group i.e. control group received topical regimen (2% hydroquinone, 1% hydrocortisone, 0.05% tretinoin). There was an overall decrease in MASI from baseline in 24 weeks of therapy in both the groups (P value peel with topical regimen showed early and greater improvement than the group which was receiving topical regimen only. This study concluded that combining topical regimen (2% hydroquinone, 1% hydrocortisone and 0.05% tretinoin) with serial glycolic acid peeling significantly enhances the therapeutic efficacy of glycolic acid peeling. The combination of glycolic acid peeling with the topical regimen is a highly effective, safe and promising therapeutic option in treatment of melasma.

Treatment of Lymphangiomas with OK-432 (Picibanil)

International Nuclear Information System (INIS)

Rautio, Riitta; Keski-Nisula, Leo; Laranne, Jussi; Laasonen, Erkki

2003-01-01

Purpose: To determine the efficacy of OK-432 sclerotherapy in the treatment of lymphangiomas. Methods: The treatment was begun for 14 patients with lymphangioma. The age range of the patients at the time of the first injection was from 10 months to 42 years. Eleven of the lesions involved the head and neck region, two the thorax and one was localized in the extremity. Prior to treatment all patients were investigated with either magnetic resonance imaging, computed tomography, ultrasound or a combination of these modalities. The injections were performed with ultrasound and/or fluoroscopic guidance. Eight patients received OK-432 as first-line treatment; five were treated after surgery and one after medical therapy. On average, 2.2 intracystic injections were performed per patient. Nine of the lesions were macrocystic and five were mixed lesions. Results: Eleven patients showed complete or marked response to the OK-432 sclerotherapy, two patients had moderate shrinkage of their lesions and only one patient showed no response to therapy. Macrocystic lesions showed the best response to therapy. Those patients who received OK-432 as first-line treatment showed complete or marked response. Conclusion: It was found that treatment of lymphangiomas with OK-432 was safe and effective

Autologous blood injection for treatment of chronic recurrent TMJ dislocation: is it successful? Is it safe enough? A systematic review.

Science.gov (United States)

Varedi, Payam; Bohluli, Behnam

2015-09-01

The purpose of this article is to review the English literature about the efficacy and safety of autologous blood injection in treating patients suffering from chronic recurrent temporomandibular joint dislocation. In this article, we highlight the key trials and recent directions about this modality and discuss about the mechanism, advantages, and disadvantages of this approach. A literature search was performed using PubMed, Medline, and Ovid Medline databases to identify articles reporting on the injection of autologous blood for treatment of chronic recurrent dislocation of temporomandibular joint. Other references cited in the retrieved reports, as well as the "related articles" tool in PubMed Medline, were also checked to improve the search and, if relevant, were included in the study. The search was restricted to articles published in the English language. Seven studies meeting the inclusion criteria were reviewed. The selected articles included four prospective clinical trials and three case report articles. There are a few articles about the clinical use of autologous blood for treating patients with chronic recurrent temporomandibular joint dislocation. Reviewing of the literature shows that there are successful results about this modality, but there are still some concerns about it in terms of the effect of the injected blood on the articular cartilage and formation of fibrous or bony ankylosis.

Combined modalities: chemotherapy/radiotherapy. Meeting summary

International Nuclear Information System (INIS)

Phillips, T.L.

1979-01-01

The effects of combined modalities, the standardization of terminology, the mechanisms of chemotherapeutic interactions with radiation and responses of normal and tumor systems are summarized from information presented at the Conference on Combined Modalities

The efficacy of stereotactic body radiation therapy on huge hepatocellular carcinoma unsuitable for other local modalities

International Nuclear Information System (INIS)

Que, Jenny Y; Lin, Li-Ching; Lin, Kuei-Li; Lin, Chia-Hui; Lin, Yu-Wei; Yang, Ching-Chieh

2014-01-01

To evaluate the safety and efficacy of Cyberknife stereotactic body radiation therapy (SBRT) and its effect on survival in patients with unresectable huge hepatocellular carcinoma (HCC) unsuitable of other standard treatment option. Between 2009 and 2011, 22 patients with unresectable huge HCC (≧10 cm) were treated with SBRT. dose ranged from 26 Gy to 40 Gy in five fractions. Overall survival (OS) and disease-progression free survival (DPFS) were determined by Kaplan-Meier analysis. Tumor response and toxicities were also assessed. After a median follow-up of 11.5 month (range 2–46 months). The objective response rate was achieved in 86.3% (complete response (CR): 22.7% and partial response (PR): 63.6%). The 1-yr. local control rate was 55.56%. The 1-year OS was 50% and median survival was 11 months (range 2–46 months). In univariate analysis, Child-Pugh stage (p = 0.0056) and SBRT dose (p = 0.0017) were significant factors for survival. However, in multivariate analysis, SBRT dose (p = 0.0072) was the most significant factor, while Child-Pugh stage of borderline significance. (p = 0.0514). Acute toxicities were mild and well tolerated. This study showed that SBRT can be delivered safely to huge HCC and achieved a substantial tumor regression and survival. The results suggest this technique should be considered a salvage treatment. However, local and regional recurrence remain the major cause of failure. Further studies of combination of SBRT and other treatment modalities may be reasonable

A modal characterization of Peirce algebras

NARCIS (Netherlands)

M. de Rijke (Maarten)

1995-01-01

textabstractPeirce algebras combine sets, relations and various operations linking the two in a unifying setting.This note offers a modal perspective on Peirce algebras.It uses modal logic to characterize the full Peirce algebras.

Anatomical Basis for Safe and Effective Volumization of the Temple.

Science.gov (United States)

Breithaupt, Andrew D; Jones, Derek H; Braz, Andre; Narins, Rhoda; Weinkle, Susan

2015-12-01

One of the earliest but often unaddressed signs of facial aging is volume loss in the temple. Treatment of the area can produce satisfying results for both patient and practitioner. Safe injection requires explicit knowledge of the anatomy to avoid complications related to the multitude of vessels that course throughout the region at various depths. The authors aim to detail the anatomy of the area and provide a safe and easy-to-follow method for injection. The authors review the relevant anatomy of the temporal region and its application to cosmetic filler injections. The authors describe an easy-to-follow approach for a safe and effective injection window based on numerous anatomical studies. Injection in this area is not without risk, including potential blindness. The authors review the potential complications and their treatments. Hollowing of the temple is an early sign of aging that, when corrected, can lead to significant patient and practitioner satisfaction. Proper anatomically knowledge is required to avoid potentially severe complications. In this study, the authors present a reliable technique to safely and effectively augment this often undertreated area of the aging face.

Dual-modal photoacoustic and ultrasound imaging of dental implants

Science.gov (United States)

Lee, Donghyun; Park, Sungjo; Kim, Chulhong

2018-02-01

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

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

Science.gov (United States)

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

2017-03-03

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

Aplicación del análisis modal de fallos y efectos en el proceso de donación de sangre total Application of modal analysis of failures and effects in the process of total blood donation

Directory of Open Access Journals (Sweden)

Tatiana Escoriza-Martínez

2010-12-01

Full Text Available La búsqueda constante de medidas para garantizar la calidad y seguridad de la sangre y hemocomponentes constituye una necesidad para el logro de la seguridad transfusional. Aunque las buenas prácticas de producción tienen el objetivo de disminuir los riesgos para obtener productos puros, seguros y eficaces, es necesario complementarlas con herramientas que permitan prevenir los posibles fallos y detectar dichos riesgos. Tal es el caso de la aplicación del Análisis Modal de Fallos y Efectos en el Banco de Sangre Provincial de Villa Clara, donde se identificaron y evaluaron las posibles fallas del proceso de donación de sangre total, lo que permitió caracterizar este proceso, identificar sus variables críticas, proporcionar las bases para proponer nuevos puntos críticos de control y establecer las acciones necesarias para la reducción o eliminación de las fallas detectadas. Esto contribuyó al aumento de la satisfacción de los servicios de transfusión hospitalarios y de los pacientes.The constant search of measures to guarantee the quality and the safe of blood and hemocomponents is a need to achieve the transfusion safe. Although the aim of the good practices of production was to decrease the risks to obtain pure, safe and effective products, it is necessary its fulfillment with tools allowing to prevent the potential failures and to detect such risks. That is the case of the application of the Modal Analysis of Failures and Effects in the Provincial Blood Bank of Villa Clara where the potential failures in the process of total blood donation were identified and assessed, allowing to characterize it, to identify its critical variables, to lay the foundations to propose new critical points of control and to establish the actions necessary to reduce or to eliminate the failures detected. All this contributed to the satisfaction of hospital transfusion services and of patients.

Clinical and immunohistochemical comparative study of the efficacy of carboxytherapy vs platelet-rich plasma in treatment of stretch marks.

Science.gov (United States)

Hodeib, Abeer A; Hassan, Ghada F R; Ragab, Marwa N M; Hasby, Eiman A

2018-01-07

Striae distensae are dermal scars with a linear atrophic depression. The exact origin of striae distensae remains unrevealed, but low expression of collagen and fibronectin genes in the affected tissue was found. Several treatment modalities have been proposed, yet no consistent modality is available. To evaluate and compare the efficacy and safety of carboxytherapy vs platelet-rich plasma (PRP) in treatment of stretch marks. This study included 20 patients with striae alba. Every patient received treatment in the form of PRP injection in their right side (group A) and carboxytherapy session in their left side (group B) every 3-4 weeks for 4 sessions. Skin biopsies were taken before and after treatment, and they were subjected to fibronectin immunohistochemical stain. There was a significant improvement in striae alba in both groups after than before treatment. There was no significant difference between both groups as regards either percentage of improvement, response (grading scale), or patient satisfaction. The fibronectin-stained area was significantly higher in both groups after than before treatment, and it was significantly higher after treatment in group (B) than group (A). Both methods were safe and effective with minimal side effects. There was no significant difference between both methods of treatments. This was confirmed histopathologically by fibronectin expression which is found to be low in striae and increased significantly after treatment. But fibronectin expression was higher in group (B) than (A). © 2018 Wiley Periodicals, Inc.

A Comparison of Therapeutic Modalities for Septated Tuberculous PleuraI Effusion on US

Energy Technology Data Exchange (ETDEWEB)

Cho, In Hwan; Kim, Kyeong Ah; Kim, Chul Joong; Kang, Eun Young; Cha, In Ho [Dae Rim St. Mary' s Hospital, Seoul (Korea, Republic of); Sim, Jae Jung [Korea University College of Medicine, Seoul (Korea, Republic of)

1995-12-15

To evaluate the utility of ultrasonography as a guide of determination of therapeutic modality an dto compare the therapeutic effects of modalities in patients with tuberculous pleural effusion. This study included 47 patients who had multiple septations on ultrasonography. We classified ultrasonographic pattern of pleural effusion into three groups according to pattern of septation : linear(n=6),moderate(n=19), honeycombing(n=22). We also classified therapeutic modalities into three groups : thoracentesis group(n=13), percutaneous catheter drainage group(n=11), intrapleural urokinase instillation group(n=23). We assessed the early and late therapeutic effects of these groups prospectively with follow-up chest radiographs. There was statistically no significant difference in therapeutic effect among the groups that had linear and moderate septa on ultrasonography(p<0.01). In patients with honeycombing septa, the therapeutic effects of catheter group and urokinase group were superior to conservative thoracentesis group(p<0.01). In urokinase group,mean duration of drainage(6.6 days) was significantly shorter than catheter group's(12.4 days) (p<0.01). Pattern of septation on ultrasonography could be an useful factor for determination of the therapeutic modality in patients with tuberculous pleural effusion. Percutaneous catheter drainage with urokinase instillation is a good therapeutic modality with shortened duration of drainage in treatment of pleural effusion with honeycombing septae

A Comparison of Therapeutic Modalities for Septated Tuberculous PleuraI Effusion on US

International Nuclear Information System (INIS)

Cho, In Hwan; Kim, Kyeong Ah; Kim, Chul Joong; Kang, Eun Young; Cha, In Ho; Sim, Jae Jung

1995-01-01

To evaluate the utility of ultrasonography as a guide of determination of therapeutic modality an dto compare the therapeutic effects of modalities in patients with tuberculous pleural effusion. This study included 47 patients who had multiple septations on ultrasonography. We classified ultrasonographic pattern of pleural effusion into three groups according to pattern of septation : linear(n=6),moderate(n=19), honeycombing(n=22). We also classified therapeutic modalities into three groups : thoracentesis group(n=13), percutaneous catheter drainage group(n=11), intrapleural urokinase instillation group(n=23). We assessed the early and late therapeutic effects of these groups prospectively with follow-up chest radiographs. There was statistically no significant difference in therapeutic effect among the groups that had linear and moderate septa on ultrasonography(p<0.01). In patients with honeycombing septa, the therapeutic effects of catheter group and urokinase group were superior to conservative thoracentesis group(p<0.01). In urokinase group,mean duration of drainage(6.6 days) was significantly shorter than catheter group's(12.4 days) (p<0.01). Pattern of septation on ultrasonography could be an useful factor for determination of the therapeutic modality in patients with tuberculous pleural effusion. Percutaneous catheter drainage with urokinase instillation is a good therapeutic modality with shortened duration of drainage in treatment of pleural effusion with honeycombing septae

A novel and effective acupuncture modality as a complementary therapy to acute pain relief in inpatients with rib fractures

Directory of Open Access Journals (Sweden)

Hsin-Yi Ho

2014-06-01

Full Text Available Background: Pain control has been emphasized as a priority for both practitioners and inpatients with rib fractures, since analgesia could only offer limited relief from severe pain. A prospective and randomized controlled trial was conducted to analyze the efficacy and efficiency of acupuncture in acute pain relief for inpatients with rib fractures. Methods: A total of 58 inpatients were recruited and allocated to two groups, receiving identical doses of conventional oral analgesics as well as filiform needles as treatment and thumbtack intradermal (TI needles placed upon the skin surface as a control, respectively, via novel acupuncture modality once daily for three consecutive days. The effect of pain relief was evaluated during activities that induce pain, and sustained maximal inspiration (SMI lung volumes and sleep quality were assessed. Results: The patients treated with filiform needles had more effective pain relief than those in the TI needle group during deep breathing, coughing, and turning over the body (p < 0.05, and the effect persisted for at least 6 h in most patients. Sustained maximal inspiration lung volumes and sleep quality did not show improvement through every acupuncture intervention, and they could not respond accurately to pain relief via acupuncture. Conclusion: The active evaluation could provide a more adaptive model for assessing pain intensity due to rib fractures. This novel acupuncture modality in which the needle insertion sites are corresponding to the pain spots can be a safe and viable therapy for relieving pain in inpatients with rib fractures.

18F-FDG PET/CT for initial staging in breast cancer patients. Is there a relevant impact on treatment planning compared to conventional staging modalities?

International Nuclear Information System (INIS)

Krammer, J.; Schnitzer, A.; Kaiser, C.G.; Buesing, K.A.; Schoenberg, S.O.; Wasser, K.; Sperk, E.; Brade, J.; Wasgindt, S.; Suetterlin, M.; Sutton, E.J.

2015-01-01

To evaluate the impact of whole-body 18 F-FDG PET/CT on initial staging of breast cancer in comparison to conventional staging modalities. This study included 102 breast cancer patients, 101 patients were eligible for evaluation. Preoperative whole-body staging with PET/CT was performed in patients with clinical stage ≥ T2 tumours or positive local lymph nodes (n = 91). Postoperative PET/CT was performed in patients without these criteria but positive sentinel lymph node biopsy (n = 10). All patients underwent PET/CT and a conventional staging algorithm, which included bone scan, chest X-ray and abdominal ultrasound. PET/CT findings were compared to conventional staging and the impact on therapeutic management was evaluated. PET/CT led to an upgrade of the N or M stage in overall 19 patients (19 %) and newly identified manifestation of breast cancer in two patients (2 %). PET/CT findings caused a change in treatment of 11 patients (11 %). This is within the range of recent studies, all applying conventional inclusion criteria based on the initial T and N status. PET/CT has a relevant impact on initial staging and treatment of breast cancer when compared to conventional modalities. Further studies should assess inclusion criteria beyond the conventional T and N status, e.g. tumour grading and receptor status. (orig.)

Evaluation and efficacy of carbon dioxide therapy (carboxytherapy) versus mesolipolysis in the treatment of cellulite.

Science.gov (United States)

Eldsouky, Fatma; Ebrahim, Howyda Mohamed

2018-01-17

Cellulite is an irregular alteration of the skin surface giving it cottage cheese appearance. Carboxytherapy is transcutaneous infusion of carbon dioxide into the affected site. Mesolipolysis aims to remove cellulite and improve skin texture. To verify the efficacy and safety of carboxytherapy versus mesolipolysis using phosphatidylcholine (PPC) in treatment of cellulite in thighs area. Forty-eight female patients with different grades of cellulite at thighs area were enrolled in this study. They were classified into two groups: group A received subcutaneous infusion of carboxytherapy, and group B was treated with mesolipolysis using PPC. Each group received six sessions at weekly intervals. sessions. The outcome measures and clinical assessment were based on cellulite grading scale and thigh circumference measurements. Standardized digital photography was taken before and after treatment. Patients were followed up for 6 months. After treatment, there was significant reduction in thigh circumference measurement p Carboxytherapy and mesolipolysis are safe and effective in cellulite treatment. Carboxytherapy is a promising alternative therapeutic modality for cellulite treatment.

Eigenvectors phase correction in inverse modal problem

Science.gov (United States)

Qiao, Guandong; Rahmatalla, Salam

2017-12-01

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

Cost-effectiveness analysis of screening modalities for breast cancer in Japan with special reference to women aged 40-49 years

International Nuclear Information System (INIS)

Ohnuki, Koji; Kuriyama, Shinichi; Shoji, Narumi; Tsuji, Ichiro; Ohuchi, Noriaki; Nishino, Yoshikazu

2006-01-01

Although the introduction of screening mammography in Japan would be expected to reduce mortality from breast cancer, the optimal screening modality in terms of cost-effectiveness remains unclear. We compared the cost-effectiveness ratio, defined as the cost required for a life-year saved, among the following three strategies: annual clinical breast examination; annual clinical breast examination combined with mammography; and biennial clinical breast examination combined with mammography for women aged 30-79 years using a hypothetical cohort of 100,000. The sensitivity, specificity and early breast cancer rates were derived from studies conducted from 1995 to 2000 in Miyagi Prefecture. The treatment costs were based on a questionnaire survey conducted at 13 institutions in Japan. We used updated parameters that were needed in the analysis. Although the effectiveness of treatment in terms of the number of expected survival years was highest for annual combined modality, biennial combined modality had a higher cost-effectiveness ratio, followed by annual combined modality and annual clinical breast examination in all age groups. In women aged 40-49 years, annual combined modality saved 852.9 lives and the cost/survival duration was 3,394,300 yen/year, whereas for biennial combined modality the corresponding figures were 833.8 and 2,025,100 yen/year, respectively. Annual clinical breast examination did not confer any advantages in terms of effectiveness (815.5 lives saved) or cost-effectiveness (3,669,900 yen/year). While the annual combined modality was the most effective with respect to life-years saved among women aged 40-49 years, biennial combined modality was found to provide the highest cost-effectiveness. (author)

High-dose-rate brachytherapy as salvage modality for locally recurrent prostate cancer after definitive radiotherapy. A systematic review

International Nuclear Information System (INIS)

Chatzikonstantinou, Georgios; Zamboglou, Nikolaos; Roedel, Claus; Tselis, Nikolaos; Zoga, Eleni; Strouthos, Iosif; Butt, Saeed Ahmed

2017-01-01

To review the current status of interstitial high-dose-rate brachytherapy as a salvage modality (sHDR BRT) for locally recurrent prostate cancer after definitive radiotherapy (RT). A literature search was performed in PubMed using ''high-dose-rate, brachytherapy, prostate cancer, salvage'' as search terms. In all, 51 search results published between 2000 and 2016 were identified. Data tables were generated and summary descriptions created. The main outcome parameters used were biochemical control (BC) and toxicity scores. Eleven publications reported clinical outcome and toxicity with follow-up ranging from 4-191 months. A variety of dose and fractionation schedules were described, including 19.0 Gy in 2 fractions up to 42.0 Gy in 6 fractions. The 5-year BC ranged from 18-77%. Late grade 3 genitourinary and gastrointestinal toxicity was 0-32% and 0-5.1%, respectively. sHDR BRT appears as safe and effective salvage modality for the reirradiation of locally recurrent prostate cancer after definitive RT. (orig.) [de

Adoptive T cell Therapy Against Solid Tumors: Success Requires Safe TCRs and Countering Immune Evasion

NARCIS (Netherlands)

A. Kunert (Andre)

2018-01-01

textabstractImmune therapy has proven its feasibility in cancer treatment and in some cases even its preeminence over other treatment modalities such as chemotherapy. Despite promising results observed in clinical trials utilizing or targeting various components of the patient’s own immune system,

Current Pathophysiological Aspects and Therapeutic Modalities for Pemphigus Vulgaris : A Review

Directory of Open Access Journals (Sweden)

J Raviraj

2007-01-01

Full Text Available Pemphigus vulgaris (PV is an autoimmune disorder manifesting primarily as blisters involving the mucocutaneous systems. The current medical literature indicates many breakthroughs in the research of pathophysiology and treatment aspects of PV. This article tries to describe some of the novel aspects briefing the role of nondesmoglein antibodies and the role of TNF-alpha in the etiopathogenesis of pemphigus vulgaris and the role of newer therapeutic modalities like Rituximab, Etanercept, intravenous Immunoglobulins, cholinergic drugs, arid the like in the treatment of PV.

The SafeCOP ECSEL Project: Safe Cooperating Cyber-Physical Systems Using Wireless Communication

DEFF Research Database (Denmark)

Pop, Paul; Scholle, Detlef; Hansson, Hans

2016-01-01

This paper presents an overview of the ECSEL project entitled "Safe Cooperating Cyber-Physical Systems using Wireless Communication" (SafeCOP), which runs during the period 2016 -- 2019. SafeCOP targets safety-related Cooperating Cyber-Physical Systems (CO-CPS) characterised by use of wireless...... detection of abnormal behaviour, triggering if needed a safe degraded mode. SafeCOP will also develop methods and tools, which will be used to produce safety assurance evidence needed to certify cooperative functions. SafeCOP will extend current wireless technologies to ensure safe and secure cooperation...

Effects of medical and mental status on treatment modalities in patients treated under general anaesthesia at the KTU Faculty of Dentistry in Trabzon, Turkey: A comparative retrospective study.

Science.gov (United States)

Baygin, Ozgul; Tuzuner, Tamer; Kusgoz, Adem; Yahyaoglu, Gorkem; Yilmaz, Nagehan; Aksoy, Simge

2017-02-01

This study evaluated the differences in dental conditions and treatment modalities between disabled and non-cooperative healthy children under general anaesthesia. The data were collected from paediatric patients between 3 and 15 years of age who received dental treatment under general anaesthesia. Patients with at least one mental/physical disturbance (group 1) and other healthy non-cooperative patients (group 2) were compared with regard to gender, age, weight, and treatment time-type. The statistical analyses were performed using Fisher's exact and Mann-Whitney U tests. No significant differences were observed between the groups with regard to gender, weight and treatment-time (p>0.05). The numbers of treated teeth (pgeneral condition of the patients may alter the type of treatment provided and confirms the necessity of performing preventive procedures.

Modality comparison for small animal radiotherapy: A simulation study

Energy Technology Data Exchange (ETDEWEB)

Bazalova, Magdalena, E-mail: bazalova@stanford.edu; Nelson, Geoff; Noll, John M.; Graves, Edward E. [Department of Radiation Oncology, Molecular Imaging Program at Stanford, Stanford University, Stanford, California 94305 (United States)

2014-01-15

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

Safe transport of radioactive material. Second edition

International Nuclear Information System (INIS)

1996-01-01

In 1991, the International Atomic Energy Agency published Training Course Series No. 1 (TCS-1), a training manual that provides in 20 chapters a detailed discussion of the background, philosophy, technical bases and requirements and implementation aspects of the Regulations for the Safe Transport of Radioactive Material. The Transport Regulations are widely implemented by the IAEA's Member States and are also used as the bases for radioactive material transport requirements of modal organisations such as the International Maritime Organization and the International Civil Aviation Organization. This document is a supplement of TCS-1 to provide additional material in the form of learning aids and new exercises, that have been developed with the use of TCS-1 at succeeding IAEA training courses. The learning aids in the first part of the supplement are hitherto unpublished material that provide detailed guidance useful in solving the exercises presented in the second part. Solutions to the exercises are on field at the IAEA Secretariat and are available by arrangement to lectures presenting IAEA training courses. 4 refs, 1 fig., 6 tabs

Safe apples for baby-food production: survey of pesticide treatment regimes leaving minimum residues.

Science.gov (United States)

Ticha, Jana; Hajslova, Jana; Kovalczuk, Tomas; Jech, Martin; Honzicek, Jiri; Kocourek, Vladimir; Lansky, Miroslav; Kloutvorova, Jana; Falta, Vladan

2007-06-01

A total of 19 pesticide preparations were used according to agricultural practice in six trials in apple orchards. Using gas chromatography-mass spectrometry (GC-MS) and liquid chromatography-tandem mass spectrometry (LC-MS/MS), premature Golden Delicious apples collected 64, 50, 36 days before harvest and mature fruit were examined for residues of active ingredients. No residues of triflumuron, triazamate, chlorpyrifos, etofenprox, fenoxycarb, kresoxim-methyl, cyprodinyl, difenoconazole or thiram were detected in the first sampling. Also, the levels of chlorpyrifos-methyl, penconazole, tebuconazole and tolylfluanid dropped during the pre-harvest interval. Detectable residues of pyridaben, thiacloprid, trifloxystrobin and tetraconazole in harvested fruits were below 0.01 mg kg(-1), which is the maximum concentration of residues acceptable by baby-food producers in any raw material. The only residues exceeding this concentration were captan and teflubenzuron. Based on the data, farmers can choose pesticides for optimal treatment of plants, while enabling growth of a safe crop suitable for baby-food production.

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

Science.gov (United States)

Janowitz, Jeffrey M.

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

Safe Kids Worldwide

Science.gov (United States)

... Blog Videos Newsletter facebook twitter instagram pinterest gplus youtube Search Menu Why It Matters Who We Are What We Do Find Your Safe Kids Safe Kids Day Main menu Keeping All Kids Safe Safety Tips Get Involved 4 Star Charity Donate Text Burns and Scalds 4 tips ...

History of Civil Engineering Modal Analysis

DEFF Research Database (Denmark)

Brincker, Rune

2008-01-01

techniques are available for civil engineering modal analysis. The testing of civil structures defers from the traditional modal testing in the sense, that very often it is difficult, or sometimes impossible, to artificially excite a large civil engineering structure. Also, many times, even though...

Different patterns of modality dominance across development.

Science.gov (United States)

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

2018-01-01

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

Multilayer modal actuator-based piezoelectric transformers.

Science.gov (United States)

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

2007-02-01

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

Uni-, bi- and tri-modal warning signals: effects of temporal parameters and sensory modality on perceived urgency

NARCIS (Netherlands)

van Erp, Johannes Bernardus Fransiscus; Toet, Alexander; Janssen, Joris B.

Multi-sensory warnings can potentially enhance risk communication. Hereto we investigated how temporal signal parameters affect perceived urgency within and across modalities. In an experiment, 78 observers rated the perceived urgency of uni-, bi-, and/or tri-modal stimuli as function of 25

Uni-, bi- and tri-modal warning signals : Effects of temporal parameters and sensory modality on perceived urgency

NARCIS (Netherlands)

Erp, J.B.F. van; Toet, A.; Janssen, J.B.

2015-01-01

Multi-sensory warnings can potentially enhance risk communication. Hereto we investigated how temporal signal parameters affect perceived urgency within and across modalities. In an experiment, 78 observers rated the perceived urgency of uni-, bi-, and/or tri-modal stimuli as function of 25

Stereotactic radiosurgery in the palliative treatment of brain metastases

International Nuclear Information System (INIS)

Faria, Sergio L.; Souhami, Luis; Bahary, Jean-Paul; Clark, Brenda; Adamson, Nelson; Podgorsak, Ervin B.; Caron, Jean-Louis; Villemure, Jean-Guy; Olivier, Andre

1995-01-01

Between October, 1988 and November, 1993, 57 patients with metastatic brain disease underwent stereotactic radiosurgery at McGill University, canada. Four patients were excluded from this analysis leaving a total of 53 evaluable patients (with 57 lesions). Radiosurgery was performed with the dynamic rotation technique which uses an isocentric, 10 MV, linear accelerator. A median dose of 1,800 c Gy was given in a single session. In 89% of the cases radiosurgery was used after failure to conventional brain radiotherapy. With a median follow-up of 6 months, the response rate was 65% . Treatments were well tolerated and only 4 patients (7%) developed late complications related to the therapy, with one patient requiring a surgical resection of an area of radionecrose. Radiosurgery appears to be and effective and safe treatment for selected patients with metastatic brain disease, recurrent post-conventional radiotherapy. Its value as a single treatment modality for patients with isolated brain metastasis is now being studied in prospective trials. (author). 29 refs., 4 figs., 4 tabs

Improved survival with combined modality treatment for Stage IV breast cancer

International Nuclear Information System (INIS)

Nervi, C.; Arcangeli, G.; Concolino, F.; Cortese, M.

1979-01-01

Between 1974 and 1977, 85 patients with breast cancer at first postmastectomy relapse were irradiated (Radiation 3500 to 6000 rad--3/5 weeks) to all clinically evident lesions. Radiation fields were properly shaped to include a maximum 40% active bone marrow. After 3 to 4 weeks rest, chemotherapy was started as adjuvant therapy for residual or subclinical disease (ADR 30 mg/M 2 Day 1 and 8, 5-FU 400 mg/M 2 Day 1 and 8, CY 100 mg/M 2 Day 1 through 14: repeated after 14 days). ADR was discontinued at 500/M 2 and substituted by MTX 30 mg/M 2 Day 1 and 8 for a total of 2 years. Irradiated sites were chest wall in 35, supraclavicular and internal mammary nodes in 22, bone in 56, single lung lesions in 12, brain in 24. Controls were 52 comparable but non-randomized patients treated with chemotherapy only. Forty days after x-irradiation 68 patients (80%) were free of disease (NED) while in 17 cases (20%) some residual was still present (RED). In 28 of 68 cases (41%) NED after x-irradiation and 13 of 17 (76%) in RED group developed second relapse after a median interval of 26 and 20 mos., respectively. Four of 52 patients (8%) in the control group had complete regression with a median interval to second relapse of 7 mos. Median survival was 30 mos., 24 mos., and 13 mos., respectively, for NED, RED and chemotherapy only. Eighteen patients (26%) are free of disease after 36 to 48 mos. in the combined modality group; none in the chemotherapy group. Combined treatment cases did not show untolerable myelodepression. In 10 long-surviving patients a marked subcutaneous and skin fibrosis developed because of drug additive effect. Stage IV breast cancers rendered clinically free of disease with x-irradiation and subsequently treated with chemotherapy survive significantly longer than with chemotherapy alone

Three-valued logics in modal logic

NARCIS (Netherlands)

Kooi, Barteld; Tamminga, Allard

2013-01-01

Every truth-functional three-valued propositional logic can be conservatively translated into the modal logic S5. We prove this claim constructively in two steps. First, we define a Translation Manual that converts any propositional formula of any three-valued logic into a modal formula. Second, we

Vacuum-Assisted Abdominal Closure Is Safe and Effective

DEFF Research Database (Denmark)

Jensen, R O; Buchbjerg, T; Simonsen, R M

2017-01-01

less likely to develop large hernias and had better self-evaluated physical health score (p mental health was found. CONCLUSION: The abdominal VAC treatment in patients with abdominal catastrophes is safe and with a relative low complication rate. Whether it might be superior...

Safe Re-use Practices in Wastewater-Irrigated Urban Vegetable Farming in Ghana

DEFF Research Database (Denmark)

Keraita, Bernard; Abaidoo, R.C; Beernaerts, I.

2012-01-01

of stakeholders at different levels along the food chain. This paper presents an overview of safe re-use practices including farm-based water treatment methods, water application techniques, post-harvest handling practices, and washing methods. The overview is based on a comprehensive analysis of the literature......Irrigation using untreated wastewater poses health risks to farmers and consumers of crop products, especially vegetables. With hardly any wastewater treatment in Ghana, a multiple-barrier approach was adopted and safe re-use practices were developed through action research involving a number...... and our own specific studies, which used data from a broad range of research methods and approaches. Identifying, testing, and assessment of safe practices were done with the active participation of key actors using observations, extensive microbiological laboratory assessments, and field...

Modal Sosial dan Partisipasi Masyarakat dalam Penemuan Penderita Tuberkulosis

Directory of Open Access Journals (Sweden)

Reviono Reviono

2013-06-01

Full Text Available Tuberkulosis merupakan masalah kesehatan masyarakat yang utama di tingkat global, regional, nasional, maupun lokal. World Health Organization menggulirkan strategi directly observed treatment short course (DOTS dan strategi stop tuberculosis partnership bertujuan untuk menjangkau semua penderita tuberkulosis. Kedua strategi tersebut masih belum mampu mencapai target case detection rate (CDR secara konsisten. Penelitian ini bertujuan merumuskan model modal sosial dan partisipasi masyarakat dalam crude death rate. Sasaran penelitian adalah petugas tuberkulosis dan kader di 30 desa di Kabupaten Karanganyar, Jawa Tengah. Metode yang digunakan adalah survei dan studi kasus. Hasil penelitian survei menunjukkan, desa dengan modal sosial yang tinggi mempunyai kemungkinan untuk melampaui target CDR ≥ 70%, 9 kali lebih besar daripada desa dengan modal sosial rendah. Desa dengan partisipasi masyarakat tinggi mempunyai kemungkinan 7,5 kali lebih besar daripada desa dengan partisipasi masyarakat rendah. Hasil penelitian studi kasus menunjukkan, faktor-faktor modal sosial yang berhubungan dengan CDR terdiri dari dimensi kognitif meliputi kepercayaan dan merasa mempunyai program tuberkulosis. Dimensi relasional meliputi norma sosial, penanaman jasa pribadi, kerja sama, dan komunikasi. Dimensi struktural meliputi jejaring dan persatuan. Faktor-faktor partisipasi yang berhubungan dengan CDR meliputi identifikasi kebutuhan, menggerakan sumber daya program, dan kepemimpinan. Tuberculosis is an important public health problem of global, regional, national, and local levels. World health organization launched directly observed treatment short course (DOTS and stop tuberculosis partnership strategies aiming to reach all tuberculosis patients. Both strategies have not been able to reach the case detection rate (CDR target consistently. This research aimed to formulate a social capital and participation model in crude death rate. The target of research was the

Fuzzy Reasoning Based on First-Order Modal Logic,

NARCIS (Netherlands)

Zhang, Xiaoru; Zhang, Z.; Sui, Y.; Huang, Z.

2008-01-01

As an extension of traditional modal logics, this paper proposes a fuzzy first-order modal logic based on believable degree, and gives out a description of the fuzzy first-order modal logic based on constant domain semantics. In order to make the reasoning procedure between the fuzzy assertions

40 CFR 1033.520 - Alternative ramped modal cycles.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Alternative ramped modal cycles. 1033... cycles. (a) Locomotive testing over a ramped modal cycle is intended to improve measurement accuracy at... locomotive notch settings. Ramped modal cycles combine multiple test modes of a discrete-mode steady-state...

Direct calculation of modal contributions to thermal conductivity via Green–Kubo modal analysis

International Nuclear Information System (INIS)

Lv, Wei; Henry, Asegun

2016-01-01

We derived a new method for direct calculation of the modal contributions to thermal conductivity, which is termed Green–Kubo modal analysis (GKMA). The GKMA method combines the lattice dynamics formalism with the Green–Kubo formula for thermal conductivity, such that the thermal conductivity becomes a direct summation of modal contributions, where one need not define the phonon velocity. As a result, the GKMA method can be applied to any material/group of atoms, where the atoms vibrate around stable equilibrium positions, which includes non-stoichiometric compounds, random alloys, amorphous materials and even rigid molecules. By using molecular dynamics simulations to obtain the time history of each mode’s contribution to the heat current, one naturally includes anharmonicity to full order and can obtain insight into the interactions between different modes through the cross-correlations. As an example, we applied the GMKA method to crystalline and amorphous silicon. The modal contributions at each frequency result from the analysis and thereby allow one to apply a quantum correction to the mode heat capacity to determine the temperature dependence of thermal conductivity. The predicted temperature dependent thermal conductivity for amorphous silicon shows the best agreement with experiments to date. The GKMA method provides new insight into the nature of phonon transport, as it casts the problem in terms of mode–mode correlation instead of scattering, and provides a general unified formalism that can be used to understand phonon–phonon interactions in essentially any class of materials or structures where the atoms vibrate around stable equilibrium sites. (paper)

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

Science.gov (United States)

Maeda, Sachiko; Sasaki, Takeshi

2015-12-01

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

Modality effects in implicit artificial grammar learning: An EEG study.

Science.gov (United States)

Silva, Susana; Folia, Vasiliki; Inácio, Filomena; Castro, São Luís; Petersson, Karl Magnus

2018-05-15

Recently, it has been proposed that sequence learning engages a combination of modality-specific operating networks and modality-independent computational principles. In the present study, we compared the behavioural and EEG outcomes of implicit artificial grammar learning in the visual vs. auditory modality. We controlled for the influence of surface characteristics of sequences (Associative Chunk Strength), thus focusing on the strictly structural aspects of sequence learning, and we adapted the paradigms to compensate for known frailties of the visual modality compared to audition (temporal presentation, fast presentation rate). The behavioural outcomes were similar across modalities. Favouring the idea of modality-specificity, ERPs in response to grammar violations differed in topography and latency (earlier and more anterior component in the visual modality), and ERPs in response to surface features emerged only in the auditory modality. In favour of modality-independence, we observed three common functional properties in the late ERPs of the two grammars: both were free of interactions between structural and surface influences, both were more extended in a grammaticality classification test than in a preference classification test, and both correlated positively and strongly with theta event-related-synchronization during baseline testing. Our findings support the idea of modality-specificity combined with modality-independence, and suggest that memory for visual vs. auditory sequences may largely contribute to cross-modal differences. Copyright © 2018 Elsevier B.V. All rights reserved.

Comparing clinical effects of photodynamic therapy as a novel method with topical corticosteroid for treatment of Oral Lichen Planus.

Science.gov (United States)

Bakhtiari, Sedigheh; Azari-Marhabi, Saranaz; Mojahedi, Seyyed Masoud; Namdari, Mahshid; Rankohi, Zahra Elmi; Jafari, Soudeh

2017-12-01

Oral lichen planus is an autoimmune disorder with several challenges in treatment. Photodynamic therapy has been proposed as a new treatment option for the disease. The present study compared the clinical effects of photodynamic therapy to dexamethasone mouthwash in the treatment of oral lichen planus lesions. In this randomized clinical trial, 30 patients with oral lichen planus were included.15 patients were treated with 5% methylene blue mediated photodynamic therapy using Fotosan device for 30s (630nm wavelength and 7.2-14.4J/cm 2 dose) for 4 sessions in the days 1, 4, 7, 14. In another group, the treatment was done on 15 patients by 0.5mg tab dexamethasone solution in 5cc water, rinsed 4 times in a day within two weeks. The sign score, symptoms scores (pain), clinical severity and treatment efficacy were measured at the days 15, 30, 60, 90 after beginning of the treatment. The results were subjected to Mann-whitney U test in both groups. No significant difference existed between the two modalities regarding the treatment efficacy index, sign score, symptom score and clinical severity on the 15, 30, 60 and 90 post-treatment days. Decreases in patient's symptoms were statistically significant in both groups. Photodynamic therapy was as effective as the dexamethasone mouth wash in the treatment of oral lichen planus. It could be used as a safe modality in the treatment of oral lichen planus lesions without identified side effects. Copyright © 2017 Elsevier B.V. All rights reserved.

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

Science.gov (United States)

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

2018-02-01

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

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

Directory of Open Access Journals (Sweden)

Pasquale Esposito

2017-01-01

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

"Same Room, Safe Place".

Science.gov (United States)

Keene Woods, Nikki

2017-04-01

There are many different professional stances on safe sleep and then there is the reality of caring for a newborn. There is a debate among professionals regarding safe sleep recommendations. The continum of recommendations vary from the American Academy of Pediatrics (AAP) Safe Sleep Guidelines to the bed-sharing recommendations from the Mother-Baby Behavioral Sleep Laboratory. The lack of consistent and uniform safe sleep recommendations from health professionals has been confusing for families but has more recently raised a real professional ethical dilemma. Despite years of focused safe sleep community education and interventions, sleep-related infant deaths are on the rise in many communities. This commentary calls for a united safe sleep message from all health professionals to improve health for mothers and infants most at-risk, "Same Room, Safe Place."

Vocabulary acquisition in aphasia: Modality can matter.

Science.gov (United States)

Tuomiranta, Leena; Grönroos, Ann-Mari; Martin, Nadine; Laine, Matti

2014-11-01

The present case study investigated modality-specific aspects of novel word acquisition in aphasia. It was prompted by recent aphasia case studies indicating great interindividual variability in the ability to learn and maintain novel words in aphasia. Moreover, two previous case studies revealed a striking effect of input modality by showing effective word learning and re-learning via visual input only (Kohen, Sola, Tuomiranta, Laine, & Martin, 2012; Tuomiranta et al., 2014). The present participant TS with chronic nonfluent aphasia and post-semantic anomia was administered novel word-referent learning tasks. In the first experiment, the learning phase included simultaneous phonological and orthographic input, while the follow-up was probed separately for spoken and written responses. In the second experiment, we studied the effect of four different input and output modality combinations on her ability to learn to name the novel items. In the first experiment, TS's spoken naming performance during the learning phase was just within the range of healthy controls. Maintenance declined and remained outside that range during the whole 6-month follow-up. However, TS maintained the learned words better in written than in spoken naming throughout the follow-up, and in written naming, her maintenance stayed within the control's range up to 8 weeks post-training. The second experiment indicated that the best learning outcome was achieved with orthographic input. Orthographic input combined with orthographic output resulted in fast and accurate learning of the novel words. Interestingly, TS's test profile was opposite to her learning profile, as she repeated better than she read aloud in the linguistic background assessment. The results from the present case highlight the importance of multiple learning channels for word acquisition in individuals with aphasia. Probing the functionality of different input and output channels for learning may also prove valuable in tailoring

Supervised Cross-Modal Factor Analysis for Multiple Modal Data Classification

KAUST Repository

Wang, Jingbin; Zhou, Yihua; Duan, Kanghong; Wang, Jim Jing-Yan; Bensmail, Halima

2015-01-01

. In this paper, we improve CFA by incorporating the supervision information to represent and classify both image and text modals of documents. We project both image and text data to a shared data space by factor analysis, and then train a class label predictor

Impact of Medical Therapy on Atheroma Volume Measured by Different Cardiovascular Imaging Modalities

Directory of Open Access Journals (Sweden)

Mohamad C. N. Sinno

2010-01-01

Full Text Available Atherosclerosis is a systemic disease that affects most vascular beds. The gold standard of atherosclerosis imaging has been invasive intravascular ultrasound (IVUS. Newer noninvasive imaging modalities like B-mode ultrasound, cardiac computed tomography (CT, positron emission tomography (PET, and magnetic resonance imaging (MRI have been used to assess these vascular territories with high accuracy and reproducibility. These imaging modalities have lately been used for the assessment of the atherosclerotic plaque and the response of its volume to several medical therapies used in the treatment of patients with cardiovascular disease. To study the impact of these medications on atheroma volume progression or regression, imaging modalities have been used on a serial basis providing a unique opportunity to monitor the effect these antiatherosclerotic strategies exert on plaque burden. As a result, studies incorporating serial IVUS imaging, quantitative coronary angiography (QCA, B-mode ultrasound, electron beam computed tomography (EBCT, and dynamic contrast-enhanced magnetic resonance imaging have all been used to evaluate the impact of therapeutic strategies that modify cholesterol and blood pressure on the progression/regression of atherosclerotic plaque. In this review, we intend to summarize the impact of different therapies aimed at halting the progression or even result in regression of atherosclerotic cardiovascular disease evaluated by different imaging modalities.

The metaphysics of quantum mechanics: Modal interpretations

Science.gov (United States)

Gluck, Stuart Murray

2004-11-01

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

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

Science.gov (United States)

Gramling, Sandra E

2018-01-01

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

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

Science.gov (United States)

Weiskittle, Rachel E; Gramling, Sandra E

2018-01-01

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

The research progress of dual-modality probes for molecular imaging

International Nuclear Information System (INIS)

Cao Feng; Chen Yue

2010-01-01

Various imaging modalities have been exploited to investigate the anatomic or functional dissemination of tissues in the body. However, no single imaging modality allows overall structural, functional, and molecular information as each imaging modality has its own unique strengths and weaknesses. The combination of two imaging modalities that investigates the strengths of different methods might offer the prospect of improved diagnostic abilities. As more and more dual-modality imaging system have become clinically adopted, significant progress has been made toward the creation of dual-modality imaging probes, which can be used as novel tools for future multimodality systems. These all-in-one probes take full advantage of two different imaging modalities and could provide comprehensive information for clinical diagnostics. This review discusses the advantages and challenges in developing dual-modality imaging probes. (authors)

Verifying different-modality properties for concepts produces switching costs.

Science.gov (United States)

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

2003-03-01

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

Effect of treatment modality on the hypothalamic-pituitary function of patients treated with radiation therapy for pituitary adenomas: Hypothalamic dose and endocrine outcomes.

Directory of Open Access Journals (Sweden)

Andrew eElson

2014-04-01

Full Text Available Background: Both fractionated external beam radiotherapy and single fraction radiosurgery for pituitary adenomas are associated with the risk of hypothalamic-pituitary (HP axis dysfunction.Objective: To analyze the effect of treatment modality (Linac, TomoTherapy, or Gamma Knife on hypothalamic dose and correlate these with HP-Axis deficits after radiotherapy.Methods:Radiation plans of patients treated postoperatively for pituitary adenomas using Linac-based 3D Conformal Radiotherapy (CRT (n=11, TomoTherapy-based Intensity Modulated Radiation Therapy (IMRT (n=10, or Gamma Knife Stereotactic Radiosurgery (SRS(n=12 were retrospectively reviewed. Dose to the hypothalamus was analyzed and postradiotherapy hormone function including growth hormone (GH, thyroid (TSH, adrenal (ACTH, prolactin (PRL, and gonadotropins (FSH/LH were assessed. Results:Post-radiation, 13 of 27 (48% patients eligible for analysis developed at least one new hormone deficit, of which 8 of 11 (72% occurred in the Linac group, 4 of 8 (50% occurred in the TomoTherapy group, and 1 of 8 (12.5% occurred in the Gamma Knife group. Compared with fractionated techniques, Gamma Knife showed improved hypothalamic sparing for DMax Hypo, and V12Gy. For fractionated modalities, TomoTherapy showed improved dosimetric characteristics over Linac-based treatment with hypothalamic DMean (44.8 Gy vs. 26.8 Gy p=0.02, DMax (49.8 Gy vs. 39.1 Gy p=0.04, and V12Gy (100% vs. 76% p=0.004.Conclusion:Maximal dosimetric avoidance of the hypothalamus was achieved using Gamma Knife-based radiosurgery followed by TomoTherapy-based IMRT, and Linac-based 3D conformal radiation therapy, respectively.

The SafeBoosC phase II clinical trial

DEFF Research Database (Denmark)

Riera, Joan; Hyttel-Sorensen, Simon; Bravo, María Carmen

2016-01-01

BACKGROUND: The SafeBoosC phase II randomised clinical trial recently demonstrated the benefits of a combination of cerebral regional tissue oxygen saturation (rStO2) by near-infrared spectroscopy (NIRS) and a treatment guideline to reduce the oxygen imbalance in extremely preterm infants. AIMS: ...

Vacuum-assisted closure in the treatment of sternal wound infection after cardiac surgery.

Science.gov (United States)

Simek, Martin; Nemec, Petr; Zalesak, Bohumil; Kalab, Martin; Hajek, Roman; Jecminkova, Lenka; Kolar, Milan

2007-12-01

Vacuum-assisted closure (VAC) was primarily designed for the treatment of pressure ulcers or chronic, debilitating wounds. Recently, VAC has become an encouraging treatment modality for sternal wound infection after cardiac surgery, providing superior results to conventional treatment strategies. From November 2004 to September 2006, 34 patients, undergoing VAC therapy for sternal wound infection following cardiac surgery, were prospectively evaluated. Ten patients (29 %) were treated for superficial sternal wound infection and 24 (71 %) for deep sternal wound infection. The median age was 69.9 years (range 48 to 82) and the median BMI was 33.4 kg/m(2) (range 28 to 41). Twenty patients (59 %) were women and 19 patients (59 %) were diabetics. Owing to sternal wound infection complications, 16 patients (47 %) were readmitted to the department. VAC was used following the previous failure of the conventional treatment strategy in 7 patients (21 %). Thirty-three patients (97 %) were treated successfully. One patient (3 %) died of multiple organ failure. The overall length of hospitalization was 34.6 days (range 9 to 62). The median number of dressing changes was 4.6 (range 3 to 10). The median VAC treatment time until surgical closure was 9.2 days (range 6 to 21 days). VAC therapy was solely used as a bridge to definite wound closure. Three patients (9 %) with chronic fistula were re-admitted 1 to 6 months after VAC therapy. VAC therapy is a safe and reliable option in the treatment of sternal wound infection in cardiac surgery. VAC therapy should be considered an effective adjunct to conventional treatment modalities for the treatment of extensive and life-threatening wound infections following cardiac surgery, particularly in the presence of risk factors.

Modal Testing of Mechanical Structures subject to Operational Excitation Forces

DEFF Research Database (Denmark)

Møller, N.; Brincker, Rune; Herlufsen, H.

2001-01-01

Operational Modal Analysis also known as Output Only Modal Analysis has in the recent years been used for extracting modal parameters of civil engineering structures and is now becoming popular for mechanical structures. The advantage of the method is that no artificial excitation need to be appl......Operational Modal Analysis also known as Output Only Modal Analysis has in the recent years been used for extracting modal parameters of civil engineering structures and is now becoming popular for mechanical structures. The advantage of the method is that no artificial excitation need...

Endovascular treatment of basilar tip aneurysms associated with moyamoya disease

International Nuclear Information System (INIS)

Arita, K.; Kurisu, K.; Ohba, S.; Shibukawa, M.; Kiura, H.; Sakamoto, S.; Uozumi, T.; Nakahara, T.

2003-01-01

We report the efficacy and safety of endovascular treatment of basilar tip aneurysms (BTA) in five patients with moyamoya disease. The patients underwent intra-aneurysmal embolisation with detachable platinum coils. Three BTA presented with subarachnoid haemorrhage (SAH); the other two were asymptomatic. In four cases, one embolisation procedure produced >95% angiographic obliteration of the aneurysm. In the other patient, 80-90% obliteration was achieved initially, but due to growth of the residual aneurysm, the procedure was repeated 7 months later. Two patients experienced transient oculomotor paresis as a procedure-related complication. Mean follow-up was 43.6±34.0 months (range 8-92 months). One patient died of putaminal haemorrhage unrelated to the aneurysm 15 months after embolisation. The other four had no subsequent SAH and survived without sequelae. Endovascular embolisation using detachable platinum coils proved to be a safe and efficient treatment modality for BTA associated with moyamoya disease. (orig.)

New and safe treatment of food impacted in the esophagus: a single center experience of 100 consecutive cases.

Science.gov (United States)

Shafique, Muhammad; Yaqub, Sheraz; Lie, Erik S; Dahl, Vegard; Olsbø, Frode; Røkke, Ola

2013-01-01

Aim. Large food bits can get stuck in the esophagus and must be removed by endoscopy. In some cases, this can be difficult or unsafe. We describe a new and safe treatment for such patients. Materials and Methods. 100 consecutive patients were referred to Akershus University Hospital with impacted food in the esophagus. In 36 patients (36%), the food passed spontaneously. In 59 (92%) of the remaining 64 patients, the food was removed by endoscopic intervention. In the last five patients, endoscopic removal was judged difficult or unsafe. These patients received the new treatment: one capsule Creon 10000 IU dissolved in 30 mL of Coca-Cola administered by a nasooesophageal tube four times daily for 2-3 days. Results. Of the 59 patients treated with endoscopic procedure, complications occurred in four (7%): three bleedings and one perforation of the esophagus. In five patients treated with Coca-Cola and Creon, the food had either passed or was soft after 2-3 days and could easily be removed. Conclusion. The treatment of choice of impacted food in the esophagus is endoscopic removal. In cases where this is difficult, we recommend treatment with Coca-Cola and Creon for 2-3 days before complications occur.

Cost-effectiveness of secondary screening modalities for hypertension.

Science.gov (United States)

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

2013-02-01

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

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

International Nuclear Information System (INIS)

Vashistha, Vishal; Wang, Hanzhang; Mazzone, Andrew; Liss, Michael A.; Svatek, Robert S.; Schleicher, Mary; Kaushik, Dharam

2017-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

Vashistha, Vishal [Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio (United States); Wang, Hanzhang [Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, Texas (United States); Mazzone, Andrew [Rush Medical College, Rush University Medical Center, Chicago, Illinois (United States); Liss, Michael A.; Svatek, Robert S. [Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, Texas (United States); Schleicher, Mary [Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio (United States); Kaushik, Dharam, E-mail: Kaushik@uthscsa.edu [Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, Texas (United States)

2017-04-01

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

Extending Modal Transition Systems with Structured Labels

DEFF Research Database (Denmark)

Bauer, Sebastian S.; Juhl, Line; Larsen, Kim Guldstrand

2012-01-01

We introduce a novel formalism of label-structured modal transition systems that combines the classical may/must modalities on transitions with structured labels that represent quantitative aspects of the model. On the one hand, the specification formalism is general enough to include models like...... weighted modal transition systems and allows the system developers to employ more complex label refinement than in the previously studied theories. On the other hand, the formalism maintains the desirable properties required by any specification theory supporting compositional reasoning. In particular, we...

Treatment of Traumatic Esophagopleural Fistula Using the Over-the-Scope-Clip System.

Science.gov (United States)

Kim, Ji Hyoung; Park, Jong-Jae; Jung, Il Woo; Kim, Sang Hoon; Kim, Hee Dong; Choe, Jung Wan; Joo, Moon Kyung; Kim, Hyun Gu

2015-09-01

Esophagopleural fistula (EPF) is a rare condition that is usually accompanied by severe infection and life-threatening morbidity. Here, we report the successful treatment of an EPF by closing an esophageal orifice using the over-the-scope-clip (OTSC) system without postprocedural complications. A 41-year-old man had serious thoracic and abdominal trauma due to a traffic accident. Computed tomography revealed findings suggestive of esophageal rupture due to Boerhaave syndrome. An emergent explorative operation was performed for primary repair with the insertion of a vacuum-assisted closure device. A postoperative upper gastrointestinal series revealed an EPF tract connecting the left pleural space and distal esophagus. We performed an endoscopic procedure using the "traumatic-type"OTSC to seal the EPF, and the esophageal orifice was completely healed 2 weeks postoperatively. The OTSC system might represent a safe and feasible modality for the treatment of EPF.

TU-A-304-02: Treatment Simulation, Planning and Delivery for SBRT

Energy Technology Data Exchange (ETDEWEB)

Yang, Y.

2015-06-15

Increased use of SBRT and hypo fractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide updated knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT or IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional (3D and 4D) and multi-modality (CT, beam-level X-ray imaging, pre- and on-treatment 3D/4D MRI, PET, robotic ultrasound, etc.) for reliable guidance of SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. Discuss treatment planning and quality assurance issues specific to SBRT. Research grant from Varian Medical Systems.

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

Science.gov (United States)

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

2013-01-01

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

Omitting cytogenetic assessment from routine treatment response monitoring in chronic myeloid leukemia is safe.

Science.gov (United States)

Geelen, Inge G P; Thielen, Noortje; Janssen, Jeroen J W M; Hoogendoorn, Mels; Roosma, Tanja J A; Valk, Peter J M; Visser, Otto; Cornelissen, Jan J; Westerweel, Peter E

2018-04-01

The monitoring of response in chronic myeloid leukemia (CML) is of great importance to identify patients failing their treatment in order to adjust TKI choice and thereby prevent progression to advanced stage disease. Cytogenetic monitoring has a lower sensitivity, is expensive, and requires invasive bone marrow sampling. Nevertheless, chronic myeloid leukemia guidelines continue to recommend performing routine cytogenetic response assessments, even when adequate molecular diagnostics are available. In a population-based registry of newly diagnosed CML patients in the Netherlands, all simultaneous cytogenetic and molecular assessments performed at 3, 6, and 12 months were identified and response of these matched assessments was classified according to European Leukemia Net (ELN) recommendations. The impact of discrepant cytogenetic and molecular response classifications and course of patients with additional chromosomal abnormalities were evaluated. The overall agreement of 200 matched assessments was 78%. In case of discordant responses, response at 24 months was consistently better predicted by the molecular outcome. Cytogenetic response assessments provided relevant additional clinical information only in some cases of molecular "warning." The development of additional cytogenetic abnormalities was always accompanied with molecular failure. We conclude that it is safe to omit routine cytogenetics for response assessment during treatment and to only use molecular monitoring, in order to prevent ambiguous classifications, reduce costs, and reduce the need for invasive bone marrow sampling. Cytogenetic re-assessment should still be performed when molecular response is suboptimal. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

DroidSafe

Science.gov (United States)

2016-12-01

Massachusetts Avenue, Build E19-750 Cambridge , MA 02139-4307 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS...Activity objects illustrating the challenges of points-to and information flow analysis...measure how many malicious flows Droid- Safe was able to detect). As these results illustrate , DroidSafe implements an analysis of unprece- dented

MO-D-BRB-02: SBRT Treatment Planning and Delivery

International Nuclear Information System (INIS)

Yang, Y.

2016-01-01

Increased use of SBRT and hypofractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide current knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT/IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional and multi-modality imaging for reliable guidance of SBRT. Discuss treatment planning and QA issues specific to SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. NIH/NCI; Varian Medical Systems; F. Yin, Duke University has a research agreement with Varian Medical Systems. In addition to research grant, I had a technology license agreement with Varian Medical Systems

MO-D-BRB-02: SBRT Treatment Planning and Delivery

Energy Technology Data Exchange (ETDEWEB)

Yang, Y. [Stanford University Cancer Center (United States)

2016-06-15

Increased use of SBRT and hypofractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide current knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT/IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional and multi-modality imaging for reliable guidance of SBRT. Discuss treatment planning and QA issues specific to SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. NIH/NCI; Varian Medical Systems; F. Yin, Duke University has a research agreement with Varian Medical Systems. In addition to research grant, I had a technology license agreement with Varian Medical Systems.

Spatial aspects of combined modality radiotherapy

International Nuclear Information System (INIS)

Bodey, Rachel K.; Evans, Phil M.; Flux, Glenn D.

2005-01-01

Background and purpose: A combined modality radiotherapy (CMRT) incorporates both external beam radiotherapy (EBT) and targeted radionuclide therapy (TRT) components. The spatial aspects of this combination were explored by utilising intensity modulated radiotherapy (IMRT) to provide a non-uniform EBT dose distribution. Patients and methods: Three methods of prescribing the required non-uniform distribution of EBT dose are described, based on both physical and biological criteria according to the distribution of TRT uptake. The results and consequences of these prescriptions are explored by application to three examples of patient data. Results: The planning procedure adopted allowed IMRT plans to be produced that met the prescription requirements. However, when the treatment was planned as a CMRT, compared with the use of EBT alone, more satisfactory target doses could be achieved with lower doses to normal tissues. The effects of errors in EBT delivery and in the functional data were found to cause a non-uniform prescription to tend towards the uniform case. Conclusions: The methods and results are relevant for more general biological treatment planning, in which IMRT may be used to produce dose distributions prescribed according to tumour function. The effects of delivery and dose calculation errors can have a significant impact on how such treatments should be planned

A prime determinant in selecting dialysis modality: peritoneal dialysis patient survival

Directory of Open Access Journals (Sweden)

Hyunwook Kim

2017-03-01

Full Text Available The number of patients with end-stage renal disease (ESRD has rapidly increased, as has the cost of dialysis. Peritoneal dialysis (PD is an established treatment for ESRD patients worldwide; it has a variety of advantages, including autonomy and flexibility, as well as economic benefits in many countries compared to hemodialysis (HD. However, the long-term survival rate of PD remains poor. Although direct comparison of survival rate between the dialysis modalities by randomized controlled trials is difficult due to the ethical issues, it has always been a crucial point when deciding which dialysis modality should be recommended to patients. Recently, in many countries, including the United States, Brazil, Spain, Australia, and New Zealand, the survival rate in PD patients has significantly improved. PD patient survival in Korea has also improved, but Korean PD patients are known to have higher risk of mortality and major adverse cardiovascular, cerebrovascular events than HD patients. Herein, we further evaluate why Korean PD patients had worse outcomes; we suggest that special attention should be paid to patients with diabetes, coronary artery disease, or congestive heart failure when they choose PD as the first dialysis modality in order to reduce mortality risk.

Delay in treatment of biliary disease during pregnancy increases morbidity and can be avoided with safe laparoscopic cholecystectomy.

Science.gov (United States)

Muench, J; Albrink, M; Serafini, F; Rosemurgy, A; Carey, L; Murr, M M

2001-06-01

Recent reports indicate that laparoscopic cholecystectomy in pregnancy is safe. The aim of this study was to evaluate whether delays in definitive treatment of symptomatic cholelithiasis increase morbidity. We reviewed the records of 16 women who underwent laparoscopic cholecystectomy during pregnancy between 1992 and 1999. Mean age was 24 +/- 5 years (mean +/- standard error). Symptom onset was during the first trimester in nine patients, second trimester in six patients, and third trimester in one patient. Patients had abdominal pain (93%), nausea (93%), emesis (80%), and fever (66%) for a median of 45 days (range 1-195 days) before cholecystectomy. Nine of 11 women who underwent cholecystectomy more than 5 weeks after onset of symptoms experienced recurrent attacks necessitating 15 hospital admissions and four emergency room visits. Moreover four women who developed symptoms in the first and second trimesters but whose operations were delayed to the third trimester had 11 hospital admissions and four emergency room visits; three of those four (75%) women developed premature contractions necessitating tocolytics. Cholecystectomy was completed laparoscopically in 14 women. There was no hospital infant or maternal mortality or morbidity. We recommend prompt laparoscopic cholecystectomy in pregnant women with symptomatic biliary disease because it is safe and it reduces hospital admissions and frequency of premature labor.

Safe havens in Europe

DEFF Research Database (Denmark)

Paldam, Martin

2013-01-01

Eleven safe havens exist in Europe providing offshore banking and low taxes. Ten of these states are very small while Switzerland is moderately small. All 11 countries are richer than their large neighbors. It is shown that causality is from small to safe haven to wealth, and that theoretically...... equilibriums are likely to exist where a certain regulation is substantially lower in a small country than in its big neighbor. This generates a large capital inflow to the safe havens. The pool of funds that may reach the safe havens is shown to be huge. It is far in excess of the absorptive capacity...... of the safe havens, but it still explains, why they are rich. Microstates offer a veil of anonymity to funds passing through, and Switzerland offers safe storage of funds....

Modalities in homotopy type theory

DEFF Research Database (Denmark)

Rijke, Egbert; Shulman, Michael; Spitters, Bas

2017-01-01

Univalent homotopy type theory (HoTT) may be seen as a language for the category of ∞-groupoids. It is being developed as a new foundation for mathematics and as an internal language for (elementary) higher toposes. We develop the theory of factorization systems, reflective subuniverses......, and modalities in homotopy type theory, including their construction using a "localization" higher inductive type. This produces in particular the (n-connected, n-truncated) factorization system as well as internal presentations of subtoposes, through lex modalities. We also develop the semantics...

Linear contextual modal type theory

DEFF Research Database (Denmark)

Schack-Nielsen, Anders; Schürmann, Carsten

Abstract. When one implements a logical framework based on linear type theory, for example the Celf system [?], one is immediately con- fronted with questions about their equational theory and how to deal with logic variables. In this paper, we propose linear contextual modal type theory that gives...... a mathematical account of the nature of logic variables. Our type theory is conservative over intuitionistic contextual modal type theory proposed by Nanevski, Pfenning, and Pientka. Our main contributions include a mechanically checked proof of soundness and a working implementation....

Integrating Conceptual Knowledge Within and Across Representational Modalities

OpenAIRE

McNorgan, Chris; Reid, Jackie; McRae, Ken

2010-01-01

Research suggests that concepts are distributed across brain regions specialized for processing information from different sensorimotor modalities. Multimodal semantic models fall into one of two broad classes differentiated by the assumed hierarchy of convergence zones over which information is integrated. In shallow models, communication within- and between-modality is accomplished using either direct connectivity, or a central semantic hub. In deep models, modalities are connected via casc...

Traveling Safely with Medicines

Science.gov (United States)

... Medications Safely My Medicine List How to Administer Traveling Safely with Medicines Planes, trains, cars – even boats ... your trip, ask your pharmacist about how to travel safely with your medicines. Make sure that you ...

Etanercept provides an effective, safe and flexible short- and long-term treatment regimen for moderate-to-severe psoriasis: a systematic review of current evidence.

Science.gov (United States)

Strohal, Robert; Chimenti, Sergio; Vena, Gino Antonio; Girolomoni, Giampiero

2013-06-01

The treatment of psoriasis requires long-lasting intervention. Conventional treatments for psoriasis comprise topical, phototherapeutic and systemic modalities, such as methotrexate or cyclosporine. Biological therapies are advocated by treatment guidelines for the use in moderate-to-severe psoriasis, when conventional treatments have failed, are contraindicated or are associated with severe adverse events. Etanercept is an anti-TNF recombinant fusion protein that has emerged as a standard biologic treatment option for moderate-to-severe psoriasis. The present review summarizes data from pivotal and post-marketing randomized controlled etanercept trials to treat moderate-to-severe psoriasis for 24 weeks and longer. During the first 12 weeks, etanercept can be administered in different dosing regimens: 50 mg twice weekly (BIW) and 50 mg once weekly. Although both regimens are effective, it has been shown that the 50 mg BIW dosage leads to higher response rates at week 24. In addition, after 24 weeks' treatment etanercept provides the unique possibility of continuous or intermittent long-term treatment programmes. The medium- to long-term efficacy of etanercept was consistent, regardless of whether etanercept therapy was interrupted or continuous. Taking the chronic nature of psoriasis into account, this flexibility in dosing regimen bestows a key advantage in facilitating individualisation of long-term treatment according to patient needs.

Treatment beliefs underlying intended treatment choices in knee and hip osteoarthritis

NARCIS (Netherlands)

Selten, E.M.H.; Geenen, R.; Schers, H.J.; van den Hoogen, F.H.J.; van der Meulen-Dilling, R.G.; Van der Laan, W.H.; Nijhof, M.W.; van den Ende, C.H.M.; Vriezekolk, J.E.

Purpose Patients’ beliefs about treatment modalities for knee and hip osteoarthritis (OA) will underlie their treatment choices. Based on the Theory of Planned Behavior, it is hypothesized that patients’ beliefs, subjective norm, and perceived behavioral control guide their treatment choices. Also,

Aeroelastic modal dynamics of wind turbines including anisotropic effects

DEFF Research Database (Denmark)

Skjoldan, Peter Fisker

frequency is thus identified as the dominant frequency in the response of a pure excitation of the mode observed in the inertial frame. A modal analysis tool based directly on the complex aeroelastic wind turbine code BHawC is presented. It uses the Coleman approach in isotropic conditions......Several methods for aeroelastic modal analysis of a rotating wind turbine are developed and used to analyse the modal dynamics of two simplified models and a complex model in isotropic and anisotropic conditions. The Coleman transformation is used to enable extraction of the modal frequencies...... of Floquet analysis or Hill's method which do not provide a unique reference frame for observing the modal frequency, to which any multiple of the rotor speed can be added. This indeterminacy is resolved by requiring that the periodic mode shape be as constant as possible in the inertial frame. The modal...

Sphenopalatine Ganglion Block for the Treatment of Acute Migraine Headache

Directory of Open Access Journals (Sweden)

Mohamed Binfalah

2018-01-01

Full Text Available Transnasal sphenopalatine ganglion block is emerging as is an attractive and effective treatment modality for acute migraine headaches, cluster headache, trigeminal neuralgia, and several other conditions. We assessed the efficacy and safety of this treatment using the Sphenocath® device. 55 patients with acute migraine headaches underwent this procedure, receiving 2 ml of 2% lidocaine in each nostril. Pain numeric rating scale (baseline, 15 minutes, 2 hours, and 24 hours and patient global impression of change (2 hours and 24 hours after treatment were recorded. The majority of patients became headache-free at 15 minutes, 2 hours, and 24 hours after procedure (70.9%, 78.2%, and 70.4%, resp.. The rate of headache relief (50% or more reduction in headache intensity was 27.3% at 15 minutes, 20% at 2 hours, and 22.2% at 24 hours. The mean pain numeric rating scale decreased significantly at 15 minutes, 2 hours, and 24 hours, respectively. Most patients rated the results as very good or good. The procedure was well-tolerated with few adverse events. This treatment is emerging as an effective and safe option for management of acute migraine attacks.

The value of serial quantitative technetium-99 m methylene diphosphonate in assessment of the response of metastatic skeletal lesions to different types of treatment modalities.

Energy Technology Data Exchange (ETDEWEB)

Moustafa, H; Elhaddad, SH; Ziada, G; Fawzi, A [Nuclear medicine department, faculty of medicine, cairo university, Cairo, (Egypt)

1995-10-01

The study included 95 patients having metastatic bone lesions, subjected to serial quantitative skeletal scintigraphy before and after treatment every 3 months for 6 months. To study the fate of metastatic bone lesions the effect of different treatment modalities, an objective index was used. This index was introduced in 1985 by Israel et al. (1), and was designated TF. A significant drop in TF ratio was observed 6 months following therapy in the groups who received combined localized radiotherapy together with systemic therapy and those who received half body irradiation. In contrast, a marked increase in TF ratio was observed in the patients who did not receive any specific treatment. The response of metastatic skeletal lesions was nearly similar whatever the site of involvement whether in the spine, flat or long bones except for an initial response in the long bones with drop of TF ratio after localized radiotherapy. 1 fig., 3 tabs.

The value of serial quantitative technetium-99 m methylene diphosphonate in assessment of the response of metastatic skeletal lesions to different types of treatment modalities

International Nuclear Information System (INIS)

Moustafa, H.; Elhaddad, SH.; Ziada, G.; Fawzi, A.

1995-01-01

The study included 95 patients having metastatic bone lesions, subjected to serial quantitative skeletal scintigraphy before and after treatment every 3 months for 6 months. To study the fate of metastatic bone lesions the effect of different treatment modalities, an objective index was used. This index was introduced in 1985 by Israel et al. (1), and was designated TF. A significant drop in TF ratio was observed 6 months following therapy in the groups who received combined localized radiotherapy together with systemic therapy and those who received half body irradiation. In contrast, a marked increase in TF ratio was observed in the patients who did not receive any specific treatment. The response of metastatic skeletal lesions was nearly similar whatever the site of involvement whether in the spine, flat or long bones except for an initial response in the long bones with drop of TF ratio after localized radiotherapy. 1 fig., 3 tabs

Safe and effective use of medicines for ethnic minorities

DEFF Research Database (Denmark)

Dam, Pernille; El-Souri, Mira Mahmoud; Herborg, Hanne

2015-01-01

, there was a need to adapt a previously developed and validated medicine-based intervention “safe and effective use of medicines” to this vulnerable group of unemployed ethnic minority patients. Methods: The objective of this before-after study was to improve medicines adherence, health status and work ability...... of the target group through an individualized pharmacist delivered intervention with focus on safe and effective implementation of medical treatments. The target group was ethnic minorities of non-western origin affiliated with a job center. Results: At baseline, 35.7 % of the patients had a potential adherence...... to the intervention. Conclusion: The counseling program “Safe and effective use of medicines” was successfully adapted to unemployed ethnic minority patients, and tested in a new collaboration between job centers and community pharmacies. The counseling program resulted in statistically significant improvements...

Artificial Vision, New Visual Modalities and Neuroadaptation

Directory of Open Access Journals (Sweden)

Hilmi Or

2012-01-01

Full Text Available To study the descriptions from which artificial vision derives, to explore the new visual modalities resulting from eye surgeries and diseases, and to gain awareness of the use of machine vision systems for both enhancement of visual perception and better understanding of neuroadaptation. Science could not define until today what vision is. However, some optical-based systems and definitions have been established considering some factors for the formation of seeing. The best known system includes Gabor filter and Gabor patch which work on edge perception, describing the visual perception in the best known way. These systems are used today in industry and technology of machines, robots and computers to provide their "seeing". These definitions are used beyond the machinery in humans for neuroadaptation in new visual modalities after some eye surgeries or to improve the quality of some already known visual modalities. Beside this, “the blindsight” -which was not known to exist until 35 years ago - can be stimulated with visual exercises. Gabor system is a description of visual perception definable in machine vision as well as in human visual perception. This system is used today in robotic vision. There are new visual modalities which arise after some eye surgeries or with the use of some visual optical devices. Also, blindsight is a different visual modality starting to be defined even though the exact etiology is not known. In all the new visual modalities, new vision stimulating therapies using the Gabor systems can be applied. (Turk J Oph thal mol 2012; 42: 61-5

On sine dwell or broadband methods for modal testing

Science.gov (United States)

Chen, Jay-Chung; Wada, Ben K.

1987-01-01

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

Converging modalities ground abstract categories: the case of politics.

Science.gov (United States)

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

2013-01-01

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

Models of galaxies - The modal approach

International Nuclear Information System (INIS)

Lin, C.C.; Lowe, S.A.

1990-01-01

The general viability of the modal approach to the spiral structure in normal spirals and the barlike structure in certain barred spirals is discussed. The usefulness of the modal approach in the construction of models of such galaxies is examined, emphasizing the adoption of a model appropriate to observational data for both the spiral structure of a galaxy and its basic mass distribution. 44 refs

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

Directory of Open Access Journals (Sweden)

Tobias T Hägi

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

Converging modalities ground abstract categories: the case of politics.

Directory of Open Access Journals (Sweden)

Ana Rita Farias

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

Improvements of ModalMax High-Fidelity Piezoelectric Audio Device

Science.gov (United States)

Woodard, Stanley E.

2005-01-01

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

Musical minds: attentional blink reveals modality-specific restrictions.

Directory of Open Access Journals (Sweden)

Sander Martens

Full Text Available Formal musical training is known to have positive effects on attentional and executive functioning, processing speed, and working memory. Consequently, one may expect to find differences in the dynamics of temporal attention between musicians and non-musicians. Here we address the question whether that is indeed the case, and whether any beneficial effects of musical training on temporal attention are modality specific or generalize across sensory modalities.When two targets are presented in close temporal succession, most people fail to report the second target, a phenomenon known as the attentional blink (AB. We measured and compared AB magnitude for musicians and non-musicians using auditory or visually presented letters and digits. Relative to non-musicians, the auditory AB was both attenuated and delayed in musicians, whereas the visual AB was larger. Non-musicians with a large auditory AB tended to show a large visual AB. However, neither a positive nor negative correlation was found in musicians, suggesting that at least in musicians, attentional restrictions within each modality are completely separate.AB magnitude within one modality can generalize to another modality, but this turns out not to be the case for every individual. Formal musical training seems to have a domain-general, but modality-specific beneficial effect on selective attention. The results fit with the idea that a major source of attentional restriction as reflected in the AB lies in modality-specific, independent sensory systems rather than a central amodal system. The findings demonstrate that individual differences in AB magnitude can provide important information about the modular structure of human cognition.

Linear Subspace Ranking Hashing for Cross-Modal Retrieval.

Science.gov (United States)

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

2017-09-01

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

Musical minds: attentional blink reveals modality-specific restrictions.

Science.gov (United States)

Martens, Sander; Wierda, Stefan M; Dun, Mathijs; de Vries, Michal; Smid, Henderikus G O M

2015-01-01

Formal musical training is known to have positive effects on attentional and executive functioning, processing speed, and working memory. Consequently, one may expect to find differences in the dynamics of temporal attention between musicians and non-musicians. Here we address the question whether that is indeed the case, and whether any beneficial effects of musical training on temporal attention are modality specific or generalize across sensory modalities. When two targets are presented in close temporal succession, most people fail to report the second target, a phenomenon known as the attentional blink (AB). We measured and compared AB magnitude for musicians and non-musicians using auditory or visually presented letters and digits. Relative to non-musicians, the auditory AB was both attenuated and delayed in musicians, whereas the visual AB was larger. Non-musicians with a large auditory AB tended to show a large visual AB. However, neither a positive nor negative correlation was found in musicians, suggesting that at least in musicians, attentional restrictions within each modality are completely separate. AB magnitude within one modality can generalize to another modality, but this turns out not to be the case for every individual. Formal musical training seems to have a domain-general, but modality-specific beneficial effect on selective attention. The results fit with the idea that a major source of attentional restriction as reflected in the AB lies in modality-specific, independent sensory systems rather than a central amodal system. The findings demonstrate that individual differences in AB magnitude can provide important information about the modular structure of human cognition.

Modalities of hemodialysis: Quality improvement

Directory of Open Access Journals (Sweden)

Ayman Karkar

2012-01-01

Full Text Available Hemodialysis (HD treatment had, over many years, improved the survival rate of patients with end-stage renal disease. However, standard or conventional HD prescription is far from being optimal in replacing the function of normal kidneys. Its unphysiologic clearance pattern and inability to remove all types and sizes of uremic toxins results in inter- and intra-dialysis complications and an unacceptably high rate of cardiovascular morbidity and mortality. Efficiency of HD can be improved by increasing blood and dialysate flow rates, dialyzer size and surface area and duration and frequency of dialysis sessions. Home HD, where short daily or long slow nocturnal HD sessions can conveniently be performed, provides an excellent option for quality of life improvement and reduction in morbidity and mortality. Recent innovations in the specifications of HD machines and improvement in dialysis membranes characteristics and water treatment technology paved the way for achieving quality HD. These advancements have resulted in efficient implementation of adsorption, diffusion and/or convection principles using adsorption HD, hemofiltration, hemodiafiltration (HDF and online HDF modalities in order to achieve optimum HD. Implementation of these innovations resulted in better quality care achievements in clinical practice and reduction in morbidity and mortality rates among HD patients.

Iatrogenic possibilities of orthodontic treatment and modalities of prevention

Science.gov (United States)

Meeran, Nazeer Ahmed

2013-01-01

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

Modal Testing of Mechanical Structures Subject to Operational Excitation Forces

DEFF Research Database (Denmark)

Møller, N.; Brincker, Rune; Herlufsen, H.

2000-01-01

to the Operational Modal Analysis. For Operational Modal Analysis two different estimation techniques are used: a non-parametric technique based on Frequency Domain Decomposition (FDD), and a parametric technique working on the raw data in time domain, a data driven Stochastic Subspace Identification (SSI) algorithm......Operational Modal Analysis also known as Output Only Modal Analysis has in the recent years been used for extracting modal parameters of civil engineering structures and is now becoming popular for mechanical structures. The advantage of the method is that no artificial excitation need...

The use of electrocautery as the primary ablation modality for malignant and benign airway obstruction.

Science.gov (United States)

Wahidi, Momen M; Unroe, Mark A; Adlakha, Natasha; Beyea, Mathew; Shofer, Scott L

2011-09-01

Laser has been the main ablative modality in the airways, but a growing experience with endobronchial electrocautery suggests a comparable efficacy and safety profile. To evaluate the efficacy and safety of electrocautery as the primary heat therapy for malignant and benign airway obstruction. A retrospective review of all patients undergoing endobronchial electrocautery, alone or in combination with other airway tools, at Duke University Medical Center between April 2004 and November 2009. Data on efficacy (luminal patency, symptomatic, radiographic, or physiologic improvement) and safety (complication rate) were collected. Ninety-four patients underwent 117 procedures with endobronchial electrocautery for endobronchial malignant and nonmalignant disease. Endoscopic improvement was seen in 94% of cases. Seventy-one percent of patients reported symptomatic improvement. Radiographic studies demonstrated luminal improvement in 78% of patients on chest computed tomography, improved aeration on chest computed tomography and chest x-ray in 63% and 43% of patients, respectively. The rate of major complications was 0.8%, whereas minor complications occurred in 6.8% of cases. There was no perioperative mortality. Endobronchial electrocautery is effective and safe when used as an ablative modality in malignant and benign airway obstruction and has a comparable profile to laser with the advantage of lower cost.

Automatic classification of early Parkinson's disease with multi-modal MR imaging.

Directory of Open Access Journals (Sweden)

Dan Long

Full Text Available BACKGROUND: In recent years, neuroimaging has been increasingly used as an objective method for the diagnosis of Parkinson's disease (PD. Most previous studies were based on invasive imaging modalities or on a single modality which was not an ideal diagnostic tool. In this study, we developed a non-invasive technology intended for use in the diagnosis of early PD by integrating the advantages of various modals. MATERIALS AND METHODS: Nineteen early PD patients and twenty-seven normal volunteers participated in this study. For each subject, we collected resting-state functional magnetic resonance imaging (rsfMRI and structural images. For the rsfMRI images, we extracted the characteristics at three different levels: ALFF (amplitude of low-frequency fluctuations, ReHo (regional homogeneity and RFCS (regional functional connectivity strength. For the structural images, we extracted the volume characteristics from the gray matter (GM, the white matter (WM and the cerebrospinal fluid (CSF. A two-sample t-test was used for the feature selection, and then the remaining features were fused for classification. Finally a classifier for early PD patients and normal control subjects was identified from support vector machine training. The performance of the classifier was evaluated using the leave-one-out cross-validation method. RESULTS: Using the proposed methods to classify the data set, good results (accuracy  = 86.96%, sensitivity  = 78.95%, specificity  = 92.59% were obtained. CONCLUSIONS: This method demonstrates a promising diagnosis performance by the integration of information from a variety of imaging modalities, and it shows potential for improving the clinical diagnosis and treatment of PD.

Cross-modal illusory conjunctions between vision and touch.

Science.gov (United States)

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

2002-10-01

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

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

Science.gov (United States)

Vincis, Roberto; Fontanini, Alfredo

2016-08-30

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

Multi-modal RGB–Depth–Thermal Human Body Segmentation

DEFF Research Database (Denmark)

Palmero, Cristina; Clapés, Albert; Bahnsen, Chris

2016-01-01

This work addresses the problem of human body segmentation from multi-modal visual cues as a first stage of automatic human behavior analysis. We propose a novel RGB-Depth-Thermal dataset along with a multi-modal seg- mentation baseline. The several modalities are registered us- ing a calibration...... to other state-of-the-art meth- ods, obtaining an overlap above 75% on the novel dataset when compared to the manually annotated ground-truth of human segmentations....

Cost-Effectiveness of Secondary Screening Modalities for Hypertension

Science.gov (United States)

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

2014-01-01

Background Clinic-based blood pressure (CBP) has been the default approach for diagnosing hypertension, but patients may be misclassified due to masked hypertension (false negative) or “white coat” hypertension (false positive). The incorporation of other diagnostic modalities, such as home blood pressure monitoring (HBPM) and ambulatory blood pressure monitoring (ABPM), holds promise to improve diagnostic accuracy and subsequent treatment decisions. Method We reviewed the literature on the costs and cost-effectiveness of adding HBPM and ABPM into routine blood pressure screening in adults. We excluded letters, editorials, and studies of pregnant and/or pre-eclamptic patients, children, and patients with specific conditions (e.g. diabetes). Results We identified 14 original, English language studies that included cost outcomes and compared two or more modalities. ABPM was found to be cost-saving for diagnostic confirmation following an elevated CBP in 6 studies. Three of 4 studies found that adding HBPM to an elevated CBP was also cost-effective. Conclusion Existing evidence supports the cost-effectiveness of incorporating HBPM or ABPM following an initial CBP-based diagnosis of hypertension. Future research should focus on their implementation in clinical practice, long-term economic values, and potential roles in identifying masked hypertension. PMID:23263535

Polarization dependence of the optical modal gain in ZnO

International Nuclear Information System (INIS)

Kim, Bumjin; Kyhm, Kwangseuk; Cho, Chaeryong

2010-01-01

The modal gain spectrum due to the electron-hole plasma in ZnO was measured using a variable stripe length method. A modal gain contour map for energy and stripe length allowed the modal gain saturation to be analyzed in terms of the spectral and the stripe length dependences. The modal gain was observed to be more significant in the TE mode than in the TM mode due to the polarization asymmetry of the wurtzite structure. We also found that the degree of polarization are enhanced as the stripe length increased, despite of modal gain saturation.

Hjertestop forårsaget af massiv lungeemboli under behandling med tranexamsyre

DEFF Research Database (Denmark)

Gybel, Mikkel; Kristensen, Kjeld; Roseva-Nielsen, Natasha

2013-01-01

Pulmonary embolism (PE) as the direct cause of cardiac arrest is well known but probably under-diagnosed. Treatment of menorrhagia with antifibrinolytics is a well documented treatment modality and it is considered safe although thromboembolic complications have been reported. We describe a case ...

Effects of auditory and visual modalities in recall of words.

Science.gov (United States)

Gadzella, B M; Whitehead, D A

1975-02-01

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

In Vivo Dual-Modality Fluorescence and Magnetic Resonance Imaging-Guided Lymph Node Mapping with Good Biocompatibility Manganese Oxide Nanoparticles

Directory of Open Access Journals (Sweden)

Yonghua Zhan

2017-12-01

Full Text Available Multifunctional manganese oxide nanoparticles (NPs with impressive enhanced T1 contrast ability show great promise in biomedical diagnosis. Herein, we developed a dual-modality imaging agent system based on polyethylene glycol (PEG-coated manganese oxide NPs conjugated with organic dye (Cy7.5, which functions as a fluorescence imaging (FI agent as well as a magnetic resonance imaging (MRI imaging agent. The formed Mn3O4@PEG-Cy7.5 NPs with the size of ~10 nm exhibit good colloidal stability in different physiological media. Serial FI and MRI studies that non-invasively assessed the bio-distribution pattern and the feasibility for in vivo dual-modality imaging-guided lymph node mapping have been investigated. In addition, histological and biochemical analyses exhibited low toxicity even at a dose of 20 mg/kg in vivo. Since Mn3O4@PEG-Cy7.5 NPs exhibited desirable properties as imaging agents and good biocompatibility, this work offers a robust, safe, and accurate diagnostic platform based on manganese oxide NPs for tumor metastasis diagnosis.

Modalization in the Political Column of Tempo Magazine

OpenAIRE

Rahmah, Maria Betti Sinaga and

2017-01-01

The study focuses on analyzing the use of modalization in the Political Column of Tempo Magazine. The objectives were to find out the type of modalization and to describe the use of modalization in the Political Column of Tempo magazine. The data were taken from Political Column of Tempo magazine published in June and July 2017. The source of data was Political Column in Tempo magazine. The data analysis applied descriptive qualitative research. There were 135 clauses which contained Modaliza...

Multimodal Image Alignment via Linear Mapping between Feature Modalities.

Science.gov (United States)

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

2017-01-01

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

Review of treatment modalities of malleolar fractures

Directory of Open Access Journals (Sweden)

Xinhao Li

2015-01-01

Full Text Available The frequency of malleolar fractures according to available literature data is about 40% of bone fractures, the majority of them are severe articular or compound fractures. The article covers the experience, accumulated by the generations of orthopedists concerning diagnostics, choice of efficient treatment, decrease of disability and improvement of patients' living standards.

Postamputation pain: epidemiology, mechanisms, and treatment

Directory of Open Access Journals (Sweden)

Hsu E

2013-02-01

Full Text Available Eugene Hsu,1 Steven P Cohen21Johns Hopkins School of Medicine, Baltimore, MD, USA; 2Johns Hopkins School of Medicine and Uniformed Services, University of the Health Sciences, Bethesda, MD, USAAbstract: Postamputation pain (PAP is highly prevalent after limb amputation but remains an extremely challenging pain condition to treat. A large part of its intractability stems from the myriad pathophysiological mechanisms. A state-of-art understanding of the pathophysiologic basis underlying postamputation phenomena can be broadly categorized in terms of supraspinal, spinal, and peripheral mechanisms. Supraspinal mechanisms involve somatosensory cortical reorganization of the area representing the deafferentated limb and are predominant in phantom limb pain and phantom sensations. Spinal reorganization in the dorsal horn occurs after deafferentation from a peripheral nerve injury. Peripherally, axonal nerve damage initiates inflammation, regenerative sprouting, and increased "ectopic" afferent input which is thought by many to be the predominant mechanism involved in residual limb pain or neuroma pain, but may also contribute to phantom phenomena. To optimize treatment outcomes, therapy should be individually tailored and mechanism based. Treatment modalities include injection therapy, pharmacotherapy, complementary and alternative therapy, surgical therapy, and interventions aimed at prevention. Unfortunately, there is a lack of high quality clinical trials to support most of these treatments. Most of the randomized controlled trials in PAP have evaluated medications, with a trend for short-term efficacy noted for ketamine and opioids. Evidence for peripheral injection therapy with botulinum toxin and pulsed radiofrequency for residual limb pain is limited to very small trials and case series. Mirror therapy is a safe and cost-effective alternative treatment modality for PAP. Neuromodulation using implanted motor cortex stimulation has shown a trend

Percutaneous nephrolithotomy is highly efficient and safe in infants and children under 3 years of age.

Science.gov (United States)

Guven, Selcuk; Istanbulluoglu, Okan; Ozturk, Ahmet; Ozturk, Bulent; Piskin, Mesut; Cicek, Tufan; Kilinc, Mehmet; Ozkardes, Hakan; Arslan, Mehmet

2010-01-01

We aimed to evaluate the efficacy and safety of percutaneous nephrolithotomy (PNL) in infants and small children (12-36 months). The PNL applications conducted in children PNL instrumentation was used in the first center, adult-size instrumentation was utilized in the second center. The complications were given according to the modified Clavien classification system. The mean age of the patients was 22.76 months (5-36 months) and the mean body weight was 11.51 kg (6-15 kg). In twelve renal units, pediatric instrumentation was used and among these, two had miniperc. In the other eight renal units, adult-size instrumentation was employed. Except for the patient with complex renal stones, all patients were stone free after the intervention and none required a conversion to open surgery. There were grade 1-2 complications in 3 patients. The postoperative hemoglobin drop was greater in the children who underwent PNL with adult-size instrumentation. In this young age group, in addition to standard PNL, simultaneous bilateral PNL, tubeless PNL and in urgent cases of renal failure, urgent PNL, are safe and effective treatment modalities provided patients are selected properly and the surgeon performing the procedure has the necessary experience. Copyright © 2010 S. Karger AG, Basel.

Therapeutic radiology: the modalities and their effects on oral tissues

International Nuclear Information System (INIS)

Rubin, R.L.; Doku, H.C.

1971-01-01

In recent years, therapeutic radiology has been used extensively in the management of head and neck malignancies. An increasing number of the population who have been exposed to such therapy are being seen by the dentist for dental treatment. It is recognized that radiation therapy may cause temporary and permanent alterations in tissue. A discussion of the various therapeutic modalities and their side effects on the oral tissues has been presented to aid the dental practitioner in understanding the problems and care of such patients

Analysis of modal frequency optimization of railway vehicle car body

Directory of Open Access Journals (Sweden)

Wenjing Sun

2016-04-01

Full Text Available High structural modal frequencies of car body are beneficial as they ensure better vibration control and enhance ride quality of railway vehicles. Modal sensitivity optimization and elastic suspension parameters used in the design of equipment beneath the chassis of the car body are proposed in order to improve the modal frequencies of car bodies under service conditions. Modal sensitivity optimization is based on sensitivity analysis theory which considers the thickness of the body frame at various positions as variables in order to achieve optimization. Equipment suspension design analyzes the influence of suspension parameters on the modal frequencies of the car body through the use of an equipment-car body coupled model. Results indicate that both methods can effectively improve the modal parameters of the car body. Modal sensitivity optimization increases vertical bending frequency from 9.70 to 10.60 Hz, while optimization of elastic suspension parameters increases the vertical bending frequency to 10.51 Hz. The suspension design can be used without alteration to the structure of the car body while ensuring better ride quality.

Comparison of sine dwell and broadband methods for modal testing

Science.gov (United States)

Chen, Jay-Chung

1989-01-01

The objectives of modal tests for large complex spacecraft structural systems are outlined. The comparison criteria for the modal test methods, namely, the broadband excitation and the sine dwell methods, are established. Using the Galileo spacecraft modal test and the Centaur G Prime upper stage vehicle modal test as examples, the relative advantage or disadvantage of each method is examined. The usefulness or shortcomings of the methods are given from a practical engineering viewpoint.

SAFE Newsletter

OpenAIRE

2013-01-01

The Center of Excellence SAFE – “Sustainable Architecture for Finance in Europe” – is a cooperation of the Center for Financial Studies and Goethe University Frankfurt. It is funded by the LOEWE initiative of the State of Hessen (Landes-Offensive zur Entwicklung wissenschaftlich-ökonomischer Exzellenz). SAFE brings together more than 40 professors and just as many junior researchers who are all dedicated to conducting research in support of a sustainable financial architecture. The Center has...

Affirmation Modality in Bulgarian, Macedonian and Serbian

Directory of Open Access Journals (Sweden)

Marcin Grygiel

2015-06-01

Full Text Available Affirmation Modality in Bulgarian, Macedonian and Serbian In the case of affirmation modality the speakers transform their utterances by stressing or attributing a positive value as an additional component added to the semantic structure of a proposition. This type of affirmative polarization is triggered in opposition to negation or hypothetically negative contexts. The goal of the present paper is twofold: on the one hand to compare and contrast affirmative periphrastic constructions in Bulgarian, Macedonian and Serbian and, on the other hand, to ascertain what these constructions reveal regarding the organization of grammatical categories in general and the status of affirmation modality as a coherent and homogenous category with a linguistic validity.

Coupling between Theta Oscillations and Cognitive Control Network during Cross-Modal Visual and Auditory Attention: Supramodal vs Modality-Specific Mechanisms.

Science.gov (United States)

Wang, Wuyi; Viswanathan, Shivakumar; Lee, Taraz; Grafton, Scott T

2016-01-01

Cortical theta band oscillations (4-8 Hz) in EEG signals have been shown to be important for a variety of different cognitive control operations in visual attention paradigms. However the synchronization source of these signals as defined by fMRI BOLD activity and the extent to which theta oscillations play a role in multimodal attention remains unknown. Here we investigated the extent to which cross-modal visual and auditory attention impacts theta oscillations. Using a simultaneous EEG-fMRI paradigm, healthy human participants performed an attentional vigilance task with six cross-modal conditions using naturalistic stimuli. To assess supramodal mechanisms, modulation of theta oscillation amplitude for attention to either visual or auditory stimuli was correlated with BOLD activity by conjunction analysis. Negative correlation was localized to cortical regions associated with the default mode network and positively with ventral premotor areas. Modality-associated attention to visual stimuli was marked by a positive correlation of theta and BOLD activity in fronto-parietal area that was not observed in the auditory condition. A positive correlation of theta and BOLD activity was observed in auditory cortex, while a negative correlation of theta and BOLD activity was observed in visual cortex during auditory attention. The data support a supramodal interaction of theta activity with of DMN function, and modality-associated processes within fronto-parietal networks related to top-down theta related cognitive control in cross-modal visual attention. On the other hand, in sensory cortices there are opposing effects of theta activity during cross-modal auditory attention.

Dynamic behaviour studies of a vertical axis wind turbine blade using Operational Modal Analysis (OMA) and Experimental Modal Analysis (EMA)

DEFF Research Database (Denmark)

Najafi, Nadia; Schmidt Paulsen, Uwe; Belloni, F.

2014-01-01

Dynamic behavior of a modified blade fitted onto a small 1 kW vertical-axis wind turbine is studied by two different approaches: Classical modal analysis (EMA) is carried out to validate the results of Operational Modal Analysis (OMA). In traditional modal analysis (EMA) one axis accelerometers...... it is excited by random and wind forces. The cameras are programmed in LabView to take pictures at the same time with 180 fps and store them on a high speed hard disk. The output deflection will be investigated in frequency domain by peak picking method, and then AR (Autoregressive) model is applied to describe...

Librarian instruction-delivery modality preferences for professional continuing education.

Science.gov (United States)

Lynn, Valerie A; Bose, Arpita; Boehmer, Susan J

2010-01-01

Attending professional continuing education (CE) is an important component of librarianship. This research study identified librarians' preferences in delivery modalities of instruction for professional CE. The study also identified influential factors associated with attending CE classes. Five instruction-delivery modalities and six influential factors were identified for inclusion in an online survey. The survey completed by members of the American Library Association (ALA), Special Libraries Association (SLA), and Medical Library Association (MLA) provided the data for analysis of librarian preferences and influential factors. The majority of respondents were MLA members, followed by ALA and SLA members. Librarians from all three library associations preferred the face-to-face instructional modality. The most influential factor associated with the decision to attend a professional CE class was cost. All five instruction-delivery modalities present useful structures for imparting professional CE. As librarians' experience with different modalities increases and as technology improves, preferences in instruction delivery may shift. But at present, face-to-face remains the most preferred modality. Based on the results of this study, cost was the most influential factor associated with attending a CE class. This may change as additional influential factors are identified and analyzed in future studies.

A pilot study of rivastigmine in the treatment of delirium after stroke: A safe alternative

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Jansen Ben PW

2008-09-01

Full Text Available Abstract Background Delirium is a common disorder in the early phase of stroke. Given the presumed cholinergic deficiency in delirium, we tested treatment with the acetylcholinesterase inhibitor rivastigmine. Methods This pilot study was performed within an epidemiological study. In 527 consecutive stroke patients presence of delirium was assessed during the first week with the confusion assessment method. Severity was scored with the delirium rating scale (DRS. Sixty-two patients developed a delirium in the acute phase of stroke. Only patients with a severe and persistent delirium (defined as a DRS of 12 or more for more than 24 hours were enrolled in the present study. In total 26 fulfilled these criteria of whom 17 were treated with orally administered rivastigmine with a total dose between 3 and 12 mg a day. Eight patients could not be treated because of dysphagia and one because of early discharge. Results No major side effects were recorded. In 16 patients there was a considerable decrease in severity of delirium. The mean DRS declined from 14.8 on day one to 8.5 after therapy and 5.6 after tapering. The mean duration of delirium was 6.7 days (range; 2–17. Conclusion Rivastigmine is safe in stroke patients with delirium even after rapid titration. In the majority of patients the delirium improved after treatment. A randomized controlled trial is needed to establish the usefulness of rivastigmine in delirium after stroke. Trial registration Nederlands Trial Register NTR1395

The contribution to the modal analysis using an infrared camera

Directory of Open Access Journals (Sweden)

Dekys Vladimír

2018-01-01

Full Text Available The paper deals with modal analysis using an infrared camera. The test objects were excited by the modal exciter with narrowband noise and the response was registered as a frame sequence by the high speed infrared camera FLIR SC7500. The resonant frequencies and the modal shapes were determined from the infrared spectrum recordings. Lock-in technology has also been used. The experimental results were compared with calculated natural frequencies and modal shapes.

Automated Modal Parameter Estimation of Civil Engineering Structures

DEFF Research Database (Denmark)

Andersen, Palle; Brincker, Rune; Goursat, Maurice

In this paper the problems of doing automatic modal parameter extraction of ambient excited civil engineering structures is considered. Two different approaches for obtaining the modal parameters automatically are presented: The Frequency Domain Decomposition (FDD) technique and a correlation...

Normal modal preferential consequence

CSIR Research Space (South Africa)

Britz, K

2012-12-01

Full Text Available beyond the basic (propositional) KLM postulates, thereby making use of the additional expressivity provided by modal logic. In particular, we show that the additional constraints we impose on the preferential semantics ensure that the rule...

To increase controllability of a large flexible antenna by modal optimization

Science.gov (United States)

Wang, Feng; Wang, Pengpeng; Jiang, Wenjian

2017-12-01

Large deployable antennas are widely used in aerospace engineering to meet the envelop limit of rocket fairing. The high flexibility and low damping of antenna has proposed critical requirement not only for stability control of the antenna itself, but also for attitude control of the satellite. This paper aims to increase controllability of a large flexible antenna by modal optimization. Firstly, Sensitivity analysis of antenna modal frequencies to stiffness of support structure and stiffness of scanning mechanism are conducted respectively. Secondly, Modal simulation results of antenna frequencies are given, influences of scanning angles on moment of inertia and modal frequencies are evaluated, and modal test is carried out to validate the simulation results. All the simulation and test results show that, after modal optimization the modal characteristic of the large deployable antenna meets the controllability requirement well.

Established rheumatoid arthritis - new imaging modalities

DEFF Research Database (Denmark)

McQueen, Fiona M; Østergaard, Mikkel

2007-01-01

in real-time and facilitates diagnostic and therapeutic interventions such as joint aspiration and injection. Exciting experimental modalities are also being developed with the potential to provide not just morphological but functional imaging. Techniques such as positron emission tomography (PET......) and high-resolution computerized tomography. Erosions are very clearly depicted using these modalities and MRI also allows imaging of soft tissues with assessment of joint inflammation. High-resolution ultrasound is a convenient clinical technique for the assessment of erosions, synovitis and tenosynovitis...

Automatic discrimination between safe and unsafe swallowing using a reputation-based classifier

Directory of Open Access Journals (Sweden)

Nikjoo Mohammad S

2011-11-01

Full Text Available Abstract Background Swallowing accelerometry has been suggested as a potential non-invasive tool for bedside dysphagia screening. Various vibratory signal features and complementary measurement modalities have been put forth in the literature for the potential discrimination between safe and unsafe swallowing. To date, automatic classification of swallowing accelerometry has exclusively involved a single-axis of vibration although a second axis is known to contain additional information about the nature of the swallow. Furthermore, the only published attempt at automatic classification in adult patients has been based on a small sample of swallowing vibrations. Methods In this paper, a large corpus of dual-axis accelerometric signals were collected from 30 older adults (aged 65.47 ± 13.4 years, 15 male referred to videofluoroscopic examination on the suspicion of dysphagia. We invoked a reputation-based classifier combination to automatically categorize the dual-axis accelerometric signals into safe and unsafe swallows, as labeled via videofluoroscopic review. From these participants, a total of 224 swallowing samples were obtained, 164 of which were labeled as unsafe swallows (swallows where the bolus entered the airway and 60 as safe swallows. Three separate support vector machine (SVM classifiers and eight different features were selected for classification. Results With selected time, frequency and information theoretic features, the reputation-based algorithm distinguished between safe and unsafe swallowing with promising accuracy (80.48 ± 5.0%, high sensitivity (97.1 ± 2% and modest specificity (64 ± 8.8%. Interpretation of the most discriminatory features revealed that in general, unsafe swallows had lower mean vibration amplitude and faster autocorrelation decay, suggestive of decreased hyoid excursion and compromised coordination, respectively. Further, owing to its performance-based weighting of component classifiers, the static

Evaluation of safe surgical treatment of peritonsillar abscess using computed tomography

Energy Technology Data Exchange (ETDEWEB)

Ishii, Kasumi; Aramaki, Hajime; Arai, Yasuko; Uchimura, Kanako; Okabe, Kunihiko; Nishida, Motoko; Yoda, Keiko [Tokyo Women' s Medical Coll. (Japan). Daini Hospital

2002-03-01

With the development of new antimicrobial agents, the incidence of peritonsillar abscess (PTA) is on the decline. PTA is still often encountered in general practice, however, where it requires immediate diagnosis and treatment. Because the internal carotid artery runs medially to the medial parapharyngeal space, damage to nearby vascular or other structures is a surgical risk of PTA. We used contrast computed tomography (CT) from PTA patients to investigate the anatomical relationship between the abscess and parapharyngeal space, and to determine safe surgical sites. We observed 31 patients with PTA, 19 men and 12 women, between February 1997 and April 1999, all examined by contrast CT and undergoing drainage or incision. The average age was 30.7 years (range: 12-54 years). The abscess was on the right side in 20 cases and on the left side in 11. We determined the sites of the abscess and carotid artery, internal jugular vein, and surrounding soft tissue density area including nerves in the parapharyngeal space based on the angle and distance from recognizable anatomical structures in CT scans. The anterior margin of the parapharyngeal space was 29{+-}5 mm posterior from the upper posterior alveolar margin. The medial margin of that space was at 15{+-}2 deg laterally from the midline of the incisors, and 24{+-}4 mm laterally from the midline sagittal plane. The internal carotid artery was located medially to the parapharyngeal space, running on the sagittal plane containing the upper posterior alveolar margin. The distance from the anterior margin of the parapharyngeal space to the posterior wall of the PTA was 9{+-}4 mm, and the distance to the anterior wall of the abscess (including the pharyngeal mucosa) was 31{+-}5 cm. The relationship between the upper posterior alveolar margin and midline sagittal plane was useful for determining the site of the parapharyngeal space. Because the internal carotid artery is located on the same sagittal plane as the upper

Evaluation of safe surgical treatment of peritonsillar abscess using computed tomography

International Nuclear Information System (INIS)

Ishii, Kasumi; Aramaki, Hajime; Arai, Yasuko; Uchimura, Kanako; Okabe, Kunihiko; Nishida, Motoko; Yoda, Keiko

2002-01-01

With the development of new antimicrobial agents, the incidence of peritonsillar abscess (PTA) is on the decline. PTA is still often encountered in general practice, however, where it requires immediate diagnosis and treatment. Because the internal carotid artery runs medially to the medial parapharyngeal space, damage to nearby vascular or other structures is a surgical risk of PTA. We used contrast computed tomography (CT) from PTA patients to investigate the anatomical relationship between the abscess and parapharyngeal space, and to determine safe surgical sites. We observed 31 patients with PTA, 19 men and 12 women, between February 1997 and April 1999, all examined by contrast CT and undergoing drainage or incision. The average age was 30.7 years (range: 12-54 years). The abscess was on the right side in 20 cases and on the left side in 11. We determined the sites of the abscess and carotid artery, internal jugular vein, and surrounding soft tissue density area including nerves in the parapharyngeal space based on the angle and distance from recognizable anatomical structures in CT scans. The anterior margin of the parapharyngeal space was 29±5 mm posterior from the upper posterior alveolar margin. The medial margin of that space was at 15±2 deg laterally from the midline of the incisors, and 24±4 mm laterally from the midline sagittal plane. The internal carotid artery was located medially to the parapharyngeal space, running on the sagittal plane containing the upper posterior alveolar margin. The distance from the anterior margin of the parapharyngeal space to the posterior wall of the PTA was 9±4 mm, and the distance to the anterior wall of the abscess (including the pharyngeal mucosa) was 31±5 cm. The relationship between the upper posterior alveolar margin and midline sagittal plane was useful for determining the site of the parapharyngeal space. Because the internal carotid artery is located on the same sagittal plane as the upper posterior

Constraint programming for modelling and solving modal satisfiability

NARCIS (Netherlands)

Brand, S.; Gennari, R.; de Rijke, M.

2003-01-01

We explore to what extent and how efficiently constraint programmingcan be used in the context of automated reasoning for modal logics. We encode modal satisfiability problems as constraint satisfactionproblems with non-boolean domains, together with suitable constraints.Experiments show that the

Use of thermo-coagulation as an alternative treatment modality in a 'screen-and-treat' programme of cervical screening in rural Malawi.

Science.gov (United States)

Campbell, Christine; Kafwafwa, Savel; Brown, Hilary; Walker, Graeme; Madetsa, Belito; Deeny, Miriam; Kabota, Beatrice; Morton, David; Ter Haar, Reynier; Grant, Liz; Cubie, Heather A

2016-08-15

The incidence of cervical cancer in Malawi is the highest in the world and projected to increase in the absence of interventions. Although government policy supports screening using visual inspection with acetic acid (VIA), screening provision is limited due to lack of infrastructure, trained personnel, and the cost and availability of gas for cryotherapy. Recently, thermo-coagulation has been acknowledged as a safe and acceptable procedure suitable for low-resource settings. We introduced thermo-coagulation for treatment of VIA-positive lesions as an alternative to cryotherapy within a cervical screening service based on VIA, coupled with appropriate, sustainable pathways of care for women with high-grade lesions and cancers. Detailed planning was undertaken for VIA clinics, and approvals were obtained from the Ministry of Health, Regional and Village Chiefs. Educational resources were developed. Thermo-coagulators were introduced into hospital and health centre settings, with theoretical and practical training in safe use and maintenance of equipment. A total of 7,088 previously unscreened women attended VIA clinics between October 2013 and March 2015. Screening clinics were held daily in the hospital and weekly in the health centres. Overall, VIA positivity was 6.1%. Almost 90% received same day treatment in the hospital setting, and 3- to 6-month cure rates of more than 90% are observed. Thermo-coagulation proved feasible and acceptable in this setting. Effective implementation requires comprehensive training and provider support, ongoing competency assessment, quality assurance and improvement audit. Thermo-coagulation offers an effective alternative to cryotherapy and encouraged VIA screening of many more women. © 2016 The Authors International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.